A body of research suggests cross-neurotype interpersonal interactions may be more challenging, and non-autistic individuals show less interest in int…

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In a synthesized contingency analysis (SCA), contingencies hypothesized to maintain problem behavior are combined into a single test condition; if the behavior occurs at a higher rate in that conditi...

Background Autism and ADHD are heritable, co-occurrent, and associated with difficulties with executive functioning (cognitive and self-regulation skills which enable us to set and work toward goals). Executive function difficulties, and their negative impacts across cognitive, health and social domains, extend to individuals with first-degree relatives who are autistic or have ADHD, even if they do not meet thresholds for a clinical diagnosis themselves. Supporting executive function development in children with elevated autism traits, or a first-degree relative with autism or ADHD, addresses community priorities for early support to help achieve the best mental health, education and life outcomes. Methods This study will evaluate the feasibility and acceptability of a randomized controlled trial (RCT) of a parent-toddler programme entitled “Supporting Toddlers with a connection to autism or ADHD to develop strong Attention, Regulation and Thinking skills” (START). START is a neurodiversity-affirming programme, co-refined through extensive Patient and Public Involvement. Sixty parent-child dyads, in Oxford or Southampton (UK), will be randomized using Sealed Envelope by a researcher not involved in recruitment, delivery or outcome data collection to receive START or usual practice, on a 1:1 ratio. Children (20 months old) will be assessed using questionnaires completed by the parent (not blind to allocation) post-intervention (within 2 weeks of the end of the active intervention wave, when children are aged 27–31 months), and using parent questionnaires and a battery of executive function measures administered by researchers blind to allocation at baseline and follow-up (36 months old). START will be delivered in small groups to 30 parent-child dyads, in community settings. Discussion We will assess the feasibility of recruiting eligible participants to the study, the reliability of measures of implementation fidelity and degree of implementation fidelity achieved, the appropriateness of proposed outcome and mechanism measures, the acceptability of an RCT of the programme, parental adherence to the programme, logistics of programme delivery, and the acceptability of START, using mixed-method measures of engagement and satisfaction. Results will inform the design and implementation of a definitive RCT of START, and yield broader insights into the delivery and evaluation of complex early-years interventions in community settings. Trial registration ISRCTN registry ISRCTN99820028 https://doi.org/10.1186/ISRCTN99820028 .

PROSPERO

When faced with many options to choose from, humans typically need to explore the utility of new choice options. People with an autism diagnosis or elevated autism traits are thought to avoid exploring such unknown options, but it remains unclear how autism affects exploration in decision spaces with many options. In a large online sample (N = 588), we investigated the impact of autism diagnosis or elevated autism traits on exploration behavior during value-based decision-making in vast decision spaces. We used a 121-armed bandit with spatially correlated choice options, and a dedicated computational model to disentangle generalization, uncertainty-guided exploration, and random exploration strategies. Our findings show that participants with a self-reported autism diagnosis were less likely to explore novel choice options and more likely to exploit known high-value options. Computational modeling suggests they engaged in less uncertainty-driven exploration but exhibited equal random exploration and generalization strategies. Interestingly, among non-diagnosed participants, people with elevated autism traits did not explore less. This study relies on self-reported autism diagnoses and trait measures collected online. This may limit the generalizability of the findings to clinically verified or more diverse autism populations. Our findings highlight important differences in exploration strategies between clinical and subclinical populations and emphasize the importance of cognitive modeling and using vast decision spaces to better understand autism.

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

This concise review summarizes the trends and outcomes of social validity assessments specifically related to functional analyses published between 2020 and 2024. Results indicate that very little da...

A study of several longitudinal birth cohorts and cross-sectional cohorts finds only moderate overlap in genetic variants between autism that is diagnosed earlier and that diagnosed later, so they may represent aetiologically different conditions.

Purpose Autistic individuals and individuals with borderline personality disorder (BPD) are both more likely than the general population to require access to mental health services, specifically inpatient services. Both groups of individuals have reported difficulties when accessing inpatient services including stigma, lack of understanding and lack of adaptations. Recent research has suggested having diagnoses of both autism and BPD is becoming more common and that individuals with both diagnoses may be more at risk of suicidal thoughts and self-harm behaviours. The aim of this study is to understand the experiences of accessing inpatient mental health services for individuals with a diagnosis of autism and BPD. Methods Semi-structured interviews were conducted with participants. The data were analysed using reflexive thematic analysis. Results Seven participants were interviewed. Six themes were developed: (i) Never fully understood, (ii) Intense need for care and connection, (iii) Prisoner or patient? When care and punishment are intertwined, (iv) Necessary evil, (v) System always wins, (vi) Responsible for own care. Conclusions Autistic individuals with BPD require personalised care that integrates both their diagnoses into their identities. To provide this, staff on inpatient wards need appropriate support including reflective spaces and clinical supervision. Inpatient systems also need to shift away from prioritising the needs of the system and towards prioritising the needs of the individual, including adaptations for autistic individuals.

Molecular Psychiatry - Asymmetric developmental bifurcations in polarized environments: a new class of human variants, which may include autism

PROSPERO

Purpose Many autistic individuals experience social challenges that may stem from negative perceptions held by their non-autistic peers. This study aimed to examine school-aged children’s first impressions of autistic and non-autistic children based on viewing brief videos. The central research question was whether autistic children are perceived differently in terms of social traits and how these perceptions affect willingness to engage with them. Methods Thirty-seven children aged 5–12 years old viewed brief (10 s) videos of both autistic and non-autistic children discussing their interests. Participants then rated each child on social traits (i.e., strange, confident, honest, mean, likeable, smart) and indicated their behavioral intentions (i.e., willingness to live near, sit near, hang out with and talk to) towards the children in the videos. Results Autistic videos were rated as appearing more awkward, more aggressive, and less likeable compared to non-autistic videos. However, participants reported a similar willingness to interact with both groups. Importantly, these negative perceptions were not associated with the rater child’s age, IQ, sex, autistic traits, or social competence. Conclusion The findings suggest that school-aged children hold biased perceptions of autistic children, independent of their own personal characteristics. This underscores the need for early educational interventions in schools to address stereotypes about and biases against autism. Teaching children about autism could reduce stigma, foster inclusion, and improve social interactions between autistic and non-autistic peers.

The long-term outcomes of regression in autism spectrum disorder (ASD) remain unclear. Previous evidence suggests that autistic individuals with regression have poorer adulthood outcomes across vario...

Autistic individuals respond to sensory information in perceptual tasks differently than non-autistic individuals. However, it is unclear which component proces...

Editors and reviewers of research manuscripts may have conflicts of interest that impact their evaluations. We aimed to characterise medical journals'…

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Purpose Autistic children have been shown to have poorer bone health than their non-autistic peers, but previous evidence on this topic has been based on small clinical samples and is limited by how b...

At its core, pathologising is choosing the language of pathology to describe suffering. In youth mental health, the prevailing choice is to use diagnostic labels such as ADHD and autism when describi...

The neurodiversity approach recognizes autism as a natural variation of human experience, emphasizing unique strengths while acknowledging social and behavioral...

Calendar calculation is the ability to answer rapidly to questions such as "What day of the week was May 12, 1978?" or "For which years is February 15…