1. Al-Bustanji R, AlRababah BK, Rumman MSA, Abukhaled Y, Al-Rabadi N, Younis HKB, Ghalyon G, Al-Tawalbeh S, Aloudat O, Alrashdan MMM, Yamin MT, Maaita M, Salah AKD, Satari A. Expanding the clinical spectrum: A case report of the first Jordanian presentation of KID syndrome with neurological and skeletal anomalies beyond the classical triad. Medicine (Baltimore). 2025; 104(47): e45577.

RATIONALE: Keratitis-ichthyosis-deafness (KID) syndrome is a rare ectodermal disorder caused by pathogenic mutations in GJB2 gene, which encodes the gap junction protein connexin 26. While the condition is traditionally defined by a triad of keratitis, ichthyosis, and sensorineural hearing loss, emerging evidence suggests that connexin 26 dysfunction may lead to broader systemic involvement. This case highlights a rare presentation with neurological and musculoskeletal abnormalities. PATIENT CONCERNS: A 3-year-old female born at 31 weeks of gestation presented with a history of global developmental delay, recurrent seizures, photophobia, and thick hyperkeratotic skin changes. At birth, she was encased in a collodion membrane and exhibited bilateral eyelid malposition. Her development was marked by delayed milestones, joint stiffness, and poor weight gain. DIAGNOSES: Clinical findings included vascularizing keratitis, lamellar ichthyosis, and right-sided sensorineural hearing loss confirmed by auditory brainstem response testing. Brain imaging revealed moderate enlargement of the cerebral ventricles, and skeletal surveys demonstrated developmental dysplasia of the hip and congenital muscular torticollis. A clinical diagnosis of KID syndrome was made based on the constellation of cutaneous, auditory, neurological, and musculoskeletal abnormalities. While genetic testing was unavailable, the phenotype was strongly suggestive of a pathogenic GJB2 mutation. Although KID syndrome is most commonly caused by autosomal dominant, frequently de novo, mutations-particularly the D50N variant-the apparent autosomal recessive pattern in this pedigree may reflect parental mosaicism, reduced penetrance, or variable expressivity. INTERVENTIONS: The patient received coordinated multidisciplinary care. Dermatologic management involved intensive emollient therapy. Ophthalmologic care included lubricants and surgical correction of eyelid malposition. Antiepileptic medication was initiated for seizure control. Physical therapy addressed joint contractures and improved motor function. OUTCOMES: Following early intervention, dermatologic symptoms stabilized, seizure activity diminished, and gradual improvements in physical function were observed. However, developmental delay and structural brain abnormalities persisted, requiring long-term follow-up and therapy. Parental compliance multidisciplinary care were essential for optimizing care. LESSONS: This case highlights potential atypical manifestations of KID syndrome, including seizures, ventriculomegaly, torticollis, and hip dysplasia, that may reflect a broader but under-recognized phenotypic range.

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2. Al-Qazzaz NK, Ali S, Ahmad SA. Evaluating the Severity of Autism Spectrum Disorder from EEG: A Multidisciplinary Approach Using Statistical and Artificial Intelligence Frameworks. Bioengineering (Basel). 2025; 12(11).

A developmental impairment known as autism spectrum disorder (ASD) impacts youngsters and is characterized by impaired social communication and limited behavioral expression. In this study, electroencephalography (EEG) is used to obtain the brain electrical activity of typically developing children and of mild, moderate, and severe ASD patients using relative powers. This study investigates ASD patients using a multidisciplinary approach involving two-way ANOVA and Pearson’s correlation statistical analyses to better understand the multistage severity of ASD from EEG by providing a spectro-spatial profile of ASD severity. Artificial intelligence frameworks, including a decision tree (DT) machine learning classifier and a long short-term memory (LSTM) neural network, are applied to discriminate mild, moderate, and severe ASD patients from typically developing children. The statistical results revealed that with increasing severity compared to the control, faster frequencies decreased and slower frequencies increased, indicating a distinct correlation between the severity of ASD and neurophysiological activity. Moreover, the DT classifier achieved a classification accuracy of 65%, and the LSTM classifier achieved a classification accuracy of 73.3%. This approach highlights the potential for statistical and artificial intelligence techniques to reliably identify EEG abnormalities associated with ASD, which could lead to earlier treatment and improved prospects for patients.

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3. Aljead M, Qashta A, Jalal Z, Jones AM. Review of Autism Spectrum Disorder (ASD): Epidemiology, Aetiology, Pathology, and Pharmacological Treatment. Pharmaceuticals (Basel). 2025; 18(11).

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by challenges in social and communication skills and restricted interests. It is associated with behavioural symptoms and/or comorbidities (e.g., attention deficit hyperactivity disorder (ADHD)). Developing effective treatments for ASD remains a challenge because its pathophysiology is not fully understood. Multiple treatment options are used for ASD with varying levels of effectiveness and safety profiles. Atypical antipsychotics (AAPs), particularly risperidone and aripiprazole, provide superiority over other drug classes of pharmacological interventions. However, they are linked to adverse drug reactions (ADRs), specifically metabolic and endocrine ADRs. These ADRs may lead to chronic diseases such as diabetes and cardiovascular conditions, adding strain to healthcare systems beyond the original treatment of ASD. This narrative review enhances our understanding of ASD and highlights a gap in current knowledge about the evaluation of the effectiveness and safety of pharmacological treatments, especially AAPs for ASD in paediatric patients.

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4. Aljead M, Qashta A, Jalal Z, Jones AM. Metabolic and Endocrine ADRs of Atypical Antipsychotics (AAPs) in Paediatric Patients with Autism Spectrum Disorder (ASD): A Review of Prevalence, Risk Factors, and Implications for Clinical Monitoring. J Clin Med. 2025; 14(22).

Atypical antipsychotics (AAPs) remain the most effective treatment to control irritability associated with autism spectrum disorder (ASD). Although there is no pharmaceutical treatment to target the core symptoms of ASD, AAPs reduce their severity. However, AAPs have been reported to be associated with severe adverse drug reactions (ADRs) that may lead to long-term conditions such as diabetes mellitus and heart disease. Their prevalence varies depending on the type of AAP prescribed, age, ethnicity, gender, healthcare systems, and the severity of the ASD. Current ADR monitoring guidelines exist, but they are broad in scope and do not fully account for these factors. Therefore, the need to develop ADR monitoring guidelines considering these factors has increased with the expanded use of AAPs in paediatrics with ASD. This gap in knowledge and clinical practice highlights the ongoing need for research to explore these factors and how they can inform the creation of tailored guidelines for monitoring ADRs in this population.

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5. Alqahtani SH, Aodah AH, Alshawakir YA, Alshehri BY, Alamer AA, Alfassam HA, Almughem FA, Alshehri AA, Tawfik EA. The Development of Risperidone-Loaded Microfibers via Centrifugal Spinning to Enhance the Palatability of a Potential Drug for Autistic Children. Pharmaceutics. 2025; 17(11).

Background/Objectives: Children with autism spectrum disorder (ASD) frequently experience poor compliance with oral medication due to bitterness, unpleasant taste, and unsuitable dosage forms such as large tablets or capsules. Risperidone, a widely prescribed antipsychotic for managing ASD symptoms, is particularly challenging in this regard. The present study aimed to develop a novel sucrose-based microfiber drug delivery system to improve the palatability, acceptance, and bioavailability of risperidone in pediatric patients with ASD. Methods: Risperidone was incorporated into sucrose microfibers using centrifugal spinning technology. Fiber morphology was characterized by scanning electron microscopy (SEM). Drug loading (DL), encapsulation efficiency (EE%), and disintegration time were measured. In vitro drug release and cytotoxicity assays were performed using human foreskin fibroblast cells (HFF-1). An in vivo palatability and preference study was conducted in male BALB/c mice to evaluate the acceptability of the formulation compared with a commercial risperidone oral solution. Results: SEM analysis revealed smooth, bead-free, non-porous fibers with uniform morphology and size distribution. The formulation showed a rapid disintegration time of ~3 s, DL of 30 ± 5 µg/mg, and EE% of 60 ± 10%. Approximately 50% of risperidone was released within 15 min. Cytotoxicity testing confirmed that concentrations ≤ 125 µg/mL maintained high cell metabolic activity, indicating biocompatibility. In vivo, the microfiber solution demonstrated a strong preference (93%) compared with the commercial oral solution (30%). Conclusions: Risperidone-loaded sucrose microfibers represent a promising fast-dissolving oral delivery system for children with ASD. This child-friendly formulation improves palatability and compliance while maintaining safety and drug release performance.

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6. Arodiwe IO, Chinawa JM, Ujunwa FA, Adiele DK, Onukwuli VO, Aronu AE, Uwaezuoke NA, Ojinnaka NC. Prevalence and Patterns of Neuro-developmental problems among children with Congenital Heart Diseases attending a tertiary institution in South East Nigeria. Malawi Med J. 2025; 37(2): 91-9.

BACKGROUND: Continued progress in early diagnosis and therapeutic options has contributed to the increased survival of infants with CHD with attendant NDD which is of profound personal and public health significance. AIM: To determine the prevalence and patterns of neuro-developmental problems in children with CHD. METHODS: A cross-sectional study consisting of 40 children with CHD attending the Cardiology clinic of University of Nigeria Teaching Hospital (UNTH), as well as 40 age and gender-matched controls with no heart disease recruited from children’s outpatient and well-baby clinics. A semi-structured pretested questionnaire was used in documenting socio-demographic data. General and systemic examinations including cardiovascular and central nervous system assessments were done. The echocardiography report from UNTH was reviewed and the type of CHD documented. Neurodevelopmental assessment using The Malawi Developmental Assessment Tool (MDAT) was carried out by the researchers. Data were analysed using IBM Statistical Package for Social Sciences (SPSS 20.0 version). Chi-Square were used to compare age and gender and other demographic variables with Yates correction where appropriate. Bivariate analysis was performed using the type of CHD to identify cardiac lesions associated with NDD. Significant statistical level was set as a p-value < 0.05. RESULTS: Forty subjects and 40 controls aged 6-60months with a male to female ratio of 3:2 were studied. Thirty-seven (92.5%) of the subjects had one or more symptoms of CHD. NDD was noted in 23 (57.50%) children with CHD compared to six (15.0%) of the controls. (χ = 15.63, p< 0.0008). The differences in the number of children with delay across all domains for both groups were (p= <0.001). While 17 (42.5%) patients with CHD had a delay in more than one domain (global delay), none of the control had a delay in more than one domain. The difference in the number of domains with NDD for patients and their controls was statistically significant (p<0.001). Though there is no significant correlation between age (χ(2) =7.243; p = 0.203) and gender (χ(2) =0.017; p = 0.896) of children with NDD, the younger age group were more affected. NDD was also commoner in children with Tetralogy of Fallot (TOF) 5 (62.5%). CONCLUSION: NDD was common in children with CHD and a significant number had a global delay when compared with their controls.

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7. Aydin A, Yildirim A, Duman ED. QEEG-Guided rTMS in Pediatric ASD with Contextual Evidence on Home-Based tDCS: Within-Cohort Reanalysis and Narrative Contextualization. Children (Basel). 2025; 12(11).

Background: Autism Spectrum Disorder (ASD) affects ~1 in 36 children and is increasingly studied as a candidate for non-invasive neuromodulation. Two of the most widely applied modalities are quantitative EEG (QEEG)-guided repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), both targeting the dorsolateral prefrontal cortex (DLPFC). While both have shown promise, questions remain regarding their relative clinical profiles and scalability. Objective: To conduct a within-cohort reanalysis of QEEG-guided rTMS outcomes in paediatric ASD and to contextualise these findings alongside published reports of home-supervised tDCS. Methods: Individual participant data (n = 56, ages 6-17) from a prospective rTMS cohort were reanalysed, focusing on the Social Responsiveness Scale (SRS-2), Autism Diagnostic Observation Schedule (ADOS-2), Aberrant Behavior Checklist (ABC), Repetitive Behavior Scale-Revised (RBS-R), and QEEG biomarkers. Findings were then situated within a narrative synthesis of published paediatric tDCS trials, which consistently report caregiver-supervised feasibility but did not provide raw, baseline-adjusted data suitable for reanalysis. Results: rTMS was associated with large within-cohort improvements (Hedges’ g ≈ 1.0-1.6), including an 11-point reduction in SRS-2 T-scores, a 12-point reduction in ABC totals, and robust QEEG normalisation (β/γ suppression, α enhancement). Published tDCS studies report moderate, clinically meaningful improvements in social communication, executive functioning, and regulation (Cohen’s d ≈ 0.4-0.6), with excellent adherence and no serious adverse events. Conclusions: rTMS produced robust behavioural and neurophysiological improvements within its cohort, while published tDCS trials demonstrate moderate, feasible benefits in home settings. Because of incomplete baseline data and protocol differences, no direct statistical comparison was possible. These findings suggest complementary roles: rTMS as a high-intensity clinic-based intervention, and tDCS as a scalable, family-centred option. A stepped-care framework that combines both modalities should be considered hypothesis-generating only and requires validation in harmonised, randomised controlled trials.

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8. Cano-Villagrasa A, Ben-Mansour F, López-Zamora M, López-Chicheri I. Therapeutic Approach in Language and Cognitive Skills in Premature Twins with ASD: Case Report. Behav Sci (Basel). 2025; 15(11).

Prematurity and autism spectrum disorder (ASD) are risk factors for alterations in language development. Their coexistence, frequent in twin pregnancies, may result in atypical communicative profiles that require specific interventions. This case report analyzed the linguistic, cognitive, and socioemotional development of two premature twins with ASD, relating the results to the therapeutic strategies applied. Standardized tests were applied to measure cognitive, linguistic, adaptive, and socioemotional development. The intervention combined the TEACCH, ABA, DIR/Floortime, and Hanen-More Than Words models. Both children showed significant impairments in communication, executive functions, and autonomy, with differentiated clinical profiles. Individualized interventions favored advances in functional language, emotional regulation, and routines, although challenges in language generalization and pragmatics persisted. The combination of prematurity and ASD creates complex challenges that require individualized therapeutic approaches. Early and intensive intervention, based on structured and relational approaches, is useful to promote functional and communicative development.

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9. Carmassi C, Dell’Oste V, Conti E, Fantasia S, Bordacchini A, Rimoldi B, Pedrinelli V, Conti L, Battini R, Calderoni S. Post-Traumatic Stress Symptoms in Parents of Preschoolers First Diagnosed with Autism: Gender Differences and Correlations with Broad Autism Phenotypes. Int J Environ Res Public Health. 2025; 22(11).

(1) Background: A child’s new diagnosis of autism can represent a highly stressful event for parents. Subthreshold autistic traits (ATs) have been linked to higher vulnerability to psychopathology when exposed to stressful situations, and high rates of ATs have been reported among parents of autistic children. This study aimed to evaluate post-traumatic stress spectrum symptoms (PTSS) in parents of preschool children newly diagnosed with autism and to explore differences between mothers and fathers, besides the correlations with ATs. (2) Methods: A total of 134 parents of children newly diagnosed with autism were assessed by trained psychiatrists from the University of Pisa using the Autism Spectrum Quotient (AQ), the Adult Autism Subthreshold Spectrum-Self Report (AdAS-SR), the Trauma and Loss Spectrum-Self Report (TALS-SR), and the Social and Occupational Functioning Assessment Scale (SOFAS). (3) Results: Approximately 10% of parents met DSM-5-TR criteria for symptomatologic PTSD, with nearly 40% experiencing partial PTSD symptoms related to their child’s diagnosis. Mothers showed higher PTSD rates than fathers. The ATs significantly correlated with elevated TALS-SR scores, and logistic regression revealed a positive association between ATs and PTSD (p < 0.001). Linear regression analysis indicated that higher TALS-SR scores predicted lower SOFAS scores (p = 0.004). (4) Conclusions: These findings highlight the potential traumatic impact of a child's new autism diagnosis on parents, particularly mothers and individuals with ATs. The results underscore the importance of targeted support strategies for parents, considering their key role in early interventions. Further research is needed to better understand parental psychological responses and to enhance support systems, ultimately improving family wellbeing and child outcomes.

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10. Cheng X, Nareddula S, Gao HC, Chen Y, Xiao T, Nadew YY, Xu F, Edens PA, Saldarriaga V, Hu X, Quinn CJ, Kimbrough A, Huang F, Chubykin AA. Disrupted theta synchronization and synaptic connectivity in the visual cortex of Fmr1 KO mice. Nat Commun. 2025; 16(1): 10583.

Fragile X syndrome (FX) is a leading inherited cause of autism spectrum disorder, characterized by sensory hypersensitivity and impaired visual learning. Visual experience induces synchronized theta oscillations in the primary visual cortex (V1) and lateromedial area (LM), supporting inter-areal sensory binding. Using the Fmr1 knockout (KO) mouse model of FX, we quantify experience-dependent c-Fos expression in V1 and LM via iDISCO whole-brain clearing. Simultaneous in vivo recordings and channelrhodopsin-2-assisted circuit mapping (CRACM) reveal synchronized V1-LM theta oscillations and strengthened feedforward V1 → LM connectivity in wild-type (WT) mice, but attenuated LM oscillations and impaired connectivity in FX mice. Using 4Pi single-molecule localization microscopy, we identify experience-driven dendritic spine remodeling in layer 5 pyramidal cells of V1 and LM in WT mice, which is absent in FX mice. FX mice also show elevated baseline spine density and length. Our findings demonstrate that visual experience drives inter-areal synchronization and synaptic plasticity, which are disrupted in FX.

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11. Chu MC, Wu CC, Chung YJ, Chang CY, Wu HF, Tsai SC, Peng TN, Yang TJ, Lin HC. AMPK Activation by ENERGI Ameliorates Behavioral and Synaptic Deficits in a Mouse Model of Autism. Mol Neurobiol. 2025; 63(1): 190.

Autism spectrum disorder (ASD), a neurodevelopmental disorder, is characterized by synaptic dysregulation as its underlying pathophysiological mechanism. AMP-activated protein kinase (AMPK), an intracellular energy sensor, plays a pivotal role in regulating synaptic integrity and function. Current treatments for ASD exhibit limited benefits in alleviating the core symptoms of ASD. Consequently, we investigated the therapeutic potential of ENERGI, a novel AMPK-activating compound, in a valproate (VPA)-induced mouse model of ASD. ENERGI was administered via drinking water to VPA-induced ASD offspring. After 7 days of treatment, ENERGI gradually alleviated social defects, repetitive behaviors, and emotional comorbidities in VPA-induced ASD offspring. At the synaptic level, ENERGI treatment restored aberrant plasticity, spine structure, and dendritic arborization in the hippocampus of VPA-induced ASD offspring. Notably, the curative effects of ENERGI in VPA-induced ASD offspring were equivalent to those of D-cycloserine (DCS), a known therapeutic candidate for ASD. Moreover, ENERGI demonstrated superior efficacy in restoring spine abnormalities than DCS. Mechanistically, 7-day ENERGI treatment reversed the reduction in AMPK phosphorylation, and normalized the elevated PSD95 and synaptic GluA2 levels in VPA-induced ASD offspring, whereas DCS treatment only rescued the synaptic GluA2 levels. Overall, these findings suggest that AMPK activation by ENERGI effectively reverses behavioral and synaptic deficits in a preclinical ASD model, supporting AMPK as a promising target for developing novel ASD therapies.

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12. Crompton CJ. Autism diagnosis and the double empathy problem. Br J Psychiatry. 2025: 1-2.

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13. Da F, Ma Y, Wang W, Li W, Guo Q, Wang T. The Impact of STEM Activities on Social Skills and Emotional-Behavioral Outcomes in Students with Autism Spectrum Disorder. Behav Sci (Basel). 2025; 15(11).

Students with autism spectrum disorder (ASD) often lack the social skills required for interpersonal interactions, highlighting the urgent need for evidence-based intervention programs. STEM activities that emphasize collaboration and communication offer a new pathway for social skill development. This study developed an adaptive STEM project-based learning instructional framework teaching model and employed a multiple-probe across-participant design to evaluate the participants’ social skills achievement rates and frequency of emotional and behavioral incidents. The results indicated that STEM activities exerted positive intervention effects; they effectively improved social skills (including cooperation, empathy, engagement, and communication) in students with ASD and reduced the occurrence of emotional and behavioral problems. Feedback from teachers, parents, and students further confirmed the social validity of STEM activities. Finally, recommendations for implementing STEM education among students with ASD are proposed from three perspectives: constructing interdisciplinary collaboration mechanisms, developing adaptive STEM curricula, and implementing dynamic teaching support strategies.

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14. Delahanty M, Daniels J, Engel S, Garcia T, Wood M, Fallin D, Ladd-Acosta C, Steiner A. Fertility Treatment, Female-Factor Infertility, and Autism Spectrum Disorder: Study to Explore Early Development. Paediatr Perinat Epidemiol. 2025.

BACKGROUND: Prior research on fertility treatments and autism spectrum disorder (ASD) suggests minimal association but confounding by indication limits inference. To make clinically relevant conclusions, studies should include populations who receive treatment specifically for female-factor infertility. OBJECTIVES: We investigated the association between ovulation-inducing medications and assisted reproductive technology (ART) and ASD. We conducted analyses in a subsample reporting female-factor infertility to reduce confounding by indication. METHODS: We used data from the Study to Explore Early Development (SEED), a 2007-2020 U.S. population-based case-control study. Children 2.5-5 years old with and without ASD were classified using in-person assessments. We identified fertility treatment via interview and included ovulation-inducing medications, ART, and a combination of both. The subsample included those who were told it would be difficult to conceive and/or who attempted to conceive for > 12 months. We estimated odds ratios and 95% confidence intervals for the whole sample and the subsample using logistic regression models adjusted for age, education, parity, pre-pregnancy body mass index, pregnancy history, smoking status, pre-existing hypertension, and other hormonal fertility treatments. RESULTS: There were 5210 participants in the whole sample and 1091 in the subsample. There was no association between ovulation-inducing medications and ASD in the full sample (adjusted odds ratio [aOR] 1.04, 95% confidence interval [CI] 0.77, 1.39) and the subsample (aOR 0.87, 95% CI 0.61, 1.2). There was an increased likelihood of ASD for ART and a combination of treatments in the whole sample (ART: aOR 1.33, 95% CI 0.70, 2.52; combination: aOR 1.39, 95% CI 0.95, 2.03) compared to the subsample (ART: aOR 1.16, 95% CI 0.57, 2.36; combination: aOR 1.08, 95% CI 0.69, 1.68). CONCLUSIONS: In our data, fertility treatment was not associated with ASD. Additional research should restrict analyses to populations with similar indications to untangle whether observed associations are due to treatment or factors related to uptake.

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15. Dickson KS, Kennedy SM, Safer J, Brookman-Frazee L, Roesch S, Anthony LG. Study protocol for a hybrid type 2 effectiveness-implementation trial of two interventions for autistic and non-autistic youth in children’s mental health settings: one tailored for neurodivergence and one universal. Implement Sci Commun. 2025; 6(1): 131.

BACKGROUND: Mental health services play a key role in caring for autistic youth given the common and often unmet mental health needs in this population. There is a pressing need to enhance the uptake and use of evidence-based interventions (EBIs) that improve mental health services for autism and optimize outcomes. EBIs targeting transdiagnostic or key factors relevant across autism and mental health conditions exist and have the potential to enhance mental health services for autism. Yet, these interventions have not been widely tested. Similarly, autism EBI training is an implementation strategy with the potential to enhance mental health service quality broadly given specific components and strategies incorporated into the EBI to enhance its impact and fit. This protocol paper describes a multisite study that examines the clinical and implementation effectiveness of a transdiagnostic EBI developed for autistic children compared to a non-autism transdiagnostic EBI in children’s mental health settings (Aim 1), confirms engaged clinical and implementation mechanisms (Aim 2), and examines the generalized and expanded effects of EBI training beyond autism (Aim 3). METHODS: This study will employ a hybrid type 2 effectiveness-implementation design to test Unstuck and On Target, an executive functioning EBI adapted for mental health services (autism EBI) and Unified Protocol for Children (non-autism EBI). Twenty-eight mental health programs will be randomized to an EBI condition and 224 therapists across these programs will be recruited and receive EBI training. Additionally, 224 autistic children and 224 non-autistic children, yoked to participating therapists, will be recruited as EBI recipients. This study will measure clinical (mental health symptom change) and implementation outcomes (EBI fidelity, training engagement, psychotherapy quality, reach) and clinical (executive functioning skills, emotion regulation skills) and implementation (autism self-efficacy and knowledge, perception of fit) mechanisms. DISCUSSION: This study will confirm the effectiveness of a promising executive functioning EBI in mental health settings as well as generate clinical knowledge about the potential of transdiagnostic interventions improve mental health outcomes for autistic children. Findings also have immense potential to demonstrate the ability of autism EBIs to enhance mental health services for autistic and non-autistic children more broadly. TRIAL REGISTRATION: This study is registered with Clinicaltrials.gov (NCT06651086). Registered on October 18, 2024.

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16. Dou J, Zhang K, Xie R, Xu H, Pan Q, Xiao X, Luo Y, Xu S, Xiao W, Wu D, Wang B, Zhang L, Sun C, Liu Y. Investigating the Effects of Long-Term Fine Particulate Matter Exposure on Autism Spectrum Disorder Severity: Evidence from Multiple Analytical Approaches. Toxics. 2025; 13(11).

With rapid industrial expansion, air pollution’s adverse neurological effects have gained increasing attention. Children face a greater risk of neurological damage because of their higher breathing rates, developing brains, and limited ability to detoxify harmful substances. Fine particulate matter has been identified as a primary neurotoxic contributor affecting developing brains. Strong evidence connects environmental pollutant exposure to the prevalence of Autism Spectrum Disorder (ASD), a neurodevelopmental condition marked by lasting difficulties with social communication and interaction. This study explores the association between long-term PM(2.5) exposure and ASD symptom exacerbation, investigating underlying mechanisms. We hypothesize that long-term PM(2.5) exposure exacerbates ASD symptoms through neuroinflammatory activation, leading to neuronal damage and impaired synaptic plasticity. Our investigation employs three complementary approaches: First, integrated analysis combining Global Burden of Disease data with Mendelian randomization demonstrates a significant association between PM(2.5) exposure and increased ASD severity risk. Second, utilizing the China High-Resolution Air Pollution Database in conjunction with cohort studies, we provide evidence that ambient air pollution substantially influences autism severity, with PM(2.5) identified as the predominant environmental determinant. Third, through network toxicology, single-cell transcriptomics, and animal experimentation, we demonstrate that chronic PM(2.5) exposure exacerbates valproic acid-induced autism-like behaviors in murine models, identifying CTNNB1, PTEN, CCR2, AKT1, and mTOR as potential core mediating genes. Importantly, these findings represent preliminary results. Several potential confounding factors such as co-exposure to other pollutants and socioeconomic variables have not been fully addressed. While our multi-modal approach provides converging lines of evidence, further validation in larger, more diverse populations with refined control of confounders will be essential to establish causality and elucidate mechanisms. Nonetheless, these early insights advance our understanding of PM(2.5)-induced neurotoxicity in the context of ASD and offer timely, albeit preliminary, evidence to inform public health policy.

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17. Faa G, Meloni C, Lastretti M, Pinna M, Manchia M, Paribello P. Perturbations of Zinc Homeostasis and Onset of Neuropsychiatric Disorders. Int J Mol Sci. 2025; 26(22).

Zinc (Zn(2+)) is a trace element essential for its catalytic, antioxidant, and immunomodulatory roles extending to synaptic signalling in the central nervous system. In this narrative review, we aim to offer the reader evidence linking perturbations of the Zn(2+) homeostasis, including deficiency, excess, or transportation anomalies, to neuropsychiatric conditions such as Alzheimer’s disease (AD), Parkinson’s disease (PD), autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD). A targeted, unsystematic PubMed search followed by an extensive pearl-growing strategy was applied to further augment study selection based on the extensive expertise of study authors. Overall, most of the evidence currently available suggests a modest benefit for a Zn(2+) supplement of around 25-30 mg/day as an augmentation to MDD treatment, with potential benefits of smaller magnitude in paediatric ADHD. Evidence for perturbations of Zn(2+) as a biomarker of risk for these neuropsychiatric disorders remains unconvincing. The role of Zn(2+) supplements in the treatment of the selected conditions remains largely unknown due to the lack of specific, randomised controlled trials conducted to explore their efficacy. The long-term safety, optimal doses for specific applications, and the exploration of possible biomarkers to stratify patient selection to identify the optimal candidate for Zn(2+) supplements remain unanswered questions.

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18. Failla C, Chilà P, Baluci D, Caporlingua C, Meduri A, Pioggia G, Marino F. Breaking barriers, building futures: Inclusive workplaces for autistic people. Front Psychiatry. 2025; 16: 1606075.

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19. Feng S, Wang J, Si X, Lu S, Lu C, Gao Z, Yang J, Wu J, He X, Wu L. Washed microbiota transplantation: candidates for a novel strategy for ameliorating autism spectrum disorder. Front Microbiol. 2025; 16: 1688325.

Autism Spectrum Disorder (ASD) is a severe neurodevelopmental disorder with an increasing global incidence, imposing substantial burdens on both society and affected families. The pathogenesis of ASD is complex, involving genetic, environmental, and other factors. Notably, children with ASD often exhibit gut microbiota dysbiosis, and the relationship between gut microbiota and ASD has garnered growing attention. Current treatments for ASD remain limited and unsatisfactory. As an emerging therapeutic approach, Washed Microbiota Transplantation (WMT) reduces undigested food residues, fungi, parasite eggs, and pro-inflammatory metabolites, thereby lowering the incidence of adverse clinical events. WMT also addresses ethical and aesthetic concerns associated with Fecal Microbiota Transplantation (FMT), enhances treatment safety, and offers new hope for ASD management. This review integrates global literature to analyze the latest findings on ASD epidemiology, societal impacts, existing therapies, and clinical research on WMT, aiming to provide scientific evidence for the clinical application of WMT in ASD treatment.

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20. Golden MJ, Lipton LR, Sideridis G, Brewster SJ, Barbaresi W, Harstad E. Cognitive Development in Children with Autism Spectrum Disorder and the Moderating Role of Intervention and ASD Persistence. Behav Sci (Basel). 2025; 15(11).

This study examined whether Bayley Scales of Infant and Toddler Development-III (Bayley-III) standardized cognitive scores from toddlers diagnosed with autism spectrum disorder (ASD) predict intellectual quotient (IQ) at early school age and whether ASD persistence or interventions received moderate this relationship. Children diagnosed clinically with ASD at 12-36 months underwent research assessments at 5-7 years. Of 212 children diagnosed as toddlers, 133 continued to meet DSM-5 ASD criteria based on current functioning at school age (« persistent ASD »), and 79 did not (« non-persistent ASD »). A moderate positive correlation was found between baseline cognitive scores in toddlerhood and school age IQ (r (210) = 0.45, p < 0.001). Children with baseline cognitive scores < 70 showed greater variation in school age IQ compared to those with baseline scores > 85. Non-persistent ASD status was associated with a higher rate of cognitive change from toddler to school age (S(diff) = 15.044; z = 4.432, p < 0.001). Overall, 94.3% of the sample received ASD-specific interventions. There was no relation between hours of ASD-specific interventions and change in cognitive trajectories for children with non-persistent ASD and an inverse relationship for children with persistent ASD.

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21. González-Devesa D, Zhou R, Rico-González M, Gómez-Carmona CD. Mini-Basketball for Preschool and School-Aged Children with Autism Spectrum Disorder: A Systematic Review of Randomized Controlled Trials. Healthcare (Basel). 2025; 13(22).

BACKGROUND: Although the participation of children with autism spectrum disorder (ASD) in team sports presents challenges, group-based physical activities could offer specific benefits for their core symptoms. Therefore, the aim of this systematic review was to analyze the benefits of mini-basketball for children with ASD. METHODS: A systematic review was conducted following PRISMA guidelines and was registered in PROSPERO (CRD420251144800). Four databases (Web of Science, SPORTDiscus, PubMed, and Scopus) were searched to select randomized controlled trials reporting the effects of mini-basketball interventions on children with ASD from their inception to August 2025. RESULTS: Eight randomized controlled trials involving 436 participants (aged 3-12 years, 87.3% male) met the inclusion criteria. All studies were conducted in China using 12-week interventions (40-45 min, 2-5 days/week at moderate intensity). The quality was rated as good in two studies and fair in six. Five studies assessed social responsiveness, with four showing significant pre-post reductions in the experimental groups and all demonstrating superior outcomes versus those of the controls. One study reported significant reductions in repetitive behaviors, self-injurious behaviors, and restricted behaviors compared to that of the controls. Joint attention improvements were observed through eye-tracking measures, with increased fixation counts, shorter time to first fixation, and more accurate gaze shifts. Physical fitness benefits included improved shuttle run times and standing long jump performance. Finally, one study demonstrated better inhibition control and improvements in sleep quality, including increased sleep duration and efficiency. CONCLUSIONS: Mini-basketball interventions can improve social responsiveness and related outcomes in children with ASD. These findings support mini-basketball as a feasible, safe, and effective intervention that could be integrated with existing therapeutic approaches.

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22. Hu W, Wang Y, Zhang S, Yu S, Li X. Three-Character Training of Question-Asking (TCT-Q) for Children with High-Functioning Autism Spectrum Disorder: A Randomized Controlled Trial. Behav Sci (Basel). 2025; 15(11).

Question-asking is a key component of social communication, and interventions targeting this skill may be able to improve social functioning in children with high-functioning autism spectrum disorder (HFASD). This study introduced a novel intervention method called the three-character training of question-asking (TCT-Q), aimed at teaching children with HFASD how to appropriately use 11 questions in social interactions. The effectiveness of TCT-Q was tested through a randomized controlled trial. Thirty-seven children were assigned to TCT-Q group (n = 19) or treatment as usual (TAU) group (n = 18). Children and their caregivers received two 60 min sessions weekly. Outcome variables were measured before training (T1), after training (T2), and three months after training (T3). Results showed that the question-asking frequency in the TCT-Q group increased significantly after the intervention (ps < 0.001), and the increase was significantly greater than that in the TAU group (η(p)(2) = 0.089-0.370). Although the TCT-Q group showed greater numerical improvements in social communication and autistic mannerisms (ps < 0.05), the group-by-time interaction did not reach statistical significance. In conclusion, TCT-Q is a promising method for enhancing question-asking behaviors and social skills in children with HFASD.

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23. Ipsiroglu OS, Gober HJ. Reply to Gringras et al. Comment on « Paditz et al. The Pharmacokinetics, Dosage, Preparation Forms, and Efficacy of Orally Administered Melatonin for Non-Organic Sleep Disorders in Autism Spectrum Disorder During Childhood and Adolescence: A Systematic Review. Children 2025, 12, 648 ». Children (Basel). 2025; 12(11).

We read, with great interest, the Letter to the Editor of Drs […].

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24. Jouali F, El Haddoumi G, Antra I, Benhida R, Ben Itto A, Fekkak J. A Case Report: Identification of a Pathogenic Microdeletion at Chromosome 21q21.3q22.13 Using Whole-Exome Sequencing and CNV Analysis in a Moroccan Child with Global Developmental Delay. Genes (Basel). 2025; 16(11).

Copy number variations (CNVs) affecting the chromosomal region 21q21.3-q22.13 are rare and have been increasingly associated with neurodevelopmental abnormalities and multisystemic manifestations. In this study, we aimed to characterize the clinical, genomic, and genotype-phenotype correlations of a Moroccan child carrying a de novo microdeletion in this region. Whole exome sequencing (WES) was performed using sequencing-by-synthesis technology on the GenoLab M platform, and CNV detection was achieved through the SeqOne platform. Variant interpretation was conducted using the Integrative Genomics Viewer (IGV), and a custom gene-phenotype heatmap was generated in R (ComplexHeatmap and pheatmap) based on OMIM, ClinVar, and DECIPHER databases to prioritize candidate genes within the deleted segment. The patient presented with global developmental delay, microcephaly, psychomotor and staturo-ponderal retardation, facial dysmorphism, epilepsy responsive to treatment, and cerebral anomalies, including passive biventricular hydrocephalus and diffuse cortical atrophy. WES-CNV analysis identified a heterozygous de novo microdeletion of approximately 8.2 Mb in 21q21.3-q22.13, encompassing 124 clinically relevant genes. Integrated analysis confirmed the pathogenicity of the deletion and highlighted genotype-phenotype correlations, particularly implicating dosage-sensitive genes such as SON and RUNX1. This case underlines the clinical utility of combining WES, CNV analysis, and phenotype-based bioinformatic tools for diagnosing complex microdeletion syndromes, contributes to understanding genotype-phenotype relationships in 21q21.3-q22.13 deletions, and supports improved clinical interpretation and patient management.

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25. Kesidou E, Mitsoudis N, Damianidou O, Taloumtzis C, Tsakiridou M, Polyzoidou E, Grigoriadou E, Bakirtzis C, Spandou E, Simeonidou C. Neuroplasticity Across the Autism-Schizophrenia Continuum. Biomedicines. 2025; 13(11).

Plasticity is a fundamental property of the brain that enables the nervous system to respond appropriately to internal and external stimuli. It primarily involves changes at the synaptic level, mediated by a wide array of molecules, ultimately leading to cognitive and behavioral changes. This review critically contrasts the developmental timing and mechanisms of plasticity in Autism spectrum disorder (early hyperplasticity and excitation-inhibition imbalance) versus Schizophrenia (adolescent overpruning and NMDAR hypofunction) and evaluates evidence for interventions that harness plasticity to improve cognitive and behavioral outcomes. Preclinical and small clinical studies suggest that interventions targeting plasticity-related pathways may improve specific cognitive and behavioral domains. However, effects appear to be symptom-domain-specific and protocol-dependent and larger randomized controlled trials are needed to confirm efficacy. Cognitive remediation for Schizophrenia has been associated with improved executive function and increased hippocampal volume, while virtual reality-based training for Autism spectrum disorder has shown gains in attention and planning skills. By highlighting both molecular mechanisms and therapeutic strategies, this review aims to provide an integrated perspective on how plasticity-targeted interventions could be optimized across neurodevelopmental and neuropsychiatric disorders.

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26. Li Y, Chen Z, Mao J, Lei Y, Tan J, Liu B. Exploring the molecular mechanisms of comorbidity between autism spectrum disorder and sleep disturbances through multi-dataset integration. Medicine (Baltimore). 2025; 104(47): e45979.

Autism spectrum disorder (ASD) is a prevalent neurodevelopmental disorder characterized by social interaction impairments and repetitive behaviors, often accompanied by sleep disturbances (SD). Despite extensive research, the molecular mechanisms underlying the co-occurrence of ASD and SD remain unclear. This study integrated gene expression data from the GEO database for ASD and SD. We performed differential gene expression analysis, functional enrichment analysis, and weighted gene co-expression network analysis (WGCNA) to identify key genes and pathways associated with both conditions. Additionally, we explored the potential regulatory roles of microRNAs (miRNAs) and transcription factors, and evaluated the therapeutic potential of drug repositioning using the CMap database. We identified LAMC3 as a common key gene in both ASD and SD, which plays a crucial role in neural development and is associated with cortical malformations. Functional enrichment analysis revealed significant associations with processes like oxidative stress, neurodevelopment, and immune responses. The miRNA-LAMC3 regulatory network highlighted several potential miRNAs, including hsa-miR-140-3p.1, which showed strong regulatory effects on LAMC3 expression. Immune infiltration analysis indicated significant differences in immune cell proportions between ASD and control groups, with LAMC3 positively correlated with certain immune cells. Our findings provide insights into the molecular links between ASD and SD, emphasizing the role of LAMC3 and its potential as a therapeutic target. The identified miRNAs and transcription factors offer new avenues for understanding the pathophysiology of these conditions. Further experimental validation and clinical trials are warranted to explore the therapeutic potential of identified compounds and to develop effective interventions for ASD and SD.

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27. Likhitweerawong N, Montanaro FAM, Santos ER, Wang JY, Dejputtawat W, Narasimhan U, Klusek J, Maltman N, Schneider A, Tassone F, Hagerman RJ. Swallowing and choking difficulties as potential markers of FXTAS progression in FMR1 premutation carriers. Sci Rep. 2025; 15(1): 42164.

Fragile X-associated tremor/ataxia syndrome (FXTAS) affects motor and coordination pathways and is linked to swallowing and choking difficulties, which can lead to aspiration pneumonia, a leading cause of death in late-stage FXTAS. Despite their severity, these issues are under-investigated. This study examined their association with FXTAS stages and potential as markers of disease progression in FMR1 premutation (PM) carriers. A secondary analysis of Genotype-Phenotype cohort data (2017-2025, MIND Institute, UC Davis) examined swallowing/choking problems, FXTAS stage, neuroimaging, and psychological distress (Symptom Checklist-90-Revised; SCL-90-R). Associations between independent and dependent variables were tested using Generalized Estimating Equation (GEE) regression due to their correlated data. The study included 169 PM carriers (mean age 65 ± 10.9 years; 54% male), with approximately 35% reporting swallowing/choking difficulties. After adjusting for age and sex, individuals in the severe stage of FXTAS (stage 4-5) had a significantly higher risk of swallowing/choking problems compared to those without FXTAS (adjusted odds ratio [aOR] = 4.17; 95%CI = 1.28-13.58). PM carriers with swallowing/choking problems showed a significantly increased association with magnetic resonance imaging (MRI) findings of moderate to severe abnormalities in several brain regions, including cerebral atrophy (aOR = 2.69, p = 0.027), cerebellar atrophy (aOR = 3.34, p = 0.013), cerebellar white matter hyperintensity (aOR = 3.33, p = 0.012), and pons white matter hyperintensity (aOR = 3.93, p = 0.035). Swallowing/choking problems are common in FXTAS, particularly in later stages, and may represent an important clinical marker of disease progression. These patients should be referred to speech-language pathologists for evaluation and treatment. Such interventions could reduce morbidity-mortality associated with these problems.

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28. López-Martínez I, Galera-Martínez R, Aparicio-Mota A, López-Martín JM, Beaudry-Bellefeuille I, Parrón-Carreño T. The Impact of Sensory Reactivity and Oral Praxis on Feeding Participation in Children with Autism (SemAlTea Study). Behav Sci (Basel). 2025; 15(11).

Clarifying the influence of sensorimotor factors on feeding participation problems (FPPs) in children with autism may have implications for therapeutic interventions. Our objective was to assess the prevalence of FPPs in a population of children with autism and to study its association with sensorimotor factors (oral and tactile reactivity and oral praxis). Descriptive observational study including 26 autistic children aged 3 to 12 years. Behavioral Pediatrics Feeding Assessment Scale (BPFAS), Sensory Profile 2 (SP-2), and Oral Praxis (OPr) tests were used. Caregiver stress was evaluated by Parental Stress Index-Short Form (PSI-4-SF). Multivariate logistic analysis and Receiver Operating Characteristic curve was used to predict the risk of FPPs. 26 children (84.6% boys) were included, with a mean age of 6.92 years (95% CI 5.94-7.91). Feeding behavior difficulties were observed in 53.8% of participants, 80.7% exhibited oral praxis issues, and 65.4% of caregivers reported stress related to their child’s FPPs. Oral reactivity and sensory avoidance behaviors were significantly associated with FPPs. Among children with higher support needs, tactile reactivity was also significantly related to FPPs. FPPs in children with autism were associated with oral and tactile hyperreactivity, higher levels of sensory avoidance, dysfunctional parent-child interactions, and increased support needs.

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29. Ma K, Webb M, Hayder H, Qin L. Kmt2c/Mll3 Haploinsufficiency Causes Autism-like Behavioral Deficits in Mice. Biomolecules. 2025; 15(11).

KMT2C (histone lysine N-methyltransferase 2C, also known as MML3, myeloid/lymphoid or mixed-lineage leukemia 3) is a causal gene for Kleefstra syndrome 2, a rare neurodevelopmental disorder. Recent human genetic studies have identified it as a high-risk gene for autism spectrum disorder (ASD), with 79% of patients harboring KMT2C variants having ASD. However, the causal link between KMT2C haploinsufficiency and ASD remains unclear. KMT2C/MLL3 encodes a histone methyltransferase, a core protein of the KMT2C/D COMPASS (complex proteins associated with Set1) complex, which plays fundamental roles in chromatin modification, occupancy, and gene expression. The expression of KMT2C/Kmt2c peaks during the developmental period in the human/mouse brain, which indicates the critical roles of KMT2C/Kmt2c in neurodevelopment. Here, we investigated the impact of germline Kmt2c haploinsufficiency on autism-like behavioral deficits in mice, which modeled humans carrying diverse KMT2C variants. Compared with Kmt2c(+/+) controls, Kmt2c haploinsufficiency mice had normal motor function without anxiety-like behaviors. Notably, Kmt2c haploinsufficiency mice exhibited autism-like social deficits and increased self-grooming in both males and females, which recapitulated the core phenotypes of ASD patients. Novel object recognition and spatial memory deficits were observed in male and female Kmt2c haploinsufficiency mice. This study reveals a causal link between Kmt2c haploinsufficiency and ASD-like behavioral deficits. These germline Kmt2c haploinsufficiency mice can be used for further studying the molecular mechanisms and developing therapeutic interventions for KMT2C haploinsufficiency-associated behavioral deficits.

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30. McCook L, Del Vecchio ML, Crosland K. Using Progressive Muscle Relaxation to Increase Academic Engagement for Elementary School Students with Autism Spectrum Disorder. Behav Sci (Basel). 2025; 15(11).

Students diagnosed with autism spectrum disorder (ASD) commonly struggle with self-regulation skills, which can lead to less social inclusion, difficulties with peer and teacher interactions, low academic performance and high levels of challenging behaviors. Alternatively, when students are equipped with strong self-regulatory capabilities, their social development and academic performance is enhanced, leading to improved well-being, increased attention in the classroom, and lower levels of challenging behaviors. Research suggests that the use of progressive muscle relaxation (PMR) may show promising results in improving observable behaviors such as academic engagement and challenging behaviors in the classroom. However, much of the current literature focuses on the positive effects of PMR solely when targeting private events, such as anxiety, executive functioning, and autonomic arousal. The purpose of this study was to conduct a preliminary examination to explore the effects of brief video-based PMR to increase academic engagement in the classroom with three elementary school students diagnosed with ASD. Using visual and statistical analyses, the results from this study showed that PMR showed promising increases in academic engagement across all three participants. Social validity ratings indicated that the teacher and participants were satisfied with the intervention and rated PMR as a feasible and acceptable behavior-management strategy in the classroom. While social validity outcomes were positive, they were limited as they consisted of short Likert-type scale questions completed by one single teacher and three students. Given the small sample size of this exploratory study, future studies should incorporate additional participants and evaluate the long-term impacts of PMR for improving engagement and academic outcomes for students with ASD.

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31. McGatlin K, Shafer RL, Unruh KE, Stevens CJ, Peterson SG, Dubinsky RM, Lee AP, Tassone F, Hagerman RJ, Bailey H, Mosconi MW. Reduced Sensorimotor, Working Memory, and Episodic Memory Abilities in Aging Female FMR1 Premutation Carriers with and Without Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS). Genes (Basel). 2025; 16(11).

BACKGROUND/OBJECTIVES: Fragile X-associated tremor/ataxia syndrome (FXTAS) is characterized by tremor, gait ataxia, and cerebellar white matter degeneration, along with possible cognitive and cerebral changes. Although diagnostic criteria were originally developed in males, emerging evidence suggests that FXTAS may present differently in females. The present study examined sensorimotor and memory features of aging in female premutation carriers with (FXTAS+) and without FXTAS (FXTAS-). METHODS: We studied 51 female premutation carriers (FXTAS+ = 16, FXTAS- = 35) and 24 age-matched female controls. Participants ranged in age from 47-80 years. All participants completed genetic testing, clinical evaluations, T2-weighted MRIs, and quantitative assessments of sensorimotor (precision grip force task) and memory (reading span; visual paired associates task) functions. RESULTS: During precision grip testing, FXTAS+ carriers showed higher sustained force regularity than FXTAS- carriers (p = 0.03, d = 1.0) and controls (p = 0.004, d = 1.1) at low gain levels only. FXTAS+ participants were slower than controls on motor reaction time (p = 0.009, d = 0.82). Initial force output was higher in FXTAS+ than FXTAS- carriers (p = 0.03, d = 1.0) and controls (p = 0.03, d = 1.0) but at low gain only. FXTAS+ carriers exhibited poorer working memory than FXTAS- carriers (p = 0.03, d = 0.91) and controls (p = 0.02, d = 1.0). During a long-term memory task, FXTAS+ participants were less accurate than FXTAS- carriers (p = 0.04, d = 0.86) and controls (p = 0.004, d = 1.1) and showed increased reaction times relative to FXTAS- carriers (p = 0.03, d = -0.82) and controls (p = 0.01, d = -1.2). CONCLUSIONS: Together, these findings indicate that FXTAS+ females exhibit distinct motor and cognitive impairments, underscoring the value of quantitative behavioral measures for detecting and tracking neurodegenerative progression in female premutation carriers.

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32. McQuaid GA, Lee NR, Wallace GL. Elucidating the structure of depressive symptoms, emotion regulation, and their interrelatedness in autistic adults: A network analysis. Personal Neurosci. 2025; 8: e6.

Relative to the general population, autistic adults are at elevated risk for depression. Factors related to this risk are poorly understood, yet identifying such factors is important for improving mental health in autistic people. Emotion regulation (ER) challenges may be one such factor. However, few studies have examined ER challenges and depression in autistic adults. We examined ER challenges, depressive symptomatology and their associations in 775 (aged 18-83 years) autistic adults using network analysis, a method that permits identification of key components of ER and depression and their interrelatedness. Three non-regularized weighted undirected networks were estimated: ER challenges, depressive symptomatology, and combined ER-depressive challenges. Community structures revealed in the ER challenges and depressive symptomatology networks align with theoretical/nosological models of ER challenges/depressive symptoms as well as extant research using network analysis to examine these constructs. The combined ER challenges-depressive symptomatology network indicated that ER challenges and depressive symptomatology are interrelated but distinct constructs. These preliminary findings using cross-sectional data provide a first step in understanding associations between a candidate factor in depression vulnerability in autistic adults – ER challenges – and identify important future research directions.

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33. Michaud M, Harvey WJ. Facilitating Physical Activity Participation Among Autistic Children and Youth: A Scoping Review. J Autism Dev Disord. 2025.

PURPOSE: Autistic children and youth (C&Y) experience low levels of physical activity (PA) participation due to persistent barriers that have traditionally been researched through deficit-based perspectives. A strengths-based approach may constitute a transformative alternative that focuses on abilities instead of deficits. The identification of facilitators plays a key role in the use of this approach. Thus, the purpose of this scoping review was to identify facilitators to PA participation among autistic C&Y, 5-18 years, and then use the identified facilitators to help conceptualize a strengths-based approach to promote, facilitate, and increase PA participation in autistic C&Y. METHODS: The Arksey and O’Malley framework, the PRISMA guidelines, and the socio-ecological model were utilized to conduct this review. Six databases were searched. RESULTS: Forty-three studies were identified and analyzed which led to the uncovering of 95 PA participation facilitators. These facilitators were organized into categories within the six socio-ecological model levels (i.e., intrapersonal, interpersonal, physical, institutional, community, public policy). CONCLUSION: This review provides solid evidence to recommend a shift in research and practice about the PA participation of autistic C&Y from deficit-based perspectives towards strengths-based approaches. We highlighted in this paper how individual strengths can be fostered through the interaction of various facilitators across all levels of the socio-ecological model. Shifting the focus of researchers and PA practitioners from PA barriers to PA strengths may help find and implement solutions to promote new and ongoing PA participation among autistic C&Y as well as empower them to take ownership of their long-term well-being.

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34. Mohamed AM, Eid OM, Amr KS, Mahrous R, Hemimi M, Elsaeid A, Erian PSF, Gharib S, Hussein SH, El-Massieh PMA, Meguid NA. Deciphering copy number variations and gene implications in an Egyptian cohort with autism spectrum disorders. BMC Med Genomics. 2025.

BACKGROUND: Genetic factors are major contributors to autism spectrum disorders (ASD), with copy number variations (CNVs) playing a significant role. Our objective was to identify and assess CNVs and their associated gene-level impacts in Egyptian ASD patients. METHODS: Our cohort comprised 40 non-syndromic ASD children, ranging in age from one year and nine months to 12 years. We conducted karyotyping, multiple ligation-dependent probe amplification (MLPA), Methylation-Specific MLPA (MS-MLPA), and chromosomal microarray (CMA) analyses for all patients. Additionally, quantitative real-time PCR (qPCR) analyses were performed on selected patients and their parents. RESULTS: We identified pathogenic or likely pathogenic CNVs in seven patients (17.5%), variants of uncertain significance (VUS) in 10 patients (25%), and classified other variants as benign. Pathogenic or likely pathogenic CNVs affected chromosomes 16p11.2 (two patients), 15q11q13 (three patients), 22q11.2 (one patient), and 7q11.23 (one patient). Many of the affected genes are associated with neuronal functions. Patients with CNVs exhibited increases in three parameters on the Children’s Autism Rating Scale (CARS): restrictive and repetitive behavior, adaptation to changes, and responses to taste, smell, and touch. According to the Autism Diagnostic Interview-Revised (ADI-R), patients with pathogenic or likely pathogenic CNVs had an increased third parameter for restricted, repetitive, and stereotyped patterns of behavior. Patients with pathogenic or likely pathogenic CNVs demonstrated some clinical manifestations involving microcephaly (two patients), macrocephaly (one patient), and abnormal electroencephalogram (EEG) with generalized epileptic focus (two patients). qRT-PCR was performed for some parents, and the CNVs were found to be de novo. CONCLUSIONS: CNV detection via CMA proved invaluable and is considered a primary tool in ASD diagnosis. Distinguishing between inherited and de novo CNVs is crucial for accurate genetic counseling. Most genes involved in the detection of pathological or likely pathogenic CNVs are linked to neuronal functions, and these CNVs impact specific parameters in CARS and ADI-R assessments. Future efforts should prioritize a more comprehensive understanding of the genetic underpinnings of ASD, enabling the adoption of personalized treatment strategies.

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35. Mora F, Manzur MJ, Morales-Zepeda D, Flores O, Schwencke C, Leonario-Rodriguez M. Food Pattern, Food Selectivity and Sensory Profile in Autism Spectrum Disorder: An Exploratory Analysis in Chilean Children. Children (Basel). 2025; 12(11).

Background/Objectives: Introduction: Food selectivity is highly prevalent in children with autism spectrum disorder (ASD) and is associated with sensory hypersensitivity, particularly in oral, olfactory, and tactile domains. Although international evidence exists, little is known about this phenomenon in Latin American populations. This study aimed to explore the relationship between sensory hypersensitivity and food selectivity in Chilean children with and without ASD. Methods: A cross-sectional study was conducted with 57 children aged 6-12 years, including 32 with ASD and 25 neurotypical controls. Sensory processing was assessed using the Dunn Sensory Profile 2, while food selectivity was evaluated with the Brief Autism Mealtime Behaviour Inventory (BAMBI) and a Food Frequency Questionnaire (FFQ). Statistical analyses included intergroup comparisons and correlation tests. Results: Children with ASD obtained significantly higher scores across all domains of sensory hypersensitivity (p < 0.001). Selective eating behaviours were more frequent, with texture (78%) and colour (53%) being the most common, and were strongly associated with ritualistic eating (OR 29.39; 95% CI 5.47-136.2; p < 0.0001). BAMBI scores were correlated with oral (p = 0.002), socio-emotional (p = 0.003), and somatic hypersensitivity (p = 0.025). Additionally, children with ASD reported lower intake of vegetables, dairy products, animal proteins, and legumes compared with controls. Conclusions: Food selectivity in Chilean children with ASD is closely related to sensory hypersensitivity, particularly in oral, socio-emotional, and somatic domains. These findings underscore the need for culturally adapted, sensory-based interventions to broaden dietary variety and reduce mealtime difficulties in this population.

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36. Morfini F, Cesarano SGD. The Autism Open Clinical Model (A.-O.C.M.) as a Phenomenological Framework for Prompt Design in Parent Training for Autism: Integrating Embodied Cognition and Artificial Intelligence. Brain Sci. 2025; 15(11).

Background/Objectives: In the treatment of autism spectrum disorders, families express the need for dedicated clinical spaces to manage emotional overload and to develop effective relational skills. Parent training addresses this need by supporting the parent-child relationship and fostering the child’s development. This study proposes a clinical protocol designed for psychotherapists and behavior analysts, based on the Autism Open Clinical Model (A.-O.C.M.), which integrates the rigor of Applied Behavior Analysis (ABA) with a phenomenological and embodied perspective. The model acknowledges technology-particularly artificial intelligence-as an opportunity to structure adaptive and personalized intervention tools. Methods: A multi-level prompt design system was developed, grounded in the principles of the A.-O.C.M. and integrated with generative AI. The tool employs clinical questions, semantic constraints, and levels of analysis to support the clinician’s reasoning and phenomenologically informed observation of behavior. Results: Recurrent relational patterns emerged in therapist-caregiver dynamics, allowing the identification of structural elements of the intersubjective field that are useful for personalizing interventions. In particular, prompt analysis highlighted how the quality of bodily and emotional attunement influences readiness for change, suggesting that intervention effectiveness increases when the clinician can adapt their style according to emerging phenomenological resonances. Conclusions: The design of clinical prompts rooted in embodied cognition and supported by AI represents a new frontier for psychotherapy that is more attuned to subjectivity. The A.-O.C.M. stands as a theoretical-clinical framework that integrates phenomenology and intelligent systems.

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37. Mori H, Takahashi M, Monden R, Adachi M, Hirota T, Shinkawa H, Osada M, Adachi M, Nakamura K. Autism and ADHD traits, effortful control and mental health during the transition from elementary to junior high schools. Sci Rep. 2025; 15(1): 42262.

The transition from elementary to junior high school presents developmental challenges, particularly for students with neurodevelopmental traits. This study examined how autism, attention-deficit/hyperactivity disorder (ADHD) traits and effortful control (EC) were related to changes in mental health during this transition in a large Japanese community sample (N = 2,564). This longitudinal study used data from a community-based cohort of Japanese students and their parents/guardians (N = 2,692). Autism traits were measured using the Autism Spectrum Screening Questionnaire (ASSQ). ADHD traits were assessed with the Attention Deficit/Hyperactivity Disorder Rating Scale (ADHD-RS). Effortful control (EC) was evaluated using the « Effortful Control » subscale of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R). Mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) before and after the transition. Generalized estimating equations (GEE) and latent profile analysis (LPA) were conducted to examine associations among autism and ADHD traits, EC, and mental health across the transition. GEE revealed that higher autism and ADHD traits and lower EC predicted more severe mental health problems. The LPA identified three distinct subgroups characterized by high, moderate, and low SDQ scores across the transition. The high-SDQ group showed elevated autism and ADHD traits and low EC, whereas the low-SDQ group showed low auism and ADHD traits and high EC. The moderate group exhibited intermediate levels for all measures. These findings suggest that pre-existing mental health problems tend to persist during the transition period. Importantly, students with higher autism and ADHD traits and lower EC exhibited diverse adaptation patterns-some improved while others worsened-highlighting that high autism traits are not necessarily associated with post-transition mental health deterioration. This underscores the need for support tailored to neurodevelopmental and self-regulatory profiles.

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38. Natroshvili I, Gakharia T, Bakhtadze S, Natsvlishvili T, Khachapuridze N. Interplay Between VCAM-1 and PGE2 Levels and Autism Spectrum Disorder Severity in Children-A Preliminary Single-Center Analysis. Children (Basel). 2025; 12(11).

BACKGROUND: The clinical heterogeneity of autism spectrum disorders (ASDs) results from dynamic interactions between genetic susceptibility and environmental exposures. Autism is increasingly recognized as involving neuroimmune dysregulation, which may contribute to ASD severity. Several studies indicate that ASD patients exhibit increased levels of VCAM-1, suggesting endothelial dysfunction and enhanced leukocyte infiltration into the brain, which may have adverse bearing on synaptic plasticity, axon growth, and repulsion. Similarly, elevated PGE2 drives microglial activation and excitotoxicity. The present study examines possible links between VCAM-1 and PGE2 levels and ASD severity. METHODS: VCAM-1 and PGE(2) concentrations were measured in children with ASD aged 2-6 years and analyzed for age effects and correlations with behavioral severity. Participants were grouped as mild, moderate, or severe based on Autism Diagnostic Observation Schedule-2 (ADOS-2) scores. RESULTS: VCAM-1 levels were subnormal in 39.3% (n = 24), and PGE(2) levels were above normal in 32.8% (n = 20). Mean VCAM-1 levels decreased significantly with age (F(4, 56) =2.98, p = 0.026) and also, were higher in moderate (U = 36.00, Z = -3.96, p < 0.001) and severe (U = 155.50, Z =-2.70, p = 0.007) ASD groups, with mean ranks rising from 14.46 (mild) to 41.13 (severe). PGE(2) did not differ between severity and age groups (p > 0.05). VCAM-1 correlated moderately with ADOS-2 scores (rho = 0.577, p < 0.001), whereas PGE2 did not (rho = 0.108, p = 0.406), suggesting higher VCAM-1 is linked to increased behavioral severity in ASD. CONCLUSIONS: Inflammation-related biomarkers could be reflecting a heterogeneous set of neuroimmune mechanisms underlying ASD, which may drive behavioral outcomes.

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39. Nuță TG, Manea MC, Varlam CI, Nuță G, Mareș AM, Iliuță FP. Beyond Vision: Unveiling the Psychiatric Dimensions of Keratoconus. Medicina (Kaunas). 2025; 61(11).

Background and Objectives: Keratoconus (KC) is a progressive corneal ectasia with multifactorial etiology, increasingly studied for potential associations with psychiatric disorders. This systematic review aimed to evaluate recent evidence linking KC with depression and other psychiatric conditions, including psychotic disorders, personality disorders, attention deficit hyperactivity disorder (ADHD), Tourette syndrome (TS), autism spectrum disorder (ASD), and obsessive-compulsive disorder (OCD). Materials and Methods: Following PRISMA guidelines, PubMed, ScienceDirect and SpringerLink were searched for English-language observational studies published since 2015 that examined psychiatric disorders in adults with keratoconus. We excluded reviews, case reports, pediatric, non-English, and inaccessible articles. Study quality was assessed using the Newcastle-Ottawa Scale and JBI Checklist. Data were narratively summarized and tabulated-without meta-analysis due to heterogeneity. Results: Twelve studies met inclusion criteria, including 41,906 KC patients and 63,267 controls. Eleven studies investigated depression and one ADHD. Findings on depression were mixed: five studies showed higher depressive symptoms among KC patients, while others found no significant association. Most were cross-sectional and of moderate-to-high quality. The single study on ADHD reported a higher prevalence of KC in males, but no evidence of casual association. Evidence on TS, ASD, and OCD was scarce and largely limited to case reports. The review was limited by heterogeneous methodologies, small sample sizes, an absence of longitudinal data, and reliance on self-report or registry data. Conclusions: Current evidence indicates increased psychological burden among some individuals with KC, particularly regarding depressive symptoms, yet casual relationships remain unproven. Male ADHD patients may have an elevated risk of KC, especially in the presence of eye rubbing. Registration: Not registered.

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40. Orendain Soto C, Dueñas AD, Castellón FA, Valdez Lopez K, Rocha J. « The Structural Rigidity of the U.S. is Missing in Mexico and the Diversity and Freedom of Mexico is Missing in the U.S. »: Experiences of Autism Service Providers Along the U.S.-Mexico Border. J Autism Dev Disord. 2025.

PURPOSE: This qualitative study examined how Mexican early intervention (EI) providers develop professional expertise in autism services and navigate systemic barriers while providing culturally responsive interventions to families near the U.S.-Mexico border. METHODS: Semi-structured interviews were conducted with 13 Spanish-speaking EI providers from Tijuana and Mexicali who work with autistic children ages 0-7. Participants completed demographic questionnaires and discussed their professional development, service delivery practices, and experiences in border cities. Data were analyzed using inductive coding based on Mignolo’s « border thinking » and « epistemic disobedience » frameworks. RESULTS: Five themes emerged: (1) Service Gaps and Structural Inequities, highlighting systemic barriers in both public and private sectors; (2) Reclaiming Knowledge-Local Pathways to Professional Expertise, demonstrating how providers create alternative learning pathways through international training, mentorship, and self-directed education; (3) Challenging Deficit Narratives-A Strength-Based View of Families, showing how providers view caregivers as co-therapists and adapt interventions to family routines and cultural contexts; (4) Navigating Dual Systems-Service Provision in the Borderlands, illustrating providers’ adaptation to serve families across different healthcare and educational systems; and (5) Cross-Border Learning and Adaptation, revealing providers’ deliberate efforts to understand U.S. autism culture and supplement services for transfronterizx families. CONCLUSION: Mexican EI providers demonstrate innovative approaches to autism intervention that challenge eurocentric models through culturally responsive, family-centered practices. Their unique border position enables them to bridge service gaps for transfronterizx families, though systemic barriers limit formal collaboration with U.S. providers. These findings highlight the need for increased cross-border partnerships to improve outcomes for Hispanic/Latine families navigating dual healthcare systems.

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41. Pavlidou E, Samara A, Michailidou S, Kinali M, Spilioti M, Ziavra N. Impact of the COVID-19 Pandemic on Children with ASD and ADHD in Northern Greece: A Pilot Study. Brain Sci. 2025; 15(11).

BACKGROUND/OBJECTIVES: The COVID-19 pandemic profoundly disrupted the daily lives of children with neurodevelopmental disorders, particularly Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Lockdowns, therapy interruptions, and reduced access to educational and healthcare services significantly affected developmental progress and family functioning. This pilot study aimed to assess the long-term impact of the pandemic on children with ASD and ADHD in Northern Greece and to explore consequences for their families in the post-pandemic period. METHODS: Parents or legal guardians of 72 children (ages 2-17 years) with confirmed diagnoses of ASD (n = 57) or ADHD (n = 15) participated. A structured 25-item questionnaire captured information on developmental, psychological, and social functioning, family well-being, therapy disruption, screen use, and access to online support. Data were collected across urban, semi-urban, and rural areas of Northern Greece over six months. Descriptive and inferential analyses were performed. RESULTS: Most participants were boys (77.8%) and in primary school (73.6%). Common co-occurring conditions included learning difficulties (33.3%), anxiety (8.3%), and epilepsy (6.9%). Nearly half of families (45.8%) reported therapy reductions exceeding 70%, while 29.2% accessed online therapy, often with limited perceived effectiveness. New behavioral symptoms emerged in 45.8% of children, including irritability, anxiety, and emotional instability. Parental psychological distress was reported by 29.2% of caregivers. Screen time increased in over 90% of cases, and 87.5% of parents perceived the pandemic as negatively affecting their child. Financial strain was noted by 37.5% of families. CONCLUSIONS: The findings highlight the significant developmental, psychological, and social consequences of the COVID-19 pandemic for children with ASD and ADHD and their families. Service disruptions, unmet therapeutic needs, and increased caregiver burden emphasize the urgency of sustainable, flexible care models. Strengthening telehealth, integrating community-based interventions, and enhancing educational accommodations are essential for resilience in the post-pandemic era.

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42. Peña-Salazar C, Kazah N, Carrillo B, Pugés M, Lupiañez I, Irazábal M, Lleonart M, Ángel S, Ochoa S. The Influence of the Level of Emotional Development on Neuropsychiatric Disorders and Problem Behaviour in People With Intellectual Disability. A Cross-Sectional Study in a Spanish Context. J Appl Res Intellect Disabil. 2025; 38(6): e70138.

BACKGROUND: People with intellectual disabilities often present a discrepancy between emotional and cognitive development, which may play a role in the presence of some psychiatric disorders and problem behaviour (PB). METHOD: Observational, cross-sectional study of 192 adults with intellectual disabilities and psychiatric disorders. RESULTS: We found a statistically significant relationship between level of emotional development (ED) and degree of intellectual disability, as well as with severity of PB and some kinds of neuropsychiatric and neurodevelopmental disorders. In a regression model, 61% of the variance in the global emotional development variable is explained by the variables: Intellectual disability mild-moderate and severe (B = -1.058; p < 0.001), Intellectual disability mild and moderate-severe (B = -0.118; p < 0.05), PB (B = -0.352; p < 0.005), autism spectrum disorder (ASD) (B = -0.129; p < 0.05) and adaptive behaviour (B = 0.017; p < 0.001). CONCLUSIONS: Level of ED could be a key factor in the severity of PB and in the presence of some psychiatric disorders in people with intellectual disabilities.

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43. Qiao W, Wang W. Intelligence analysis of the Chinese version of WISC-IV profiles in children with autism spectrum disorders with FSIQ ≥ 85. Medicine (Baltimore). 2025; 104(47): e46061.

Previous studies have investigated the cognitive characteristics of children with autism spectrum disorder (ASD) using the Chinese version of the Wechsler Intelligence Scale for Children-Fourth Edition, but little is known about those with a full scale intelligence quotient (FSIQ) ≥ 85. This study aimed to compare the intellectual profiles of ASD children with FSIQ ≥ 85 and typically developing (TD) children, and to explore potential gender- and age-related differences within the ASD group. Ninety-three children with ASD (79 males, 14 females; aged 6-16 years) and 30 TD children (20 males, 10 females; aged 6-16 years) were assessed using the Wechsler Intelligence Scale for Children-Fourth Edition, Chinese Version, which is normed for the Chinese population. Composite indices (Verbal Comprehension Index [VCI], Perceptual Reasoning Index [PRI], Working Memory Index [WMI], Processing Speed Index [PSI], and FSIQ) as well as their subtests were analyzed. Statistical analyses included independent-sample t tests, repeated measures ANOVA, and multivariate analysis of variance. The TD group scored significantly higher than the ASD group on most composite indices and subtests (P < .05), except for PRI and its subtests (Block Design, Picture Concepts, and Matrix Reasoning), where no significant group differences were found. Within the ASD group, PSI scores were significantly lower than VCI, PRI, and WMI scores (P < .05). Boys scored higher on VCI and PRI compared with PSI and WMI (P < .05), while girls had significantly higher PSI scores than boys (P < .05). Age comparisons showed no statistically significant differences (P > .05), although younger children (6-11 years) tended to have higher scores than older children (12-16 years). Even among ASD children with FSIQ ≥ 85, cognitive performance was generally lower than that of TD peers, particularly in PSI and WMI. Gender differences were evident in processing speed, with girls outperforming boys, while age differences were minimal. These findings provide a more refined understanding of cognitive strengths and weaknesses in ASD children with average or above-average intelligence and may inform the design of age- and gender-sensitive interventions.

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44. Rakotomanana H, Rouhafzay G. A Scoping Review of AI-Based Approaches for Detecting Autism Traits Using Voice and Behavioral Data. Bioengineering (Basel). 2025; 12(11).

This scoping review systematically maps the rapidly evolving application of Artificial Intelligence (AI) in Autism Spectrum Disorder (ASD) diagnostics, specifically focusing on computational behavioral phenotyping. Recognizing that observable traits like speech and movement are critical for early, timely intervention, the study synthesizes AI’s use across eight key behavioral modalities. These include voice biomarkers, conversational dynamics, linguistic analysis, movement analysis, activity recognition, facial gestures, visual attention, and multimodal approaches. The review analyzed 158 studies published between 2015 and 2025, revealing that modern Machine Learning and Deep Learning techniques demonstrate highly promising diagnostic performance in controlled environments, with reported accuracies of up to 99%. Despite this significant capability, the review identifies critical challenges that impede clinical implementation and generalizability. These persistent limitations include pervasive issues with dataset heterogeneity, gender bias in samples, and small overall sample sizes. By detailing the current landscape of observable data types, computational methodologies, and available datasets, this work establishes a comprehensive overview of AI’s current strengths and fundamental weaknesses in ASD diagnosis. The article concludes by providing actionable recommendations aimed at guiding future research toward developing diagnostic solutions that are more inclusive, generalizable, and ultimately applicable in clinical settings.

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45. Ricou C, Mofid Y, Roché L, Bufo MR, Houy-Durand E, Malvy J, Lemaire M, Elian JC, Martineau J, Bonnet-Brilhault F, Aguillon-Hernandez N, Wardak C. Invariant response to faces in ASD: Unexpected trajectory of oculo-pupillometric biomarkers from childhood to adulthood. Brain Res. 2025: 150070.

Human faces contain a large amount of information, capturing our attention and inducing physiological engagement. Oculometric (visual exploration) and pupillometric (physiological reactivity) parameters quantified by eye-tracking are potent tools for exploring attraction to human faces from an early age. Autistic people have particularities in visual exploration and physiological reactivity to faces, with reduced time spent on the eyes associated with reduced pupil dilation. To date, no study has assessed the age differences of oculo-pupillometric parameters in response to faces. This study aimed to characterize these parameters in neurotypical (n = 150) and autistic (n = 109) populations (3-34 years old). Visual stimuli were organized along a social saliency gradient, from objects to faces. Oculo-pupillometric responses to faces appear invariant across age in the autistic population, contrary to the neurotypical population that shows an increasing attentional focus on the eye region with age, and a larger pupillary sensitivity to social salient stimuli at an early age. Our results highlight an apparent lack of maturation of face processing in autismspectrum disorder (ASD) at the population level, possibly hiding atypical and complex individual trajectories. However, these findings also point to age windows in which specific parameters could be used as discriminating biomarkers of ASD.

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46. Rodgers AD, Dale BA, Ruble LA. Hybrid Telehealth Adaptation of COMPASS for Hope: Parent-Mediated Outcomes in Autism. Behav Sci (Basel). 2025; 15(11).

There are limited empirically supported interventions that target three outcomes-behavior of children with ASD (instead of using adjectives such as « disruptive, » « interfering, » « problem, » or « challenging » behavior, we use « behavior » to avoid ableist language), parent stress, and parenting sense of competence. To help address this need, we tested a hybrid telehealth adaptation of COMPASS for Hope (C-HOPE), an 8-week parent-mediated program originally offered via face-to-face or synchronous telehealth delivery. The present study incorporated asynchronous group discussion board sessions hosted on a learning-management platform together with synchronous individual coaching sessions by telephone. Using a pre-post design, 10 caregivers completed the intervention. Effect sizes were calculated for three treatment outcomes of child behavior, parent stress, and parenting sense of competence. There was a statistically significant difference in the scores for child behavior, with a large effect size (d = 0.73) and a statistically significant difference in parent stress, with a medium effect size (d = 0.50). No difference was observed for parenting sense of competence. Treatment adherence and caregiver satisfaction for the intervention were acceptable. Findings support the feasibility and promise of combining asynchronous and synchronous telehealth elements to increase access to evidence-based parent-mediated interventions for ASD.

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47. Skogli-Christensen B, Tyldum Lefstad K, Moufack MF, Chahboun S. Opening New Worlds of Meaning-A Scoping Review of Figurative Language in Autism Spectrum Disorder. Behav Sci (Basel). 2025; 15(11).

Figurative language (metaphor, idiom, irony/sarcasm) is central to pragmatic communication but is frequently challenging for children and adolescents with autism spectrum disorder (ASD). A scoping review was conducted to map pedagogical and clinical interventions that target figurative-language skills in school-age learners with ASD and to summarize reported outcomes. Following a PCC (Population-Concept-Context) framework and PRISMA-ScR reporting, systematic searches were performed in ERIC and Google Scholar (2010-2025). Eligibility required an ASD sample (ages 5-18), an intervention explicitly addressing figurative-language comprehension, and empirical outcome data from educational or related practice settings. Seven studies met inclusion criteria: five targeting metaphors, one targeting idioms, and one targeting sarcasm/irony. Interventions were predominantly delivered one-to-one or in small groups and emphasized structured, explicit instruction with visual scaffolds and stepwise prompting. Across studies, participants demonstrated clear gains on trained items. Generalization beyond trained material was most often observed for metaphor and sarcasm interventions, particularly when instruction highlighted underlying semantic relations or cue-based pragmatic signals; by contrast, the idiom program yielded item-specific learning with minimal near-term transfer. Limited follow-up data suggested short-term maintenance where assessed. Reported variability across individuals was substantial, underscoring the influence of underlying structural-language skills and social-pragmatic demands. Overall, the evidence indicates that figurative-language skills in ASD are amenable to targeted intervention; effective programs tend to combine explicit teaching, visual supports, multiple exemplars, and planned generalization opportunities. Given small samples and methodological heterogeneity, further classroom-based trials with longer follow-up and detailed learner profiles are needed. The findings support integrating figurative-language goals within individualized education and speech-language therapy plans, while aligning instructional complexity with each learner’s linguistic and pragmatic profile.

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48. Song J, Kim YK. Regulatory Functions of Long Non-coding RNAs and Circular RNAs in the Molecular Pathogenesis of Autism Spectrum Disorder. Cell Mol Neurobiol. 2025.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a strong genetic basis. There is increasing evidence that long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) play key roles in ASD pathophysiology. This review examines current findings regarding these non-coding RNAs, including genetic studies that have identified ASD-associated variants in non-coding regions; expression analyses that have revealed their dysregulation in brain tissue and peripheral blood; and mechanistic investigations that have demonstrated their involvement in neuronal differentiation, synaptic function, and gene regulatory networks. Despite substantial progress, the precise contributions of lncRNAs and circRNAs to ASD have not been fully characterized. Further research is required to elucidate their complex regulatory interactions, which may ultimately facilitate the development of novel diagnostic biomarkers and targeted therapeutic strategies for ASD.

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49. Sulas F, Favero G, Bonini SA, Lonati C, Pinto D, Memo M, Rinaldi F, Rezzani R. Melatonin Improves Intestinal Barrier Impairment in a Mouse Model of Autism Spectrum Disorder. Biology (Basel). 2025; 14(11).

Autism spectrum disorder (ASD) is a neurodevelopmental condition mainly characterized by social impairments and repetitive behaviors. An altered intestinal barrier morphology and increased transmucosal leaks have also been implicated in ASD; in fact, comorbidities such as gastrointestinal problems (leaky gut) have frequently been reported in these patients. The regulation of tight junctions (TJs) is essential in maintaining intestinal barrier morphology and in regulating the delicate balance of trafficking between the intestinal lumen and the submucosa. To date, there are no definitive treatments for ASD comorbidities; however, melatonin (MLT) represents a well-validated and tolerated treatment for sleep disorders in ASD patients. The potential beneficial effects of MLT on this disorder have been and continue to be better investigated. In this context, the present study examines the effects of oral MLT administration (10 mg/kg/day for 16 weeks) on the intestinal barrier in BTBR T + Itpr3tf/J (BTBR) mice, a validated ASD model. Morphological analyses of the ileum of these animals reveal modified villus height (Vh), crypt depth (Cd), and Vh-Cd ratios; an inflammatory state; and a decrease in Paneth cells. Moreover, these mice showed altered TJ expression compared to the control animals (C57BL6/J mice). Notably, MLT normalizes morphological indices and TJ expression, consistent with an improved gut barrier morphology. These data collectively suggest that orally administered MLT can promote the remodeling of the intestinal barrier; thus, we can suppose that MLT reduces gastrointestinal barrier leaks. The overall safety and economy of MLT use suggest that this indolamine could be efficacious as an adjuvant therapy to reduce the condition known as leaky gut.

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50. Toprak TB, Özçelik HN, Işık HR. A brief religiously-adapted cognitive behavioral therapy intervention for Acute Stress Disorder (ASD) after Kahramanmaraş earthquake in Türkiye: a case series. BMC Psychiatry. 2025; 25(1): 1123.

BACKGROUND: After earthquakes, disaster survivors frequently experience acute psychological distress and require time- and resource-efficient, accessible, and culturally sensitive interventions. Integrating religious values into psychological interventions may enhance acceptability and effectiveness in such contexts. METHODS: This case series aimed to develop a brief religiously-adapted cognitive behavioral therapy (CBT) intervention program sensitive to religious values for individuals experiencing acute stress symptoms. Seven earthquake survivors with acute stress symptoms participated. The DSM-5 Acute Stress Symptoms Severity Scale was used for initial screening, and the Stress Symptoms Subscale of the Posttraumatic Diagnostic Scale (PDS) was used to assess symptom severity at pre-intervention, post-intervention, and at 1-week, 1-month, and 1-year follow-up. Participants received a 5-session, 2.5-week intervention designed in consultation with religious authorities and trauma experts. The study was conducted in March 2023. RESULTS: The intervention appeared to contribute to a notable reduction in posttraumatic stress symptoms. On average, participants exhibited a 46% decrease in scores on the PDS Stress Symptoms Subscale following the intervention. These improvements were sustained across all follow-up periods. CONCLUSIONS: The brief religiously-adapted cognitive behavioral therapy intervention for ASD appears to be a feasible and practical short-term approach for reducing acute stress symptoms and potentially preventing the development of PTSD in post-earthquake populations seeking religious-sensitive psychological care.

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51. Walker K, Singleton JL, Shield A. A Case Study of a Deaf Autistic Adolescent’s Affective and Linguistic Expressions. Behav Sci (Basel). 2025; 15(11).

Facial expressions and body language play crucial roles in communication by conveying emotional and contextual information. In signed languages, facial expressions also serve linguistic functions. While previous research on autistic individuals’ facial expressions has focused primarily on affective expressions in hearing people, studying deaf autistic individuals offers insight into how autism affects linguistic and affective facial expressions. This case study examines the nonmanual expressions of « Brent, » a Deaf autistic adolescent natively exposed to American Sign Language (ASL). Five video recordings (four monologues and one conversation, totaling 35 m) were coded for nonmanual expressions, including affective facial expressions, question marking, negation, and other functions. Across 590 coded utterances, Brent showed absent or reduced facial expressions for both linguistic and affective purposes. However, he frequently used alternative communicative strategies, including additional manual signs, sign modification, and body enactment. Use of body movement to convey negation, affirmation, or emphasis was observed but inconsistently applied. These findings expand the current understanding of how autistic individuals use facial expressions by including linguistic functions in a signed language and support a broader view of autistic communication that embraces diverse and effective languaging strategies beyond neurotypical norms.

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52. Wei S, Lai AHY, Ho HWH. The Effectiveness of Art Therapy on Children and Adolescents with ASD: A Systematic Review of RCTs. Healthcare (Basel). 2025; 13(22).

BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects social interaction, communication, and behavior. Traditional interventions such as Applied Behavior Analysis and sensory integration therapy often lack a person-centered approach. Art therapy offers a creative and holistic alternative for supporting children and adolescents with ASD. OBJECTIVES: This study systematically reviewed and evaluated the effectiveness, modalities, formats, and methodological quality of randomized controlled trials (RCTs) involving art therapy interventions for children and adolescents with ASD. METHODS: A systematic search of eight databases identified 12 RCTs involving art therapy for children and adolescents with ASD. Intervention outcomes, formats, and methodological rigor were assessed through this systematic review. Methodological rigor was assessed using the Cochrane ROB 2.0 tool, and the Delphi list with four additional items. RESULTS: Art therapy showed promise in reducing ASD symptoms and stress-related symptoms, and in improving social communication, motor skills, language, and neurodevelopment. Most studies had limitations, including small sample sizes, short durations, a high risk of bias, and low methodological quality. CONCLUSIONS: Although existing studies suggest that art therapy may benefit children and adolescents with ASD, further rigorously designed studies are required to establish its efficacy and inform evidence-based practice.

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53. Wu Q. New intelligent music therapy method for applications of enhancing social skills of autism children based on TL-GCN and deep learning. Sci Rep. 2025; 15(1): 42364.

To address the long-standing challenges children with autism face in social skills and emotional regulation, this study introduces Emotion-based Music Intelligent Network (EmoMusik-Net)-a deep learning model designed for intelligent music therapy. The model focuses on emotional impairments exhibited during social interactions, integrating Transformer-based temporal modeling with a Transfer Learning-based Graph Convolutional Network (TL-GCN). This combination enables high-precision recognition of facial expression sequences and supports a dynamically adaptive, closed-loop mechanism for personalized music recommendation. EmoMusik-Net was trained and optimized using three publicly available emotional video datasets. A pre- and post-intervention study, conducted in collaboration with the families of 182 children with autism, employed questionnaire-based assessments to systematically evaluate the model’s real-world feasibility and effectiveness. Experimental results demonstrated that EmoMusik-Net achieved an emotion recognition accuracy above 0.970, an F1-score consistently over 0.960, and an Area Under the Curve (AUC) of 0.978. The model also showed outstanding robustness on large-scale datasets, with a stability score of 0.994, indicating strong classification performance and generalizability. In terms of intervention outcomes, boys aged 1-6 showed a marked increase in social interest scores, rising from 1.280 to 2.540-a 98.44% improvement. Girls aged 7-12 exhibited significant gains in emotional response scores, from 1.670 to 3.120-an 86.77% increase. Further statistical analysis using the Mixed-effects Model for Repeated Measures (MMRM) and bootstrap confidence interval estimation confirmed the intervention’s significance both statistically and clinically, with particularly strong effects observed in younger participants. Expert blind evaluations further validated the system’s effectiveness, showing high consistency in rhythm and emotion matching. The Intraclass Correlation Coefficient (ICC) ranged from 0.75 to 0.91, with matching accuracy surpassing 94% in certain subgroups. EmoMusik-Net not only addresses the current research gap in integrating intelligent emotion recognition with music-based interventions but also offers a responsive, technology-driven support tool for parents, educators, and clinicians. This approach holds strong potential to advance autism spectrum disorder interventions toward personalized, data-driven methodologies.

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54. Yaffe Y, Ben-Eli M, Huri O, Hazan-Liran B, Levental O. Linking Parenting Styles and Practices to Anxiety and Physical Activity in Autistic Youth: A Mediation Model. Children (Basel). 2025; 12(11).

Background/Objectives: Individuals with autism spectrum disorder (ASD) often experience high anxiety and low physical activity (PA). While the influence of parenting styles on these outcomes is well-documented in typically developing children, their role in autistic youth remains underexplored. The study examines how parenting style and parental encouragement of physical activity relate to anxiety and activity levels in ASD youth. Methods: The sample consisted of 76 parents of school-aged children diagnosed with ASD, including 54 parents of boys and 22 parents of girls (Aged 6-18; Mage = 10.75, SD = 3.67). The parents’ ages ranged from 23 to 65 years (M = 42.96, SD = 7.01). Results: Using a path model analysis, we found that authoritarian and permissive parenting were directly associated with elevated child anxiety. Authoritative and permissive parenting were inversely associated with child anxiety indirectly via parental encouragement of PA. Furthermore, authoritative and permissive parenting were inversely associated with the child’s PA score via encouragement of PA. Conclusions: The study establishes links between parenting styles and anxiety and physical activity in ASD children and adolescents, while identifying a specific mechanism that partially explains these associations.

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55. Yang S, Yin Z, Ma Y, Wang M, Huang S, Zhang L. M(3)ASD: Integrating Multi-Atlas and Multi-Center Data via Multi-View Low-Rank Graph Structure Learning for Autism Spectrum Disorder Diagnosis. Brain Sci. 2025; 15(11).

BACKGROUND: Autism spectrum disorder (ASD) is a highly heterogeneous neurodevelopmental condition for which accurate and automated diagnosis is crucial to enable timely intervention. Resting-state functional magnetic resonance imaging (rs-fMRI) serves as one of the key modalities for diagnosing ASD and elucidating its underlying mechanisms. Numerous existing studies using rs-fMRI data have achieved accurate diagnostic performance. However, these methods often rely on a single brain atlas for constructing brain networks and overlook the data heterogeneity caused by variations in imaging devices, acquisition parameters, and processing pipelines across multiple centers. METHODS: To address these limitations, this paper proposes a multi-view, low-rank subspace graph structure learning method to integrate multi-atlas and multi-center data for automated ASD diagnosis, termed M(3)ASD. The proposed framework first constructs functional connectivity matrices from multi-center neuroimaging data using multiple brain atlases. Edge weight filtering is then applied to build multiple brain networks with diverse topological properties, forming several complementary views. Samples from different classes are separately projected into low-rank subspaces within each view to mitigate data heterogeneity. Multi-view consistency regularization is further incorporated to extract more consistent and discriminative features from the low-rank subspaces across views. RESULTS: Experimental results on the ABIDE-I dataset demonstrate that our model achieves an accuracy of 83.21%, outperforming most existing methods and confirming its effectiveness. CONCLUSIONS: The proposed method was validated using the publicly available Autism Brain Imaging Data Exchange (ABIDE) dataset. Experimental results demonstrate that the M(3)ASD method not only improves ASD diagnostic accuracy but also identifies common functional brain connections across atlases, thereby enhancing the interpretability of the method.

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56. Yi H, Zhou X, Quan S, Liu T. Enhancing motor coordination and social interaction in children with autism through virtual reality rehabilitation. Medicine (Baltimore). 2025; 104(47): e45950.

This study evaluates the effects of virtual reality (VR) rehabilitation on motor coordination and social interaction in children with autism and explores related neural mechanisms and caregiver perspectives. A retrospective analysis was conducted on 80 children with autism who underwent either VR-based or conventional rehabilitation. Outcomes included motor performance, social behaviors, training adherence, caregiver satisfaction, and brain activation assessed by functional near-infrared spectroscopy. Compared with conventional training, VR rehabilitation was associated with greater improvements in motor coordination and social engagement. Enhanced activation was observed in brain regions linked to motor control and social cognition. Higher training adherence was positively correlated with caregiver satisfaction. VR-based rehabilitation can effectively support motor and social development in children with autism while improving treatment adherence and caregiver acceptance. These findings highlight VR as a promising tool for personalized pediatric neurorehabilitation.

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57. Yin W, Reichenberg A, Sandin S, Silverman ME. The association between parental postpartum depression and offspring autism spectrum disorder. Front Psychiatry. 2025; 16: 1693979.

OBJECTIVE: Postpartum depression (PPD) reportedly affects up to 20% of new mothers. While parental psychiatric history has been associated with an increased likelihood of neurodevelopmental conditions in the offspring, only a few studies of clinically diagnosed PPD exist exploring associated autism spectrum disorder (ASD) outcomes and no study to date has explored the contributions of paternal PPD with ASD risk or the combined influence. METHODS: A nationwide prospective cohort of all live births in Sweden from 1997 through 2021, followed up through December 31, 2022. Associations between parental PPD and ASD were quantified by hazard ratios and two-sided 95% confidence intervals (CIs) from Cox regressions. RESULTS: Among 1,781,349 live-births, ASD was diagnosed in 986 (4.6%) children of 21,461 born to mothers with PPD (574.3 per 100,000 person-years), 331 (5.3%) of 6,292 born to fathers with PPD (589.0 per 100,000 person-years), and 37 (8.8%) of 420 when both parents had PPD (1177.3 per 100,000 person-years). The hazard ratio of ASD when the mother was diagnosed with PPD was 2.56[CI:2.29-2.85], for fathers 2.59[CI:2.43-2.76] and both 5.54[CI:4.02-7.65]. Adjustment for possible confounders and depression history provided similar trends (mother 1.53[CI:1.36-1.71], fathers 1.71[CI:1.60-1.83] and both 2.19[CI:1.58-3.03]). CONCLUSION: Parental PPD was associated with an increased risk of ASD in the offspring, and this association was partially, though not fully, explained by depression history, antidepressant use, and other parental psychiatric factors. The magnitude of the association increased comparably when either parent was diagnosed with PPD and increased further when both parents were diagnosed, with a pattern indicative of shared genetic influences.

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58. Zaliene L, Mockeviciene D, Macerauskas E, Zalys V, Dovydaitiene M. Postural and Muscular Responses to a Novel Multisensory Relaxation System in Children with Autism Spectrum Disorder: A Pilot Feasibility Study. Children (Basel). 2025; 12(11).

BACKGROUND: Children with autism spectrum disorder (ASD) frequently show postural abnormalities and elevated muscle tone, which can hinder participation in education and rehabilitation. Evidence on the immediate physiological effects of standardized multisensory environments is limited. OBJECTIVE: To evaluate feasibility, safety and short-term physiological/postural responses to an automated multisensory smart relaxation system in children with severe ASD. METHODS: In a single-session pilot across three sites, 30 children (27 boys; 6-16 years) underwent pre-post postural observation and bilateral surface EMG of the upper trapezius, biceps brachii and rectus abdominis. The system delivered parameterized sound, vibration, and mild heat. EMG was normalized to a quiet-sitting baseline. RESULTS: The intervention was well tolerated with no adverse events. Most children sat independently (25/30; 80%) and a majority stood up unaided after the session (24/30; 76.9%). Postural profiles reflected common ASD features (neutral trunk 76%, forward head 52%, rounded/protracted shoulders 46%), while limb behavior was predominantly calm (73%). Normalized EMG amplitudes were low, with no significant pre-post changes and no meaningful left-right asymmetries (all p > 0.05; Cohen’s d < 0.20), indicating physiological calmness rather than tonic co-contraction. CONCLUSIONS: A single session with a smart multisensory relaxation system was safe, feasible, and physiologically calming for children with severe ASD, without increasing postural or muscular tension. The platform's standardization and objective monitoring support its potential as a short-term calming adjunct before therapy or classroom tasks. Larger, gender-balanced, multi-session trials with behavioral outcomes are warranted.

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59. Zhang Z, Kang W, Mi Y, Zhong X, He Y. The Microbiota-Gut-Brain Axis in Autism: Associations, Causal Inference, and Interventions-A Narrative Review. Pathogens. 2025; 14(11).

Autism spectrum disorder is markedly heterogeneous and frequently accompanied by gastrointestinal symptoms that often correlate with behavioral phenotypes. Emerging evidence suggests that the microbiota-gut-brain axis may contribute to these associations through multiple bidirectional communication routes-including neural, immune, and endocrine pathways, as well as microbial metabolites such as short-chain fatty acids and tryptophan-kynurenine intermediates. This narrative review synthesizes clinical, mechanistic, and interventional evidence published between January 2010 and July 2025, clarifies the extent to which current data support association versus causation, evaluates key confounding factors, summarizes evidence for interventions such as probiotics, prebiotics, and fecal microbiota transplantation, and outlines future directions for precision research and targeted interventions based on functional pathways and stratified subgroups.

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60. Zhou J, Fu Z, Gao Y, An C, Zhang Z, Zhong X, Tian L, Yang X, Zhang J, Zhang Q, Wang D, Li N. Gut Microbiotas, Plasma Metabolites, and Autism Spectrum Disorder: A Bidirectional Mendelian Randomization Analysis. Pathogens. 2025; 14(11).

Background: Previous studies have indicated that the gut microbiome and plasma metabolites play key roles in autism spectrum disorder (ASD), but their causal relationships remain unclear. Linkage disequilibrium score regression (LDSC) and Mendelian randomization (MR) are powerful tools for assessing genetic causality. This study uses LDSC and MR to investigate the genetic links between the gut microbiome and ASD and explore the mediating role of plasma metabolites. Methods: To explore the genetic relationships between the gut microbiome, plasma metabolites, and ASD, we obtained summary statistics from large-scale genome-wide association studies (GWAS). Gut microbiome data came from a MiBioGen consortium meta-analysis (N = 18,340), ASD data from the Danish Psychiatric Central Research Register (DPCRR) (N = 18,382), and plasma metabolite data from the Canadian Longitudinal Study of Aging (CLSA) (N = 8299). We applied LDSC and bidirectional MR to analyze the genetic associations between the gut microbiome and ASD and plasma metabolites and ASD. Mediation MR was used to assess the mediating role of plasma metabolites in the gut microbiome-ASD relationship. Results: LDSC analysis revealed significant genetic correlations between the gut microbiota Lachnospiraceae NK4A136 group and Sellimonas with ASD. Moreover, bidirectional MR demonstrated causal effects of five gut microbial genera on ASD risk, as indicated by inverse variance weighted (IVW) methods. Similarly, we identified 49 plasma metabolites that exhibited genetic correlations with ASD, and 58 metabolites had causal effects on ASD in MR analysis. Mediation analysis revealed that specific bacteria, Ruminiclostridium5, reduce the occurrence of ASD through metabolites Delta-CEHC and Docosadioate (C22-DC). Furthermore, Ruminococcaceae UCG005 and Sutterella modulate ASD by inhibiting Serotonin and N-acetyl-L-glutamine, respectively. Conclusions: This study provides evidence of a causal relationship between the gut microbiome and ASD, with plasma metabolites acting as a potential mediator. Our findings offer new insights into the causal mechanisms linking the gut microbiome and ASD and provide a theoretical foundation for microbiome-based therapeutic strategies.

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61. Zubizarreta SC, Isaksson J, Faresjö Å, Faresjö T, Carracedo A, Prieto MF, Bölte S, Lundin Remnélius K. The impact of camouflaging autistic traits on psychological and physiological stress: a co-twin control study. Mol Autism. 2025; 16(1): 59.

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