1. Aarthi D, Kannimuthu S. Hybrid deep learning model for autism spectrum disorder diagnosis. Sci Rep. 2025; 15(1): 44707.

Autism spectrum disorder (ASD) is a neurodevelopmental condition pertaining to the communication, social connectivity and conduct of individuals. ASD individuals develop symptoms such as recurrent actions, atypical facial expressions and challenges in social engagement. ASD prediction depends on various measures such as functional Magnetic Resonance Imaging (fMRI) data, game-based assessments, kinematic traits, questionnaires, head activity analysis, motor activities and eye-tracking. Traditional diagnostic approaches are subjective. These approaches are clinician-dependent and time-consuming. This has resulted in various challenges for the early detection of the condition. This work evaluated the performance of five hybrid approaches such as MobileNetV2+BiLSTM, ResNet50+LSTM, EfficientNetB4, InceptionV3 and MobileNetV2+GRU. Each model was meticulously refined to achieve optimal performance on the facial image dataset obtained from the Kaggle repository. The hybrid MobileNetV2+GRU model showed high performance with 95.5% test accuracy, 95.94% precision, and 95.45% F1-score. When the suggested hybrid model was compared with the remaining models, the latter outperformed with a ROC value of 98%. The findings highlight the optimal performance and generalizability of the proposed MobileNetV2+GRU model in ASD diagnosis in children.

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2. Alodaili MSM, Cornejo LTO, Saleh KA, Alrashedi H, Alrubaiee GG, Almoliky MA, Alqalah TAH, Alkubati SA. Quality of life of caregivers of children with autism spectrum disorder in Saudi Arabia. J Pediatr Nurs. 2025; 86: 709-16.

BACKGROUND: Caregivers of children with autism spectrum disorder (ASD) often experience significant emotional, physical, financial, and social challenges that influence their quality of life (QoL). In Saudi Arabia, the impact of caregiving within culturally distinct family structures remain underexplored. OBJECTIVE: To assess the caregivers QoL with ASD in Saudi Arabia and to analyze how demographic factors affect the QoL across the four domains of the WHOQOL-BREF. METHODS: A descriptive cross-sectional study was conducted between March and May 2025 among 302 caregivers recruited from autism centers and online groups. The validated WHOQOL-BREF was used to assess physical, psychological, social, and environmental domains. Data were analyzed using SPSS v25 with descriptive statistics, independent t-test, ANOVA, multiple regression analyses, and Pearson correlation. RESULTS: Caregivers scored lowest in physical health (M = 2.67, 41.8/100), while social relationships scored highest (M = 2.94, 48.5/100). Female caregivers had significantly lower physical QoL than male (p = 0.011; d = 0.36, 95 % CI: 0.12-0.60). Moderate positive correlations were found between physical and psychological health (r = 0.31, p < 0.001). The socioeconomic status and employment positively predicted QoL across domains. CONCLUSION: Caregivers, particularly women, experience poorer physical and psychological well-being. Findings underscore the need for gender-responsive, family-centered nursing interventions that integrate psychological support and community resources. IMPLICATIONS FOR PRACTICE: Pediatric nurses should incorporate caregiver burden screening, psychoeducation, and referral pathways into ASD care plans to enhance overall family health.

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3. Balaum R, Elbedour L, Alhozyel E, Meiri G, Zigdon D, Michaelovski A, Kerub O, Menashe I. Head Growth Trajectories During the First Year of Life and Risk of Autism Spectrum Disorder. Autism Res. 2025.

Atypical infant head circumference (HC)-including increased rates of macrocephaly and microcephaly-has been linked to autism spectrum disorder (ASD). However, specific head growth trajectories associated with ASD remain poorly defined. This retrospective case-control study aimed to delineate these trajectories and examine their relationship to height. The study sample included 262 children diagnosed with ASD and 560 matched controls. Growth measures at 1, 2, 4, 6, 9, and 12 months of age were obtained from health clinics in southern Israel. The sample was classified into seven clusters based on HC patterns across these six time points, and associations with ASD were estimated using conditional logistic regression. Results demonstrated significant correlations between HC and height throughout the study period (Pearson correlation r = 0.44-0.55, p < 0.001), with stronger correlations in ASD (r = 0.50-0.67) compared to controls (r = 0.32-0.50). Children with consistently small or large HC exhibited the highest ASD likelihood (adjusted odds ratio [aOR] = 2.95, 95% CI = 1.88-4.94; and aOR = 3.17, 95% CI = 1.92-5.01, respectively), with the most extreme percentiles (0-5th and 95th-100th) showing the strongest associations (aOR = 9.53, 95% CI = 2.49-35.26; aOR = 6.51, 95% CI = 2.91-15.35, respectively). These associations were primarily driven by children with similar height trajectories (aOR = 7.71, 95% CI = 3.23-15.43; and aOR = 6.89, 95% CI = 2.99-13.26, respectively), indicating that atypical HC growth in ASD during infancy may reflect broader physiological growth dysregulation. This study explored the link between head size and autism spectrum disorder (ASD) in infants. Head and height growth of 262 children with ASD and 560 children without ASD were examined, using data collected from health clinics in southern Israel. We grouped infants based on their growth patterns during the first year of life and found that children with head sizes at the low or high end of the growth chart were more likely to have ASD, especially when their height followed the same pattern. These results suggest that unusual head growth may be part of an overall growth difference in some infants with ASD. eng.

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4. Benallie KJ, McClain MB, Schwartz SE, Davis G, Lopez A. The impact of autism and ADHD symptomology and cognitive functioning on executive functioning in autistic children. Child Neuropsychol. 2025: 1-22.

Children with ADHD, autism, and/or IDD often demonstrate EF challenges. Many children with these conditions likely demonstrate overlapping and differing EF presentations and profiles of strengths and difficulties. The extant literature investigating the impact of co-occurring ADHD and IDD on the EF of autistic children is limited and contradictory, potentially due to varying levels of symptom severity, undiagnosed co-occurring ADHD and ID, and overlapping areas of EF. Consequently, we examine how autism symptomology, ADHD symptomology, and cognitive functioning predict the EF of autistic children. Participants were 65 autistic children between the ages of 6 and 17 years and their caregivers. Multilevel modeling was used to determine the impact of ADHD symptom severity, autism symptom severity, and cognitive functioning on the EF of children with autism. Aspects of ADHD symptomology – specifically hyperactivity – and autism symptomology – namely social communication difficulties – had a significant and positive relation with EF functioning. After controlling for hyperactivity and social communication skills, there were significant differences in EF domains with emotion regulation being the most negatively impacted. The severity of ADHD and autism symptoms is positively related to EF difficulties in autistic children. Specifically, greater levels of hyperactivity and social communication difficulties predict more EF challenges. Emotion regulation appears to be the EF skill most impacted. A significant association between cognitive functioning and EF was not found in this sample.

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5. Bullen JC, Lerro LS, Hesse T, Zajic MC, McIntyre N, Mundy P. Sensory Processing Modalities and Their Associations With Academic Achievement in Autism and Attention Deficit/Hyperactivity Disorder. J Autism Dev Disord. 2025.

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6. Casella E, Depovere J, Delger C, Butynets M, Antczak P, Price T, Jirtle RL, Murphy SK, Hoyo C, Soubry A. Age-specific DNA methylation alterations in sperm at imprint control regions may contribute to the risk of autism spectrum disorder in offspring. Aging (Albany NY). 2025; 17(12): 2950-88.

Research findings suggest that advanced paternal age is associated with an increased risk of autism spectrum disorder (ASD) in children. The biological process behind this father-to-child inheritance of a disease may be driven by sperm epigenetic marks. This has been suggested earlier, but the identification of epigenomic regions responsible for these age-related responses have not been further elaborated. To identify sperm-specific marks, we conducted an epigenome-wide association study in sperm from 63 men, using the Illumina 450K array. Linear regression modeling was applied to identify differentially methylated CpGs (DMCs) by age; we controlled for body mass index, patient status, and multiple testing. We found 14,622 statistically significant age-related DMCs; most (69%) were inversely correlated. We identified 95 imprinted genes and emphasized 747 age-related DMCs adjacent to an imprint control region (ICR). Altered methylation patterns in ICRs may result in disturbed expression of imprinted genes and are suspected to be at the origin of several diseases in offspring, including neurodevelopmental disorders. Mapping our results to other databases revealed the following set of imprinted genes linked to ASD: OTX1, PRDM16, PTPRN2, B4GALNT4, KCNQ1, KCNQ1OT1, DLGAP2, PLAGL1, GNAS, GRB10, MAGEL2, CDH24, and FBRSL1. Further research on these genes could help understand the contribution of paternal age on the development of autism. A change in DNA methylation levels in ICRs before conception may contribute to the heterogeneity and complexity of ASD. Measured DNA methylation effect sizes were subtle, but small epigenetic disturbances in sperm may be important on a population level, especially if men continue delaying fatherhood. Public health would benefit from the development of preventive and educational programs.

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7. Ciric T, White LC, Allison-Duncan C, Maloney E, Gillespie-Smith K. ‘It’s quite difficult to put Autistic relationships in a box’: A qualitative exploration of romantic relationships in gender and sexually diverse Autistic adults. Autism. 2025: 13623613251407765.

Autistic people enjoy friendships and sexual and romantic relationships. Many Autistic people are also part of a gender or sexual minority, yet gender and sexual minorities are often under-represented in autism research. The current study asked, ‘How do gender and sexually diverse Autistic adults experience and perceive romantic relationships?’ Sixteen gender and/or sexual minority Autistic adults took part in semi-structured interviews. Interviews were transcribed and analysed using thematic analysis. Four main themes were identified from the interview data: (1) ‘It’s Quite Difficult to Put Autistic Relationships Into a Box’, (2) Challenging Social Norms, (3) The Perks and Perils of Online Dating and (4) Understanding and Neurotype. Overall, participants described their relationships as individual, inherently valuable and shaped by unique preferences, mutual understanding and explicit communication. They also emphasized the fluidity between friendships and romantic partnerships, the importance of mutual understanding and the inherent value of rejecting prescriptive social norms in favour of individualized romantic relationship dynamics. These findings highlight relationship structures in Autistic groups who identify as gender and/or sexual minority.Lay abstractAutistic people enjoy friendships and sexual and romantic relationships. A proportion of the Autistic community identify as being a part of a gender and sexual minority (e.g., trans, non-binary, gay, lesbian, etc.), yet this group is often under-represented in autism research. The current study focused on this group specifically and asked them, ‘How do gender and sexually diverse Autistic adults experience and perceive romantic relationships?’ Sixteen gender and/or sexual minority Autistic adults took part in interviews. Interviews were transcribed and analysed using thematic analysis. Four main themes were identified from the interview data: (1) ‘It’s Quite Difficult to Put Autistic Relationships Into a Box’, (2) Challenging Social Norms, (3) The Perks and Perils of Online Dating and (4) Understanding and Neurotype. The participants described their relationships as individual, valuable and shaped by unique preferences, mutual understanding and clear communication. They also talked about how the lines between friendships and romantic partnerships can be blurred, for example, sometimes they have sex with their friends and don’t see this as an activity exclusively for romantic relationships. They also mentioned the importance of mutual understanding and the inherent value of rejecting social norms in favour of more individualized romantic relationships.

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8. de Lima AFB, Fernandes AC, Soares AAR, Leite HR, de Sousa Junior RR. Instruments assessing mobility of children and adolescents with autism spectrum disorder: A systematic review and decision map. Dev Med Child Neurol. 2025.

AIM: To identify the standardized instruments used to assess mobility aspects in children and adolescents with autism spectrum disorder (ASD), analyse the quality of their psychometric properties and their level of evidence, and develop a clinical decision map for these instruments. METHOD: Articles were screened and study characteristics were extracted. The methodological quality of the selected studies was analysed using the COSMIN Risk of Bias checklist. The quality of evidence for each measurement property was defined using a modified version of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: Eleven instruments were analysed in 11 studies. Of these instruments, three are directed towards performance assessment and eight towards capacity assessment. The selected studies evaluated the psychometric properties of Vineland Adaptive Behavior Scales, Gross Motor Assessment of Children and Adolescents with Autism Spectrum Disorder, Ignite Challenge, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, Miller Function and Participation Scales, Peabody Developmental Motor Scales, Second Edition, Test of Gross Motor Development, Second and Third Editions, Timed Up and Go, Developmental Coordination Disorder Questionnaire, and Movement Assessment Battery for Children, Second Edition. Of these instruments, nine were developed for the evaluation of typically developing children and children with disabilities, and have been validated for the population with ASD (81.8%). The other two instruments (18.2%) were specifically developed for the evaluation of the population with ASD. INTERPRETATION: Most (56.51%) of the measurement properties of the instruments demonstrated low or very low evidence because of risk of bias and imprecision, reinforcing the importance of further studies to strengthen the validity and applicability of these assessments.

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9. de Lima AFB, Fernandes AC, Soares AAR, Leite HR, de Sousa Junior RR. Instrumentos que avaliam a mobilidade de crianças e adolescentes com transtorno do espectro autista: Uma revisão sistemática e mapa de decisão. Dev Med Child Neurol. 2025.

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10. Ding Y, Li Z, Zou Y, Dong X. A DeepSeek cross-modal platform for personalized art education in Autism Spectrum Disorder. Sci Rep. 2025; 15(1): 44800.

Educational inequity in arts learning disproportionately marginalizes students with Autism Spectrum Disorder (ASD), who require structured, predictable environments for aesthetic development and sensory regulation that traditional pedagogies fail to provide. This study introduces an AI-powered e-learning platform that addresses these systematic barriers through intelligent cross-modal integration, democratizing access to personalized art education for neurodivergent learners. Our DeepSeek-based system transforms visual art features into structured musical accompaniments that accommodate individual sensory processing patterns, cultural backgrounds, and neurodevelopmental profiles while maintaining the predictability essential for ASD learning success. The platform employs enhanced ResNet-50 architecture, high-dimensional manifold mapping, and conditional generation models specifically optimized for sensory regulation principles. Comprehensive evaluation with 203 participants (including 53 neurodivergent learners) and 19 autism education specialists demonstrates substantial improvements: sensory comfort ratings of 4.6/5, learning satisfaction of 4.3/5, and educational outcomes showing 20.5% NAEP score improvements compared to 8.2% for traditional methods (p < 0.008). Technical performance achieved superior cross-modal consistency (MSE 0.05, PCC 0.92) with 89% accommodation success across diverse sensory profiles. This research offers a promising model for inclusive digital education by demonstrating how AI can contribute to mitigating educational inequities for neurodivergent populations. It provides a scalable framework that advances accessible arts education, embracing neurodiversity while maintaining academic rigor.

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11. Francés Soriano L, Iglesias Huguet A, Andrés Tauler JM, Morey Cañellas J, Soler Gost CV, Jiménez Motilla S, Rodríguez-Quiroga A, Quintero M, Quintero J. Potential use of propranolol in autism spectrum disorder: A narrative review. J Psychopharmacol. 2025: 2698811251399567.

RATIONALE: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social communication difficulties and restricted, repetitive behaviors. Although several pharmacological agents have been trialed, treatments for core features remain limited. Propranolol, a non-selective β₁/β₂-adrenoceptor antagonist (β-blocker, NbN), has shown potential effects across multiple ASD-related domains. METHODS: A narrative review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses principles. Systematic searches in PubMed, Scopus, ScienceDirect, and ProQuest identified 22 studies, of which 15 were included, comprising randomized controlled trials, single-dose psychopharmacological challenge studies, and reviews. RESULTS: Evidence suggests that propranolol may improve social anxiety, verbal problem-solving, cognitive flexibility, emotional regulation, and behavioral dysregulation. Benefits of facial scanning and verbal fluency have also been described. The drug may attenuate adrenergic hyperarousal and promote parasympathetic dominance. However, most positive findings derive from small samples or single-dose studies, while sustained double-blind trials are scarce. Polypharmacy contexts remain underexplored. DISCUSSION: Propranolol may serve as an adjunctive therapy in selected ASD cases, particularly when other strategies are insufficient. Its central nervous system penetration and anxiolytic profile support potential clinical use. Emerging evidence suggests that autonomic biomarkers and pharmacogenetic factors (e.g., CYP2D6, ADRB1/2 polymorphisms) could inform patient selection. CONCLUSIONS: Propranolol shows promise in modulating adrenergic activity relevant to several ASD symptom domains. The most consistent evidence supports anxiolytic effects under sustained dosing, whereas cognitive and behavioral findings remain preliminary. Larger, placebo-controlled trials with biomarker integration are needed to clarify efficacy, long-term safety, and clinical positioning. Until then, its use should remain cautious and highly individualized.

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12. Furnier SM, Gangnon R, Durkin MS. Trends Over Time in the Prevalence of Autism by Adaptive and Intellectual Functioning Levels. Autism Res. 2025.

The autistic community is a large, growing, and heterogeneous population, and there is a need for improved methods to describe their diverse needs. Measures of adaptive functioning collected through public health surveillance may provide valuable information on functioning and support needs at a population level. We aimed to use adaptive behavior and cognitive scores abstracted from health and educational records to describe trends over time in the population prevalence of autism by adaptive level and co-occurrence of intellectual disability (ID). Using data from the Autism and Developmental Disabilities Monitoring Network, years 2000 to 2016, we estimated the prevalence of autism per 1000 8-year-old children by four levels of adaptive challenges (moderate to profound, mild, borderline, or none) and by co-occurrence of ID. The prevalence of autism with mild, borderline, or no significant adaptive challenges increased between 2000 and 2016, from 5.1 per 1000 (95% confidence interval [CI]: 4.6-5.5) to 17.6 (95% CI: 17.1-18.1) while the prevalence of autism with moderate to profound challenges decreased slightly, from 1.5 (95% CI: 1.2-1.7) to 1.2 (95% CI: 1.1-1.4). The prevalence increase was greater for autism without co-occurring ID than for autism with co-occurring ID. The increase in autism prevalence between 2000 and 2016 was confined to autism with milder phenotypes. This trend could indicate improved identification of milder forms of autism over time. It is possible that increased access to therapies that improve intellectual and adaptive functioning of children diagnosed with autism also contributed to the trends. Autism has become more common over time, especially since the early 1990s. Between 2000 and 2016, the frequency of autism among 8 year‐old children in the United States nearly tripled. During the same time period, the proportion of autistic children with significantly below average intellectual functioning decreased. We found that all of the increase in autism frequency between 2000 and 2016 was for autism with mild or no significant adaptive challenges. Also, the frequency of autism with the highest level of adaptive challenges declined slightly during this time. These findings may be due to improved recognition over time of autistic children with few adaptive challenges. They could also indicate improvements over time in the functioning of autistic children due to better access to effective therapies. eng.

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13. Gaever MV, Eggers K. Adults with Autism Spectrum Disorder Demonstrate Increased Disfluency in Spontaneous Speech but Not in Reading. Int J Lang Commun Disord. 2026; 61(1): e70184.

PURPOSE: This study aimed to analyse the frequency and types of disfluencies in spontaneous speech and reading among adults with autism spectrum disorder (ASD) compared to neurotypical adults. METHOD: The participants were 56 Dutch-speaking adults, 28 with ASD and 28 age- and gender-matched controls. Samples of spontaneous speech and text reading were orthographically transcribed, and the speech disfluencies were identified and classified, using an expanded version of the Illinois Disfluency Classification System. The frequencies of stuttering-like disfluencies (SLDs), other disfluencies (ODs), word-final disfluencies (WFDs), and total disfluencies (TDs) were calculated. RESULTS: Adults with ASD exhibited significantly more SLDs and WFDs in spontaneous speech than the control group. While no statistically significant differences were observed between both groups in reading, a trend towards increased WFDs was noted. CONCLUSIONS: Adults with ASD exhibit increased speech disfluencies, more specific SLDs and WFDs, in spontaneous speech, than neurotypical adults, but not during reading. This discrepancy may arise because spontaneous speech requires real-time language formulation and social communication skills, which can differ in ASD, whereas reading offers an external linguistic structure that reduces cognitive and social processing demands. Increased speech disfluencies may impact how speech is perceived in terms of intelligibility and/or social communication dynamics. WHAT THIS PAPER ADDS: What is already known on this subject Individuals with autism spectrum disorder (ASD) often exhibit challenges in pragmatic language use along with varying abilities in vocabulary, grammar and speech production. Concerning the latter, a limited body of research has identified specific characteristics of speech fluency in individuals with ASD, including a higher frequency of speech disfluencies and the occurrence of word-final disfluencies. What this study adds to the existing knowledge However, research on speech disfluency in people with ASD remains all in all limited. To date, only two studies have conducted an in-depth analysis of disfluency types using an elaborate classification system such as the Illinois Disfluency Classification System, both incorporating neurotypical control groups. One study focused on English-speaking school-aged children and the other on Finnish-speaking young adults. As these studies are confined to two linguistically distinct populations and based on similar speech sample types, the generalizability of their findings to other languages and speech samples remains uncertain. In the current study, we analysed the speech disfluency of Dutch-speaking adults with ASD, with a broader age range. In addition to the analysis of spontaneous speech, also a standard reading text was included to evaluate the impact of sample type. This study therefore extends the existing database and provides further insights into the types and frequency of speech disfluencies in adults with ASD. What are the potential or actual clinical implications for this work? Increased speech disfluencies can affect the speech intelligibility and/or social interaction of adults with ASD. Moreover, the integration of a more detailed analysis of disfluencies in individuals with ASD as part of a broader overall assessment might optimize the diagnostical and clinical decision-making process.

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14. Gao L, Hou Y, Dong X, Wang C, Cui D, Guo X. Sex heterogeneity of functional brain network dynamics in autism spectrum disorder based on the high-amplitude co-fluctuation analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2025: 111604.

Autism spectrum disorder (ASD) is a neurodevelopmental condition exhibiting marked sex heterogeneity in functional connectivity. Given that high-amplitude co-fluctuation patterns dominate whole-brain functional connectivity, this study investigated sex heterogeneity in these patterns in ASD from the perspective of temporal variability. Resting-state functional magnetic resonance imaging data were obtained from the Autism Brain Imaging Data Exchange database, comprising 284 males/65 females with ASD and 340 male/119 female typical controls. High-amplitude co-fluctuation patterns were obtained using an edge time series analysis, and temporal variability of intra-network and inter-network functional architecture was calculated to characterize functional brain network dynamics. A two-way analysis of variance was further conducted to explore sex heterogeneity of functional brain network dynamics in ASD. At the intra-network level, significant diagnosis-by-sex interactions were observed in the default-mode network (DMN), salience network (SAN), cingulo-opercular network (CO), motor and somatosensory network (SMN), subcortical network (SUB), and visual network (VN). In ASD, sex differences in temporal variability were reduced in the DMN, SMN, and VN, increased in the CO and SUB, and an additional sex difference emerged in the SAN relative to controls. In contrast, at the inter-network level, all brain networks showed varying degrees of diagnosis-by-sex interaction effects. Moreover, network-level functional connectivity dynamics predicted the severity of social interaction impairments in females with ASD and social communication impairments in males with ASD, respectively. These findings reveal the sex heterogeneity of functional brain network dynamics in ASD, and highlight the potential role of altered high-amplitude co-fluctuations in the sex-specific neural mechanism underlying ASD.

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15. Grant Tejada MP, Klomhaus AM, Ortiz R, Tibbe TD, Nwaobi SE. Migraine prevalence and phenotype in autism: A retrospective cohort study using a US National Health Survey and large academic health system electronic health record. Headache. 2025.

OBJECTIVE: We analyzed data from both a national survey and a single hospital system to determine the prevalence of migraine in individuals with autism as well as identify sociodemographic and clinical characteristics associated with migraine in individuals with autism. BACKGROUND: Few studies have examined the prevalence of migraine in autism and there are no studies examining the migraine phenotype and clinical features associated with migraine in autism. METHODS: This retrospective cohort study used two databases-the National Survey of Children’s Health (NSCH) and the University of California Los Angeles hospital system electronic health record (UCLA EHR). NSCH survey data from 2018, 2019, 2020, and 2021 (data collection period for each year is June to January; e.g., NSCH 2021 period is June 2021 to January 2022; N = 50,892) were queried to identify cohorts based on responses to two survey questions identifying the presence of frequent/severe headache and autism. For UCLA cohorts, patients (12/01/1979-4/16/2023, N = 4,334,162) were queried for migraine and autism based on the International Classification of Diseases diagnosis codes. We tested the hypothesis: Headache/migraine occurs more frequently in individuals with autism versus without autism. Variables including social determinants of health (SDoH) and co-occurring illnesses were compared between autism with versus without headache/migraine. RESULTS: Headache and migraine prevalence was higher in individuals with autism versus those without (2021 NSCH-headache % [95% confidence interval {CI}], 7.1% [4.62-9.56] vs. 3.0% [2.62-3.19], p < 0.001 and UCLA-migraine: 3.1% [2.86-3.43] vs. 2.0% [1.97-1.99], p < 0.001). Among those with autism, the presence of headache/migraine was associated with increased odds of adverse childhood experiences such as bullying (NSCH-'Weekly/Almost daily' bullying aOR = 5.93 [2.01-17.50], p = 0.001, 'Never' reference) and being a victim of violence (NSCH-'Yes' aOR = 2.82, [1.19-6.66], p = 0.018), poor general health (NSCH-'Fair/Poor' health aOR = 9.68, [3.01-31.19], p < 0.001, 'Excellent' reference), mood disturbances, including anxiety (NSCH-'Yes' aOR = 4.50, [1.63-12.41], p = 0.004; UCLA aOR = 3.40, [2.78-4.17], p < 0.001), and depression (NSCH-'Yes' aOR = 5.70, [2.50-12.97], p < 0.001; UCLA aOR = 3.76, [3.08-4.60], p < 0.001), as well as increased rates of concussion (NSCH-'Yes' aOR = 9.05, [3.19-25.66], p < 0.001; UCLA aOR = 10.28, [6.91-15.30], p < 0.001). CONCLUSIONS: Headache/migraine occurs at higher rates in individuals with autism and is associated with increased odds of negative SDoH and clinically relevant co-occurring illnesses. This study highlights the importance of migraine screening in individuals with autism. Future work is needed to understand the burden and impact of migraine in autism. Autism is associated with altered sensory processing, including pain perception, but few studies have evaluated headache and/or migraine in autism. In this study, we observed increased rates of migraine in individuals with autism compared to those without. Among those with autism, the presence of headache/migraine was associated with increased odds of adverse childhood experiences, poor health, and concussion, suggesting that these may be important directions for future research on the interaction between migraine and autism. eng.

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16. Hoffmann LV, Silva E, Castro K, Roman L, Costa LP, Luçardo J, Roman E, Vaucher R, Giongo J, Flores da Cruz PH, Cunha DB, Valle S, Vaz JDS. Dietary Patterns and Serum Lipid Profile in Children and Adolescents with Autism Spectrum Disorder. Br J Nutr. 2025: 1-32.

Autism Spectrum Disorder (ASD) has been frequently associated with an increased risk of obesity and metabolic disorders, including dyslipidaemia. However, research on lipid profiles and dietary intake in this population remains scarce. This cross-sectional study aimed to evaluate dietary patterns and their association with serum lipid profile in children and adolescents diagnosed with ASD. The study included 233 individuals from 2 to under 19 years assisted by the public health system in Pelotas, Brazil. Fasting blood samples were collected and analysed for serum concentrations of total cholesterol (TC), HDL-C, LDL-C, and triglycerides (TG). Dietary intake was assessed using three non-consecutive 24-hour food recalls (two weekdays and one weekend day). Dietary patterns were derived through reduced rank regression, using food group intakes as predictors and fibre density, energy density, carbohydrate, and saturated fat intakes as response variables. Standardised pattern scores were calculated to assess individual adherence, and linear regression models, adjusted for potential confounders, were applied to examine the association between the dietary pattern scores and lipid profiles. Elevated TG concentrations were observed in 48.9% of the participants. Four dietary patterns were identified: Healthy, Sugar and Starches, Mixed and Dairy and Biscuits. After adjustment, no significant associations were observed between dietary pattern scores and lipid profile. These findings underscore the complex nature of lipid metabolism in individuals with ASD, and suggest that dietary patterns alone may not fully explain variations in lipid profiles. This reinforces the need for further research and development of appropriate nutritional interventions for this population.

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17. Huang H, Geng J, Long Y, Xiong W, Wang X, Wang C, Zhang Q, Tang T, Chen Y, Zhao Y, Cheng J, Lu Y, Bu F, Yuan H. Improving variant interpretation and diagnosis in Koolen-de Vries syndrome through a curated genotype-phenotype repository. Mol Genet Genomics. 2025; 301(1): 10.

Neurodevelopmental disorders (NDDs) exhibit complex genotype-phenotype associations that frequently result in inconclusive variant interpretations, contributing to suboptimal diagnostic yields (~ 40%). Koolen-de Vries syndrome (KdVS), an autosomal dominant NDD caused by KANSL1 haploinsufficiency, exemplifies this diagnostic challenge with its multisystem manifestations and lack of systematic genotype-phenotype associations. To address this gap, we constructed a comprehensive KdVS genotype-phenotype repository by systematically integrating all molecularly confirmed cases from global literature. Comprehensive phenotypic analysis revealed that core KdVS features include developmental delay/intellectual disability, characteristic craniofacial dysmorphism, hypotonia, and multisystem abnormalities. Phenotypic association analysis identified 249 significant correlations, demonstrating that KdVS clinical manifestations are highly interconnected rather than representing isolated features, such as the association between strabismus and hydrocephalus (OR = 14.26). Application of this repository to screen a Chinese rare disease cohort identified 53 KANSL1 variants. Among these, one de novo nonsense variant (NM_001193466.2: c.902T > G, p.Leu301Ter) was classified as pathogenic in a Chinese boy with classic KdVS features. The remaining 52 variants were categorized as variants of uncertain significance (VUS), approximately half of which were absent from gnomAD databases. Each VUS was comprehensively annotated with detailed clinical profiles to facilitate phenotype-driven reinterpretation. In conclusion, this study establishes KdVS as a highly interconnected multisystem disorder and demonstrates that deep phenotypic association analysis enhanced genetic diagnosis. This disease-specific repository approach provides a scalable framework for improving molecular diagnostics across rare NDDs.

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18. Hussein Al-Sultan RR, Jasim SM, Lami F, Jaber OA, Nayeri ND, Sabet MS, Al-Gburi G. Translation and Validation of the Arabic Version of the Revised Restrictive Behaviours Scale Among Iraqi Children With Autism Spectrum Disorder: A Suggestion for Model Modification. Int J Methods Psychiatr Res. 2025; 34(4): e70048.

OBJECTIVES: Comprehensive scales should be used to better understand the patterns of restrictive and repetitive behaviours in children with autism spectrum disorder in middle and lower-income countries. This study aimed to validate an Arabic translation of the revised Repetitive Behaviours Scale. METHODS: Parents of 258 children were interviewed in a cross-sectional study conducted at Al-Subtain Academy from December 1, 2023, to August 1, 2024. The R Language and Environment for Statistical Programing v4.4.2 was utilised for statistical analysis. RESULTS: Following confirmatory factor analysis, the 6-factor solution was selected for further testing based on more favourable fitness indices and the 2-factor solution was selected based on an acceptable RMSEA of 0.064 and evidence of cross-cultural validity from previous validations. The 2-factor solution demonstrated better subscales’ reliability, with composite coefficients of 0.801 and 0.908, and corrected item-total correlations that are more consistent with the theoretical framework for the scale. A modification for this model was suggested based on item performance and demonstrated a marginal improvement in the CFI and TLI indices. CONCLUSION: The Arabic revised repetitive behaviours scale demonstrates a valid and reliable structure, aligning with the conceptual classification of repetitive and restrictive behaviours into repetitive sensory-motor behaviours and insistence on sameness.

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19. Jiang D, Ni P, He J. Both Self-Other Distinction and Overlap Enhance Visual Perspective-Taking in Children With Autism Spectrum Conditions. J Autism Dev Disord. 2025.

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20. Kaur M, Heilferty B. Commentary on « Describing Physical Therapy Services Delivered to Autistic Children in the Outpatient Medical Setting ». Pediatr Phys Ther. 2026; 38(1): 49.

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21. Kayış H, Çelik M, Gedizlioğlu Ç, Kayış E, Aydemir C, Hatipoğlu A, Sarı S, Dogan N, Mumcu E, Arı R, Özbaran B. A new approach in autism diagnosis: Evaluating natural interaction using point of view (POV) glasses. Asian J Psychiatr. 2025; 116: 104798.

This study introduces an AI-assisted method based on examiner-worn Point of View (POV) glasses and computer vision analysis to provide objective behavioral data for the diagnosis of Autism Spectrum Disorder (ASD). The study included 29 children with ASD and 27 children without ASD, aged between 17 and 36 months. During semi-structured naturalistic interactions, the examiner wore POV glasses equipped with a scene camera that captured the child’s face from an eye-level perspective, preserving ecological validity. Behavioral parameters-including facial expressions, approximate social gaze (operationalized as the child’s eyes orientation toward the POV camera), and head mobility-were extracted using OpenFace and MediaPipe and subsequently analyzed with machine learning techniques. Statistical analyses revealed that total social gaze duration, longest social gaze, social smiling, number of responses to name, response latency, response duration, social responsiveness, and head movements along the z-axis had p-values ≤ 0.05, while head movements on the x- and y-axes, total head movement, and rapid head movements had p-values > 0.05. The classification model developed using decision trees and the AdaBoost algorithm demonstrated high performance, achieving an accuracy of 91.07 % and a sensitivity of 89.65 %. These findings support the clinical applicability of examiner-worn POV recordings for early ASD detection and highlight their potential to complement traditional, subjective assessment methods.

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22. Li Q, Zeng S, Xie H, Zhang T, Zhao H, Wu W. Effectiveness of a culturally responsive early intervention model for children with autism and family outcomes. Res Dev Disabil. 2025; 168: 105193.

The purpose of this study was to evaluate the effects of an early intervention model based on the principles of Naturalistic Developmental Behavioral Intervention (NDBI) on young children with autism spectrum disorder (ASD) and family outcomes in China. We used a quasi-experimental design with participants assigned to either the control or intervention groups. The sample (N = 60) mean age was 4.8 years (SD = 1.1) in this study. Children in the treatment group received the culturally adapted intervention 3 h per day, 15 h per week. Children in the control group received public-funded intervention services for 3 h per day, and 15 h per week for a total of 8 weeks. Findings demonstrated a significant decrease in autism condition and improved level of support needed categorization for children in the intervention group, compared with the control group. Also, there were positive changes in the treatment group’s parental stress and anxiety levels. Discussion and implications for culturally responsive early intervention are discussed.

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23. MacBain E, Conroy AL, Brophy J, Kakkar F, Namasopo S, Opoka RO, Hawkes MT. Chitinase-3-like 1 is associated with stunting and developmental delay in HIV-exposed but uninfected Ugandan children. Aids. 2026; 40(2): 263-6.

Chronic systemic inflammation may affect linear growth and neurodevelopment in children who are HIV-exposed but uninfected (cHEU). We examined plasma concentrations of neutrophil activation marker chitinase-3-like protein 1 (CHI3L1) levels in 153 Ugandan cHEU. At 18 months of age, CHI3L1 levels were inversely correlated with height-for-age z scores (τB = -0.17, P = 0.0035) and a normalized developmental score (τB = -0.20, P = 0.00027). CHI3L1 appears to be a marker of adverse growth and development in cHEU.

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24. Minami A, Matsuoka K, Takahashi M, Ueda K, Ohnishi H, Fujimoto Y, Yoshikawa H, Ishida R, Takado Y, Near J, Yamatani Y, Miyasaka T, Tai Y, Ochi T, Tanaka T, Okada T, Iwata N, Makinodan M. Association between decreased taurine levels in the anterior cingulate cortex and restricted and repetitive behaviors in autism spectrum disorder: a cross-sectional study. Front Psychiatry. 2025; 16: 1700059.

INTRODUCTION: Children with autism spectrum disorder (ASD) often experience reduced quality of life due to core autistic traits, such as restricted and repetitive behaviors (RRBs), yet no pharmacological treatments have been established to date. Oxidative stress, a potential contributor to ASD pathology, may reduce taurine and glutathione (GSH) levels. Although animal studies have reported altered antioxidant levels, studies investigating the brain antioxidant levels in individuals with ASD remain limited. This study investigated whether reduced antioxidant levels in the anterior cingulate cortex (ACC), a region consistently characterized by functional and metabolic abnormalities in individuals with ASD, and closely associated with RRBs. METHODS: A total of 44 children with ASD and 40 typically developing controls were enrolled in this study. Diagnoses were confirmed using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Magnetic resonance spectroscopy was used to quantify taurine and GSH levels in the ACC. Statistical analyses were conducted to compare metabolite levels between the groups and assess associations with ADOS-2 subscale scores. RESULTS: The ASD group exhibited significantly lower taurine levels, whereas GSH levels remained unchanged. Taurine levels were negatively correlated with RRBs but not with social affect. DISCUSSION: These findings suggest that reduced taurine levels in the ACC of children with ASD, alongside unchanged GSH levels, may indicate distinct biosynthetic pathways and functional roles of these metabolites in oxidative stress defense mechanisms associated with ASD pathology. Taurine depletion may disrupt physiological processes associated with RRBs and could serve as a potential therapeutic target for symptom management.

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25. Park H, Na J, Kim SY, Lee S. A mixed-methods study examining the ripple effect of inclusive employment on reducing stigma toward autistic people in South Korea. Autism. 2025: 13623613251407763.

This mixed-methods study examines how contact with Autistar, a Korean company providing strength-based, institutional-level support to autistic designers, is associated with stigma toward autistic people. One-hundred thirty-eight non-autistic community members completed an online survey; mixed-effects and stepwise regression analyses assessed relationships between contact with Autistar and stigma. Focus group interviews with 11 participants drawn from this full survey sample who had extensive contact with Autistar were analyzed using qualitative content analysis. Quantitative analyses indicated that greater contact breadth with Autistar was linked to lower stigma. In particular, participation in exhibitions and introduction by acquaintances predicted lower stigma. Qualitative analysis revealed that sustained and informed contact, which allowed participants to notice similarities between themselves and autistic employees and the strengths of these employees, helped them view autistic people as part of their ingroup. This study linked contact theory and ingroup bias theory to explain how high-quality contact may be associated with perceiving autistic people as part of one’s ingroup. The findings underscored the societal impact of an inclusive employment model, which extends beyond individual interactions to influence societal attitudes, and suggested the need for further research on systemic policies to expand such initiatives.Lay abstractAutistic people often face stigma, meaning they are treated unfairly or seen as different in a negative way. This stigma can make it difficult for them to find jobs, build relationships, and fully participate in society. This study looks at how Autistar may help change the way people think about autism. Autistar is a South Korean company that hires and supports autistic designers. We wanted to understand if seeing and interacting with Autistar and autistic designers at Autistar could help reduce stigma. To do this, we surveyed 138 non-autistic people who had some level of contact with Autistar. We asked about their experiences and attitudes toward autistic people. We also conducted group interviews with 11 participants who had more experience with the company to get deeper insights. Quantitative analysis showed that people who had more interactions with Autistar reported more positive attitudes. The results from the interviews showed that seeing autistic people’s talents helped break stereotypes. Seeing autistic people at exhibitions, learning about them, or meeting them through friends and family was linked to less stigma. Some participants said they no longer saw autistic people as « different » but as part of the same world with valuable skills. Participants were more comfortable working with or spending time with autistic people than before interacting with autistic employees of Autistar. This study shows that inclusive workplaces like this can help change how people think about autism. By creating more job opportunities with proper support for autistic people, we may be able to build a more inclusive society.

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26. Philosoph LK, Yoffe C, El Biri B, Baryakh P, Saar EG, Mayorov M, Yosef OB. Distinct protein profiles in cord blood plasma of children with autism spectrum disorder. Sci Rep. 2025; 15(1): 44947.

Autism spectrum disorder (ASD) has a genetic origin in approximately 30% of cases, while the remaining causes are primarily linked to epigenetic and non-genetic factors. This study aims to identify potential non-genetic causes contributing to ASD by investigating the underlying cellular mechanisms through proteomic analysis. Extracellular vesicles (EVs) mediate cellular communication and are linked to brain development disorders. Here, we utilize mass-spectrometry-based proteomic analysis of EVs derived from umbilical cord blood plasma collected from 30 children diagnosed with non-syndromic ASD and 30 neurotypical controls. The analysis identified 565 proteins with significantly different expression levels, most of which were more abundant in the ASD group. Notably, the protein expression variances were markedly lower in the ASD group, suggesting a similar cellular activity. Differentially expressed proteins were clustered using String software into 3 groups: mitochondria, endoplasmic reticulum (ER), and a mixture of immune and cytoskeletal proteins. Further statistical analysis identified 11 strongly predictive ASD proteins, while the Human Protein Atlas recognized an additional 13 brain-specific proteins. A portion of these 24 proteins was associated with synaptogenesis and myelination. These findings suggest that, despite diverse etiologies, ASD may converge on a common final pathway involving mitochondrial and ER dysfunction, resulting in abnormal synaptogenesis. This study presents the first unbiased proteomic analysis of exosomal proteins aimed at determining whether neurodevelopmental disruptions linked to ASD originate prenatally or postnatally.

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27. Rajaei I, Babaei A, Djalalinia S, Qorbani M. Oral Health Interventions in Children With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Interventional Studies. Clin Exp Dent Res. 2025; 11(6): e70258.

OBJECTIVES: Children with autism spectrum disorder (ASD) exhibit a higher prevalence of oral health diseases. These oral health issues significantly impair quality of life and increase caregiver burden. Despite emerging interventions like specialized behavioral guidance and caregiver training, a comprehensive evaluation of their effectiveness remains absent. This systematic review and meta-analysis was designed to pool the effectiveness of Oral health interventions in children with ASD. MATERIALS AND METHODS: In this systematic review, some international databases, including PubMed, ISI/WOS, CENTRAL, and Scopus, were searched via appropriate keywords until January 1, 2025. All clinical trials that assessed the effect of interventions on oral health indices including Simplified Oral Hygiene Index (OHI-S), plaque index (PI), and gingival index (GI) without any language or time restrictions were included in the study. Search strategy process, screening, data extraction, and quality assessment were performed by two experts independently. Heterogeneity between studies was assessed using I(2) and Q-Cochrane test. Random effect meta-analysis was performed to pool the standardized mean difference (SMD) with 95% confidence intervals (CIs). RESULTS: Overall, 27 studies with 1918 participants were included in this study. Interventions are categorized into the educational (visual, verbal, booklet/leaflet) and procedural approaches. Random effect meta-analysis showed significant improvements for PI (SMD = -0.73, 95% CI: [-1.02 to -0.44]) and OHI-S (SMD = -1.44, 95% CI: [-2.79 to -0.08]), with video interventions notably effective for PI (SMD = -0.69, 95% CI: [-1.2 to -0.14]). The GI index also improved (SMD = -0.74, 95% CI: [-1.34 to -0.14]). CONCLUSIONS: Visual pedagogy, particularly videos, and parental involvement significantly improved oral health in children with ASD. Video-based interventions should be added to traditional methods such as verbal or picture-based approaches to improve oral health interventions in ASD.

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28. Ray PC, Doğan M, Bozdoğan S, Gül G, Binokay H. Hereditary thrombophilia parameters in children with autism spectrum disorder and their mothers. Front Pediatr. 2025; 13: 1680354.

OBJECTIVE: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition influencyed by genetic and environmental factors. There is emerging evidence of an association between hereditary thrombophilia and ASD, potentially mediated by impaired placental perfusion and resultant neuroinflammatory processes. This study aimed to investigate the frequency of thrombophilia-related genetic polymorphisms in children diagnosed with ASD and their mothers. METHODS: A total of 24 children with ASD aged 2-6 and their mothers were compared with 24 age-matched healthy children and their mothers. Sociodemographic, developmental and genetic data were collected. A psychiatric evaluation was performed according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the children were assessed using the Autism Behavior Checklist (ABC), the Modified Checklist for Autism in Toddlers (M-CHAT) and the Ankara Developmental Screening Inventory (ADSI). Thrombophilia-related polymorphisms, including FVL G1691A, FII G20210A, C677T MTHFR and 1298AC MTHFR, FXIII-Val34Leu and PAI-1 4G/5G, were analyzed using PCR-based methods. Statistical comparisons and logistic regression analyses were performed to evaluate associations with ASD. RESULTS: The FXIII-Val34Leu heterozygous variant was significantly more prevalent in children with ASD (37.5% vs. 8.3%, p = 0.036) and their mothers (54.2% vs. 16.7%, p = 0.015) than in the control group. Logistic regression analysis revealed that the presence of the FXIII-Val34Leu heterozygous polymorphism in either the mother or child was associated with an approximately 4.130-fold increase in the odds of ASD (adjusted odds ratio = 4.130, 95% confidence interval = 1.180-5.300, p = 0.027). Other thrombophilia polymorphisms did not differ significantly between groups. Additionally, children with ASD exhibited significant delays in speech development and lower developmental scores across several domains. CONCLUSION: This study is among the first to examine the FXIII Val34Leu mutation in children with ASD and their mothers. Further large-scale, longitudinal studies are needed to investigate thrombophilia markers in relation to ASD.

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29. Seki M, Ogata H, Hishida T, Nakane E, Saima S, Kondo C, Yoshikawa T, Miyachi K, Ihara H. Peer-shared hobbies and quality of life in boys with autism spectrum disorder: An exploratory cross-sectional study in Japan. PCN Rep. 2025; 4(4): e70276.

AIM: In adolescence, peer relationships and leisure engagement become central to well-being. This study aimed to characterize the hobbies of boys with autism spectrum disorder (ASD) and examine whether engagement in peer-shared hobbies is associated with higher quality of life (QOL) across school stages (upper elementary vs. middle school). METHODS: This exploratory cross-sectional study included boys with ASD in Japan (N = 71). Participants reported hobby types and whether they engaged in these hobbies with friends. QOL was assessed using a validated child-reported instrument with six subscales and a total score. Group differences (with vs. without peer-shared hobbies) were tested for each school stage using independent-samples t-tests; effect sizes (Cohen’s d) and both uncorrected and Holm-Bonferroni-adjusted p-values were reported. Proportions were compared with χ (2) tests. RESULTS: Many boys expressed a desire to play with friends, but only 36.8% of upper elementary boys and 21.2% of middle school boys did so. Middle school boys with peer-shared hobbies showed higher unadjusted total QOL than those without such hobbies (e.g., t(31) = 2.55, p = 0.016; d = 1.04), with small-to-large advantages on several subscales; however, these differences did not remain statistically significant after Holm-Bonferroni correction. Age-group comparisons suggested increasing difficulty in achieving peer-shared hobby engagement from late childhood to adolescence. CONCLUSION: Findings suggest that hobby-based engagement with peers may be an important-but underrealized-pathway to better QOL in boys with autism. Larger, preregistered studies are warranted to confirm these associations and inform interventions that leverage shared hobbies as a scaffold for social connection and well-being.

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30. Sush DJ, Lustig SL, Morrison LP. A Neurodiverse Perspective on Autism Spectrum Disorder and the Medical Necessity of Applied Behavior Analysis. J Am Acad Child Adolesc Psychiatry. 2025.

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31. Sut E, Ayaslan Z, Cetin S, Turan Kaya T, Gundogan Kucuksahin N, Halac E, Ciray O. Validity and Reliability of the Turkish Version of the Subthreshold Autism Trait Questionnaire (SATQ-TR). J Autism Dev Disord. 2025.

PURPOSE: The subthreshold autism trait questionnaire (SATQ) is a brief self-report measure designed to assess subthreshold autistic traits in the general population. While several parent-report instruments have been validated in Turkish, no self-report tool has been adapted for adolescents. This study aimed to translate, culturally adapt, and examine the psychometric properties of the Turkish version of the SATQ for adolescents aged 12-18 years. METHOD: A cross-sectional, multicenter case-control design was employed with 412 adolescents (143 patients, 269 non-clinical controls). Following translation and back-translation, the Turkish SATQ underwent item analysis, reliability testing, exploratory and confirmatory factor analyses, criterion validity evaluation, and ROC analysis. Two items were removed due to cross-loadings, yielding a 30-item version (SATQ-TR). RESULTS: The SATQ-TR showed good internal consistency (Cronbach’s α = 0.74) and excellent test-retest reliability (r = 0.92). Item discrimination analyses were significant for all items (p < 0.001). Exploratory factor analysis identified a seven-factor structure explaining 53.5% of the variance (KMO = 0.86, p < 0.001), and confirmatory factor analysis indicated acceptable model fit (RMSEA = 0.071; CFI = 0.93; TLI = 0.92; NFI = 0.90; GFI = 0.95). ROC analysis demonstrated satisfactory discriminative ability for ASD (AUC = 0.73, 95% CI 0.60-0.86). Significant correlations between SATQ and AQ scores supported criterion validity. CONCLUSION: The 30-item Turkish version of the SATQ (SATQ-TR) is a valid and reliable tool for assessing subthreshold autistic traits in adolescents. By providing a brief, multidimensional self-report measure, it fills an important gap in Turkish adolescent populations and supports early identification and dimensional approaches in autism research and practice.

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32. Tan SW, Tan MY, Chong SC, Koh MY, Ng JQX, Aishworiya R, Shorey S. Exploring Parental Perspectives on Mental Health Screening and Support for Parents of Children With Autism in Singapore: A Descriptive Qualitative Study. Int J Ment Health Nurs. 2026; 35(1): e70208.

Parents of children with autism spectrum disorder (ASD) face unique mental health challenges. Systematic mental health screening could identify parents in need of timely support; however, parental perceptions toward this have not been adequately explored. This qualitative descriptive study aimed to explore parental knowledge and attitudes toward mental health screening among parents of children with ASD in Singapore. Adult parents, who were primary caregivers of children with ASD aged between 2 and 18 years, were invited to participate in semi-structured individual online interviews. A purposive sample of 14 mothers was recruited from a tertiary paediatric developmental clinic between July and November 2024. Data were analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist was used for reporting. Three themes identified as follows: (1) Understanding and Acceptance of Mental Health Screening, (2) Navigating Barriers to Mental Health Support, and (3) Shaping Effective Mental Health Services. Our findings indicate that while mothers recognise the benefits of mental health screening, stigma, lack of awareness and logistical challenges remain significant barriers. Effective implementation of mental health screening and follow-up support requires collaboration between healthcare, schools, government and community organisations to ensure a non-judgmental and accessible screening process.

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33. Thunberg S, Lagerstedt E, Jönsson A, Sundell AL. Exploring companion robots for children with autism spectrum disorder: a reflexive thematic analysis in specialist dental care. Front Robot AI. 2025; 12: 1659784.

INTRODUCTION: As robotic technologies become increasingly integrated into care settings, it is critical to assess their impact within the complexity of real-world contexts. This exploratory study examines the introduction of a robot cat for children with Autism Spectrum Disorder (ASD) in a specialist dental care unit. Children with ASD often face challenges in dental care, including anxiety, sensory sensitivities, and difficulty with collaboration. The study investigates if a robot cat can provide psychosocial support to the patients. METHODS: Ten patients, aged 5-10, participated in the 12-months study, each undergoing one baseline session without the robot and 3-5 subsequent visits with the robot, yielding 37 sessions of video data. RESULTS: Reflexive thematic analysis revealed three key themes: the robot cat can enhance training and treatment, robot cats can serve as a beneficial but a non-essential tool, and robot cats can sometimes hinder progress in training and treatment. These findings highlight significant individual variation in how the robot was experienced, shaped by context, timing, and emotional state. The robot’s role was not universally positive or passive; its effectiveness depended on how it was integrated into personalised care strategies by the dental hygienist, guardians, and the patients themselves. DISCUSSION: This study underscores the importance of tailoring technological interventions in care, advocating for cautious, context-sensitive use rather than one-size-fits-all solutions. Future work should further explore adaptive, individualised deployment.

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34. Tzila E, Panagouli E, Tsouka M, Shihada A, Venieratos D, Chrysikos D, Troupis T. Connections Between Prefrontal Cortex Anatomy and Autism Spectrum Disorder: A Literature Review. Acta Med Acad. 2025.

OBJECTIVE: This review examines the existing literature on the structural and functional changes in the anatomy of the prefrontal cortex (PFC) associated with autism spectrum disorder (ASD), focusing on the roles of molecular signaling disruptions and trace element imbalances. METHODS: A literature review was performed through a structured search of academic publications from 2010 to 2025. DISCUSSION: Anatomic variations and structural and functional abnormalities within the PFC, including disruptions in neural connectivity, synaptic plasticity, and neurochemical balance, significantly contribute to the cognitive, social, and emotional deficits observed in ASD. The interplay between brain-derived neurotrophic factor dysregulation, oxidative stress, and trace element imbalances further exacerbates these dysfunctions. CONCLUSION: According to our findings, the anatomy of the PFC appears to play a crucial role in the pathophysiology of ASD, given its involvement in executive function, emotional processing, and social cognition, suggesting a multifactorial pathophysiology that demands a multidimensional research approach.

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35. Wolfer P, Baumeister F, Durrleman S. Bilingualism Enhances Metalinguistic Awareness in Autism: Extending the Two-Dimensional Grammaticality Judgment Task. Autism Res. 2025.

Bilingualism has been associated with enhanced metalinguistic awareness (MA), the ability to reflect upon language. However, findings remain mixed, and little is known about how proficiency in the most proficient (L1) and second-best language (L2) contribute to MA, especially in children with autism spectrum disorder (ASD), who often present heterogeneous cognitive and linguistic profiles. We tested 270 children aged 5-12 (90 autistic, 180 neurotypical) using a two-dimensional Grammaticality Judgment Task (GJT) requiring two components of MA: analyzed knowledge (understanding of grammatical rules) and cognitive control (suppressing irrelevant semantic cues). Bilingualism was examined both categorically (monolingual vs. bilingual) and continuously (L2 proficiency), using generalized linear mixed-effects models controlling for age, nonverbal IQ, and L1 proficiency. Among neurotypical children, no significant bilingual advantage was found. In contrast, bilingual autistic children significantly outperformed monolingual peers on items requiring cognitive control, and higher L2 proficiency was associated with better overall GJT performance. These findings advance understanding of how bilingualism relates to metalinguistic abilities in autism and suggest that it is not only non-detrimental but may confer specific metalinguistic benefits. The study underscores the importance of combining categorical and continuous approaches to bilingualism to better capture individual variability in neurodiverse populations.

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36. Zhan X, Kuang Z, Li X, Wang Y, Yuan C, Shi T, Zeng Y, Cheng K. The effects of adapted physical activity on physical activity levels and social adaptive behaviors in children with autism spectrum disorders: a study using the ICF-CY framework. Front Psychiatry. 2025; 16: 1708901.

OBJECTIVE: This study investigated the effects of an adapted physical activity (APA) program, based on the ICF-CY framework, on physical activity and social adaptive behaviors in children with autism spectrum disorder (ASD). METHODS: 41 children with ASD (aged 6~12) were ultimately included and divided into an experimental group (EG) and a control group (CG). The EG received the APA intervention, while the CG participated in routine extracurricular physical activity sessions. Both groups received 24-week interventions, with 3 sessions per week, each lasting 80 minutes. Assessments were conducted before and after the intervention using the ActiGraph wGT3X-BT triaxial accelerometer and the Child Adaptive Behavior Rating Scale (CABRS). RESULTS: After 24 weeks, the EG showed significant improvements in adaptive behaviors (independent, cognitive, social/self-control, and total scores), reduced sedentary time, and increased light and moderate-to-vigorous physical activity compared to the CG. CONCLUSIONS: The ICF-CY-based APA program effectively enhanced physical activity levels and social adaptive behaviors in children with ASD.

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37. Zuckerman KE, Owens Reinitz M, Solgi M, Feryn A, Tae M, Cavanaugh P, Raja-Vora J, Fombonne E. Preliminary Efficacy of Telehealth Family Navigation for Early Autism Services Access. J Autism Dev Disord. 2025.

PURPOSE: In-person family navigation accelerates autism diagnosis; however, effectiveness of telehealth autism navigation is unknown. This study tested preliminary efficacy of telehealth autism navigation. METHOD: In this site-randomized pilot trial of telehealth autism family navigation, 7 clinics (66 primary care providers) were trained in autism screening and randomized to family navigation versus usual care. 49 children aged 12-54 months enrolled. We used Early Intervention/Early Childhood Special Education (EI/ECSE) and health records to compare navigation intervention and control arms on time from enrollment to EI/ECSE eligibility determination, percent receiving EI/ECSE eligibility determination within 6 months, percent of children receiving EI/ECSE referrals within 6 months, and percent receiving autism educational and medical diagnoses within 6 months. RESULTS: In intention-to-treat analysis, 46.7% of the navigation (66.7% of those referred to EI/ECSE) and 36.8% of control families (87.5% of those referred to EI/ECSE) had EI/ECSE eligibility determinations. Median time to EI/ECSE eligibility determination was 66.5 days in navigation and 120 days in control. 70% of navigation and 42.1% of control children were referred to EI/ECSE. 23.8% of navigation and 0% of control children received an autism educational eligibility within 6 months, but 10% of navigation children versus 42.1% of control had autism medical diagnostic determination within 6 months. 50% of the navigation arm had < 4 navigator interactions. CONCLUSION: Telehealth family navigation shows preliminary promise for improving access to services in EI/ECSE, especially for referral and evaluation. Access to medical diagnostic evaluation may need additional support. A larger trial can investigate longer-term services receipt. GOV ID: NCT04861740, Registered 4/7/2021.

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