To investigate associations between possible sleep bruxism (PSB) and sleep disorders in children/adolescents with autism spectrum disorder (ASD) as well as parental perceived stress.

This study investigated whether attending mainstream school is associated with improved social inclusion among children on the autism spectrum and their parents. The cross-sectional study took place from July to August 2023 at 30 rehabilitation centers for children on the autism spectrum in Hunan Province, China. Participants included 860 children aged 3-14 years, with autism history receiving outpatient rehabilitation services, and their primary caregiver parents aged 23-54 years. Social inclusion among children on the autism spectrum was evaluated using the Chinese version of the social inclusion subscale of the KidsLife-ASD Scale. Parental social inclusion was assessed using the Chinese version of the Social Inclusion Scale. Linear mixed models were used to explore the association between attending mainstream school and social inclusion. Among children on the autism spectrum, 36.2% attended mainstream school. These children showed significantly higher levels of social inclusion compared to non-attenders. Subgroup analysis based on the severity of autism symptoms revealed that the significant association remained in both the mild and moderate/severe subgroups, being more pronouced in the mild subgroup (P < 0.001). Parents of children attending mainstream school reported greater social inclusion levels than those whose children did not; however, after adjusting for severity of autism symptoms and other factors, this association became non-significant. Our study demonstrates a positive association between attending mainstream school and social inclusion for children on the autism spectrum, highlighting the critical role of mainstream school education in fostering social opportunities and providing diverse learning resources. It also underscores the need for targeted support strategies for parents.

Human-Animal Interaction (HAI) has been widely adopted as an approach to enhance the well-being of children with ASD, who often experience significant social impairments, emotional dysregulation, and other daily challenges. Given the potential variation of HAI across countries, there is a particular need to explore this phenomenon within different cultural contexts and to illuminate directions for facilitating positive HAI among children with ASD. The purpose of this review is to systematically synthesize the current knowledge of HAI as applied to children with ASD and to discuss possible variations across different cultural contexts. A systematic database search was conducted to synthesize HAI characteristics from existing studies that met the selection criteria. The results highlighted that most of the selected studies (N = 97) were conducted in Europe or the United States. The most common format of HAI identified was animal-assisted intervention, followed by pet ownership. Dogs and horses were the primary animals involved in HAI for children with ASD, while the majority of HAI occurred in home settings and at horse riding or training centres. To conclude, this review provides a more comprehensive lens for understanding the phenomenon of HAI for children with ASD across different countries and discusses cultural variations in terms of the companion animals involved, the formats, and the settings of HAI. It also offers therapeutic insights into the multicultural aspects of HAI, which may shed light on future interventions for children with ASD through HAI in more diverse settings.

Autistic trans and gender diverse (TGD) individuals face unique voice and communication challenges compounded by minority stressors, impacting wellbeing and access to care. Speech pathologists are crucial in providing gender-affirming and neurodiversity-affirming support; however, guidance for working with this intersectional population remains limited. This scoping review mapped current knowledge on voice and communication challenges, identifies available supports, and demonstrates the limitations of existing guidance for speech pathologists. This review draws on 40 sources, including 29 peer-reviewed articles, 8 clinical guidelines, 2 books, and 1 position statement, identified through comprehensive searches of databases such as CINAHL, ERIC, Medline, APA PsycINFO, and grey literature in May 2024. Findings indicated that 96.8% of identified challenges pertained to communication, while fewer (3.2%) focused on voice-specific issues. Similarly, supports primarily addressed communication (91.3%), with 8.7% targeting voice needs. Communication challenges included barriers faced by autistic TGD individuals and those interacting with them, including healthcare professionals, peers, and family. Supports were identified as strategies and resources to enhance service delivery and client wellbeing, such as using visual aids or offering multiple communication options. However, significant gaps remain in addressing the unique voice and communication needs of this population, particularly regarding voice dysphoria, camouflaging versus identity disclosure, and communication within healthcare settings. Autistic TGD individuals represent a unique population whose needs are not sufficiently addressed by current guidance. This review highlights significant gaps in research and clinical practice and calls for improved clinical guidelines and specialized training for speech pathologists to enhance care.

Cry analysis is emerging as a promising tool for early autism identification. Acoustic features such as fundamental frequency (F0), cry duration, and phonation have shown potential as early vocal biomarkers. This systematic review and meta-analysis aimed to evaluate the diagnostic value of cry characteristics and the role of Machine Learning (ML) in improving autism screening. A comprehensive search of relevant databases was conducted to identify studies examining acoustic cry features in infants with an elevated likelihood of autism. Inclusion criteria focused on retrospective and prospective studies with clear cry feature extraction methods. A meta-analysis was performed to synthesize findings, particularly focusing on differences in F0, and assessing the role of ML-based cry analysis. The review identified eleven studies with consistent acoustic markers, including F0, phonation, duration, amplitude, and voice quality, as reliable indicators of neurodevelopmental differences associated with autism. ML approaches significantly improved screening precision by capturing non-linear patterns in cry data. The meta-analysis of six studies revealed a trend toward higher F0 in autistic infants, although the pooled effect size was not statistically significant. Methodological heterogeneity and small sample sizes were notable limitations across studies. Cry analysis holds promise as a non-invasive, accessible tool for early autism screening, with ML integration enhancing its diagnostic potential. However, the findings emphasize the need for large-scale, longitudinal studies with standardized methodologies to validate its utility and ensure its applicability across diverse populations. Addressing these gaps could establish cry analysis as a cornerstone of early autism identification.

Despite the importance of monitoring changes in expressive language in early intervention, existing approaches to language assessment are often costly, time-intensive, and capture limited variability in autistic children. The Language ENvironmental Analysis (LENA) system has thus received considerable attention as an automated approach that may hold promise for capturing fine-grained changes in language development in a more efficient and cost-effective manner. However, evaluations of the utility of the LENA system for tracking response to early intervention in unstructured contexts are currently limited.

This study investigated sex differences in adult autism screening by comparing self-reports on current traits (Autism Spectrum Quotient; AQ) and parent-reports on childhood traits (Relatives Questionnaire; RQ). The aim was to examine the differential contribution of these distinct measures to diagnostic classification in both sexes. The study compared 102 clinically diagnosed autistic adults (30 females) and 152 non-autistic adults (60 females), aged 17-35 years. Participants completed the AQ, while their parents completed the RQ. Multivariate analysis of variance and sex-stratified discriminant analyses were employed to evaluate measurement patterns in males and in females. Significant main effects were found for diagnostic group on both measures and for sex on the RQ only. Group × sex interactions were significant for both measures. Within the autistic group, males and females showed no significant difference in AQ scores, but females scored significantly lower than males on the RQ. Discriminant analyses revealed high classification accuracies for both males (95.1%) and females (96.7%), with different weighting patterns between males (AQ = 0.597 [CI: 0.413-0.720], RQ = 0.712 [CI: 0.553-0.789]) and females (AQ = 0.763 [CI: 0.637-0.898], RQ = 0.478 [CI: 0.191-0.616]). The findings suggest that current self-report may be more central for identifying autism in females, while a more balanced combination of current-self and past-parent reports may be optimal for males. These sex-specific patterns highlight the importance of considering both current self-reported traits and developmental history in adult autism screening, with potential implications for improving diagnostic accuracy across sexes.

Resilience within families may temper the risk of high parenting stress faced by parents of young children with ASD. Within families, individual differences between parents may contribute differently to resilience. There is a lack in knowledge regarding the contribution of intrapersonal and contextual factors associated with resilience in parents of young children with ASD within the same family. In this cross-sectional study (n=249 individuals), resilience within families is addressed by investigating (1) family parenting stress, (2) associated factors contributing to maternal (n=87) and paternal (n=74) resilience, and (3) relating to resilience within families (n=74) of 3-to-6-year-old children with ASD (n=88). (1) The percentage of families with regular parenting stress in both parents (33%) is almost equal to the proportion of families with (sub)clinical parenting stress in both parents (36%), families with mothers experiencing (sub)clinical and fathers experience regular parenting stress are twice as common (22%) than the other way around (9%). Contributors to (2) mothers' resilience to parenting stress are good planning/organizing skills and satisfactory social relations. Contributors to fathers' resilience are low levels of 'worrying' and good social relations. The shared contributing factor to resilience within families (3) is the satisfaction of both parents with their social relations. Most of the parents of the same young child with ASD experience a comparable degree of parental stress, with different dynamics in individual parents contributing to resilience within families. This suggests the need for a personalized parental approach in families with young children with ASD.

Autism Spectrum Disorder (ASD) is a prevalent neurodevelopmental disorder, and early diagnosis plays a pivotal role in prognosis and management. This study aims to examine the psychometric properties of the Autism Mental Status Exam (AMSE), a tool that shows great promise in terms of clinical utility, within the Turkish population. This study conducted in a cohort of 307 Turkish children aged 17 to 120 months with suspected ASD. Participants underwent a multidisciplinary assessment based on DSM-5 criteria for diagnosis and were categorized into ASD and non-ASD groups. Subsequently, the research team conducted blinded administrations of the AMSE and Childhood Autism Rating Scale (CARS). Additionally, a subset of 61 children underwent retesting for AMSE and CARS after three weeks for temporal stability. The results revealed an optimal cut-off score of 4 for AMSE, yielding sensitivity and specificity rates of 84% and 97%, respectively. Internal consistency, indicated by a Cronbach's alpha of 0.80, was very good. The test-retest reliability, assessed using the Intraclass Correlation Coefficient (ICC), was excellent (ICC = 0.959). The inter-rater reliability also showed excellent agreement (ICC = 0.997). Furthermore, a significant correlation was observed between the AMSE and CARS scores (r = 0.94, p < 0.001). Notably, the AMSE scores were significantly different between the ASD and non-ASD groups (p < 0.001) with a large effect size (Cohen's d = 1.40). The findings of this study underscore the utility of AMSE as a valid and reliable tool for Turkish children with robust psychometric properties.

Daily living skills (DLS) are one key predictor of autistic adults attending post-secondary education, obtaining employment, and living independently. However, these skills often lag behind typical development for autistic people regardless of their cognitive abilities. Autistic adolescents and their caregivers have indicated a desire for more DLS supports. While there are evidence-based practices (EBPs) to teach DLS, autistic adolescents without intellectual disabilities are unlikely to receive DLS instruction in their general education coursework, and caregivers report lacking resources and strategies to teach these skills at home. To address these concerns, we developed an eLearning module series to support caregivers of autistic adolescents without intellectual disabilities in promoting DLS at home. The current single case design study measured the impact of the modules on caregiver fidelity to the EBPs and adolescent independence with self-selected DLS. The study also assessed the social validity of the modules. The results of this study reveal functional relationships between the module series and caregiver fidelity to the EBPs and to adolescent independence with targeted DLS. The caregivers and the adolescents both rated the acceptability, feasibility, and significance of the intervention favorably. These results indicate that the novel eLearning series is a successful and practical way to support autistic adolescents and their families to target and enhance DLS at home.

Siblings of children with chronic disorders are at risk of developing mental health problems. Studies are inconclusive about whether sibling mental health is best predicted by the specific diagnoses of the child with disorder or by transdiagnostic factors. The aims of the present study were (1) to examine if specific diagnoses predicted sibling mental health, and (2) to examine if disorder severity in the child with the chronic disorder predicted sibling mental health. Baseline data from a randomized controlled trial were used. Siblings (aged 8 - 16 years) of children with chronic disorders and their parents were recruited from eight municipality and hospital clinics (N = 288). The children with chronic disorders were placed in ICD-10 diagnostic categories based on combined parent report and clinical records. Regression analyses with the most frequent primary diagnoses (ADHD, Asperger syndrome, autism, down syndrome, rare disorders) and a measure of disorder severity as predictors of sibling mental health were run. Father-reported disorder severity predicted sibling-reported internalizing problems and father-reported internalizing and externalizing problems in siblings. Mother-reported disorder severity predicted mother-reported sibling internalizing problems. No single primary diagnosis predicted sibling internalizing or externalizing problems. Disorder severity does to an extent predict sibling mental health, whereas single diagnostic categories do not. Disorder severity may be used to identify siblings at risk and/or in need of interventions. Fathers should be included in assessment and health care for siblings as their reports seem to predict sibling mental health better than the mothers.

The goal of this study was to develop a comprehensive Theory of Change of caregiver coaching processes for an early social communication intervention for young autistic children, with attention to the caregiver learning process and a full constellation of outcomes for the caregiver and family unit. We interviewed intervention experts (n = 10), community providers (n = 22), and caregivers (n = 12) about their knowledge and experiences with a parent-mediated intervention (Project ImPACT), guided by the Theory of Change Framework. Qualitative interviews were transcribed and coded using the Framework Method and causation coding. We developed a comprehensive causal model which describes how both learning and motivational processes contribute to caregivers' implementation of the intervention, as well as broader outcomes with regard to sustainment, quality of life, advocacy, and goals and expectations. We also identified aspects of service need and contextual fit which inform the broader context for our theory of change. This study identified two mechanistic processes by which caregiver coaching impacts relevant short- and long-term caregiver and family outcomes, informed by practice-based knowledge. In the future, these findings can be used to guide empirical research that directly tests the mechanistic processes underlying effective parent-mediated interventions for young autistic children.

AutInsight is an innovative, consumer-informed parent support program for parents of autistic children grounded in perspectives from qualitative research with autistic adults. The current study outlines the development and evaluation of AutInsight through a pilot randomised controlled trial. Parents (N = 41) of autistic children (10 years and younger) were randomly allocated to AutInsight (n = 20) or care-as-usual (n = 21) and completed online questionnaires across three timepoints (baseline, post-program and 3-month follow-up). Measures include parental sensitivity, parental acceptance and understanding, psychological flexibility, mindful parenting, parental mental health, overall family experience, quality of life, and child behaviours. Intent-to-treat analyses indicated greater rates of improvement for parents allocated to the AutInsight program, with small- to medium-sized effects for parent-reported parental sensitivity (EA-SR mutual attunement d = 0.84, EA-SR child involvement d = 0.50), as well as overall autism family experience (AFEQ d = 0.38, AFEQ d = 0.29). Greater rates of improvement were also found in parent-reported child conduct problems (SDQ d = 0.62) and prosocial behaviours (SDQ d = 0.48). No significant results were found in observed parental sensitivity or any other measure. Results suggest preliminary evidence of effectiveness, feasibility and acceptability of the AutInsight program. A larger, fully powered trial is warranted. This trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry (Trial ID: ACTRN12623000806662).

Conduct a bibliometric analysis of articles related to dentistry and autism. A search strategy was constructed and conducted at the Web of Science database. The following information was extracted from each paper: title, authorship, year of publication, title of the journal, study subject dental care, oral health status, dental behavior support), study design, and number of citations. A total of 2,637 articles were obtained from the WoS-CC search. After selection, 422 papers were included, published from 1996 to 2024, and had 6,728 citations. Observational studies constituted most publications (214 papers). Among the focus of published articles, "oral health status" emerged as the predominant subject followed by "dental behavior support". More than half of the included papers were published in the last five years, accounting for 70.6% of the total. There has been a notable increase in research publications on autism and dentistry over time, primarily comprising observational studies. The predominant themes revolved around oral health status and dental behavior support.

Grammatical comprehension remains a strength in English-acquiring autistic preschoolers, yet limited studies have examined how autistic children process grammatical constructions in real time, in any language. This study sought to characterize the online processing of grammatical aspect in a diverse sample of Mandarin-acquiring autistic children. Forty-six 3-6-year-old autistic children, further divided into high (N = 23) and low verbal subgroups (N = 23) based on their expressive vocabulary levels, were assessed via Intermodal Preferential Looking (IPL). Children viewed side-by-side renditions of the same event, one of which was ongoing, while the other was completed, paired with familiar verbs with the perfective aspect le or the durative aspect zhe. Both high and low verbal autistic groups demonstrated robust comprehension of le and zhe. Similar to TD children, autistic children in each group showed processing facilities upon the initial presentation of the zhe test audio, but they may be less efficient at le processing. Moreover, the comprehension degree of grammatical aspect correlated negatively with their autism severity scores for the total autistic group; the processing efficiency correlated positively with the production of grammatical aspect for the total and low verbal autistic groups. The findings confirm the strength of processing grammatical aspect in subsamples of preschoolers with autism spanning a wide range of language functioning, suggesting that young autistic group across languages could surmount at least some challenges of aspect acquisition, such as delayed expressive language skills and pragmatic deficits. Additionally, the influencing factors provided insight into the informing intervention strategies that are optimally, developmentally timed.

The Vocational Index, a tool to reliably capture the range of vocational and educational activities in which adults with autism engage, is regularly used in studies of adult outcomes in autism. However, recently it has been noted that there are some activities (primarily postsecondary education options) that were infrequently available when the index was developed and thus are not fully represented in the current categories. The purpose of this report is to describe the process and results of updating the Vocational Index coding categories to reflect this wider range of activities. An iterative process was used to develop updated codes (called the Vocational and Educational Index). The original Vocational Index and updated Vocational and Educational Index codes were applied to a sample of 384 autistic young adults, and differences between original and updated codes were described. The major changes to the codes involved the development of a parallel educational dimension, benchmarked to the vocational dimension in level of integration, supports, and number of hours. Applying original Vocational Index and updated Vocational and Educational Index codes resulted in few differences in the overall distribution of codes but provided additional information about the contribution of vocational versus educational activities to the overall code. Limitations of the Vocational and Educational Index and future directions for research are discussed.

To report results of the Parent's Observations of Social Interactions (POSI) and identify associations between POSI results with referrals for developmental evaluations and autism diagnoses.

The crippling impacts of autistic burnout are well known to the autistic community, yet research is only in its early stages. While research to date has chiefly relied on structured interviews and Delphi studies, it has focused on defining and measuring burnout. What is missing from the research is an analysis of the broader experiences of autistic burnout, and the very real implications that autistic people face when impacted by it. This study reviewed the narratives of autistic people discussing their experiences of autistic burnout on the social media platform Reddit. Using data scraped from Reddit, quantitative and qualitative analyses were undertaken to elicit meaning from the online discourse. After analysing 249 Reddit threads using quantitative content analysis, the results supported existing research identifying three core components of autistic burnout, those being: chronic exhaustion; increased sensory sensitivities; and social withdrawal. New insights were found with users reporting physiological ailments as a complicating factor in their burnout experience. The research also found evidence supporting suggested treatment options for autistic burnout including reducing/stopping social obligations, reducing sensory inputs as much as possible, and time spent alone to reset and recharge. Most importantly, users identified that being autonomous in their recovery choices was critical to the success of their recovery.

Multi-informants are essential for capturing the full range of adaptive functioning abilities necessary for daily living and independence. However, discrepancies within parent-child dyads, specifically comparing parent-reports to child self-reports, can cloud interpretation from assessments and hinder support planning. This study examines discrepancies in parent-youth perceptions of adaptive functioning, focusing on the social domain, and investigates associations among parents, youth, and independent ratings, considering factors like IQ, autism severity, and parental education. The study included 132 individuals (66 autistic, 66 non-autistic) aged 16-24 years. Adaptive functioning was measured using the Adaptive Behavior Assessment System-3 across the conceptual, practical, and social domains. Agreement between reporters was assessed using paired-sample t-tests, intraclass-correlations, and Bland-Altman plots. Spearman's correlations examined associations between raters, while the effects of IQ, autism severity, and parental education on discrepancies were analyzed using linear regression. Autistic self- and parent-reports showed lower adaptive functioning than non-autistic dyads. Autistic youth reported higher social and less practical adaptive skills compared to parents. Autistic self-reports in the social domain correlated significantly with independent assessment. Increased autistic symptoms were associated with greater parent-child discrepancies. This study underscores the importance of multi-informant assessments to understand the full range of adaptive functioning in autistic individuals. Discrepancies in social and practical domains highlight the need for both perspectives, because parents may not observe all behaviors and may overlook autistic individuals' perception of support needs in the practical domain. Understanding these differences is crucial for improving supports planning and enhancing quality of life for autistic individuals.

The present study investigated the effects of a short-term synergic growth mindset intervention towards abilities and towards stress on reducing parental stress and promoting stress-related growth (SRG) among Arab parents of children diagnosed with Autistic Spectrum Disorder (ASD). One hundred and seven parents (70 mothers, 37 fathers) of male children with ASD, completed several questionnaires, including a demographic questionnaire; the Childhood Autism Rating Scale, the Parenting Stress Index-Short Form, the revised Stress- Related Growth Scale, The Implicit Self-Theories Scale, and the Stress Mindset Scale. Seventy- two parents were randomly assigned to an "intervention group", and 35 to a comparison group. Members of the intervention group participated in a short synergic growth mindset intervention, created especially for this research. Six months after the intervention, all participants re-completed the same questionnaires. The intervention significantly increased growth mindset and SRG and decreased parental stress. This study demonstrates the effectiveness of a short-term intervention in promoting growth mindsets, reducing parental stress, and fostering SRG among parents of children with a chronic disorder. These findings are particularly important since many parents of children with chronic disorders often exhibit fixed mindset patterns due to their children's slow progress in various developmental domains.

A systematic screening program for detecting autism at 18 months was progressively implemented in Oman since 2017. The primary objective of this study was to examine whether systematic use of M-CHAT-R/F screening is associated with lowering the age at ASD diagnosis, controlling for other predictors of age at ASD diagnosis. The study is based on a cross-sectional retrospective review of data extracted from electronic records of 756 children diagnosed with ASD between 1st January 2017 and 30th June 2023. Descriptive statistics and multiple linear regression models were used for data analysis. Of 756 children (mean age: 7.3 years, age range: 1.8-14 years; 77.5% males) included in this study, 98 (13%) underwent M-CHAT-R/F screening. The average age at ASD diagnosis was 60.7 months (95% CI: 58.8, 62.7 months). A significantly lower age at ASD diagnosis was observed among children who underwent M-CHAT-R/F screening compared to those who did not (39.4 vs. 63.8 months; p < 0.001). Multiple regression analysis indicates that children who were screened with M-CHAT-R/F received a diagnosis of ASD at an average age 20% earlier than children who were not screened with M-CHAT-R/F (adjOR = 0.80; 95% CI: 0.73, 0.88, p < 0.001). The population-based M-CHAT-R/F screening program appears to have reduced the average age of diagnosis of ASD among children. The findings may translate into earlier access to intervention and possibly improved long-term outcomes for children with ASD.