1. Al Askar BA, AlBishry FY, Alotaibi NM, Alzaben A, Albishi SM, Almajed AA, Alammari FS, Albarrak AS. Experience of special care patients receiving dental rehabilitation under general anesthesia at King Saud University Dental University Hospital. Sci Rep. 2025; 15(1): 33493.

Patients with special healthcare needs (SHCN) face significant challenges in accessing dental rehabilitation services, particularly under general anesthesia (GA). This study examined the waiting time from screening to pre-anesthesia appointments and association between demographics and clinical factors with the waiting time among the SHCN patients treated at xxx Dental University Hospital. This retrospective study included 210 SHCN patients who had full mouth rehabilitation under GA. Analysis of the collected data showed that the average waiting time from clinical first visit screening appointment to pre-anesthesia clinic assessment was 10.06 ± 12.49 months while average complete dental rehabilitation surgery duration was 213.80 ± 101.98 min. ADHD (attention deficit hyperactivity disorder) patients had the highest waiting time, while ASD (autism spectrum disorder) patients had the least waiting time, which was 14.29 and 9.29 months respectively. Findings indicate that systemic barriers, such as limited operating room (OR) availability and a lack of specialized professionals, contribute to prolonged waiting times and variability in treatment experiences. The study highlights the need for targeted reforms and tailored care approaches to improve access and outcomes for SHCN patients.

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2. Alkhawaldeh RS, AlShaqsi J, Al-Ahmad B, Alkhawaldeh SM, Drogham O. An attention-based multi-residual and BiLSTM architecture for early diagnosis of autism spectrum disorder. Sci Rep. 2025; 15(1): 33608.

The prevalence of autism as a neurological disorder affecting approximately 1 in 54 children diagnosed with the condition and the absence of definitive biomarkers forces clinicians to depend on behavioral observations and history information. The variety of symptom presentations and the dependence on subjective clinical evaluations make the diagnostic process still difficult and require long periods of observing behavior and analysis. Effective and automated methods for early detection of patients are crucial to reducing adverse outcomes. Therefore, we propose a framework model that combines the features of attention layers, Residual layers, and the BiLSTM models as a promising transfer learning model with a multi-phase pipeline that significantly improves detection and recognition performance. The experimental results show that the proposed model obtains effective performance, achieving average values for precision, recall, F1 score, and accuracy scores of 87.5%, 87%, 87.5%, and 87.7%, respectively. These values indicate a balanced performance across the metrics, emphasising the model’s ability to precisely and consistently classify autism-related features. Regarding ROC AUC values, the class-specific ROC AUC values are close to 95%, ensuring the robustness of the model to distinguish autism among images effectively.

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3. AlMarshedi AA, Behisi MA, Al-Taweel HM, Albasuony TM, Almuqrin SM, Alkhawashki SH, Alkhiri AT, Alsalehi SM, Alhaidar FA, Ad-Dab’bagh Y, Laugeson EA. Feasibility and Preliminary Effectiveness of the Arabic Version of the Program for the Education and Enrichment of Relational Skills (Peers-AA) for Autistic Adolescents in Saudi Arabia. Autism Dev Lang Impair. 2025; 10: 23969415251371547.

Autism spectrum disorder is a neurodevelopmental condition characterized by significant deficits in social skills that impact youths’ academic, adaptive, and psychological functioning. Social skills deficits are imperative targets for interventions. This pilot study explored the feasibility and preliminary effectiveness of the translated and culturally adapted Arabic version of the UCLA PEERS(®) among autistic adolescents (ages 11-17) in Saudi Arabia. The study utilized a quasi-experimental design, collected pre-, post-, and three-month follow-up data, and used focus group discussion and a prospective cohort study with pre- and postintervention assessments. Feasibility was assessed based on subjective methods: recruitment, retention, attendance rate, comprehension of the translated material, and homework completion. Effectiveness was evaluated based on postintervention and three-month follow-up interval changes in scores on three outcome measures: the Social Responsiveness Scale, Second Edition, Child Behavior Checklist, QSQ, and Test of Adolescent Social Skills Knowledge. Written informed consent was obtained from caregivers, and oral assent was obtained from the study participants. These initial findings support the feasibility and preliminary effectiveness of the PEERS-AA. The outcomes suggested significant improvement in the subjects’ social skills and knowledge of social etiquette, as reported by the adolescents and their parents, with improvements retained at the three-month follow-up. However, there was no reported improvement in the number of get-togethers, which was likely explained by COVID-19 pandemic restrictions and culture-related considerations. This study represents the first cross-cultural validation trial of an established evidence-based social skills intervention for autistic adolescents in an Arabic-speaking country. The PEERS-AA manual’s feasibility and preliminary effectiveness indicate its promising applicability for interventions and research. Further research to evaluate the generalizability and long-term effectiveness of the PEERS-AA program is needed.

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4. Ayoub G. Neurodevelopmental Impact of Maternal Immune Activation and Autoimmune Disorders, Environmental Toxicants and Folate Metabolism on Autism Spectrum Disorder. Curr Issues Mol Biol. 2025; 47(9).

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by deficits in social communication, repetitive behaviors, and sensory sensitivities. While genetic factors contribute significantly to ASD risk, a growing body of evidence implicates environmental exposures and immune-mediated mechanisms in the etiology and severity of ASD. This review synthesizes peer-reviewed findings on (1) maternal immune activation, (2) environmental toxicant co-exposures, (3) maternal autoimmune disease, and (4) cerebral folate deficiency (via folate receptor alpha autoantibodies), detailing their mechanistic contributions to core and associated ASD symptoms. Collectively, these findings illuminate converging neuroimmune and metabolic pathways that, when disrupted in utero, substantially alter the developmental trajectory of the brain and increase the likelihood of ASD. Such interruptions leading to developmental changes can trigger immune activation from environmental sources of infection and pollution, with these triggers compounded in cases of autoimmune disease or cerebral folate deficiency. Understanding these mechanisms provides a foundation for early identification, stratified risk assessment, and the development of targeted prenatal interventions. Thus, a lesson we learn from autism is that neurodevelopmental disorders should be understood as the product of combined genetic vulnerabilities and modifiable prenatal and postnatal influences. Further exploration of this framework will open paths for precision intervention and prevention.

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5. Birtwell K, Planner C, Epton T, Gowen E, Corsellis E, Botha M, Longley S, Khan G, Stratton C, Wong G. Optimising general practice support for autistic adults: a realist review protocol. Syst Rev. 2025; 14(1): 184.

BACKGROUND: Mental and physical health conditions are more common in autistic than non-autistic people, including anxiety, depression, suicidality, gastrointestinal problems, cancer, epilepsy, and heart disease. General practice is often the first point of contact for patients, yet research has found that autistic people face barriers to healthcare, report lower satisfaction with healthcare, and have more unmet health needs than non-autistic people. This can be due to misunderstandings about the needs of autistic people, different communication styles, the clinic environment, and challenges making and getting to appointments, compounded by slow dissemination of research findings. Our aim is to find out how, why, and to what extent general practice supports autistic adults with and without intellectual disabilities (ID) throughout their lives, in order to suggest improvements to practice. METHODS: We will conduct a realist review which is a theory-driven systematic review. Electronic databases will be searched including MEDLINE, PsycInfo, EMBASE, the Cochrane Database of Systematic Reviews, CINAHL, Scopus, ASSIA and grey literature sources (e.g. Google Scholar). To be included articles must concern general practice, autistic adults aged 18 and over, contain information relevant to a UK setting, and be written in English. Any study design or article type may be included and articles will be assessed for relevance and rigour. In line with realist synthesis methods we will identify relevant contexts, mechanisms and outcomes and develop a programme theory to explain how, why, and when general practice optimally supports (or not) autistic adults. We will also seek to identify resources that are available for and used by general practice to support autistic adults. We will involve stakeholders in each stage of the review including autistic individuals, family members, and healthcare professionals (including general practice staff). The review will be reported in line with the RAMESES publication standards. DISCUSSION: The findings will inform guidance for i) general practice about potentially helpful adaptations to service, and ii) autistic people to help them gain the support they need. This will help to improve access to and engagement with general practice care, and thus potentially improve the health and wellbeing of autistic individuals. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024545403.

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6. Bowden SL, Miller PK. Menstruation among autistic adults: An occupational perspective. Br J Occup Ther. 2025; 88(10): 626-34.

INTRODUCTION: Menstruation is known to have potentially adverse impacts at multiple levels of occupational performance. However, little research has directly investigated the everyday menstruation experiences of autistic individuals, for whom menses and menarche are widely thought to be particularly occupationally disruptive. METHOD: A qualitative research design was employed to address the lived experiences of menstruation among N = 6 autistic adults living in the United Kingdom. With institutional ethical approval, in-depth online interviews were conducted, yielding 34,734 words of transcript. Thematic analysis of these revealed interconnected global themes. FINDINGS: The global themes identified were: (1) ‘Sense of self’, addressing participants’ sensory overload and experiences of anxiety, ‘brain fog’ and concern with cleanliness. (2) ‘Attributional work’, addressing events and contexts which were taken to trigger and/or exacerbate key problems (such as the need to use public restrooms). (3) ‘Reclaiming orderliness’, addressing participants’ pragmatic strategies for overcoming increased unpredictability in their lives during periods. CONCLUSION: Menstruation poses specific, significant challenges for autistic individuals that require autism-specific solutions. These challenges impact individuals’ ability to perform occupations of self-care, productivity and leisure. As such, Occupational Therapists have a key role in the provision of support to address the impact of menstruation on occupational engagement and participation.

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7. Bustnes KA, Schäfer S, Held L, Wessels H, Friehs MA. Risks to the Unborn: An Umbrella Review on the Effects of Prenatal Maternal Stress Caused by Natural Disasters. Stress Health. 2025; 41(5): e70108.

Traditionally, to promote an optimal pregnancy trajectory and child development, encompassing both physical and mental health, a preventative focus is crucial and – ideally – exposure to negative influences is supposed to be limited. However, when prevention is not feasible, early identification of developmental impairments is paramount to address potential risk factors for future development. Specifically, one source of developmental impairment is prenatal maternal stress. This umbrella review integrates and summarizes current research on the diverse developmental consequences of prenatal maternal stress caused by natural disasters. The cumulative evidence strongly suggests that the effect of maternal stress during pregnancy does not end after pregnancy but can lead to a wide range of detrimental effects on a child’s development throughout the whole lifespan. By synthesizing previous empirical findings, the current review provides an overview about potential congenital developmental difficulties as well as the interdependence of these negative effects. The depicted results highlight a risk of overarching negative effects of prenatal stress for the child. It is stated that in order to prevent possible long-lasting effects this risk has to be effectively taken into account. Possible recommendations for prevention interventions are discussed.

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8. Cajachagua-Torres KN, Boer OD, Louwerse A, Ghassabian A, Reiss IKM, Jaddoe VWV, El Marroun H. The association of preconception and prenatal cannabis and tobacco exposure with autism symptoms in offspring: A population-based longitudinal study. Neurotoxicol Teratol. 2025; 112: 107561.

Prenatal cannabis and tobacco exposure is associated with attention and behavior problems in children, while associations with autism symptoms remain unclear. We prospectively examined whether parental cannabis and tobacco use during pregnancy were associated with childhood autism symptoms. Information on parental cannabis and tobacco use was assessed using questionnaires, and maternal cannabis metabolites were detected via urinalysis. We measured autistic symptoms using two mother-reported instruments: Child Behavior Checklist (CBCL) at ages 1.5, 3, and 6; and Social Responsiveness Scale (SRS) at 6 years (n = 4380). Linear mixed models were used to examine the association between parental cannabis and tobacco use and CBCL autism symptoms across childhood. Linear regression was used for SRS autism symptoms. Maternal cannabis use before, but not during, pregnancy was associated with higher CBCL autism symptoms across childhood (β: 0.33, 95 % CI: 0.02, 0.63). Paternal cannabis use was linked to higher CBCL autism symptoms across childhood (β: 0.27, 95 % CI: 0.05, 0.50), explained by maternal psychopathology; no association was found with SRS autism symptoms. Excluding cannabis users, children whose mothers used tobacco throughout pregnancy had more SRS autism symptoms (β: 0.03, 95 % CI: 0.003, 0.05), not CBCL; no association was found with paternal tobacco use. Our results suggest that maternal and paternal cannabis use is not associated with offspring autism symptoms, although preconception use is associated with autism symptoms across childhood. In contrast, maternal continued tobacco use during pregnancy was associated with autism symptoms, but not paternal use, suggesting possible intrauterine programming rather than family-based factors.

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9. Chen B, Zhao J, Li Y, Chen C, He R, Wang G, Xu P, Li F, Yao D. Biological motion stimuli reveals the severity of the social deficits of ASD: an EEG study. Prog Neuropsychopharmacol Biol Psychiatry. 2025: 111513.

The integration of individuals with autism spectrum disorder (ASD) into society and their capacity to lead fulfilling lives are significantly hindered by challenges in social communication. Consequently, it is crucial to explore the underlying neural mechanisms and establish early diagnostic approaches to accurately assess the severity of social interaction impairments in ASD. To investigate the social deficits in ASD, particularly in identifying reliable biomarkers for predicting the severity of social impairments, the current study focused on the sample entropy, functional connectivity, and network properties under biological motion tasks (biological motion (BM) and scramble motion (Scr) in both ASD and typically developing (TD) children. The findings suggest that, compared to TD, those with ASD exhibit higher sample entropy in localized brain regions, specifically the frontal and occipital lobes, regardless of whether they are under BM or Scr conditions. Moreover, ASD is characterized by enhanced long-range connectivity involving the frontal, parietal, and occipital lobes. These results collectively highlight the abnormal neural mechanisms of ASD when engaging with BM tasks, which further found a significant correlation between the network properties and the ADOS social score. Notably, by utilizing network properties and sample entropy as features, the severity of social impairments in autism can be effectively predicted through multiple stepwise regression analyses. These findings illuminate the pathophysiological mechanisms of ASD’s social deficits from both local and global perspectives, offering potential biomarkers for quantifying social dysfunction in autism.

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10. Chen M, Peng K, Zhou L, Weng X. Differential item functioning in the children autism rating scale first edition in children with autism spectrum disorder based on a machine learning approach. Front Neurol. 2025; 16: 1648991.

PURPOSE: Our study used Rasch Analysis to examine the psychometric properties of the Children Autism Rating Scale First Edition (CARS1) in children with autism spectrum disorder (ASD). METHODS: The Partial Credit Model (PCM) was used to test reliability and validity. The GPCMlasso Model was used to test the differential item functioning (DIF). RESULTS: The response pattern of this sample showed acceptable fitness for the PCM. This analysis supports the unidimensionality assumption of the CARS1. Disordered category functions and DIF were found for all items in CARS1. Performance can be related to age group, gender, symptom classification, and autistic symptoms. CONCLUSION: Rasch analysis provides reliable evidence to support the clinical application of the CARS1. Some items may produce inaccurate measurements originating from unreasonable category structures. Differences in age group, sex, and symptom classification can be related to test performance and may lead to unnecessary bias. Hence, clinical applications may require additional consideration of population characteristics to draw reliable conclusions.

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11. Chung H, Job Said A, Tager-Flusberg H, Nelson CA, Wilkinson CL. The association between infant EEG aperiodic exponent and the trajectory of restricted and repetitive behaviors for toddlers with and without autism. J Neurodev Disord. 2025; 17(1): 58.

BACKGROUND: Restricted and repetitive behaviors (RRB) are core features of autism but are also observed in typical development. Our understanding of the neural underpinnings of RRBs is limited. Given that excitation-inhibition (E/I) balance may underlie RRBs, we aimed to evaluate the relationship between aperiodic exponent (as a proxy of E/I balance) and changes in RRBs over time in infants with and without elevated likelihood of autism. METHODS: Resting-state EEG data were collected from 12-to-14-month-old infants and aperiodic exponent was calculated. Parent-reported RRBs were obtained using the Repetitive Behavior Scale-Revised questionnaire to measure the severity and change in RRBs from 12-to-36 months. Multiple linear regressions were conducted to assess relationships between aperiodic and change in RRBs. RESULTS: Marginal effects analysis of linear regressions revealed significant associations such that lower aperiodic exponent was associated with elevated RRBs reported over time across the whole sample ([Formula: see text]=0.31, β= -0.21, p = 0.01), which was more prominently observed in the infants who later received an autism diagnosis (δy/δx = -15.57, p < .001). CONCLUSIONS: Results suggest that early EEG aperiodic activity may serve as a potential correlate of increased manifestation of RRBs. Longitudinal studies are needed to elucidate whether the early trajectory of aperiodic activity in development influences the severity of RRBs in childhood.

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12. Corbett BA, Calvosa R, Tamaroff J, Muscatello RA, McGonigle T, Vandekar S. Examining androgen and estrogen profiles during pubertal development in autistic and neurotypical girls. Horm Behav. 2025; 176: 105837.

BACKGROUND: Puberty is a normative albeit complex developmental period marked by significant changes in hormonal, physical, and socioemotional functioning. Research has theorized an important role for sex hormones in the etiology and profile of autism spectrum disorder (ASD), especially during developmental periods including puberty. Differences in pubertal onset in autistic compared to neurotypical girls have been reported. Aims examined female participants based on diagnostic (autistic, neurotypical) and hormonal expression (dehydroepiandrosterone (DHEA-S), estradiol, testosterone) in the context of development (puberty, age). Hypotheses included: Hyp 1: autistic compared to neurotypical girls would demonstrate earlier pubertal onset. Hyp 2: DHEA-S and estradiol would be higher in older, more physically mature girls. Hyp 3: Testosterone would be stable. METHODS: Participants included females between 6-to-12 years with ASD (N = 112) or typical development (TD, N = 96). Morning salivary samples were collected for hormone assays. Nonlinear least squares and ordinary linear regression models were used. RESULTS: Autistic girls did not show significant evidence of earlier pubertal onset in pubertal stage (p = 0.692). There were no observed diagnostic differences in hormone changes through the pubertal or age range (p = 0.8367, p = 0.0694, p = 0.6812, p = 0.8418, p = 0.7358, & p = 0.1438) sampled. All hormones showed significant changes with puberty and age (p < 0.001). CONCLUSIONS: The study examined profiles of females based on diagnostic group and hormonal expression in the context of development. Although group differences were not observed in this cross-sectional study, hormonal differences may emerge as girls progress through puberty. It is vital to track and support autistic girls through this time of change and vulnerability.

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13. Dick K, Kaczmarek E, Ducharme R, Bowie AC, Dingwall-Harvey ALJ, Howley H, Hawken S, Walker MC, Armour CM. Correction: Transformer-based deep learning ensemble framework predicts autism spectrum disorder using health administrative and birth registry data. Sci Rep. 2025; 15(1): 33322.

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14. Dolfi A, Tudose C. Diagnostic challenges of autism spectrum disorder in women without intellectual or language impairments: a narrative review. J Med Life. 2025; 18(8): 710-20.

Autism Spectrum Disorder (ASD) in adult women without intellectual or language impairments is frequently under-recognized, due to subtler manifestations, greater use of compensatory social strategies, and reliance on diagnostic frameworks developed from male presentations. Diagnostic overshadowing, where autistic traits are misattributed to other psychiatric conditions, further delays accurate identification. This narrative review aims to critically evaluate recent evidence on the diagnostic challenges of ASD in adult women without intellectual or language impairments, assess the performance of widely used screening tools, and present recommendations for improving gender-sensitive diagnostic practices. A structured literature search was applied (PubMed, PsycINFO, Scopus; January 2010-July 2025; English language) targeting studies on females aged ≥18 years without intellectual or language impairment. Diagnostic accuracy, screening tools, camouflaging, misdiagnosis, and psychosocial outcomes were examined. Original research, meta-analyses, and systematic reviews were included, and a narrative synthesis approach was chosen due to study heterogeneity. Female-typical presentations often include subtle social-communication differences, context-specific restricted interests, and higher camouflage levels than males, which decrease the sensitivity of standard screening tools. Women are more likely to receive prior psychiatric diagnoses before ASD is recognized, contributing to mental health burdens and poorer functional outcomes. Current adult ASD screening tools have limited capacity to detect female phenotypes. Integrating camouflaging assessment, nuanced developmental histories, and updated, gender-inclusive screening instruments is essential to improving diagnostic equity.

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15. Eldridge LA, Agley J, Piatt J, Hamre K, Nord D. Treating Substance Use Disorder in Individuals With Intellectual Disability: A Regional System Capacity Assessment. Intellect Dev Disabil. 2025; 63(5): 384-400.

This mixed-methods study assessed substance use disorder (SUD) treatment for individuals with intellectual and developmental disabilities within California’s regional center system. The system is the primary organization in California that coordinates and monitors services for these individuals. Data were solicited from the 21 service centers in the system and six vendored programs overseeing SUD services. This article reports on those programs and analyzes qualitative data from seven service coordinators regarding overall SUD treatment. Both the programs and the coordinators identified 0barriers to treatment, such as a lack of training and inadequate service structures. Despite being formal referral targets, these programs often only offered adaptations for physical access. Proposed solutions included interagency collaboration and adopting a biopsychosocial model of care.

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16. Johnson KR, Mitchell S, Parkin R, Peak K, Chavis C, Cleveland S, Comer K, Cross C, Hawkins T, Ingram C, Johnson T, Jones A. Systemic Inequities in Health Care: Lessons Learned From Black People With IDD and Their Care Partners. Prog Community Health Partnersh. 2025; 19(3): 297-306.

BACKGROUND: Black people with intellectual and developmental disabilities (IDD) are disproportionately impacted by health disparities and endure distinctive systemic challenges as a result of their intersecting identities. OBJECTIVES: This manuscript describes a collaborative project between university researchers, people with IDD and their care partners, and providers to understand contextual and individual characteristics that influence equitable health services access and use. METHODS: The project follows a critical participatory action research approach to address issues of power and equity at the intersections of race, gender, and disability. Data collection strategies included individual semi-structured interviews and focus groups, as well as interactive activities to facilitate deeper discussion. LESSONS LEARNED: We describe strategies to manage challenges of delayed recruitment, power sharing, equitable and inclusive engagement, and dissemination. CONCLUSIONS: Lessons learned underscore the diverse experiential expertise of Black people with IDD, their care partners, and providers in the co-creation of knowledge, the importance of opportunities for partners from different stakeholder groups to cultivate relationships as part of the research process, co-reflexivity as instrumental to assessing and reassessing engagement processes in real time, and implementation of inclusive strategies for participation in dissemination activities.

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17. Kato S, Hanawa K, Linh VP, Saito M, Iimura R, Inui K, Nakamura K. Correction: Toward mapping pragmatic impairment of autism spectrum disorder individuals through the development of a corpus of spoken Japanese. PLoS One. 2025; 20(9): e0333589.

[This corrects the article DOI: 10.1371/journal.pone.0264204.].

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18. Kemere KJ, Appelbaum N, Chandan P, Acosta E. Community-Engaged Medical Student Elective to Improve Knowledge and Attitudes Toward Individuals With Intellectual and Developmental Disabilities. Cureus. 2025; 17(8): e91126.

Individuals with intellectual and developmental disabilities (IDD) face multiple barriers to inclusion throughout life. One barrier is the medical knowledge and biases of adult healthcare providers with diagnoses traditionally associated with childhood. Medical school curricula have limited content related to IDD, and students have limited opportunities to engage with community organizations during their clinical years. Methods: We created a one-month clinical elective to address medical students’ attitudes and knowledge regarding individuals with IDD using experiential learning. Students saw adult patients in our primary care clinic with a variety of IDD diagnoses and spent 30% of their time at community sites engaging with individuals with IDD in nonmedical settings. A survey of 38 attitudinal questions (Likert-scale) and a 48-item knowledge exam were administered before and after the elective. Results: Of the 47 participants, 42 (89%) completed the paired instruments between 2018 and 2022. Of the attitudinal items, nine resulted in a more positive direction post-elective (p < 0.05). Respondents indicated receiving adequate training so that they felt increased comfort, p < 0.001, r = 0.86 (large effect), and more competent to care for a person with IDD (p < 0.001, r = 0.85). Based on a composite score of a 48-question knowledge exam, post-scores were higher than pre-scores (p < 0.001) and Cohen's d = 0.90 (large effect). Conclusion: The creation and implementation of a medical student elective that combines clinical experience with community engagement had a significant impact on knowledge and attitudes toward individuals with IDD. Community engagement should be considered as a mechanism to enhance other clinical electives and break down attitudinal barriers.

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19. Loizou S, Beresford K, Baudinet J, Herrera-Gener P, Oregan D, Alford C, Tchanturia K, Stewart C. A pilot study investigating the acceptability and feasibility of a group intervention for parents of autistic young people with anorexia nervosa within a specialist eating disorders service. J Eat Disord. 2025; 13(1): 217.

BACKGROUND: Many children and young people presenting with anorexia nervosa will also be autistic. While autistic children and young people may have similar physical health outcomes compared to their neurotypical peers, they are more likely to experience poorer recovery, requiring more intensive treatments. Similarly, parents report needing additional support from mental health services. Parents may benefit from a group intervention as an adjunct to family therapy to help them effectively care for their children and to reduce the psychological impact this may have on them. This study aimed to provide an overview of the group intervention and evaluate its feasibility and acceptability. METHODS: Attendance rates were used to evaluate the feasibility of the group. Parents were invited to evaluate the acceptability of the group with brief quantitative measures each session. Individual qualitative interviews were conducted with six parents to evaluate both feasibility and acceptability. Recordings were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS: 17 parents (mothers n = 8, fathers n = 8, stepmother n = 1) from eight families took part in two pilot groups (group 1 n = 8, group 2 n = 9). Total attendance rate was 66.5%, with one parent from each family attending 85.7% of sessions. On average, sessions were rated highly relevant, useful and improved parents’ understanding of their child. From qualitative interviews conducted with six parents (group 1 n = 4, group 2 n = 2), two main themes were generated: (1) A space for connection and support, (2) From knowledge to practice. Parents spoke of the way the group helped them feel less isolated, gain skills and begin to practice implementing new learning at home. Not all aspects of the group were helpful, and recommendations were made regarding the resources, structure and intensity of the intervention. DISCUSSION: Findings suggest that the intervention is feasible and acceptable. This pilot study replicates previous findings about benefits of additional support for carers. The aim of the current study was to test a new group intervention aimed to support parents of autistic young people with anorexia nervosa. Parents rated each group session and were interviewed to gather feedback on their experiences of attending the group intervention. Most parents who took part in the interviews generally described the group as helpful, particularly in providing a sense of connection and identifying practical ways to support their autistic children with their eating. The positive feedback highlights the group’s potential value. Parents described several challenges to attending and fully engaging with the group, including work and caring commitments, and differences in relating to others who might have had different experiences. Suggestions to improve the group included developing and sharing electronic handouts and offering a follow-up session to reinforce the learning. Parents also felt the group would be more helpful if it was offered earlier in their child’s treatment. eng.

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20. Mandell DS. Why We Should Be Concerned About an Autism Registry. JAMA Pediatr. 2025.

This Viewpoint considers issues related to implementation of a nationwide autism registry. eng.

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21. Moser C, Adams R, Zheng S, Bishop S, Taylor JL. Brief Report: The Vocational and Educational Activities of Transition-Aged Autistic Youth With Low IQ. J Intellect Disabil Res. 2025.

BACKGROUND: Previous research has shown that autistic transition-aged youth with low IQ experience low rates of integrated employment and postsecondary education (PSE) enrolment. Notably, much of this work was conducted over a decade ago, and the landscape of opportunities has changed since that time. Therefore, the present study described the rate of involvement in vocational and PSE activities among a contemporary sample of autistic youth with low IQ residing in the United States. METHOD: Online survey responses were collected from 91 caregivers of autistic youth with low IQ residing in the United States. The survey gathered demographic information and assessed the behavioural functioning of the youth, along with their vocational and educational experiences. RESULTS: Thirty-five per cent of autistic youth with low IQ were not involved in any vocational/PSE activity. Approximately 15% of youth were participating in integrated employment (with or without supports), and 5% were enrolled in a range of degree- and non-degree-seeking PSE programmes. In a follow-up analysis, we found that youth who were engaged in vocational/PSE activities had higher family incomes, higher daily living skills, and lower rates of borderline-to-clinical levels of internalising and externalising behaviours than those who were not engaged in any vocational or PSE activity. CONCLUSIONS: Our findings indicate low participation (~20%) in integrated employment and PSE programmes, despite national efforts to increase these types of activities, and highlight the continued need to remove barriers that prevent engagement in vocational and PSE activities among autistic youth with low IQ.

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22. Mottron L, Lavigne-Champagne A, Bernhardt B, Dumas G, Jacquemont S, Gagnon D. Asymmetric developmental bifurcations in polarized environments: a new class of human variants, which may include autism. Mol Psychiatry. 2025.

Inspired by discrete stable alternative states that often coexist with the dominant phenotypes of a species, we propose that asymmetric developmental bifurcations (ADB) may provide a biological framework for grouping autism together with some human alternative organizations rather than with disorders or diseases. These include minority embryological or obstetrical variants, such as twinning and breech presentation, as well as minority information processing variants, such as left-handedness and importantly prototypical autism. Four common contextual, developmental, adaptive, and mechanistic features unify these alternative conditions as ADBs: 1) ADBs occur in a dynamic system formed by an individual and his environment with two polarized stable solutions. 2) The bifurcation occurs in a critical period of development and is significantly shorter than the stable states that precede and follow it. 3) While the frequent branch of the ADB optimizes evolutionary success, its rare branch has an adaptive cost, which is still compatible with survival. 4) Both rare and frequent branches of the ADB are human possibilities, favoured without major/deleterious changes by familial and/or sexual predispositions. Framing autism as a categorical, alternative phenotypic prototype in a polarized choice between social bias and its absence, elucidates autism’s recurrent divergence within the species, its developmental and information processing characteristics, and its adaptive challenges.

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23. Ni HC, Chien H, Yeh CH, Cheng M, Lin WC, Lin HY. Lateral Cerebellar Theta Burst Stimulation Can Modulate Default Mode Network Connectivity in Autistic Adults. Cerebellum. 2025; 24(6): 159.

Developing effective neuromodulation strategies for core autistic symptoms remains a critical need. The lateral cerebellum, implicated in socio-cognitive functions often affected in autism, represents a promising target for repetitive transcranial magnetic stimulation (rTMS), which has not yet been tested in this population. Here, we report a pilot investigation of the safety, feasibility, and network-level effects of one-session intermittent theta burst stimulation (iTBS, a variant of rTMS; 1200 pulses delivered at 80% active motor threshold with a 15-minute inter-train interval) targeting the right lateral cerebellum (Crus I/II) in 10 autistic adults (7 assigned male, 3 assigned female at birth, aged 19-30 years). All participants tolerated the protocol well, with no severe adverse events and a 100% retention rate. Resting-state functional MRI indicated a significant post-iTBS decrease in functional connectivity within the default-mode network and somatosensory motor network, while other networks remained unchanged. Moreover, idiosyncrasy in functional connectivity within the ventral attention, frontoparietal, default-mode and visual networks significantly decreased after iTBS. These findings suggest that cerebellar iTBS is safe and feasible for autistic adults and may acutely modulate multiple large-scale functional networks in their brain. Future multi-session, sham-controlled trials are warranted to validate these results and investigate whether repeated cerebellar stimulation yields sustained neurobiological or clinical benefits in autism.

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24. Raza R, Khan A. Comment on « Impact of AOC1 and HNMT Variants on the Therapeutic Outcomes of a Histamine Reducing Diet in Autism Spectrum Disorder ». J Mol Neurosci. 2025; 75(4): 128.

Kadiyska et al. recently investigated the impact of a histamine-reducing diet in children with autism spectrum disorder (ASD), with attention to potential modifying effects of AOC1 and HNMT gene variants. Although the study poses an important question, several design limitations may affect the certainty of its conclusions. The dietary intervention removed not only foods high in histamine but also gluten, dairy, sugar, and other items. Such broad restrictions can influence health and behavior on their own. This makes it difficult to determine whether the reported improvements were specifically the result of reduced histamine. The histamine cut-off chosen for participant selection was not explained or tied to clinical standards, which makes reproducibility less clear. In addition, some of the genetic results rested on very small numbers, at times a single child, reducing confidence in their reliability. Finally, histamine levels were not re-measured after the intervention, and the developmental outcomes were not fully explained in terms of clinical significance. Stronger evidence will require controlled diets, standardized thresholds, larger cohorts, and outcomes relevant to daily life.

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25. Saeed MA, Jaber OA, Lami F, Jasim SM, Nayeri ND, Sabet MS, Al-Gburi G. Awareness of autism spectrum disorder among public primary school teachers in Iraq. BMC Psychol. 2025; 13(1): 1075.

BACKGROUND: Primary school teachers play a vital role in detecting children with autism spectrum disorder (ASD), thereby allowing early interventions that enhance their quality of life and reduce the burden. This study aims to estimate the awareness levels of Iraqi primary school teachers regarding ASD and assess the association with the teachers’ demographic factors. METHODS: A descriptive study was conducted among primary school teachers affiliated with the Rusafa 1 educational directorate of Baghdad from March 21, 2024, to June 1, 2024, using a structured questionnaire developed by reviewing the DSM-5 criteria for ASD and JM Rey’s IACAPAP Textbook of Child and Adolescent Mental Health. RESULTS: A total of 301 teachers were included. Of whom, 86 (28.6%) had inadequate awareness, with higher scores demonstrated among teachers who had previous contact with ASD children (Ɛ(2) = 0.046, 95% CI = 0.009 to 0.092, Adjusted p < 0.05) or used workshops as a source of information (r = 0.169, 95% CI = 0.048 to 0.275, Adjusted p < 0.05). However, no significant correlation was found with work experience (r = -0.073, adj. p-value = 0.373). Teachers were more likely to recognize repetitive behaviors (79.1%) and inappropriate attachment to toys (72.4%) as symptoms compared to lack of good verbal communication (60.1%). Furthermore, 241 (80.1%) correctly identified the benefits of early diagnosis. However, 215 (71.4%) still believed that ASD can be completely cured. CONCLUSION: Around a quarter of teachers have a limited understanding of ASD, with common misconceptions in identifying risk factors, signs and symptoms, and treatment outcomes. These findings may support future educational initiatives and policy changes, potentially playing a role in ensuring early identification and timely referrals for these children. CLINICAL TRIAL NUMBER: Not applicable.

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26. Selick A, Campitelli MA, Huang A, Balogh R, Kurdyak P, Lunsky Y. Long-Stay Psychiatric Inpatients With and Without Intellectual and Developmental Disabilities: An Ontario Population-Based Study: Patients hospitalisés pour de longs séjours en psychiatrie avec ou sans déficiences intellectuelles et développementales,: Une étude fondée sur la population de l’Ontario. Can J Psychiatry. 2025: 7067437251380731.

ObjectivePatients with intellectual and developmental disabilities (IDDs) and psychiatric disorders are at higher risk for prolonged hospitalisations. The aim of this study was to examine the prevalence of IDD among long-stay inpatients in Ontario psychiatric beds, and compare the demographic and clinical profiles of long-stay inpatients with and without IDD.MethodsThis Ontario population-based cross-sectional study used linked health administrative databases. All patients over 18 years of age occupying a non-forensic psychiatric inpatient bed in Ontario on September 30th, 2023 were included in the analysis. We examined prevalence of IDD among patients with a length of stay (LOS) ≥ 365 days (‘long-stay patients’). Standardised differences were used to compare demographic, clinical, functional, and health care utilisation characteristics between patients with and without IDD.ResultsOf the 1,466 long-stay patients in an Ontario non-forensic psychiatric inpatient bed, 22.0% had IDD. They were younger (mean age 44.3 vs. 47.6) and a higher proportion were male (64.3% vs. 50.1%). In the 2 years prior to admission, a higher proportion of long-stay patients with IDD had a psychotic disorder (73.3% vs. 54.0%), and they had a higher median number of ED visits (5 vs. 3). Long-stay inpatients with IDD were more likely to have difficulty with activities of daily living (39.8% vs. 15.0%), moderate/severe cognitive impairment (63.0% vs. 29.9%) and fewer social contacts in place to support discharge (59.3% vs. 48.6%). While in hospital, a greater proportion of long-stay patients with IDD were subject to restraints (12.4% vs. 8.0%) and seclusion (20.2% vs. 11.2%).ConclusionsAdults with IDD account for more than one in five long-stay psychiatric inpatients and have unique needs including greater cognitive impairment and difficulty caring for themselves. Successful transitions out of hospital require specialised resources and cross-sectoral collaboration. A closer look at patients with and without developmental disabilities with lengthy hospitalisations. eng.

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27. Sperling J. « She Like, Sugarcoats Things »: Maternal Influence on Sexual (in)Agency of Young College Women With Disabilities. Intellect Dev Disabil. 2025; 63(5): 401-13.

By amplifying the voices of young college women with intellectual and developmental disabilities, this study explores the intersections of disability, gender, sexuality, and higher education. It highlights how maternal socialization shapes their sexual knowledge prior to college, revealing that mothers often leave their daughters misinformed, disempowered, and dependent, even into adulthood. The study also addresses how persistent taboos and embodied avoidance strategies, such as euphemisms and gestures, limit these women’s agency and reflect constrained communication patterns from their upbringing. The findings underscore the crucial role of mothers in their daughters’ sexual self-determination and advocate for tailored resources to support both mothers and their daughters, aiming to enhance sexual autonomy and education for women with disabilities.

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28. Unholz-Bowden EK, Wu Y, Nyce A, Abery BH, Anderson LL. Technology Access, Utility, and Unmet Needs: Results From the Arc’s FINDS Survey. Intellect Dev Disabil. 2025; 63(5): 370-83.

Technology can enhance the quality of life of people with intellectual and developmental disabilities (IDD). However, little is known about the extent to which it is accessible to and useful for people with IDD and their caregivers from different backgrounds. A secondary analysis was conducted using 3,113 caregiver responses from the Arc’s Family and Individual Needs for Disability Supports Survey to explore associations between technology access, utility, unmet needs, and various demographic characteristics of individuals with IDD and their families. Overall, reports of family members with IDD being older, employed, having more education, less health-related needs, and greater access to state-based services were associated with technology being reported as accessible and useful. Implications for research, practice, and policy are discussed.

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29. Walters I, Malcolmson C, Potashner R, Nelson C, Cho R. Pseudothrombotic microangiopathy resulting from severe vitamin B12 deficiency in a pediatric patient with autism: A case report. SAGE Open Med Case Rep. 2025; 13: 2050313×251377265.

Vitamin B12 deficiency is typically characterized by megaloblastic anemia, but can also rarely present with pseudomicroangiopathic hemolytic anemia or multilineage cytopenias secondary to dyserythropoiesis and apoptotic cell death. We describe a 12-year-old male with autism spectrum disorder who presented with fever, night sweats, and weight loss. Laboratory testing identified severe neutropenia and hemolytic anemia, and an undetectably low vitamin B12 level. Dietary history confirmed significant food restriction over the preceding 6 months. He received 1000 µg of intramuscular vitamin B12 daily for 7 days and subsequently transitioned to oral therapy. His hemoglobin, hemolytic markers, and neutrophil count normalized within 13 days of vitamin B12 initiation. Our report describes a rare and severe manifestation of vitamin B12 deficiency in a patient with autism spectrum disorder and emphasizes the importance of screening for micronutrient deficiencies among vulnerable pediatric populations to avoid unnecessary and invasive testing.

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30. Wang HFW, Smith SS, O’Flaherty M, Trost SG, Thomas G, Walker JL, Fortnum K, McNaughton S, Cairney J, Bourke M. Associations Between Screen Time, Sleep Quality, Diet Quality and Food Selectivity Among School-Aged Autistic Children. J Autism Dev Disord. 2025.

PURPOSE: Autistic children are more likely to experience challenges with poor diet quality or selective eating behaviours in comparison to neurotypical peers, which may predispose them to nutrient deficiencies and suboptimal weight status. Thus, it is crucial to identify factors associated with these two unfavourable dietary behaviours in autistic children. This cross-sectional study examined the associations between screen time and sleep quality with diet quality and food selectivity among autistic children, and the extent to which screen time was indirectly associated with diet quality and food selectivity through sleep quality. METHOD: The parents of 628 autistic children aged 7-12 years in Australia reported on their child’s screen time, sleep quality, diet quality and food selectivity via an online questionnaire. RESULTS: Structural equation modelling of the hypothesised mediation model revealed significant associations between screen time and sleep disturbances (β = 0.118, 95%CI = 0.032, 0.204, p = .007), and between sleep disturbances with lower diet quality (β = -0.077, 95%CI = -0.153, -0.001, p = .047) and higher food selectivity (β = 0.198, 95%CI = 0.119, p < .001). Sleep disturbances only weakly explained the indirect association between screen time and food selectivity (β = 0.023, 95%CI = 0.004, 0.043, p = .018), whereas the indirect association between screen time and diet quality through sleep disturbances was non-significant (β = -0.009, 95%CI = -0.020, 0.002, p = .110). CONCLUSION: Higher screen time and poor sleep quality emerged as significant factors associated with unfavourable dietary behaviours among autistic children.

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31. Wang L, Yuan C, He J, Jiang B. Acquisition of Digital Literacy Skills in Learners With Developmental Disabilities. Intellect Dev Disabil. 2025; 63(5): 428-40.

Learners with developmental disabilities often encounter difficulties in performing daily activities that involve digital platforms, operating systems, applications, and other digital tools. Considering the growing importance of digital literacy, we examined the effectiveness of the clustered forward chaining (CFC) procedure in teaching digital transaction skills to three adolescents with intellectual and developmental disabilities (IDD). In the context of a multiple-baselines-across-skills design with between-participant replications, we taught participants four digital transaction tasks. The results showed that all participants acquired the four tasks during CFC and maintained their performance post-intervention. Two participants completed the intervention before all clusters were targeted, possibly due to observational learning and continuous performance probes. Furthermore, both the participants and the instructors found CFC to be an acceptable intervention for teaching digital literacy.

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