Experiences of first-generation immigrant parents accessing early services for their autistic children in the UK

Conceptualizing the substrates and sequelae of decreased sound tolerance as a developmental cascade: A pilot study.

The Simons Sleep Project (SSP) is an open-science resource designed to accelerate digital health research into sleep and daily behaviors of autistic children. The SSP contains data from Dreem3 EEG headbands, multi-sensor EmbracePlus smartwatches and Withings' sleep mats, as well as parent questionnaires and daily sleep diaries. It contains data from >3,600 days and nights collected from 102 children (aged 10-17 years) with idiopathic autism and 98 of their nonautistic siblings, and enables access to whole-exome sequencing for all participants. Here we present the breadth of available harmonized data and show that digital devices have higher accuracy and reliability compared to parent reports. The data show that autistic children have longer sleep-onset latencies than their siblings and longer latencies are associated with behavioral difficulties in all participants, regardless of diagnosis. The results highlight the advantages of using digital devices and demonstrate the opportunities afforded by the SSP to study autism and develop broad digital phenotyping techniques.

ABSTRACT 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.

Based on a review of scientific literature, this article analyzes factors in the development of autism (autism spectrum disorder) in children. Emphasis is placed on the analysis of essential micronutrient imbalances and the effects of toxic elements. It is shown that autism is a neurodevelopmental disorder characterized by a deficit in social interaction, limited interests, and a tendency toward stereotypical behavior. The causal factors of autism are not fully understood, reflecting the complex interaction between genetics and the environment. Autism is believed to arise from a genetic predisposition that is realized under adverse circumstances. The subjectivity of ASD diagnosis, based on behavioral responses, necessitates the inclusion of objective biomarkers. It is shown that the balance of chemical elements in the body significantly influences the development and progression of autism. Toxic elements, as well as a deficiency or excess of essential micronutrients (calcium, iron, selenium, zinc, and copper), have been shown to play a role in the development of ASD. Most of the reviewed publications focus on the role of toxic metals (mercury, cadmium, lead, aluminum, and arsenic). A review of the extensive literature on the link between ASD and excess mercury exposure yielded inconclusive results. Mercury exposure to ASD has been linked to the use of vaccines containing thimerosal, but the incidence of the disease continued to increase after thimerosal was removed or reduced from vaccine formulations. The toxic effects of aluminum on the brain have also been linked to the use of pediatric vaccines containing immune adjuvants. References to autism increased during the period when mercury was removed from vaccines, and the presence of aluminum adjuvant increased. According to the researchers, there is a negative correlation between ASD and aluminum, leading the authors to believe that aluminum may be a biomarker of autism in children. Further study of the elemental status of children with ASD will clarify the mechanisms of autism development, and the elemental characteristics of people with ASD may be a diagnostic marker of autism.

Teaching at the Right Level Approach for Autistic Children in Islamic Religious Education in Inclusive Classrooms

ABSTRACT Long-term care for autistic children tends to expose parents to higher levels of parenting stress, which affects the quality of family life and the child’s development and well-being. The first objective of this study was to identify profiles of parenting stress in parents of autistic children, and the second objective was to explore the influencing factors affecting the profiles. The Parenting Stress Index-Short Form (PSI-SF) was administered to 231 parents. Results indicated significant within-group differences in parenting stress, which could be profiled into three profiles: low-stress, medium-stress, and high-stress. Coping styles, support utilization and autism symptom severity significantly influenced the profiles of parenting stress. This study will provide an effective guide to alleviate parenting stress and facilitate the development and well-being of autistic children.

There is a growing need to examine how Theory of Mind (ToM) abilities impact real-time social engagement in autistic children. Caregivers of 45 young autistic children (70.7 ± 23.3 months) and those of 36 neurotypical peers (59.2 ± 11.8 months) carried a mobile device for 7 days to repeatedly record their child's social interactions and in-the-moment anxiety. They also completed the Social Responsiveness Scale-2 and the Theory of Mind Inventory-2 to evaluate their child's severity of autistic symptoms and ToM abilities. Multilevel analyses found that young autistic children with higher ToM abilities were more likely than those with lower abilities to interact with peers (OR = 1.12, 95% CI = 1.01-1.23) but also experienced more anxiety during interactions with both peers and adults (OR = 1.36, 1.28, 95% CI = 1.12-1.67, 1.01-1.63). In contrast, no significant associations between ToM and social interactions or anxiety were found in the neurotypical group. This study highlights the critical role of ToM abilities in the real-life social engagement of autistic children and emphasizes the importance of understanding real-time subjective social experiences.

Rosiglitazone Adjunct to Risperidone for Irritability in Autistic Children: A Randomized, Double-Blind, Placebo-Controlled Trial.

This paper investigates the effect of drama therapy as a form of intervention to improve social awareness of children with autism from between the ages of 3-8 years old at the Guangxi Special Children Care Service Center in Guangxi China. Using an experimental methodology, 5 autistic children are chosen based on a specific level of support for ASD disorder from DSM-1 to DSM-5. A 6-month drama treatment intervention experiment is carried out where SRS 2nd ed. Scale for Autism, Emotional Recognition Test for Autism, Development-Based Behavioral Assessment System for Children with Autism was used to record the changes before and after the intervention. The experiment involves interviewing the parents of these autistic children through in-depth interviews as well as experts’ observation of the changes that form the data for this research. There are 3 phases of observation that are pre-, progressive and post-tests after drama therapy where the data are coded and triangulated with expert’s as well as parental observations to be coded in themes and sub-themes according to case-study in qualitative research methodology to explore the effect of drama therapy. This paper however, will focus only on social awareness in children with autism. The findings of this data hope to promote a new innovative method to successfully educate and improve social awareness in children with autism. Keywords: Drama Therapy, Autism, China, Interpretive Phenomenological Analysis

Symptoms of irritability are commonly reported in autism, yet correlates of this domain remain poorly understood. While prevalence estimates in the literature vary considerably, they range up to 80%. Irritability can interfere with daily functioning, social relationships, and academic performance. Despite years of research and the availability of approved medications, intervention outcomes for irritability remain highly variable. To advance understanding and inform more targeted, personalized interventions, the present study aimed to clarify the correlates of irritability in autism using network analysis, an analytical tool suited to capture complex associations across interconnected variables. We examined demographic, phenotypic, and physiological factors in a sample of autistic and neurotypical children. Our findings identified strong direct associations between irritability and externalizing behaviors, emotion dysregulation, autism features, and negative affect. Physiological responses, including heart rate reactivity and variability, were indirectly connected to irritability through links with self-regulation abilities and ADHD traits. These results highlight the importance of conceptualizing irritability in autism as part of a broader, interconnected network of influences rather than an isolated symptom. Recognizing these relationships informs potential targets for future intervention studies.

Academic achievement in autistic children is highly variable: some experience significant difficulties, others perform on par with their peers. While the preschool home learning environment (HLE) supports academic development in neurotypical children, it remains unclear what this environment looks like for autistic preschoolers, how it differs from their peers, and how it relates to child characteristics and academic skills. This systematic review searched Web of Science, PubMed, ERIC and Scopus, following PRISMA guidelines. It provides a comprehensive overview of 43 studies on the HLE of autistic preschoolers, exploring differences with peers, associations with child characteristics and academic skills, and outcomes of HLE-focused interventions. Overall, parents of autistic preschoolers reported engaging in a range of learning activities, having many books available and holding positive beliefs about the HLE. While some differences with peers emerged, these often disappeared once children's language skills were taken into account. Child characteristics appeared to influence the HLE. However, evidence on associations between the HLE and academic skills was limited and mixed. Notably, only one study examined home numeracy, and no studies investigated the longitudinal impact of the preschool HLE on academic outcomes. Intervention studies showed promising effects on parent and child behaviours, though long-term effectivity and methodological rigour remain concerns. Autistic preschoolers generally experience rich HLEs, with limited differences from peers. Future research should clarify how the HLE influences learning development in the short and long term, consider the role of child characteristics, and address the notable gap in home numeracy research.

One of the most common problems faced by autistic children is sensory integration problems related to the challenges of developing social cognition. This research aims to establish the causal effect of sensory motor at home and its role in enhancing the social cognitive development of preschool children with autism spectrum disorder. Considering the difficulties of autistic children in the sensory processing and reciprocal social interaction domains, the active early intervention introduced in a familiar home environment has great potential to promote the development and improvement of the key cognitive and social skills. This qualitative research will involve interviewing parents of autistic children between the ages of three to six years. The researchers will identify the range of interesting and efficient sensory motor activities that are already taking place in the home environment and then analyse how these actions affect the social cognition development of the children in a more detailed manner. This research will provide a better perspective on the use of home-based sensory motor practices by providing empirically generated information in the process of facilitating social cognition. It can then be used to directly develop more accessible, convenient, and parent-friendly ways of the early intervention stage, enabling families to actively enhance their child's development in all areas beyond clinical environments and provide significant insights for stakeholders in the autism community, such as parents, educators, and therapists.

Background/ObjectivesThis study aimed to evaluate the performance of deep learning models for recognizing facial expressions of children with autism through face recognition technologies.MethodsConducted between November 2024 and February 2025, this research introduced a novel deep learning architecture, AutismEfficientNet, by integrating EfficientNetV2 and MobileNetV3. Two previously published datasets—Dr. Fatma M. Talaat’s Emotions of Autistic Children and the FERAC dataset—were used, both containing labeled facial images of children with autism displaying various emotions. Images were preprocessed and divided into training, validation, and test sets. Emotion classification was performed using convolutional neural networks. Models were evaluated using accuracy, sensitivity, specificity, and F1 scores.ResultsDeep learning models were able to accurately recognize emotional expressions in children with autism. The proposed AutismEfficientNet achieved the highest accuracy (75.8%) among the tested models, outperforming EfficientNetV2-L (72.4%) and MobileNetV3-L (70.2%).ConclusionsThe findings indicate that AutismEfficientNet provides improved classification accuracy compared to standard architectures when applied to datasets of children with autism. Further validation is required in clinical settings and diverse populations before integration into pediatric care.

To address the dearth of literature on outcomes for autistic individuals with significant intellectual disability, researchers require validated measures to use in research. This study examined the psychometric properties of PROMIS quality-of-life caregiver-proxy scales included in the PROMIS Autism Battery-Lifespan among autistic children who are minimally verbal and with intellectual disability (MVID). We examined basic psychometric properties of the PROMIS caregiver-proxy scales and tested the scales for measurement invariance between groups of autistic children who are minimally verbal with intellectual disability and those without signficant intellectuatl disability (N = 448). We also descriptively examined feedback from caregivers regarding the appropriateness of the questions to capture meaningful outcomes for their autistic children who are minimally verbal with intellectual disability. Results indicated that some PROMIS caregiver-proxy scales (Anger, Positive Affect, and Life Satisfaction) exhibited strong psychometric evidence and content validity, but many other scales either did not demonstrate measurement invariance between groups or included a high proportion of items endorsed by caregivers as not applicable for their minimally verbal autistic child. Our findings emphasize the need for continued work developing appropriate measures for capturing meaningful outcomes among minimally verbal autistic people with significant intellectual disability.

This work evaluates use of the TELE-ASD-PEDS-Preschool (TAP-P), a telemedicine-based autism assessment tool for the preschool age range. The TAP-P is a play-based instrument with varied administration and scoring procedures based on a child's language level. This study compared tele-assessment using the TAP-P to in-person autism assessment. Participants were 116 children (aged 36-71months) referred for autism evaluation. Participants first completed in-home tele-assessment (administration of the TAP-P, clinical interview, and Developmental Profile 4). All participants then completed in-person assessment with a different psychological provider, including cognitive or developmental assessment, adaptive behavior assessment, and autism-focused assessment (ADOS-2). Caregivers completed questionnaires after each appointment assessing their perceptions. When asked to make a binary decision about presence or absence of autism, tele-assessment and in-person clinicians agreed for 82% of participants (n = 95). In most instances of diagnostic disagreement (n = 17), tele-assessment clinicians indicated the absence of autism and in-person clinicians indicated the presence of autism. When given the option to select "unsure," tele-assessment clinicians reported uncertainty for 28% of participants assessed using Form 1 of the TAP-P (designed for children with less verbal language, defined as two-word phrases or less) and 52% of children assessed using Form 2 (for children with more verbal language). Families reported broad satisfaction with tele-assessment procedures. This work highlights potential utility of tele-assessment for identification of autism in preschool-aged children with less verbal language, while emphasizing the critical need for additional research related to use of tele-assessment for children using more complex and flexible verbal language.

Study ObjectivesEvaluate the effect and safety of alpha rhythm-guided repetitive transcranial magnetic stimulation (α-rTMS) on sleep difficulties in children with autism spectrum disorder (ASD).MethodsTwenty children (6–12 years old; 16 males; 4 females) with ASD level 2 were randomly assigned (1:1 ratio) to a treatment group (TG) or a waitlist control group (WLCG) (T1). The TG received ten α-rTMS sessions over two weeks, while the WLCG acted as control for that period (T2). Next, the WLCG received α-rTMS for two weeks (T3). All study participants were followed up at one (T4) and four (T5) months. Sleep difficulties were measured using the Children’s Sleep Habit Questionnaire (CSHQ), Actigraphy, and Polysomnography (PSG).ResultsGroup-by-time interactions indicated that the TG had greater improvements than the WLCG in total CSHQ score (p=.008) and, bedtime resistance (p=.003), sleep onset delay (p=.004), and sleep duration (p=.003) subdomain scores. When the WLCG received the α-rTMS, there were improvements in their sleep-disordered breathing (p=.001), parasomnia (p=.002) and sleep duration (p=.018) subdomain scores, while PSG data showed improved Waking After Sleep Onset (WASO) (p=.014), Sleep efficiency (p=.046), and N2 stage (p=.039). The improved CSHQ scores persisted, with actigraphy data showing significant improvement in WASO at T4 and T5. Side effects of α-rTMS were mild and transient.ConclusionsThis RCT study presents preliminary evidence on the effect and safety of α-rTMS in improving subjective sleep difficulties in children with ASD, with effects lasting up to four months post-intervention. Further studies using a larger sample size and sham-controlled group are warranted.Clinical Trial RegistrationThe trial was registered on July 11, 2023 within the Australian New Zealand Clinical Trials Registry (ANZCTR) https://www.anzctr.org.au/TrialSearch.aspx with registration number: ACTRN12623000757617.Statement of SignificanceThere is a need for new interventions that address the prevalent and significant sleep difficulties in children with autism spectrum disorder (ASD). This study presented preliminary evidence on the safety and effect of alpha rhythm-guided repetitive transcranial magnetic stimulation as a potential therapeutic option for improving sleep difficulties in children with ASD. Such technology-based intervention may provide an alternative approach to autistic children who do not respond to behavioral and or pharmacological-based sleep interventions. However, future studies using a larger sample size and sham-controlled design are warranted to translate this intervention into clinical practice.

Background/Objectives: Autism spectrum disorder (ASD), a neurodevelopmental condition characterised by social and communication differences, is complex and aetiologically heterogeneous. Untargeted metabolomics is emerging as a tool in screening for biochemical abnormalities. This research was conducted using the Australian Autism Biobank resource and involved analysis of plasma metabolites to characterise metabolite differences between autistic children and controls. Methods: We sought to identify molecular signatures in the plasma of study subjects using mass-spectrometry methods. We included 955 untargeted plasma metabolites from autistic children (n = 491; 2–18 years; 78% male) and control subjects (n = 97; 2–17 years of age; 51% male). Statistical analyses were performed using questionnaire data for both groups, including standardised scores from the Autism Diagnostic Observation Schedule—Second Edition (ADOS-2), which measures the severity of autism-related behaviours. We also evaluated intellectual disability by examining the relationships between metabolites and clinical phenotypes. Results: After controlling the false discovery rate at 5%, we identified significant negative associations between the uncharacterised metabolites X-21383 and X-24970 and ASD status (p = 1.85 × 10−6 and p = 1.92 × 10−5 respectively). X-21383 was also found to be significantly reduced in autistic children with coexisting intellectual disability when compared with controls (p = 6.06 × 10−6). No significant associations were identified between the metabolite data and ADOS-2 scores. However, greater levels of X-16938, N1-methyladenosine, and 2-oxoarginine were found to be suggestively associated with higher ADOS-2 scores (p = 2.95 × 10−4–9.6 × 10−5). Conclusion: This metabolomics study in the Australian Autism Biobank has identified several novel metabolites associated with core autism diagnostic behaviours.

Effectiveness of Motor Support Program in Multidimensional Development of Autistic Children.

In the last two decades, autism research in computing has experienced tremendous growth, highlighting the potential to improve the experience of autistic individuals. Our research offers a detailed understanding of the landscape of autism computing research in the ACM Digital Library by conducting a literature review (N=533). Our analysis reveals that autism computing research lacks inclusiveness in several important demographic dimensions, including gender identity, age, and culture. The developed technology is largely focused on diagnosis (e.g., autism detection) and addressing the needs of autistic children (e.g., improving social communication) while ignoring the challenges of autistic elderly and adults (e.g., independent living and employment). Also, autism computing research in the ACM Digital Library is concentrated in North America and Europe, with no or little representation from Africa, South America, and Oceania. We identify areas that deserve attention and provide actionable guidelines to enhance the inclusiveness and generalizability of autism research in computing.