Autism Research

Background Autism spectrum disorder (ASD) and Intellectual disability (ID) share an in-creased male prevalence, but the biological mechanisms underlying this male bias remain poorly understood. Mice deficient for CC2D1A, a protein scaffold mutated in ASD/ID, have shown multiple male-specific deficits both in ASD-like behaviors and in the regulation of neuronal intracellular signaling pathways. However, previous re-search relied on conditional knockout (cKO) models due to early postnatal lethality of global Cc2d1a KO strains. Thus, the ability to define the developmental impacts of CC2D1A LOF in mice has been limited. While generating a Cc2d1a knock-in strain with V5-HA epitope tags, we found that homozygous animals (Cc2d1aVH/VH) resulted in a hypomorph line that can be used to study developmental loss of CC2D1A. Methods We assessed gross morphology, behavior, and intracellular signaling in male and female Cc2d1aVH/VH animals, where only ~20% of CC2D1A is present. We then crossed this line with a null allele to obtain a more severe hypomorph (Cc2d1a-/VH) and explore phenotypic penetrance thresholds. In addition to the previous phenotypic characterization, we also assessed body composition, feeding, and molecular hall-marks of metabolic function in both sexes. Results We found that ~80% CC2D1A reduction in Cc2d1aVH/VH mice did not recapitu-late any of the behavioral or molecular disruptions seen in cKO models. In contrast, ~90% CC2D1A reduction in Cc2d1a-/VH mice resulted in ASD/ID-like behavioral phe-notypes in males, similar to those reported in cKO lines, with distinct intracellular sig-naling disruptions. Male and female Cc2d1a-/VH mice also showed subtle but signifi-cant adult weight deficits associated with distinct metabolic changes. Limitations These models still do not fully recapitulate the complete CC2D1A LOF found in patients. Due to the analysis of two independent strains over multiple metrics, these studies are not powered to compare statistical differences between sexes and data were analyzed in males and females independently. Conclusions We identified a strikingly narrow CC2D1A expression threshold for the emer-gence of ASD/ID-like behavioral deficits in males. In addition, we revealed a novel role for CC2D1A in adult weight gain. These mouse strains will be useful to better under-stand CC2D1A LOF phenotypes.

Background: Brain functions emerge from temporally organized neural dynamics, and an appropriate level of neural complexity may support flexible information processing. Electroencephalographic (EEG) studies using multiscale entropy (MSE), which quantifies signal complexity across multiple temporal scales, have reported reduced MSE at longer scales in individuals with autism spectrum disorder (ASD). However, most evidence comes from studies of infant and child samples, leaving adult data scarce, and the associations between reduced MSE, clinical symptoms, and social information processing are insufficiently understood. Methods: We recorded and analyzed EEG data from adults with ASD (n = 47) and typically developing (TD) controls (n = 40) during eyes-closed rest and two movie viewing conditions: Inscapes, comprising dynamically changing abstract visual patterns, and Partly Cloudy, an emotionally engaging animated social narrative. Group and condition effects were assessed using cluster-based permutation tests, and associations between MSE and Social Affect (SA) scores from the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), as well as group differences in event-related MSE changes, were examined using linear mixed-effects models. Results: Across conditions, adults with ASD showed lower MSE at longer scales ({tau} = 16-30), corresponding to effective sampling rates of 12.50-6.67 Hz in the coarse-grained time series, than TD adults. Longer-scale MSE within the ASD-TD difference cluster was negatively associated with ADOS-2 SA scores across diagnostic groups. The difference in event-related MSE change between Social and Non-Social conditions, comparing empathic-pain and mentalizing events in Partly Cloudy with temporally matched non-social windows in Inscapes, was smaller in ASD participants than in TD participants. No significant difference between Social and Non-Social windows was observed among ASD participants, whereas TD participants showed significantly greater MSE change during Social than Non-Social windows. Limitations: This study used a modest sample without an independent replication cohort, and the short event windows limited the precision of the MSE estimation. Conclusions: Reduced longer-scale MSE extends to adults with ASD and is associated with higher ADOS-2 SA scores across diagnostic groups. Event-related findings further suggest attenuated differentiation of longer-scale MSE between socially relevant and matched non-social windows in ASD.

Communication deficits are a defining feature of autism spectrum disorder (ASD) and among the earliest detectable markers of atypical neurodevelopment. Yet how specific genetic ASD risk factors shape the developmental trajectory of vocal communication remains poorly understood. Fragile X syndrome (FXS) is the most common inherited cause of ASD, resulting from the transcriptional silencing of the FMR1 gene, and a majority of FXS individuals exhibit impaired language development and atypical vocal communication. Rodent ultrasonic vocalizations (USVs) produced during maternal isolation provide a tractable model for studying the developmental trajectory of early vocal communication in FXS. Here, we characterized isolation- induced USVs in Fmr1 knockout (KO) and littermate wildtype (WT) rats from postnatal days 3- 21 to determine whether Fmr1 mutation disrupts the acoustic structure, temporal organization, or sequential syntax of USVs across postnatal development. We found that Fmr1 KO rat pups exhibited reduced call number during the peak developmental window for isolation-induced calling (p6-p10), while acoustic structure and temporal organization were largely preserved. Network analysis of call transitions revealed that WT pups exhibited a progressive increase in syntactic complexity from p3-p10. However, this developmental trajectory was significantly altered and delayed in Fmr1 KO pups. Together, these findings demonstrate that Fmr1 mutation not only disrupts vocal production but the developmental expansion of syntactic flexibility in rats, highlighting USV syntax as a sensitive marker of atypical communicative development in FXS models.

Background: Infant muscle tone reflects early central nervous system integrity and has been associated with later motor and cognitive development, including autism traits. The cerebellum regulates both motor control and higher-order socio-cognitive functions and has been repeatedly implicated in autism, but its role in linking infant muscle tone to adolescent autistic traits has not previously been studied in a large, prospective population cohort. Methods: We used data from the prospective Generation R Study. Infant muscle tone (hypotonia and hypertonia) was assessed via Prechtl examination, and third-trimester fetal transcerebellar diameter was measured using ultrasound n=6,842). Cerebellar morphology at ages 6, 10, and 14 years (n=4,861) was measured using structural MRI. Linear mixed-effects models tested associations between infant muscle tone and 35 anatomical and 10 functional cerebellar regions. Causal mediation models tested whether cerebellar volume mediated associations between infant muscle tone and adolescent autistic traits at age 14 (Social Responsiveness Scale). Results: Hypotonia predicted larger vermis IX volumes across childhood (beta=0.037, pFDR =0.043). Hypertonia showed an age-dependent association with left lateral lobule IX (beta=-0.0027, pFDR =0.041), with differences diminishing with age. Third-trimester transcerebellar diameter did not predict postnatal muscle tone. Given its significant main effect, vermis IX volume was tested as a mediator, but did not mediate the pathway to adolescent autistic traits. However, infant hypotonia showed a small direct association with elevated autistic traits at age 14, specific to girls (beta=0.0255, p=0.020). Conclusions: Infant muscle tone is associated with localized differences in cerebellar volumes. These associations are specific to vermal and left hemispheric lobule IX, a region commonly implicated in spinocerebellar postural control, axial stability, and higher-order sensorimotor integration. Furthermore, infant muscle tone was not predicted by prenatal cerebellar diameter, and cerebellar volumes did not mediate the association between infant hypotonia and adolescent autistic traits in our study. Future research should further investigate these findings in clinical populations, integrating longitudinal whole-brain, multi-modal imaging to clarify the association between infant muscle tone, the cerebellar functioning, and autistic traits.

Purpose Autistic adults have diverse communication characteristics that are not well captured by standard demographic measures. Communication affects self-determination, relationships, access to healthcare, and services. Characterizing communication differences may improve research and intervention targeting for meaningful subgroups of autistic adults. Methods The Academic Autism Spectrum Partnership in Research and Education (AASPIRE) Outcomes Project team used a community based participatory research (CBPR) approach to develop a self- or caregiver-report module to characterize communication among autistic adults. The 10-item module asks about receptive and expressive communication, literacy, speech reliability, usage of digital communication, use of alternatives to speech, and communication fluency. It can be completed directly, with or without support, or via a caregiver. We used baseline survey data from 844 autistic adults to evaluate the module and derived a five-level variable, Communication Profile, from selected module items to stratify participants. We examined completion feasibility, response consistency, and construct validity. We also assessed test-retest reliability in a 15% random subsample who completed a 2-week retest following the 6-month survey, with oversampling of caregiver-report respondents. Results The Communication Characteristics module demonstrated high completion feasibility, minimal systematic error, and strong construct validity. The Communication Profile variable stratified participants into five meaningful communication profiles and demonstrated strong construct validity and substantial test-retest reliability ({kappa} = .69). Conclusion The Communication Characteristics module and Communication Profile variable provide a valid approach for characterizing communication diversity among autistic adults for research, clinical, and service settings. The full AASPIRE Measurement Toolkit is available at https://aaspire.org/measurement. Lay Summary Autistic people communicate in many different ways, and their communication may change in different situations. We developed and tested a set of survey questions to describe an individuals communication. We also used the results to describe 5 groups of autistic people based on how they communicate, without treating these groups as different types of autism.

Music-based interventions (MIs) have shown promise in autism spectrum disorder (ASD), yet the molecular mechanisms underlying their effects remain poorly understood. The transcriptomic response to music exposure in individuals with ASD and healthy controls (HCs) was analyzed using buccal swab samples and a targeted NanoString gene expression panel. The discovery cohort included baseline and post-intervention samples, whereas the validation cohort added a 25-minute intermediate sample to assess transcriptional dynamics. Thirty-three candidate genes were identified in the discovery cohort, of which 20 (61%) remained significantly differentially expressed in the independent validation cohort, including 13 that withstood multiple-testing correction. Replicated genes included several key regulators of innate immunity and inflammatory signaling, such as CXCL8, MYD88, RELA, PTGS2, PTPRC, SELL, LYN, and LTBR. Functional enrichment analyses revealed robust innate immune and inflammatory pathways, characterized by TLR/IL-1-MYD88 signaling, cytokine activity, leukocyte activation, and antimicrobial responses. Co-expression network analysis identified coordinated remodeling of immune transcriptional programs in ASD. Consensus feature selection identified a two-gene signature that accurately discriminated pre- and post-musical stimulation samples in ASD but not in HCs. The same signature detected transcriptomic responses after only 25 minutes of music exposure by discriminating baseline and intermediate samples, with intermediate expression levels between baseline and post-intervention values, suggesting a progressive duration-dependent response. These findings demonstrate a reproducible transcriptional response to music in ASD across independent cohorts implicating neuroimmune pathways. The resulting transcriptional signature supports the development of minimally invasive biomarkers for monitoring MIs in neurodevelopmental disorders.

Purpose: In clinical trials, treatment efficacy is commonly assessed by comparing control and treatment groups. However, in large samples, even small and clinically trivial differences may achieve statistical significance. Accordingly, the Minimal Clinically Important Difference (MCID) is used as a threshold to determine whether statistically-significant effects are also clinically meaningful to patients. The objective of this study was to estimate the MCID for the Childhood Autism Rating Scale Second-Edition (CARS2) using the Patient Impression of Change (PIC) as an external anchor. Methods: Single-item PICs are not well suited to characterizing improvement in a multifaceted disorder such as ASD. Accordingly, the 77-item Autism Treatment Evaluation Checklist (ATEC) was used as a multi-item PIC. CARS2 and ATEC were administered concurrently to 62 children with ASD, aged 1.8-7.9 years, with assessments conducted six months apart. Results: The correlation between changes in CARS2 and ATEC total scores was 0.41-0.44 (p<0.0001), supporting the use of ATEC as an anchor measure. Two anchor-based methods yielded MCIDs of 2.39-2.82 CARS2 points. Two distribution-based methods produced MCIDs of 1.33-3.32. Conclusions: Taken together, these approaches suggest that a between-group difference of 2.6 CARS2 points (the midpoint of the anchor-based estimates) may serve as the MCID in children with ASD.

Genetic loss-of-function (LoF) variants in SCN2A, a gene encoding the voltage-gated sodium channel Nav1.2, have been identified as one of the foremost monogenic causes of autism spectrum disorder (ASD). ASD encompasses a broad spectrum of behavioral phenotypes, with impaired sociability as a core characteristic. We have established Scn2a-deficient mice (Scn2agt/gt) to model Scn2a-related ASD and found that this model recapitulates social impairment, exhibiting severe social deficits. Scn2agt/gt mice exhibit neuronal hyperexcitability and a marked global reduction in potassium channel expression, which plays a crucial role in maintaining the resting membrane potential and repolarizing neurons after an action potential. Among these downregulated potassium channels, potassium voltage-gated channel subfamily A member 1 (Kv1.1) was one of the most affected. To explore whether Kv1.1 could be a potential therapeutic target in SCN2A-related ASD, we evaluated the in vivo efficacy of a genetic construct driven by the CaMKII promoter that allows for exogenous expression of human Kv1.1 (hKv1.1) in principal neurons. In Scn2agt/gt mice, we found that hKv1.1 expression normalizes neuronal hyperexcitability. Importantly, doxycycline-induced hKv1.1 expression enhances sociability in Scn2a-deficient mice without influencing social behavior in wild-type mice, and this effect was reversed upon doxycycline withdrawal. Overall, we demonstrate the successful use of an inducible AAV-mediated gene delivery system to supplement hKv1.1 expression to mitigate neuronal hyperexcitability and ameliorate social impairments in a mouse model of SCN2A-related ASD. These findings highlight the contribution of Kv1.1 to SCN2A-associated pathophysiology and its potential as a therapeutic target for severe social deficits.

Background Elevated resting gamma power is a reproducible, robust neurophysiology marker across species in fragile X syndrome (FXS), a major known cause of autism spectrum disorders (ASD). In FXS, this neurophysiological phenotype is well described and particularly prominent in males harboring fully methylated full CGG repeat expansions. However, gamma power evaluations in idiopathic ASD have yielded variable results. As a single-gene model of ASD, FXS hold promise to biologically model some of the autism spectrum. Exaggerated gamma power in FXS is thought to reflect increased cortical excitability, a common feature of ASD, and has been shown to correlate with symptoms in both human FXS individuals and the Fmr1 knockout mouse model of FXS. A recent clinical trial of the BK channel positive modulator, Codabakalner, provided encouraging signs that normalization of gamma power in FXS may provide therapeutic benefit [14]. Interventional and biomarker studies in ASD provide support that this may also be the case in ASD. We utilized gamma band power to evaluate neurophysiological overlap between ASD and FXS seeking to determine the prevalence and clinical characteristics of those with ASD who exhibit a FXS-like elevated resting state gamma phenotype. Methods This cross-sectional resting EEG analysis included 159 individuals with non-syndromic ASD and 41 males with fully methylated full mutation FXS. Relative gamma power was calculated as 30-100 Hz power divided by 1-100 Hz power across 10-20-equivalent electrodes, excluding 55-65 Hz. We defined the cutoff for elevated resting gamma band power in ASD as relative gamma power of greater than or equal to the median minus one standard deviation of gamma power in our FXS male sample. Results A FXS-derived relative-gamma threshold of 0.185 or greater was met by 22% of participants with ASD (n=35). As expected, the mean ASD group resting state gamma was lower than the male FXS sample (p < 0.001). ASD participant threshold proportions by age group were 3/37 (8.1%) below 13 years, 9/50 (18.0%) age 13-18 years, and 23/72 (31.9%) in the 18+ years group. Within the ASD group, there were no observable clinical characteristics that readily differentiated participants with an elevated gamma phenotype from those without this phenotype. Conclusions Approximately one fifth of all participants and slightly over 30 percent of adults with ASD met the FXS-derived elevated resting gamma band power criterion. This represents the first investigation using a translational brain neurophysiology marker in a syndromic form of autism to parse a clinical idiopathic ASD sample to identify potential overlapping brain features. The results will work to support potential targeting of ASD subgroups in the future utilizing therapeutic approaches initially established in a single-gene form of developmental disability.

The Autism Spectrum Quotient (AQ-50) is widely used to assess autistic traits, yet its Hungarian version has not been psychometrically evaluated. We assessed the reliability, factor structure, temporal stability, convergent validity, and clinical utility of the Hungarian AQ-50 and a revised translation (AQ-50-HU-R) in two samples (N1 = 1967; N2 = 423), including autistic and non-autistic participants. The AQ-50-HU-R showed high internal consistency and test-retest reliability. A bifactor model provided the best fit ({chi}2[1125] = 1650.433, p < 0.001; CFI = 0.991; TLI = 0.990; RMSEA = 0.033 [90% CI = 0.030-0.037]; SRMR = 0.083), with 71% of common variance attributable to a general autistic traits factor. The total score distinguished clinically verified autistic participants from participants reporting no ASD diagnosis (AUC = 0.906), with a cutoff of 25. Associations with ADOS scores were weak or nonsignificant. The AQ-50-HU-R is best interpreted as a reliable total-score screening measure, supporting referral for comprehensive autism assessment.

In many high-income countries, autistic children attend preschools ranging from exclusive special education (SE) to inclusive mainstream education (ME). These settings differ in staff expertise, capacity to implement structured autism interventions, exposure to typically developing peers, and cost. In this prospective longitudinal study, we compared 119 autistic children across three preschool settings in southern Israel: SE with TABAM services, an extended intervention program; SE without TABAM; and ME. Children completed behavioral assessments at the beginning and end of their first preschool year, yielding measures of cognition, autism symptom severity, joint attention, verbal abilities, adaptive behaviors, and aberrant behaviors. Developmental trajectories varied across children, with some demonstrating marked gains and others showing limited progress. On average, developmental changes were modest across most domains and were not explained by educational setting. The only exception was verbal ability, where children in SE with TABAM showed greater gains than children in SE without TABAM. These findings suggest that autistic children in ME and SE demonstrated broadly similar developmental trajectories during their first preschool year. Further large-scale research is needed to identify which children may benefit more from specific educational environments and intervention approaches, and to inform ongoing efforts to optimize preschool services for autistic children.

Background: Reduced concentrations of the neuropeptide oxytocin can occur in disorders with social dysfunction, notably autism. However, the role of peripheral endogenous oxytocin concentrations and increased ones following exogenous administration in modulating key social behaviors in humans is still unclear. Here we investigated effects of targeting peripheral oxytocin receptors through oromucosal administration of oxytocin and an oxytocin receptor antagonist (atosiban) on social attention. Methods: We carried out a pre-registered, randomized, double-blind, placebo-controlled experiment with 250 adult male subjects in five treatment groups (placebo + placebo, placebo + 24 IU OT, placebo + 48 IU OT, atosiban + placebo, and atosiban + 24 IU OT), each receiving two oromucosal (lingual) administrations separated by 15 minutes. Following treatment, subjects performed an autism-sensitive dynamic social versus geometric pattern eye-tracking paradigm. Pre- and post-treatment blood samples were collected for oxytocin measurement. Results: Results showed that 48IU but not 24IU oxytocin significantly increased preferential viewing of social stimuli relative to placebo, and effects were associated with, and mediated by, increased oxytocin concentrations and negatively correlated with subjects autism quotient scores. On the other hand, atosiban reduced preference for social stimuli relative to placebo even after subsequent administration of 24IU oxytocin. Conclusions: Our findings suggest that both exogenous and endogenous oxytocin can act via peripheral receptors to enhance interest in social relative to non-social stimuli, possibly influencing the brain via acting on G[q]-coupled receptors in the vagal system. This further supports the therapeutic potential of oxytocin for social dysfunction.

Abstract Autistic young adults experience substantial gaps in services supporting community living and participation. The Community Autism Peer Support (CAPS) program is a community-based intervention in which trained autistic peer specialists provide individualized support to autistic young adults pursuing self-determined goals related to community participation and independent living. We conducted a single-site, two-arm randomized controlled trial to evaluate the feasibility of implementing the CAPS program. Forty autistic adults aged 18 to 30 years were randomized to CAPS (n = 20) or services as usual alone (n = 20) and assessed at baseline, 3 months, and 12 months. Study findings showed that CAPS attracted autistic young adults with diverse demographic and diagnostic backgrounds, and most intervention participants remained engaged in services for extended periods. While the study was underpowered to detect statistical differences in outcomes because it was not a main focus of the research, a consistent pattern of results favored the CAPS condition across all outcomes. The largest positive signals were observed for overall and social quality of life, with additional favorable changes in internalized stigma, unmet needs, social functioning, loneliness, and positive autistic identity. Findings provide support for the feasibility and promise of an autistic-delivered peer specialist model focused on community living and participation. The consistent pattern of favorable changes supports continued development of CAPS as a person-centered approach to addressing outcomes important to autistic adults.

Background The global increase in autism spectrum disorder (ASD) diagnoses is expected to substantially increase demand for long-term rehabilitation services. However, little is known about how this increase affects rehabilitation service utilization and capacity in low- and middle-income countries. Methods We conducted a retrospective longitudinal study of children receiving developmental care at a tertiary rehabilitation center in Salvador, Brazil (2017-2026). Patients were classified into Childhood Autism, Other ASD, and non-ASD diagnostic groups according to ICD-10 diagnoses. Temporal trends in admissions and patients under follow-up were analyzed using generalized additive models and segmented Poisson regression. Factors associated with follow-up duration were evaluated using multivariable Cox proportional hazards models. Results Among 2,123 eligible children, 833 (39.2%) had Childhood Autism, 462 (21.8%) had Other ASD, and 828 (39.0%) had non-ASD diagnoses. Compared with children with non-ASD diagnoses, those with Childhood Autism entered care at younger ages, were predominantly male (77.9% vs. 57.2%), attended more visits, and remained under follow-up longer (all P<0.001). Admissions of children with Childhood Autism increased by 30.2% annually before 2023 but declined thereafter (-19.6% annually; P<0.001). Despite this decline, the number of children with Childhood Autism receiving ongoing rehabilitation continued to increase, reflecting prolonged follow-up. In adjusted analyses, Childhood Autism was associated with a substantially lower hazard of reaching the last recorded follow-up visit than non-ASD diagnoses (adjusted hazard ratio, 0.35; 95% CI, 0.30-0.40; P<0.001). Conclusions The rapid increase in ASD admissions fundamentally reshaped rehabilitation service utilization. Because children with ASD remained under follow-up substantially longer than those with other developmental conditions, they accounted for an increasing share of the rehabilitation caseload, even after new admissions began to decline. These findings highlight the importance of planning rehabilitation services according to both new admissions and the cumulative demand generated by long-term follow-up.

Autism is a common neurodevelopmental condition with considerable between-person variability and unknown biological etiology. Diagnosis of autism in adults relies on measurement of performance (e.g., clinician rating of social behavior, standardized assessment of cognition) and self-report of autism features. Our prior work revealed a strong relationship between clinician ratings of social function in autism and in vivo measures of synaptic density as measured by [11C]UCB-J PET (Matuskey et al., 2025). However, it is not understood how the measured aspects of the autism phenotype index underlying biology. Here, in a sample of 12 autistic adults, we address this question by relating synaptic density imaging to a range of performance measures, such as cognition and face recognition, in contrast to self-report measures. Our results identify a dissociation between these measurement types in that synaptic density correlates strongly with measures of performance but shows virtually no relationship with self-report. These findings suggest that, while self-report and performance measures share variance in characterizing phenotypes in autism, they diverge when mapping onto the underlying biology. Results suggest that higher synaptic density may index a general mechanism that facilitates social and cognitive performance across a range of tasks. These data also indicate that performance and self-report measures are not interchangeable in capturing brain-behavior correspondences in autism, a finding that can guide measure selection in future biomarker studies and clinical research.

Autism spectrum disorder is a neurodevelopmental disorder with both genetic and environmental contributors. SCN2A, the gene which encodes the alpha subunit of the voltage-gated sodium channel Nav1.2, is a known monogenetic risk factor for autism spectrum disorder. The cerebellum is frequently implicated in autism spectrum disorder and other neurodevelopmental disorders but has largely been unexplored in relation to SCN2A variants, especially from a developmental perspective. Nav1.2 is highly expressed within the cerebellum, specifically within cerebellar granule neurons, where it helps to drive action potential generation and propagation. Cerebellar granule neuron activity and maturation is crucial for shaping the development and morphology of the rest of the cerebellar cortex. Here we investigated early-postnatal cerebellar development in two mouse models carrying patient-derived SCN2A premature termination codon variants, Scn2a-p.Y84X and -p.R1627X. Overall, both Scn2a premature termination codon variant mouse lines displayed largely normal physical development and unaffected non-cerebellar developmental milestones. Scn2aY84X/+ mice, but not Scn2aR1627X/+ mice, demonstrated alterations in cerebellar-driven motor behaviors, specifically faster performance in the surface righting reflex and cliff avoidance compared to wildtype littermates. Coinciding with the behavioral findings, Scn2a variants had divergent and age-dependent effects on cerebellar glutamatergic presynaptic marker expression, indicating that some, but not all, Scn2a premature termination codons impair glutamatergic synapse development. Both Scn2a variants exhibited changes to cerebellar cytoarchitecture, such as reductions in Purkinje cell density and soma size, which was more prominent in Scn2aY84X/+ mice, and faster migration of cerebellar granule neurons from the external granule layer to the internal, indicating a possible shift in the timing of cerebellar maturation. Our results situate the cerebellum as an early site for SCN2A pathophysiology and establish that cerebellar consequences of SCN2A premature termination codon variants may be position- and age-dependent, suggesting that influences beyond simple heterozygous loss of Nav1.2 drive phenotypes. Our characterization of how Scn2a premature termination codon variants differentially impair cerebellar development may help explain the heterogeneity of clinical presentations of SCN2A loss of function variants and potentially inform upon the timing of therapeutic intervention.

Phelan-McDermid syndrome (PMS) is a genetic neurodevelopmental disorder caused by a microdeletion within chromosome 22q13.3 1-6, and accounts for [~]1-3% of cases of autism spectrum disorders (ASD). Individuals with PMS typically present with neonatal hypotonia, severe speech delay, intellectual disability, motor impairments, and autism-related features, although additional manifestations such as epilepsy, sleep disturbances, and developmental regression are common. As in ASD, there is considerable heterogeneity in cognitive and behavioral impairments in PMS, making it difficult to determine which features arise directly from SHANK3/Shank3 deficiency and how deficits manifest across development. In the present study, we transferred the targeted Shank3 mutation, previously characterized on the Sprague Dawley background, onto the Long-Evans strain and performed a longitudinal behavioral assessment of Shank3-deficient rats from infancy to adulthood. The rats were evaluated for delays in early sensory and motor development, and ultrasonic vocalizations as neonates, social behavior, short term memory and gait as juveniles, and cognitive-executive dysfunction using a touchscreen-based visual discrimination and reversal learning task as adults. Despite profound reductions and/or complete loss of Shank3 protein expression, heterozygous and homozygous male and female rats showed normal physical and neurological reflexes across development, yet female Shank3 knockout pups showed a selective reduction in distress-associated ultrasonic vocalizations. As juveniles, subtle abnormalities emerged in short-term memory and limb coordination, while social preference for novelty and recognition was normal. Prominent behavioral abnormalities were observed in adults characterized by rapid and error-prone responding to visual stimuli during discrimination learning and reversal. These data suggest that rats with complete or partial Shank3 deficiency produce a selective behavioral profile in which high-order cognitive dysfunction is more pronounced than deficits in basic sensorimotor or select social behaviors. More broadly, these findings highlight executive dysfunction as a key consequence of the loss of Shank3. For the first time, we report the loss of Shank3 expression on a Long-Evans background strain as a valuable translational tool for investigating cognitive dysfunction and therapeutic windows in Shank3-associated disorders.

Neuroimaging studies identify the superior temporal sulcus (STS) as an anatomical and functional target in autism spectrum disorder (ASD). Yet, the STS is a heterogeneous structure containing unique subregions, such as the superior temporal asymmetrical pit (STAP), which is a recently identified human-specific landmark. To date, no study has compared the STAP between ASD individuals and neurotypical controls (NTs) in a large sample. Here, we analyzed the mean intra-hemispheric sulcal depth and inter-hemispheric laterality of the STAP, as well as the anterior and posterior portions of the STS (aSTS, pSTS), in 100 NTs and 100 ASD male individuals (ages 5-18) using a discovery-replication design. Across samples, the STAP and pSTS showed rightward asymmetry, while the aSTS showed leftward asymmetry within groups. All features of the STAP, aSTS, or pSTS did not differ significantly between groups. However, pSTS laterality related to individual differences in social cognition, which was further supported by a meta-analysis across over 200 studies showing that neurocognitive functional differences associated with social cognition and ASD are restricted to portions of the STS outside of the STAP. Together, these findings provide fine-grained insight into prior studies showing coarse morphological differences of the STS between individuals with ASD and NTs, as well as open up new questions and new neuroanatomical targets of the heterogeneous STS in future studies of brain structure, brain function, and cognition in ASD, as well as other neurodevelopmental disorders targeting the superior temporal cortex.

Purpose: This study examined whether word-based and non-word natural language sampling (NLS) measures complement standardized language scores in characterizing expressive communication among preschool children with autism with language impairment (AUT-LI), Down syndrome (DS), and fragile X syndrome (FXS). Method: Participants included 82 preschool children with AUT-LI (n = 32), DS (n = 34), or FXS (n = 16). Expressive communication was characterized using the Preschool Language Scales and 10-minute natural language samples collected during a standardized play-based protocol. NLS measures included traditional word-based metrics, such as lexical diversity, intelligibility, and word approximations, as well as tiered non-word vocalization measures, including non-speech, single-phoneme, and multi-phoneme vocalizations. Analyses examined age associations, diagnostic group differences, between group differences in variability, and exploratory communication profiles derived using principal component analysis and partitioning around medoids clustering. Results: Diagnostic groups did not significantly differ on standardized expressive language scores. Children with FXS showed higher performance than the AUT-LI and DS groups on several word-based NLS measures, whereas non-word vocalization measures primarily revealed differences in within-group variability. Word-based NLS measures were consistently associated with standardized expressive language skills, while associations for non-word vocalizations varied by vocalizations type. Cluster-validity indices factored a two-cluster solution. A hypothesis-informed three cluster solution that included non-word vocalizations suggested Higher Language, Lower Output, and High Output-Low Structure profiles. Conclusions: Standardized and NLS measures provide complementary descriptions of expressive communication in children with neurodevelopmental disorders. Non-word vocalization coding may be especially useful for describing clinical meaningful variation among children with limited expressive language. Keywords: Natural language sampling; expressive language; neurodevelopmental disorders; autism spectrum disorder; Down syndrome; Fragile X syndrome

Auditory hypersensitivity or decreased sound tolerance is a common phenotype of Fragile X Syndrome (FXS). Impairments in adaptation, defined as the reduction in the neuronal responsiveness to repeating sounds, can contribute to this prevalent phenotype. Previous studies on event-related potential observed impairments in mismatch negativity (MMN) in both FXS individuals and in the FMR1-knockout (KO) mouse model of FXS. Therefore, in the present study we characterized stimulus-specific adaptation (SSA), a neural correlate of MMN, at the auditory cortex (AC) of anesthetized (with ketamine/xylazine) female and male postnatal day 20 (P20) wild-type (WT) and FMR1-KO mice, using the oddball paradigm with either 4 Hz or 1 Hz repetition rate. We observed robust SSA at the 4 Hz repetition rate of the oddball paradigm in the AC neurons of all four groups of animals. We also noted that the strength of SSA diminished between 4 to 1 Hz repetition rate. In addition, at both the 4 Hz and 1 Hz repetition rate, reduced SSA was observed particularly in the male FMR1-KO mice compared to their WT counterparts, while female WT and FMR1-KO mice displayed similar SSA. In terms of sex differences, male FMR1-KO mice had lower SSA than female FMR1-KO mice, while SSA was similar in male and female WT mice. Overall, our observation of reduced SSA in the male FMR1-KO mice suggests that impairments in neuronal adaptation potentially contribute to the auditory hypersensitivity phenotype particularly within the male population.