Autism Research

Individuals with autism spectrum disorder (ASD) often exhibit atypical auditory processing, yet it remains unclear whether and how the integration of simple acoustic features and contextual information is impacted in ASD. One real-world example of this integration is the auditory looming bias, the prioritized processing and perception of approaching auditory stimuli. We designed a paradigm that presents intensity-rising (looming) and intensity-falling (receding) auditory stimuli to 3-4-year-old children with ASD (n = 21), children with sensory processing concerns who do not have ASD (SPC; n = 16) and children with typical development (TD; n = 30). We recorded neural responses using electroencephalography (EEG) and found evidence of looming bias in the SPC and TD groups, as indexed by greater P1 peak amplitude during the looming than receding stimuli (TD: t(64) = 6.87, p < .001; SPC: t(64) = 4.07, p < .001). But this finding was not present in the ASD group (p = .194). Additionally, the ASD group showed reduced differentiation between looming and receding stimuli, as indicated by significantly lower Rise-Fall Difference Score (RFDS) in comparison to the TD group (Z = -3.00, padj = .008). These findings suggested altered context-dependent modulation of sensory input in ASD. Lay SummaryMany children with autism show differences in how they process sounds. Using sound patterns in which loudness gradually increased and decreased over time, like many real-world sounds, we found that children with autism showed less neural differentiation between increasing and decreasing sounds. This finding suggested that the brain may process changes in sound differently in autism, particularly in how it adjusts to sounds as they change over time, which could contribute to the sensory challenges many children with autism experience in daily life.

Atypical processing of emotional faces has been proposed as a characteristic of Autism Spectrum Disorder (ASD), but functional neuroimaging research has yielded inconsistent findings. Prior work is limited in generalizability due to methodological heterogeneity, imbalanced or small sample sizes, and underrepresentation of females. The present study examined functional brain activation during the Hariri Emotional Face-Matching Task (EFMT) in a large, sex-balanced sample of both typically developing and ASD participants (n=295, 8-18 years old) from the multi-site Autism Center of Excellence GENDAAR project. Using an ROI-driven approach, we targeted the right FFA, right OFA, right pSTS, and bilateral amygdala, we investigated whether ASD diagnosis was associated with atypical regional activation when viewing emotional faces, and if these differences were generalizable across sexes. Results revealed a group-by-sex interaction in the right FFA, driven by divergence of ASD males from the ASD female and typically developing participants. Generally, ASD females did not diverge greatly from typically developing populations. These findings suggest that atypical face processing is present, but meaningfully modulated by sex, underscoring the importance of sex-balanced, well-powered developmental samples in autism.

Autism spectrum disorder (ASD) is frequently accompanied by sensory and motor abnormalities, including impaired balance, postural control, and spatial orientation, that are often attributed largely to altered central circuitry. Emerging evidence, however, suggests that peripheral sensory dysfunction can also shape ASD related behavioral phenotypes. Here, we tested whether loss of the ASD associated gene Cntnap2/Caspr2 alters vestibular signaling in Cntnap2-/- mice. Developmental transcriptomic analysis showed that Cntnap2 is expressed in vestibular sensory organs and increases during the first postnatal month, coincident with vestibular pathway maturation. Vestibular sensory evoked potentials revealed reduced response amplitudes and prolonged latencies in Cntnap2-/- mice, indicating impaired peripheral afferent responses to transient linear acceleration. Cntnap2-/- mice also showed delayed contact righting, reduced ocular counter roll, and increased hindlimb slips and compensatory tail excursions during balance beam walking, whereas rotational vestibulo-ocular reflex gain and phase were preserved. These vestibular and balance abnormalities were accompanied by reduced novel arm preference in the Y maze and severe impairment of Barnes maze acquisition, consistent with impaired spatial learning. Together, these findings identify Cntnap2/Caspr2 as a regulator of vestibular sensory signaling and support a model in which disrupted peripheral vestibular input, likely acting together with central effects of Cntnap2 loss, contributes to sensorimotor and spatial cognitive phenotypes relevant to ASD.

A large subset of ASD associated genes, almost 50% of the highest confidence risk genes listed on the Simons Foundation Autism Research Institute database, are epigenetic modifiers. This suggests that the organization of sensory biology and its coupling to underlying genetic control are an important element underpinning this discord. Furthermore, sensory processing changes in individuals with autism spectrum disorder (ASD) has been a growing area of study in recent years. C. elegans have robust readouts for both developmental and sensory biology allowing these signatures of ASD to be systematically modelled. 52 epigenetic modifiers (65 strains) were selected for study in C. elegans based on gene function, presence of orthologues in C. elegans and the availability of viable putative null strains. This highlighted significant changes to reproduction, gross development and sensory processing across the range of epigenetic modifiers. Each strain was filtered against selective criteria for significant sensory and developmental phenotypes allowing for selective phenotypic profiles to emerge. These were three primary groups, those with sensory perturbations but unaffected gross development (6), developmentally affected genes with intact sensory function (10) and finally genes with impaired gross development and sensory function (11). Thus, this study provides a link between sensory and developmental outcomes in ASD associated mutant strains and suggests that more regular sensory testing should be performed in human cohorts to further refine sub-categorisation of ASD cohorts.

WAC is an autism-associated gene involved in neurodevelopment. However, the effects of reduced WAC function on behavior and synaptic regulation in vivo remain unclear. Taking cues from the previous studies on the wac gene and the C. elegans model of ASD, we elucidated the effects of wac gene deletion on food-leaving behavior, a known parameter linked to ASD associated genes along with the cholinergic pathway. wac-deficient worms exhibited curtailed food-leaving behavior. Notably, observed phenotype was similar to that exhibited by nematodes with mutation in ASD related gene, neuroligin. In addition, wac-deficient worms showed impaired growth, reduced pharyngeal pumping, and lifespan. To examine potential synaptic mechanisms, we analyzed expression of genes related to cholinergic signaling across all developmental stages (L1-L4) through young adult (YA). Stage-specific transcriptional changes were observed, with increased expression of ace-1 and acr-3 at L1, acr-3 at L3, and acr-3, cha-1, lev-1, and lev-10 at L4. The transcriptomic alteration was most prominent at YA stage, exhibiting upregulation of ace-1, cha-1, cho-1, lev-1, lev-10, unc-17, unc-29, unc-38, and unc-50. To identify specific suppressor of upmodulated Ach signaling, RNAi of the upregulated genes was performed. cho-1 was identified as a specific suppressor of elevated Ach signaling. cho-1 encodes a high-affinity choline transporter responsible for choline uptake in the pre-synapse. These studies identify the molecular mechanisms pertaining to up-modulation of cholinergic signaling in wac mutant worms. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=112 SRC="FIGDIR/small/719318v1_ufig1.gif" ALT="Figure 1"> View larger version (24K): org.highwire.dtl.DTLVardef@13b9510org.highwire.dtl.DTLVardef@b74e11org.highwire.dtl.DTLVardef@6676e0org.highwire.dtl.DTLVardef@1068f35_HPS_FORMAT_FIGEXP M_FIG C_FIG

BackgroundPhelan McDermid syndrome (PMS), caused by SHANK3 haploinsufficiency, is a genetic form of autism spectrum disorder (ASD) that provides a genetically defined model for studying ASD-related circuit dysfunction. SHANK3 mutations disrupt synaptic organization and cortical synchrony, leading to attenuated gamma-band auditory steady-state responses (ASSRs). We investigated whether PMS-related electrophysiological signatures could be identified using machine learning and whether similar patterns are present in a subset of individuals with idiopathic ASD (iASD). MethodsEEG recorded during a 40-Hz ASSR paradigm was collected from 123 participants (42 TD aged 2-30, 56 iASD aged 3-31, 25 PMS aged 2-26). We extracted time-series, ERSP, FOOOF-derived spectral, and intertrial phase coherence (ITPC) features. XGBoost models with leave-one-out cross-validation classified PMS versus TD; the best age/sex-adjusted ITPC model was then applied to iASD participants to derive a Synchrony Atypicality Index (SAI). Unsupervised clustering of high-dimensional ITPC features was also performed. ResultsITPC-based models showed the strongest discrimination between TD and PMS participants (AUROC = 0.83). When applied to iASD participants, 35.7% exhibited elevated SAI, indicating a PMS-like gamma-band phase-locking profile. Classification of iASD versus PMS performed poorly in the full sample but improved markedly after excluding high-SAI iASD individuals, consistent with substantial heterogeneity within iASD. Unsupervised clustering of ITPC features identified PMS-enriched clusters that also captured high-SAI iASD participants. Results were consistent after controlling for age in sensitivity analyses. ConclusionsReduced 40-Hz ITPC is a mechanistically interpretable electrophysiological signature of PMS and identifies a biologically meaningful PMS-like subgroup within iASD, supporting biomarker-guided stratification.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with symptoms spanning cognitive, social and behavioral domains and leading to lifelong challenges. Autism is heritable but specific genetic and environmental factors that shape its early neurodevelopmental trajectory remain unknown. Despite the clinical variability, neuroimaging findings from Enhancing Neuro Imaging Genetics through Meta Analysis (ENIGMA)-ASD consortium identified stable and replicable patterns of cortical and subcortical differences that were consistent with those reported by an independent consortium, the Cognitive Genetics Collaborative Research Organization (COCORO) in Japan. Here we developed and evaluated a regional vulnerability index (RVI), a similarity metric that quantifies how closely a persons brain resembles the specific pattern of an individual with autism. RVI-ASD is based on combining the regional effect sizes for regional brain measurements published by the ENIGMA-ASD group with microstructural white matter integrity differences reported by COCORO. RVI-ASD showed significantly higher effect size for case-control differences relative to any individual brain measure (d=0.30 vs. d=0.01-0.21) in individuals with autism, particularly in the adolescent-to-adult sample (N=2,577; Mean age = 16.1; SD=5.0). We next calculated RVI-ASD in the baseline and follow-up (ages 10 and 12) data from normally developing participants of the ABCD study (N=4,201). We tested the longitudinal stability, heritability, genotype-by-age interaction and sensitivity of RVI-ASD to known factors and cognitive measurements. RVI-ASD were stable on the 2-year follow up (ICC=0.76-0.92); showed significant heritability (h{superscript 2}=0.55-0.83, p<10-16) but was not affected by gene-by-age interaction. RVI-ASD showed significant positive correlation with paternal age, while correlation with maternal age was non-significant. Baseline and follow-up RVI-ASD were negatively correlated with cognitive measures including total, fluid and crystallized intelligence (r=-0.09 to -0.11, p<10-6). RVI-ASD scores tracked with core autism phenotypes including poor eye contact and rigid routines (p < .01). In a sub-sample of children with symptoms of autism (N=20), we found that earlier age of symptom onset was strongly correlated with higher White Matter RVI (r = -0.61), linking early behavioral emergence to the neuroanatomical signature. Longitudinal changes in subcortical RVI-ASD are significantly correlated with change in social functioning. The RVI-ASD is a neuroimaging-based biomarker linked to stable and reproducible brain patterns in autism. RVI-ASD allows researchers to study associations with factors associated with the likelihood for autism and cognition across large and inclusive non-clinical samples, thus moving beyond simple case-control models to understand the biological pathways of autism.

BackgroundAutism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) share substantial clinical and physiological overlap. While naturalistic and sensory-driven paradigms increasingly capture evoked neurophysiological responses, the intrinsic baseline physiology of these conditions remains poorly defined. We aimed to characterize resting-state autonomic arousal and oculomotor stability across the ASD-ADHD spectrum using both continuous (RDoC) and categorical (DSM-5) analytical frameworks. MethodsWe analyzed resting-state eye-tracking data from a large pediatric cohort (N = 2,640) from the Healthy Brain Network. During an unconstrained baseline, we extracted Pupil Relative Volatility (Coefficient of Variation [CV]) to index intrinsic autonomic arousal, and the Bivariate Contour Ellipse Area (BCEA) to index spatial gaze instability. Data were evaluated using continuous dimensional regressions against the Social Responsiveness Scale (SRS) and SWAN inventories, followed by 2x2 factorial ANCOVAs based on clinical diagnoses. Sensitivity analyses accounted for clinical collinearity, spatial outliers, and psychostimulant medication. ResultsDimensional models revealed that Pupil CV was significantly and uniquely associated with continuous autistic traits (q = 0.0043, joint model), exhibiting a strong statistical suppression effect when controlling for ADHD trait covariance. However, this pupillary biomarker lost significance in binary categorical models. Conversely, spatial gaze instability (BCEA) demonstrated robust categorical threshold effects; isolated ASD and ADHD diagnoses significantly impaired baseline gaze stability. Furthermore, comorbid ASD+ADHD produced a distinct, sub-additive interaction for BCEA (q = 0.005) that remained robust to extreme spatial outliers. Both physiological phenotypes were independent of active psychostimulant use. LimitationsWhile this study included a large and diverse group of children, the eye-tracking data were collected during a brief resting period -- watching a simple cross on a screen -- which may not capture how children behave in everyday, real-world situations. Because holding still for eye-tracking can be difficult, particularly for children with more severe symptoms, some data were lost; however, we statistically accounted for how much data each child contributed. Finally, while we confirmed that ADHD medication taken on the day of testing did not explain our findings, complete medication records were not available for every participant in this large observational study. ConclusionsPupillary dynamics and oculomotor stability associate with the ASD-ADHD spectrum through differing analytical patterns during resting states. Baseline autonomic volatility is more strongly captured by dimensional models of autistic trait severity, whereas baseline gaze instability is more clearly differentiated across categorical diagnostic groups, exhibiting a sub-additive interaction in comorbidity. Integrating both dimensional and categorical frameworks provides a more comprehensive understanding of these physiological variations, establishing a necessary foundation for future naturalistic and sensory-evoked research.

Abstract Background & Aims: Language development in autism is heterogeneous and strongly predicts later functioning. The balance between receptive and expressive abilities and their developmental trajectories, however, remains poorly understood. While some autistic children exhibit a relative expressive advantage (ExpAdv), others show receptive advantage (RecAdv) or a balanced profile. Prior studies report inconsistent findings and are often limited by cross-sectional designs and small samples. The present study aimed to (1) describe longitudinal trajectories of receptive and expressive language in autistic and typically developing (TD) children; (2) classify children into ExpAdv, Balanced, and RecAdv profiles across early childhood; and (3) examine the stability and transitions of these profiles over time, including associated clinical features. Methods: We analyzed 1,174 longitudinal time points from 318 autistic children and 294 time points from 108 TD children (1.2-5.8 years) from the Geneva Autism Cohort. Receptive and expressive language were assessed with the Mullen Scales of Early Learning. Receptive-expressive balance was quantified as the ratio of receptive to expressive age equivalent scores, classifying children into ExpAdv, Balanced, and RecAdv profiles using adapted cut-offs. Mixed-effects models examined developmental trajectories, and Sankey diagrams visualized profile transitions. Autism features and adaptive behavior were compared across profiles. Results: Autistic children displayed lower expressive and receptive language than TD peers, with receptive abilities exceeding expressive skills in both groups. Overall, 30-35% of autistic children were classified as ExpAdv at 18-36 months, declining to ~12% by 48-54 months, while Balanced and RecAdv profiles became more prevalent with age. ExpAdv was associated with slower verbal and non-verbal developmental gains. Stability was highest for Balanced and RecAdv profiles (50-60%), whereas ExpAdv often transitioned to Balanced. Autistic children with stable ExpAdv profiles were more often female, less likely to receive early intervention, and showed weaker adaptive communication. Conclusions: Receptive-expressive language profiles in autistic children are dynamic. ExpAdv profile is more frequent in younger autistic children, less stable, and linked to slower verbal and non-verbal development and higher autism severity. Implications: ExpAdv may represent an early marker of autism associated with slower expressive and receptive language growth. Longitudinal monitoring of receptive and expressive skills is essential, as transitions toward Balanced or RecAdv profiles are associated with improved developmental outcomes. Early intervention before age three may facilitate transitions toward Balanced or RecAdv profiles, supporting more favorable language development and long-term outcomes. Keywords: autism; early childhood; longitudinal design; expressive language; receptive language; language profile; early intervention; language gap; discrepant profiles

The brain generates predictions to prepare for upcoming events. Because the environment is not perfectly predictable, the brain also estimates the certainty of these predictions and adjusts preparatory processes accordingly. Given that autistic individuals often resist even small changes to everyday routines, we hypothesized altered tuning of prediction certainty in autism. To test this, EEG was recorded from adolescents and young autistic adults (n = 20) and from age- and IQ-matched non-autistic adults (n = 19) during a probabilistic cued target identification task during which cue validity was systematically varied across four levels: 100%, 84%, 67%, and 33%. Participants were not informed of the cue-target validity nor when it changed. We focused on two neural signatures of anticipatory readiness, contingent negative variation (CNV) and alpha-band event-related desynchronization (-ERD), and one of cognitive updating: the P3 to targets and to invalid (e.g., a non-target in place of the target) stimuli. Across groups, preparatory activity increased as contextual certainty decreased, with larger CNV amplitudes and stronger -ERD preceding targets in lower-probability contexts, suggesting enhanced preparatory engagement under greater uncertainty. Furthermore, larger CNV amplitudes predicted faster reaction times, indicating functionally significant anticipatory dynamics. However, modulation of both neural preparation and response times as a function of cue-target probability was significantly reduced in the autistic group. In addition, autistic participants showed diminished probability-dependent modulation of the P3b to both targets and invalid stimuli, and coupling between anticipatory activity (CNV) and subsequent updating (P3b) was observed in non-autistic participants whereas it was absent in autism. Together, these findings suggest that while predictive mechanisms are present in autism, anticipatory processes are less flexibly tuned to contextual uncertainty and less effectively linked to subsequent cognitive updating. This reduced adaptability may reflect difficulty adjusting internal predictive models to changing environmental contingencies, potentially contributing to core features of autism such as resistance to change and insistence on sameness. HighlightsO_LIAnticipatory brain mechanisms (CNV and alpha desynchronization) are present in autism and are behaviorally relevant, predicting faster responses. C_LIO_LIAutistic individuals exhibit reduced modulation of anticipatory CNV and alpha activity as a function of cue-target validity. C_LIO_LIP3b responses to both targets and invalid stimuli show diminished sensitivity to contextual probability in autism, consistent with altered prior updating. C_LIO_LIThe link between anticipatory activity and cognitive updating (i.e., CNV to P3b) is disrupted in autism. C_LIO_LIP3a amplitude to invalid stimuli is reduced in autism, suggesting diminished engagement of violation-sensitive processes. C_LIO_LITogether, findings point to less flexible tuning of predictive mechanisms and reduced adaptation to contextual uncertainty in autism. C_LI

During typical development, non-social visual object recognition emerges in the first year of life, engaging low-level visual cues and higher-level mechanisms involving inference and prior knowledge. How these processes function in minimally verbal autism (mvASD) remains poorly understood. We studied children with mvASD (n=22, 6-11 years) using touchscreen-based oddball and contour-detection tasks targeting low-level stimuli (e.g. shape and orientation), and mid-level stimuli (e.g. illusory Kanizsa contours and 3D shapes). Pointing and eye-gaze responses were measured. Typically developing children (n=22, 6-12 years) served as a reference group. Accuracy and reaction-time profiles among mvASD participants were heterogeneous across experimental visual tasks and standardized developmental measures. All mvASD participants detected targets in the easiest condition, and approximately half succeeded across low-level tasks. Overall performance declined with increasing visual complexity, consistent with attenuated inference-based processing; communication ability and nonverbal reasoning together accounted for approximately 69% of between-participant variance in visual task performance. Critically, exploratory analyses suggested systematic perception-action dissociations rather than random error. First, the majority of participants who failed to point correctly (n=9) reliably fixated the correct target. Second, in the Kanizsa oddball task, nearly half of successful mvASD participants pointed to local inducers rather than the illusory figure center, unlike TDs. Third, more participants showed within-age-range nonverbal reasoning performance on Ravens colorful progressive matrices when responding by puzzle placement than by pointing. These converging findings challenge interpretations of mvASD performance as reflecting perceptual or cognitive capacity alone, suggesting visual signals may guide action selection differently in mvASD. Lay SummaryMinimally verbal children with autism showed individual differences in visual processing tasks. While developmental measures like communication ability and reasoning skills predicted most of the variation in performance, exploratory observations revealed an intriguing pattern: the same children sometimes succeeded when using their eyes to indicate answers but failed when pointing or performing better when placing puzzle pieces than pointing in a booklet to identical visual display. Several children who correctly detected illusory triangular shapes consistently touched the corner pieces rather than the triangle centers. These patterns suggest that performance depends not only on developmental and visual perceptual abilities, but also on how children are asked to respond. Parents and educators should consider: might a child who fails a pointing-based test succeed with a different response method?

Mutations in the synaptic scaffold protein SHANK3 represent one of the most frequent genetic causes of autism spectrum disorder (ASD), yet the circuit mechanisms through which SHANK3 dysfunction leads to behavioral alterations remain incompletely understood. The anterior insular cortex (aINS) is a key integrative hub involved in socio-emotional processing, anxiety regulation, and social cognition, a group of behaviors frequently disrupted in ASD. Here, we investigated whether selective deletion of SHANK3 signaling in glutamatergic neurons of the aINS is sufficient to produce ASD-relevant behavioral and circuit phenotypes. Using conditional Shank3flox4-22 mice combined with stereotaxic viral delivery of Cre recombinase under the CaMKII promoter, we selectively deleted Shank3 in glutamatergic neurons of the aINS. Behavioral phenotyping revealed increased anxiety-like behavior, enhanced repetitive behavior, and impaired social memory, while sociability and locomotor activity were largely preserved. These behavioral alterations were accompanied by genotype-dependent differences in neuronal activity revealed by calcium imaging, indicating disrupted activity dynamics in insular glutamatergic neurons following Shank3 deletion. To assess the broader relevance of these findings, we evaluated the behavioral profile of BTBR T+ Itpr3tf/J mice, a model of idiopathic ASD, in the same battery of behavioral tests. Several behavioral alterations observed following insular Shank3 deletion partially overlapped with those present in BTBR mice, supporting the relevance of aINS Shank3 in ASD-related phenotypes. Together, these findings identify glutamatergic neurons of the aINS as a critical locus through which Shank3 dysfunction can disrupt socio-emotional, cognitive, and repetitive behaviors. Our results highlight the aINS as a key circuit node contributing to ASD-related behavioral alterations and provide mechanistic insight into how synaptic scaffold disruption leads to circuit dysfunction and produces behavioral alterations.

Atypical sensory experiences are highly prevalent in autistic children and include both hyper- and hypo-responsivity, often accompanied by sensory overload. Alpha oscillations (7-13 Hz), which dynamically regulate cortical excitability, represent a plausible neural mechanism underlying these phenomena: reduced alpha activity is associated with enhanced sensory responsiveness, whereas increased alpha supports suppression of external input. Although decreased alpha power has been repeatedly reported in autism, it remains unclear whether this reduction reflects lower oscillatory amplitude or reduced temporal stability of alpha rhythms, two mechanisms with distinct neurophysiological implications. To better characterize alpha activity in autism, we examined resting-state alpha dynamics in non-autistic children (NA; n = 39), autistic children (AU; n = 52), and siblings of autistic children (SIB; n = 26), aged 8-14 years. We combined traditional broadband measures of relative alpha power, parametric separation of periodic and aperiodic activity, and single-event analyses that quantify the temporal structure of alpha oscillations. Both broadband relative alpha power and periodic alpha power were reduced in autism over parietal regions, replicating prior findings. Importantly, ordinal analyses revealed an intermediate profile in siblings, supporting a liability-related gradient of alpha alterations. However, single-event analyses demonstrated that the average amplitude of individual alpha bursts did not differ between groups. Instead, autistic children showed significantly shorter alpha burst duration and reduced alpha abundance (i.e., proportion of time occupied by rhythmic alpha episodes), with siblings again exhibiting intermediate values. Linear regression analyses confirmed that reductions in relative and periodic alpha power were primarily driven by decreased alpha abundance rather than diminished burst amplitude. These findings indicate that altered alpha activity in autism reflects reduced temporal stability and density of alpha events rather than weaker oscillatory amplitude per se. Reduced persistence of alpha rhythms may therefore represent a neural marker of altered cortical excitability and sensory regulation in autism. Lay summaryAutistic children often experience the world differently at the sensory level, including being more easily overwhelmed by sounds, lights, or other stimuli. In this study, we looked at a type of brain activity called alpha rhythms, which help regulate how strongly the brain responds to incoming information. We found that, in autistic children, these alpha rhythms were not weaker when they occurred, but they lasted for a shorter time and happened less often. Siblings of autistic children showed an intermediate pattern. These results suggest that sensory differences in autism may be linked to less stable brain rhythms that normally help control sensory input. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=158 SRC="FIGDIR/small/716324v1_ufig1.gif" ALT="Figure 1"> View larger version (32K): org.highwire.dtl.DTLVardef@1be733dorg.highwire.dtl.DTLVardef@7fea49org.highwire.dtl.DTLVardef@1ee9124org.highwire.dtl.DTLVardef@17af139_HPS_FORMAT_FIGEXP M_FIG C_FIG

Delayed onset of canonical babbling and first words is often reported in infants later diagnosed with autism spectrum disorder. Identifying the neural mechanisms underlying language acquisition in autism is therefore critical to inform early diagnosis, prognosis, and intervention strategies. In this study, we investigated two speech processing mechanisms previously identified as atypical in children and adults with autism: the neural ability to track syllables; and statistical learning, the capacity to detect speech regularities beneath surface variability. We recorded 83 longitudinal high-density EEGs from 44 infants (2.5-22.6 months) at high (HL) and low (LL) likelihood for autism and assessed their verbal outcomes at 20 months. Neural entrainment was measured at syllable and word frequencies during exposure to a multi-speaker stream of concatenated tri-syllabic words, followed by a word recognition test using ERP recording. Our findings revealed reduced tracking abilities at the syllabic level in HL infants, a measure that correlated with verbal outcomes. While HL infants did not exhibit deficits in statistical learning itself, they displayed reduced novelty orientation during the word recognition test, indicated by a reduced late ERP. By contrast, multi-talker variability temporarily disrupted word segmentation around 12 months in LL infants, but not in HL infants, potentially reflecting decreased sensitivity to human voices variability in the HL group. These results emphasize the importance of longitudinal protocols employing online, implicit measures to track the hierarchical stages of speech processing in both HL and LL infants.

Background: Female individuals tend to be diagnosed with autism later. One factor suggested to contribute to diagnostic timing is verbal ability, in which autistic females may show strengths relative to male peers. Social drivers of health (SDOH) predict higher verbal skills, yet access to resources may facilitate diagnosis; thus, SDOH likely contributes to diagnostic timing in complex ways. We use data from two autism cohorts with substantial representation of those assigned female at birth (AFAB) to examine interactions among assigned sex at birth (sex), verbal IQ (VIQ), and SDOH in predicting autism diagnostic timing. Methods: We used multiple linear regression to examine sex assigned at birth and VIQ as predictors of diagnostic timing in an assigned-sex-balanced research sample (N=164, AFAB: 71) and an independent clinical sample (N=641, AFAB: 177). We hypothesized VIQ would positively predict diagnostic age, particularly among AFAB. Available data in the clinical sample also permitted us to explore the contributions of SDOH and inclusion criteria to model fit in this cohort. Results: In the research sample, VIQ, but not sex, positively predicted diagnostic age. In the clinical sample, VIQ and VIQ x SDOH, but not sex, predicted diagnostic age. Fitting the same model in a subsample of the clinical cohort formed by applying exclusion criteria used in the research sample (N=484, AFAB: 110), VIQ x SDOH x Sex became significant. For AFAB, higher VIQ and lower SDOH together were associated with later diagnosis in the clinical subsample, while for AMAB the opposite was true. Conclusions: Autistic youth with strong verbal ability may experience diagnostic delays. SDOH interacts with VIQ in a complex fashion, with lower SDOH generally exacerbating the tendency for VIQ to be associated with later diagnosis across a large clinical sample. However, among autistic youth without complicating medical factors or intellectual disability, this relationship is dependent upon sex.

The causes of severe neuropsychiatric deteriorations among patients with previously stable autism spectrum disorder (ASD) are poorly understood and present substantial challenges for care. We aimed to characterize the prevalence of autoimmune and inflammatory conditions and markers, as well as musculoskeletal findings, among youth with ASD experiencing a suspected post-infectious neuropsychiatric deterioration. The Stanford Immune Behavioral Health (IBH) Clinic is a specialty program for youth with neuropsychiatric deteriorations that are suspected to be post-infectious (non-psychosocial). We report findings for 43 consecutive patients with ASD (70% male [30 of 43]) evaluated in the IBH Clinic. The average (SD) age at clinical presentation was 12.0 (4.0) years. Juvenile arthritis was diagnosed in 15 patients (35%), predominantly enthesitis-related arthritis (ERA) and psoriatic arthritis (PsA). Seven patients had ultrasonographic evidence of joint effusions and/or synovitis without meeting juvenile idiopathic arthritis (JIA) criteria. Autoimmune conditions other than arthritis were observed in 9 patients (21%). The mean (SD) age at arthritis and other autoimmune condition diagnoses were 16.2 (5.5) and 12.7 (4.9) years, respectively. We observe markers of immune activation during neuropsychiatric deteriorations in over half of patients (60% [26 of 43]), including markers of autoimmunity (33% [12 of 36]), complement activation (41% [13 of 32]), immune dysregulation/inflammation (11% [4 of 37]), and vasculopathy (30% [13 of 43]). One-third (37% [16 of 43]) demonstrated two or more markers. These data underscore the importance of targeted immune evaluation--including musculoskeletal imaging and inflammatory marker screening--in ASD patients who have had a suspected post-infectious behavioral regression. Lay SummaryIn this cohort study of 43 patients with autism spectrum disorder (ASD) and suspected post-infectious deteriorations, more than half had laboratory markers of immune activation (using a limited panel), one-third had joint inflammation (confirmed by ultrasound), and additional autoimmune conditions were observed in 21%. From this, we conclude that patients with ASD who experience a suspected post-infectious neuropsychiatric deterioration may have underlying inflammation which may contribute to neuropsychiatric and behavioral regressions, highlighting the importance of immunologic and rheumatologic evaluation in clinical assessment.

During social interactions, people continuously align their movements and rhythms, a process known as interpersonal synchrony that supports rapport, mutual understanding, and smooth communication. In autism spectrum disorder (ASD), previous studies have often reported atypical or reduced synchrony, but most have relied on aggregate or session-averaged measures that may miss how coordination develops over time. It therefore remains unclear whether interactional differences in autism reflect a general reduction in synchrony or altered temporal dynamics of interpersonal coordination. We examined the temporal dynamics of head-movement synchrony during a structured face-to-face communication task, comparing non-autistic dyads (two typically developing [TD] partners) with mixed-neurotype dyads (one TD speaker paired with one autistic listener), using gyroscope-based tracking and time-resolved trajectory modelling. Phase-based synchrony, indexed by the phase-locking value (PLV), was lower overall in mixed-neurotype dyads. Critically, time-resolved analyses revealed a marked group difference in synchrony trajectories: non-autistic dyads showed progressive, adaptive growth in synchrony over the interaction, whereas mixed-neurotype dyads showed a significantly attenuated, flatter pattern. These findings suggest that autism may involve altered temporal organization of social coordination rather than simply reduced synchrony overall. Lay AbstractWhen we talk with someone, we often naturally match their body language and rhythms without even realizing it. This physical "syncing up" helps us feel connected, builds trust and shared understanding, and makes communication flow easily. Research shows that autistic people might sync their movements differently during conversations compared to non-autistic people. However, past studies usually just measured an overall average of this syncing across a whole interaction. This approach misses how human interactions actually unfold over time. We wanted to know: do autistic people just sync less overall, or does their syncing change differently as the conversation goes on? To find out, we used small motion sensors to track the head movements of adults having structured face-to-face conversations and compared two types of pairs: non-autistic pairs, where both people were non-autistic, and mixed-neurotype pairs, where one non-autistic speaker talked to one autistic listener. We found a notable difference in how the two groups interacted over time. For the non-autistic pairs, the physical syncing grew progressively stronger as the conversation progressed; they progressively "tuned in" to each other. In contrast, mixed-neurotype pairs showed a flatter pattern--their level of syncing stayed relatively constant from start to finish without that same gradual build-up. These findings are important because they suggest that differences in autistic communication are not simply a "lack" or "deficit" in social coordination. Instead, autistic individuals have a distinct style of interacting--one that maintains social engagement without relying on the progressive build-up of physical syncing that non-autistic people use. Taken together, our results highlight the importance of examining how interactions evolve over time to better understand the different ways autistic and non-autistic people communicate.

Previously we found that female autistic youth (Aut-F) showed reduced brain response in dorsal striatum (putamen) when viewing human motion, alongside larger rare copy number variants that included genes expressed in early striatal development. Thus, striatal differences may characterize Aut-F, but broader systems-level and behavioral implications of these differences remain unexplored. We conducted secondary data analysis of the sex-balanced cohort (8-17y) in which we first discovered these patterns, in order to: 1) understand how functional connectivity between putamen and frontal targets might vary from the non-autistic population, and differ by sex; and 2) explore which brain connectivity and phenotypic features best predicted executive function. Using psychophysiological interaction analysis (N=184), we found that Aut-F youth (n=45) showed reduced functional connectivity between left anterior putamen (Pa) and dorsal premotor cortex/pre-supplementary motor area versus matched non-autistic female peers (NAut-F; n=45), suggesting reduced engagement of a typical Pa-frontal pathway for attentional regulation. Best subsets regression (N=200) indicated that left Pa-left dorsolateral prefrontal functional connectivity explained significant variance in executive functioning across all participants, controlling for neurotype. These results suggest that striatal differences in Aut-F may have adaptive consequences in part due to impacts on connectivity between Pa and frontal regions important for attentional control. Lay summaryWe previously found that female autistic people show differences in a part of the brain called the striatum. Some parts of the striatum connect to the frontal lobe of the brain, and may help people control their attention and behavior. We studied how the striatum "talked to" the frontal lobe in autistic girls. We found out that this communication is lower in autistic than non-autistic girls. We also found out that how much striatum "talks to" frontal lobe helps explain differences in how well both autistic and non-autistic youth of both sexes control their attention and behavior.

PurposeNavigational ability develops throughout childhood alongside the maturation of brain regions supporting egocentric and allocentric processing. In Autism Spectrum Disorder (ASD), atypical hippocampal development may impact flexible spatial memory; however, findings on navigational ability in autistic children remain inconsistent. This study aimed to compare both objective and perceived navigation ability in children with ASD and typically developing (TD) peers. MethodTwenty-six children with high-functioning ASD and twenty-five age- and gender-matched TD children (M_age = 12.04 years, SD = 1.64) completed a battery of navigational tasks from the Spatial Performance Assessment for Cognitive Evaluation (SPACE), including Path Integration, Egocentric Pointing, Mapping, Associative Memory, and Perspective Taking. Perceived navigation ability was assessed using the Santa Barbara Sense of Direction (SBSOD) scale. ResultsNo significant group differences were observed across any objective navigation tasks. However, children with ASD reported significantly lower perceived navigation ability compared to TD peers. ConclusionThese findings suggest a dissociation between perceived and actual navigational ability in ASD. By early adolescence, objective navigation performance appears intact, potentially reflecting sufficient maturation of underlying neural systems or the presence of compensatory mechanisms. The results underscore the importance of incorporating objective, task-based measures when assessing cognitive abilities in autistic populations.

The mechanistic role of the third visual pathway in autism spectrum disorder (ASD) remains unknown. We previously developed a neurofeedback therapy for autism targeting the posterior superior temporal sulcus (pSTS), a region in this network that underlies the perception and imagery of emotional facial expressions, resulting in improvements in adaptive behavior and recognition of fear in facial expressions. Here, we investigated the impact of this 5-session therapy on the functional connectivity of that core region of the third visual pathway. We found evidence for a profound reorganization of this network with treatment-induced decreases in connectivity between low-level visual areas, the pSTS, and the posterior occipital face area (OFA), and increased connectivity with higher-level visual regions (fusiform face area - FFA), right middle STS (mSTS), and parietal cortex. These changes, suggesting the restoration of connectivity in regions known to be underconnected in ASD, such as mSTS and pSTS, and in a set of regions belonging to the temporoparietal junction and the ventral attention network, which are known to be involved in broader aspects of social cognition, were positively associated with clinical improvements. The demonstration of treatment response associated with network reconfiguration paves the way for multicentric trials to probe this observed reorganization as a treatment target.