Supporting Ukrainian refugees on the autism spectrum in Polish educational and therapy centers: The perspective of professionals

The subtle pragmatic language differences that characterize the broad autism phenotype have also been observed among female FMR1 premutation carriers, suggesting a potential role of the FMR1 gene in autism-related pragmatic language differences. This study evaluated the use of discourse markers (language units that support conversational discourse) in a direct comparison of these groups to examine how this key pragmatic skill may be used differently and potentially contribute to pragmatic language profiles in each group. Participants included 83 mothers of autistic individuals, 61 female FMR1 premutation carriers, and 41 female controls. Discourse marker use was evaluated in the context of a semi-structured conversation. Patterns were compared across groups and evaluated in relationship to global pragmatics and variability in the FMR1 gene across the CGG range. Mothers of autistic individuals demonstrated clear differences in discourse marker patterns compared with FMR1 premutation carriers and controls. Relationships to pragmatics were observed in the use of backchannels only. Links to FMR1were observed within the premutation CGG range. Findings suggest that differences in discourse marker use could be an important component of the broader pragmatic differences noted in first degree relatives of autistic individuals, although evidence of a direct relationship with FMR1 was limited.

Children on the autism spectrum (AS) show considerable individual differences in language development. It remains unclear whether their lexical and grammatical skills develop in a typical pattern, with or without delays in both domains, or whether they exhibit an atypical language profile in which lexical and grammatical development are differentially affected. Since most existing studies involve English-speaking children, the relationship between these language domains in morphologically rich languages such as Croatian remains underexplored. The aim of this study was to examine the relationship between lexical and grammatical (morphological and syntactic) skills in Croatian-speaking children on the AS and to determine whether they display a typical or atypical language profile. The study employed a cross-sectional design. The sample consisted of 30 children on the AS and 30 vocabulary-matched typically developing (TD) two-year-old children. Lexical, morphological, and syntactic abilities were assessed using parent reports, and data were analyzed both within and between the groups. Significant positive correlations were found between vocabulary and grammatical measures in both groups, with no significant differences in grammatical abilities between vocabulary-matched AS and TD children. Although both groups demonstrated more advanced lexical than morphological abilities, this pattern reflects typical Croatian language acquisition rather than a characteristic specific to autism spectrum. The findings support the hypothesis of a typical, though often delayed, language profile in children on the AS, in which grammatical development follows lexical growth. The grammatical development of children on the AS acquiring a morphologically rich language did not differ from that of younger vocabulary-matched TD peers. These results underscore the importance of assessing and targeting both vocabulary and grammar in parallel during early intervention for children on the AS.

There is growing recognition that some individuals who receive a diagnosis of borderline personality disorder (BPD) are later diagnosed with autism. However, existing literature on this topic remains limited. This study aimed to explore the experiences of individuals diagnosed with BPD prior to autism, how they made sense of these diagnoses, navigated clinical systems and learnt to manage the complex challenges associated with this diagnostic sequence. Thirteen (6 male, 6 female, 1 non-binary) adult participants took part in semi-structured interviews exploring their diagnostic journeys. Reflexive thematic analysis was used to develop a nuanced understanding of their experiences. Three themes were constructed: (1) The Limitations and Challenges of Diagnostic Overshadowing, capturing how participants felt their BPD diagnosis failed to fully explain their difficulties, prompting them to seek further assessment; (2) Stereotyping and Misconceptions, exploring the impact of stigma and stereotyping, both internalized and encountered within clinical settings; and (3) Learning to Cope in a New World, describing how receiving an autism diagnosis enabled participants to reframe past experiences and develop new, often sensory-informed coping strategies. These findings underscore the need for diagnostic processes that are open, curious and sensitive to overlapping presentations, and attentive to how historic stereotyping may shape clinical decision-making. They also highlight the importance of post-diagnostic support that empowers individuals to understand and adapt to their neurodivergence, fostering growth rather than perpetuating shame.

PurposeThis study aimed to explore and examine the relationship between sleep-wake rhythms and sensory processing characteristics in school-age children with autistic spectrum disorder (ASD) using objective sleep measurement indices.Patients and MethodsThis cross-sectional exploratory study included 30 children with ASD aged 6–9 years. Sleep–wake rhythms were recorded continuously for at least 14 days using a waist-worn actigraph (MTN-220) and analyzed with SleepSign Act. Sensory processing ability was assessed using the Japanese version of the Sensory Profile (SP-J), with SP-J quadrant and sensory processing scores. Associations between sleep variables and SP-J quadrant and sensory processing scores were examined using Spearman’s rank correlation coefficient, applying Bonferroni correction within each pre-specified correlation set.ResultsOf the 30 children initially enrolled, 11 were excluded, yielding data from 19 participants. After Bonferroni correction, no significant associations were found between SP-J quadrant scores and sleep variables (r = −0.411–0.540). Regarding associations with sensory processing scores, the oral sensory score showed a positive correlation with the mean wake time (r = 0.698, p = 0.006). However, no other significant associations were found between sensory processing scores and sleep variables.ConclusionThese results suggest that the relationship between oral sensory scores and the average wake time remains strong even during the school-age period when sleep–wake rhythms change. Although exploratory, this study provides foundational insights with clinical significance for understanding and supporting sleep disorders in children with ASD.

Purpose This study aims to compare the effectiveness of video modeling and in vivo modeling in enhancing imitation-based practical skills in children with a diagnosis of autism. It also examines the generalization and maintenance of these skills over time, taking into account individual cognitive profiles. Design/methodology/approach This study involved eight autistic children, aged 4–10, who participated in structured training sessions focused on practical and social tasks. Using a randomized sequence, each participant was exposed to both video and in vivo modeling. The authors used a comparison study to measure progress and compare the two methods. Findings Both interventions led to significant improvements in imitation-based skills. In vivo modeling produced quicker initial responses, while video modeling proved more effective in promoting generalization to unstructured contexts and ensuring better long-term maintenance. The participants’ cognitive profiles influenced the effectiveness of each method. Research limitations/implications The small sample size and short-term observation period limit the generalizability of the results. Further studies are needed to refine instructional protocols and tailor interventions based on individual learner profiles. Practical implications The findings highlight the practical value of video modeling as a flexible tool for teaching functional skills in people with Autism while also recognizing the situational strengths of in vivo instruction. Social implications This research supports the use of individualized, evidence-based teaching strategies to promote autonomy and social participation among autistic children, underscoring the importance of adaptive and inclusive practices in educational and therapeutic settings. Originality/value By offering a direct comparison between two widely used modeling approaches, this study provides new insights into the design of effective, personalized interventions for developing imitation and daily living skills in autistic children.

Parents of children on the autism spectrum face challenging treatment-related decisions, often with limited knowledge about available options. Shared Decision Making (SDM), a process where clinicians, patients, and families collaborate to make decisions based on evidence and preferences, can assist parents in navigating these choices. However, little is known about the use of SDM interventions for autism-related parental decisions. A systematic and scoping review was conducted across four databases (PubMed, Embase, Web of Science, and PsycInfo), and grey literature in two clinical trial registries. Study selection was conducted in two phases: title and abstract screening and full-text screening. From 7,610 records identified, two studies were included from Australia and Italy, describing multicomponent SDM interventions for parents of young children (< 18 years) on the autism spectrum. Both interventions demonstrated improvements in SDM-related outcomes, including parents' knowledge of autism treatments (such as speech pathology services and Early Intensive Behavior Intervention) and parents' involvement in treatment discussions. This review reveals a critical gap in SDM intervention research for autism parental decision-making. Despite the critical role parents play in autism treatment decisions, evidence-based SDM interventions remain scarce. This finding is significant given the well-established benefits of SDM in other healthcare populations and underscores the urgent need to develop and rigorously evaluate SDM interventions tailored to autism care contexts that support parents in making informed decisions about their children's care.Systematic review registration: A protocol was registered on PROSPERO.

Treatment Adherence Challenges in Pediatric Atopic Dermatitis Patients on the Autism Spectrum: A Provider Survey on Sensory Sensitivities and Steroid Phobia

Knowledge is not power, after all? Knowledge about autism and its associations with self-stigma, cognitive fusion, and distress among parents of children on the autism spectrum

ObjectivesThis study aimed to clarify whether clinical diagnosis, as opposed to trait severity alone, differentiates sensory processing profiles in adults with ADHD and ASD. Specifically, we compared clinical and non-clinical cohorts matched on standardized self-report measures to test the impact of diagnosis on visual orientation discrimination.MethodsA total of 152 adults were assigned to four matched groups: clinical ADHD, non-clinical ADHD, clinical ASD, and non-clinical ASD (n = 38/group). ADHD and ASD traits were assessed using the Adult ADHD Self-Report Scale (ASRS) and Broad Autism Phenotype Questionnaire (BAPQ). Sensory performance was measured using a visual orientation discrimination task (with vertical and oblique conditions). Propensity score matching and ANCOVAs (controlling for age/gender) were used to ensure comparability between the clinical and non-clinical groups.ResultsClinically diagnosed ADHD participants displayed significantly poorer oblique orientation sensitivity than non-clinical controls, while clinical ASD participants exhibited superior vertical orientation discrimination compared to their matched non-clinical group. No significant differences were found for vertical thresholds in ADHD and oblique thresholds in ASD. These patterns remained after controlling for age and gender, indicating disorder-specific sensory trajectories, with bidirectional effects of severity and/or clinical diagnosis on sensory performance.ConclusionsFindings suggest that clinical diagnosis captures qualitative as well as quantitative differences not reflected by trait severity alone. Within visual orientation discrimination, ADHD and ASD showed different patterns of diagnostic modulation that are consistent with dimensional and dimensional-categorical (hybrid) interpretative frameworks, respectively.

Autistic spectrum disorder (ASD) is a neurodevelopmental disorder that affects the learner in school and their general functioning in school. Over time, efforts to address these challenges have been made, but attention to empathy has scarcely been paid. It is important that these students are integrated appropriately into the social environment. This study sought to examine how executive functions can be modelled to explain the variances in ASD students’ empathy. A cross-sectional survey design was used with a total of 245 students. The Reniers et al. (2011) scale on cognitive and affective empathy (CAES) and the Behavioral Rating Inventory of Executive Functions (BRIEF), developed by Gioia et al. (2000), were the major instruments used for data collection. The data collected were analyzed using regression techniques, and the findings revealed that executive functions: cognitive flexibility, working memory, planning, emotional control, and inhibitor control relatively and compositely contribute to explaining the variances in affective and cognitive empathy among students with ASD. The study provided valuable insights into the experiences of students with ASD, and it recommends interventions aimed at supporting emotional regulation as a potential means of enhancing social tolerance and empathetic abilities, thereby facilitating better social functioning.

Parents of children on the autism spectrum experience elevated psychological distress, which can impact both their well-being and child outcomes. While prior research has focused primarily on child-related contributors to parental mental health, parent-specific factors remain underexplored. This study addresses this gap by examining a range of psychiatric concerns in parents of children on the autism spectrum, considering both child and parent-related factors. Participants were drawn from a Korean genetic cohort study on autism multiplex families. Parental mental health was assessed using the Korean-Symptom Checklist 95 (K-SCL95), and measures of autistic traits were collected. Parents with T-scores greater than 70 on the K-SCL95 subdomains were considered to have clinical concern. An exploratory factor analysis (EFA) was conducted to better understand the dimensions of parental mental health. Univariate linear regressions were performed for both child- and parent-related variables, with significant factors subsequently included in multivariate linear regression analyses. Among 464 parents, 29.09% had a T-score above 70 on the K-SCL95 subdomain. EFA identified two factors in fathers (“High Sensitivity-Dysregulation” and “Depressive Domain”), and two dimensions in mothers (“High Sensitivity” and “Depressive-Dysregulation”). Parental difficulties in pragmatic language measured by the Broad Autism Phenotype Questionnaire were consistently associated with the mental health dimensions. Child-related factors were largely attenuated after adjustment, although child externalizing behaviors remained positively associated with paternal mental health domains. Findings highlight the need for targeted mental health support for parents of children on the spectrum, particularly those with autistic traits, to enhance caregiver well-being.

ABSTRACT The prevalence of autism is rising. Inclusive education is promoted in England, Finland and Sweden, which means that many pupils on the autism spectrum are taught in the regular classroom. Student teachers’ attributions of success or failure of educational interactions with pupils were sought. Data were collected from student teachers in England (n = 191), Finland (n = 251) and Sweden (n = 262), using the method of empathy stories, in which the students produced imaginary texts based on short frame stories. Drawing on attribution theory, a qualitative deductive analysis was conducted. Causes related to teacher actions and child skills or behaviours were perceived to be the primary causes of success or failure. A key cross-national difference is that the Swedish and English student teachers attributed the causes to teacher actions and child skills in a binary manner, whilst the Finnish student teacher attributions were more diverse. Additionally, the Finnish student teachers wrote longer stories with more detailed descriptions, indicating a more complex understanding of educational interactions with pupils on the autism spectrum.

Purpose Autism is a complex neurodevelopmental condition thought to affect 1 in 100 children globally. More commonly diagnosed in males, and during childhood, diagnoses are increasingly being made throughout adulthood. This study aims to establish what age autistic people receive their diagnosis, and whether the age of diagnosis was influenced by their sex and by the presence of intellectual disability. Design/methodology/approach A quantitative, cross-sectional, retrospective study. Data was collected from the Primary Care records of six GP Practices covering Ellesmere Port, a large town in Northwest England with 71,210 people registered. Mean age of diagnosis was calculated for the group then for each subgroup, to allow comparison between males and females, and those with and without a documented intellectual disability. Findings Data from 1,130 autistic participants were analysed. Age of participants was between 3 and 81 years with an age of autism diagnosis of 1–72 years. In total, 85.6% of participants were diagnosed with autism by the age of 25 years, most commonly at 3 years of age (11.9%). The average age of diagnosis was 2.48 years later for females diagnosed across the lifespan. Average age of diagnosis was 5.05 years later for those with a learning disability. Practical implications This study highlights the importance of healthcare professionals, educators and care givers recognising autistic traits in people across the lifespan, including the potential for diagnostic overshadowing. There are implications for commissioning autistic services, to ensure adequate assessment pathway capacity for adolescents and adults as well as children. Originality/value This study used Primary Care records from all the practices covering a large town, aiming to reduce recruitment bias and allowing a snapshot of a large sample size with a common referral pathway.

Associations between symptom severity in autism and functional neuroimaging measures of audiovisual speech perception.

Autism Spectrum Disorder (ASD) is a heterogenous condition that has no biologically relevant subtypes yet. Here, we utilized a multidimensional approach considering social deficits in ASD alongside negative valence and empathy dysfunction to distinguish ASD from Neurotypicals (NT) and to generate ASD subtypes using machine learning approaches. 114 subjects were analyzed, with 70 being NT and 44 ASD, all male with an IQ greater than 70, with 5 domains of personality (NEO-PI-r) and Reading the Mind the Eyes Test (RMET) scores included in the main classifier. We then used a multitude of behavioral (such as IQ, Broader Autism Phenotype, Autism Quotient, Interpersonal Reactivity Index) and clinical measures such as Autism Diagnostic Interview-Revised (ADI-R) alongside biological methods including DNA methylation of OXTR gene and resting-state functional connectivity (rsFC) to validate the putative subtypes. 30 ASD who received IN-OXT in a randomized, placebo-controlled, within-subject design and 17 new NT were part of the rs-FC analysis. A random forest tree algorithm was used to classify NT and ASD and Shapley Additive Explanation Values were used to describe the model and to cluster ASD subtypes using K-Means clustering. Three subtypes were generated with two of them being highly distinctive in behavioral and brain functional traits. One subtype named NASA (or Negative Affect and Social Aloofness) was characterized by high Neuroticism and Low warmth alongside lower rsFC between networks involved in social cognition, self-awareness, and sensory processing, such as Superior Temporal Sulcus and Sensorimotor Network; or ACC/Insula with visual cortex, Posterior Cingulate Cortex and visual cortex. The second subtype NADR (Neurocognitive and Affect Dysregulation with Resistance to Change) was characterized by higher DNA methylation of OXTR , hyperconnectivity between default mode network, reward areas and inferior frontal and fusiform networks. NADR has more cognitive difficulties and higher ADI-R scores as well as higher Neuroticism, higher personal distress, higher rigidity and lower openness. In a mixed model analysis, we found that IN-OXT in a dose dependent manner impacted NASA subtype by modulating rsFC between PCC and cerebellum and between Brainstem/Cerebellum and Parietal cortex to probably enhance social cognition and to reduce negative valence in this subtype.

Pathogenic variants in the non-coding spliceosomal gene RNU4-2 underlie ReNU syndrome, one of the most prevalent monogenic causes of neurodevelopmental disorders, accounting for ~0.4% of cases. Despite increasing recognition, little is known about the longitudinal behavioral and neuropsychiatric phenotype of affected individuals. We report two patients with RNU4-2 variants, providing a comprehensive description of their developmental trajectories from infancy to adolescence. Both exhibited global developmental delay, impaired adaptive functioning, and significant language deficits. Distinctive features included persistent attention deficits and Autistic Spectrum Disorder, which emerged as hallmarks of the Syndrome. Case-specific differences were notable: one patient developed self-injurious behavior and social anxiety during adolescence, while the other presented with epilepsy and structural brain anomalies. Neuroimaging revealed convergent features, including white matter reduction, corpus callosum thinning, and ventricular dysmorphisms. Our findings highlight the importance of early, individualized interventions, with particular emphasis on augmentative and alternative communication strategies and cognitive-behavioral approaches to mitigate communicative frustration, behavioral dysregulation, and social anxiety. This study provides the first longitudinal neuropsychiatric characterization of RNU4-2-related disorder, delineating clinical hallmarks, and therapeutic windows. A better understanding of developmental trajectories in this condition is essential to optimize patient management and improve long-term outcomes.

Immigrant and racialized families raising children on the autism spectrum in Canada navigate intersecting inequities shaped by racism, language barriers, immigration status, and fragmented health and education systems. Yet their perspectives remain underrepresented in autism and health policy research. Guided by the socioecological and critical social science lens, this community-based participatory study employed a PhotoVoice approach in partnership with SMILE Canada-Support Services. Ten immigrant and/or racialized family caregivers from the Greater Toronto area participated in four in-person sessions involving ethical training, guided photo-taking, group-based reflections, and collaborative theme refinement. The data included 38 participant-generated photographs, narratives, and an audio-recorded final group discussion. Seven interrelated themes were identified: (1) family support and child needs; (2) physical and emotional burden on caregivers; (3) school support or its missingness; (4) stigma and discrimination; (5) overall journey with barriers; (6) transitions and uncertainty; and (7) two sides of a coin: isolation and strength, loneliness and hope. Caregivers highlighted extensive invisible labor, exclusionary schooling, financial and systemic barriers, and cumulative stress. Simultaneously, they articulated resilience, mutual support, and a strong sense of collective responsibility. The PhotoVoice process itself was experienced as validating, unifying, and empowering, with participants expressing readiness to disseminate findings through exhibitions, school boards, universities, and policy-engagement initiatives. Caregiving among immigrant and racialized families is both a profound act of love and a site of structural injustice. Centering on caregivers as co-researchers and knowledge holders reveals urgent needs for equity-oriented autism policies and culturally responsive, accessible support systems in Canada.

Background/objectives: The prevalence of autistic spectrum disorder has been increasing rapidly in the world population and the cause of this increase is unknown. Autistic spectrum disorder is an important cause of social, communication and specific learning difficulties in children. Assortative mating may increase the genetic burden leading to manifestation of polygenic diseases affecting mental health in the offspring. Correlation of scores in the social responsiveness scale (SRS), which is used to quantify autistic spectrum disorder features, between spouses, has been used as indicator of phenotypic assortative mating. We investigated whether assortative mating is involved in increased severity of autism spectrum disorder in the offspring. Methods: All studies reporting on investigation of assortative mating in relationship to autistic spectrum disorder were included. Information sources were PubMed, EMBASE and the Cochrane Library. Results were synthesized by entering correlation analyses of results of the SRS conducted in spouses in a meta-analysis. A sub-group analysis was performed comparing spouses with offspring with diagnosed autistic spectrum disorder to spouses without. Prevalence of autistic spectrum disorders in children in countries with and without predominant assortative mating was compared. Results: A total of 14 investigations of assortative mating including 9914 spouse pairs were included. In total, 8 studies (4641 spouse pairs) reported intra-class correlation (ICC) or Spearman's correlation coefficients between spouses' SRS scores. There was a significant correlation of SRS scores in studies using ICC or Spearman's correlation with a pooled coefficient = 0.37. Spouse pairs (n = 401) with offspring diagnosed with autistic spectrum disorder had a pooled ICC coefficient which was 0.278 (95% CI 0.08 to 0.46), significantly lower than spouse pairs without (n = 1525): 0.40 (95% CI 0.35 to 0.46). Higher scores in SRS of both spouses were associated with higher scores and more autism diagnoses in offspring. Pooled prevalence of autistic spectrum disorder in children in countries where assortative mating is most common was 63.1 per 10,000 of population and in countries without it was significantly lower with 14.1 per 10,000 of population. Conclusions: There is evidence of assortative mating according to social responsiveness scale score which correlates significantly in spouse pairs with and without children with autistic spectrum disorder. In countries where assortative mating is predominant, a higher prevalence of autism spectrum disorder in children is found compared to countries without.

Objectives This study aimed to compare broad autism phenotype (BAP) features – considered an endophenotype of autism spectrum disorder (ASD) – and mind-reading from the eyes skills in parents of children diagnosed with ASD and language disorder (LD) with those of parents of healthy developing (HD) children, and to identify possible differences. Methods The study included 92 children (ASD n = 31, LD n = 31, HD n = 30) and their parents (n = 184). Parents who participated completed the Autism Spectrum Quotient (ASQ) and the Reading the Mind in the Eyes Test (RMET). Results Fathers of children with ASD and LD showed similar scores on the social skills and attention to detail subscales and scored significantly higher than fathers of HD children (p < .05). No significant differences were found in RMET scores among parent groups (mothers p = .344; fathers p = .834). Across all participants, ASQ total and social skills subscale scores were negatively correlated with RMET total scores. Conclusions Parents of children with ASD and LD differed from controls in BAP characteristics, but RMET performance showed no group differences. These findings support previous research indicating etiological and pathological continuity between ASD and LD.