Journal of Autism and Developmental Disorders

Lin, Yunqiang; Wang, Chenglong; Chen, Rongdi; Zhang, Hongxia; Zhao, Dingwei

doi: 10.1007/s10803-025-06796-xpmid: 40106124

Identifying a “core deficit” is essential for early detection and intervention in developmental disorders among children. However, the presence of a core deficit within autism spectrum disorder (ASD) continues to be unclear. Therefore, the purpose of this study was to examine the possibility of the core deficit in autism spectrum disorders. This study evaluated 543 children diagnosed with ASD by using Chinese version of the Psychoeducational Profile-Third Edition (CPEP-3). Structural equation modeling (SEM) was used to construct single-factor models (assuming the presence of a core deficit) and a multi-factor model (assuming the absence of core deficits) based on the assessed data, and then to compare the fit of the two types of models. Assessments revealed developmental delays and adaptive challenges among the children with ASD. The single-factor model assuming the “motor” domain as the “core deficit” showed a superior fit (CFI = 0.86, AIC = 356.47, ECVI = 0.66) than other single-factor models. The multi-factor model, which assumes no core deficit, provided a better fit and greater predictive accuracy (CFI = 0.87, AIC = 351.94, ECVI = 0.65) than all single-factor models. ASD is characterized by widespread developmental delays and adaptive challenges. While motor impairment may serve as an effective predictor of these issues, it does not fully account for the diverse and complex symptomatology observed in children with ASD. The symptoms in these children likely arise from multiple factors, which are not adequately explained by a single core deficit model.

Pusil, Sandra; Laguna, Ana; Chino, Brenda; Zegarra, Jonathan Adrián; Orlandi, Silvia

doi: 10.1007/s10803-025-06757-4pmid: 40032758

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.

Key, Alexandra P.; Jones, Dorita; Corbett, Blythe A.

doi: 10.1007/s10803-025-06755-6pmid: 40075007

Despite the relatively high rates of intellectual disability (ID) in autism, research studies and clinical trials commonly exclude autistic participants with below-average IQ. This study aimed to characterize the effect of intellectual ability on social functioning in autistic adolescents assessed using behavioral and neural measures. Caregiver reports and direct standardized behavioral assessments of social abilities along with event-related potential measures of social and nonsocial information processing were obtained in school-age children with autism and ID (n = 41) matched on age, sex, and autism symptom severity to autistic participants with average IQ (n = 41). Full-scale IQ differences did not affect caregiver reports of social functioning in daily life. Group differences were observed only for the direct behavioral assessments of social perception and cognition (NEPSY Memory for Faces delayed, Theory of Mind) as well as social behavior with an unfamiliar friendly confederate, where higher IQ was associated with better performance. Similarly, the impact of IQ on neural responses was limited to a minimal delay in the processing speed of all visual stimuli and the magnitude of differences between social and nonsocial images, but not on incidental memory for the repeated stimuli. The effects of IQ on behavioral or neural responses did not vary based on biological sex. Below-average full-scale IQ in autistic youth affects results of some but not all behavioral or neural measures probing social functioning. Therefore, enrolling participants with a wider range of intellectual ability could be feasible in future studies.

Lin, Ingrid Y.; Morgan, Anna C.; Stave, Christopher D.; Feldman, Heidi M.; Huffman, Lynne C.

doi: 10.1007/s10803-025-06798-9pmid: 40100561

Family navigation (FN) has emerged as a promising intervention for reducing barriers and addressing social and economic inequities in autism service delivery. Little is known regarding the implementation and effectiveness of FN for children with autism. The aims of this scoping review are to: (1) summarize the breadth, quantity, and characteristics of the existing literature on FN for children diagnosed with autism; (2) describe the models and outcomes of FN for this population; and (3) identify knowledge gaps and provide directions for future research. Authors used Arksey and O’Malley’s methodological framework for scoping reviews. Searches were conducted in PubMed, CINAHL, Embase, Social Services Abstracts, and Web of Science, resulting in identification of 308 papers. Two independent raters completed title/abstract and full-text screenings. Data was extracted using a researcher-developed tool. Results synthesis involved content and construct analysis and descriptive numerical summaries. 17 publications met inclusion criteria. Among these, seven studies evaluated FN models delivered by professional or peer navigators. Three studies investigated FN tools. The remaining seven papers included five qualitative and two mixed methods studies that provided valuable insights on improving FN programs. Overall, studies on FN models reported positive impacts on family activation and well-being, knowledge, and service access and utilization. None addressed improvements in child developmental status or behavioral profiles. FN is a promising intervention for improving family outcomes and increasing service access and utilization. Further research is needed to establish best practices, identify child- and family-centered outcome metrics, and promote scalability and sustainability.

Turecki, Samuel C.; Payne, Tabitha W.

doi: 10.1007/s10803-025-06794-zpmid: 40088405

As autistic young adults increasingly enter into higher education, many are faced with difficult social adjustment (e.g., making friends, acquiring social support) in college (McLeod et al. McLeod et al., Journal of Autism and Developmental Disorders 49:2320–2336, 2019). Understanding peer acceptance of autistic college students is critical for community growth toward an equitable education experience. Predictors of autism acceptance, such as knowledge of autism, quantity and quality of experience with autism, and family relationships were explored. Acceptance of autism was assessed with a standardized vignette describing behavior of a hypothetical peer on campus, with no disclosure of a diagnosis (Nevill & White (Nevill and White, Journal of Autism and Developmental Disorders 41:1619–1628, 2011). Following the reading, participants made ratings on statements regarding willingness to engage and interact with the hypothetical case. Results revealed a positive correlation between raters’ quality of past experience with autism and their acceptance of a hypothetical autistic peer. Knowledge and quantity of experience did not predict acceptance. Having an autistic family member was also not associated with higher acceptance, however, the closeness of relationships with diagnosed family members was positively correlated with acceptance. These findings promote the idea that increasing acceptance of autistic college students could be facilitated through high quality social experiences with autistic individuals.

Fuqua, Amelia; Baker, Joshua; Morgan, Joseph J.; Higgins, Kyle

doi: 10.1007/s10803-025-06787-ypmid: 40106126

PurposeThe purpose of this research study was to determine the effect of self-monitoring with I-Connect on communication initiation attempts by elementary school students on the autism spectrum who are non-speaking or minimally speaking and participate in an alternate assessment. Initiations are essential for developing basic communication skills for this population of students.MethodsThis research study replicated a published study that used a physical token-based self-monitoring intervention to improve the initiation skills of students on the autism spectrum. The published study provided a benchmark for comparison with self-monitoring of initiations using the I-Connect application for self-monitoring. Participants in the study were three elementary school students aged 8–11 years on the autism spectrum who were non-speaking or minimally speaking and participated in the state’s alternate assessment. A multiple baseline design across participants visualized the effect of self-monitoring of initiations using I-Connect.ResultsVisual analysis demonstrated that all participants increased initiation levels comparable with the results of the benchmark study. Tau-U showed statistical significance of three potential demonstrations of effect. Pre- and post-study surveys and tests showed improved functional and verbal skills, and positive social outcomes.ConclusionThe outcomes add to the limited studies on technology-based self-monitoring of communication initiations by participants on the autism spectrum who are also non-speaking or minimally-speaking and who participate in an alternate assessment. The study limitations included lack of individualization, predictability of the fixed interval length of the intervention, and the potential for selection bias.

Lerner, Juliette E.; Schiltz, Hillary; Schisterman, Noa; Ziegler, Sonja; Lord, Catherine

doi: 10.1007/s10803-025-06800-4pmid: 40146316

Few studies have asked autistic adults and caregivers directly about what has most positively and negatively impacted their lives. This study sought to: (a) identify positive and negative factors experienced by autistic adults and caregivers; (b) test for within-subject differences in endorsement of promotive factors reported specific to four stages of development; and (c) test for differences in factors between adults with varying cognitive ability (i.e., less cognitively able [LCA; verbal IQ < 70] and more cognitively able [MCA; verbal IQ ≥ 70]). Participants included 91 autistic adults and caregivers. Autistic adults’ VIQs ranged from 4 to 139. Participants completed a modified version of the Social/Emotional Functioning Interview which consists of open-ended questions about positive and negative factors experienced across development. Autistic adults and caregivers, regardless of cognitive abilities, frequently reported people supports as more helpful than specific services, aspects of education, or generative activities from early childhood through adulthood. For both cognitive groups, generative activities were increasingly important after childhood. Services were more frequently identified as helpful by LCA caregivers in adulthood, while education was reported more by MCA caregivers and autistic adults. Differences by cognitive ability in negative factors included that more LCA caregivers reported poorly prepared professionals/caregivers as disruptive, while more MCA caregivers and autistic adults reported family conflict and bullying. Positive and negative factors identified through interviews of lived experiences can inform targeted care based on strengths and needs across cognitive abilities and life stages.

Gunderson, Jaclyn; Howie, Flora; Mehta, Sunil; Redlin, Annie; Huebner, Andrea

doi: 10.1007/s10803-025-06778-zpmid: 40057932

The current study evaluated the agreement of the Screening Tool for Autism in Toddlers & Young Children (STAT) in differential diagnosis of autism in an outpatient clinical population, compared to the more time and resource-intensive Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Sensitivity and specificity comparative analyses were completed on 44 patients (aged 24–36 months) who were administered both the STAT and the ADOS. Sensitivity and specificity were also calculated independently on patients that received a STAT (n = 102, 24–36 months) or ADOS-2 (n = 72, 24–36 months) and multidisciplinary clinical evaluation. Using clinical diagnosis as the measure of truth, 33 of the 44 received a clinical diagnosis of ASD. Agreement between the STAT and ADOS-2 was 90.9% (40/44; 95% CI 78.3–97.5%). The sensitivity of the STAT was 90.9% (30/33; 95% CI 75.7–98.1%) and the sensitivity of the ADOS was 100% (33/33, 95% CI 89.4–100%) in our sample. The specificity of the STAT was 90.9% (10/11; 95% CI 58.7–99.8%) and the specificity of the ADOS was 100% (11/11; 95% CI 75.1–100.0%). The STAT showed high sensitivity and moderate specificity in differentiating children with autism from those with other neurodevelopmental disorders in this outpatient clinic population. There was excellent agreement between the STAT and ADOS-2. The STAT may be an acceptable diagnostic tool to refine clinic models and reduce wait times for evaluation in toddlers who present with concerns for autism.

ten Hoopen, Leontine W.; de Nijs, Pieter F. A.; Greaves-Lord, Kirstin; Hillegers, Manon H. J.; Brouwer, Werner B. F.; Roijen, Leona Hakkaart-van

doi: 10.1007/s10803-025-06760-9pmid: 40057931

Previous studies showed an impact of autism on the child’s quality of life and societal costs, although little is known about changes from pre- to post-diagnosis. Therefore, our study explored the utilization of health-related services and associated costs in a group of 36 clinically referred Dutch children with autism (aged 2–10 years), pre- and post-diagnosis. Taking a broad societal perspective, we included the child’s quality of life, educational needs, and absenteeism in school and leisure activities. Furthermore, we assessed the service utilization in various categories, such as healthcare, youth care, and school guidance. The caregivers, mainly the parents, provided the information. Special needs daycare was the overall major cost driver pre- and post-diagnosis. We found a non-significant decrease in total annual costs (from €6513 to €5060). Post-diagnosis, healthcare costs were halved, changing towards less somatic and more mental healthcare. No shift to adjacent cost categories was seen. At the same time, the child’s quality of life improved not significantly from 0.58 to 0.66 (EQ-5D-3L), with significantly fewer everyday activity problems. In addition, we observed a trend of less school absenteeism after the diagnosis. Regression analysis identified pre-diagnostic costs as the sole independent factor influencing post-diagnostic costs, explaining 23% of the variance. Our findings suggest the importance of timely clarification of autism as a foundation for informed intervention and treatment planning. This could potentially result in improved quality of life, appropriate service allocation, and reduced societal costs.

Murphy, Jennifer; Ichijo, Eri; Bird, Geoffrey; Cooper, Lauren

doi: 10.1007/s10803-025-06803-1pmid: 40121600

PurposeSeveral studies have investigated false memory production in autistic adults, yet it remains unclear whether susceptibility to false memories differs from non-autistic adults and what mechanisms might contribute to any differences. This study examines the mechanisms behind false memory formation in autistic adults using the Deese-Roediger-McDermott (DRM) paradigm.MethodsParticipants studied DRM word lists designed to activate a critical word (the ‘critical lure). To examine false memory formation and associative processing, participants completed three tasks: a standard recognition test to measure false memory rates, a word stem completion task to assess implicit priming of the critical lure, and a free association task to evaluate explicit associative processing.ResultsAutistic individuals showed comparable rates of false memories as non-autistic adults (i.e., falsely reporting having studied the critical lure), were as likely to mention the critical lure on the free association task but showed no tendency to complete word stems with the critical lure when implicitly primed to do so.ConclusionThese findings suggest that autistic adults may rely less on spontaneous spreading of semantic activation during encoding but are capable of engaging in explicit associative processing when directed. The results provide valuable insights into the mechanisms underlying false memory formation in autism.