Journal of Autism and Developmental Disorders

Language development, a core pillar of social communication, has variable trajectories in autism that include a regression or loss of skills in roughly 20% of autistic individuals. Language regression is most frequently identified through parent report but can also be observed as a decrease in raw scores on a repeated language assessment (measure-defined). Later language outcomes after regression have been observed to be highly variable, but not lower than children without a language regression. The current study explores rates of parent-reported and measure-defined language regression in a large sample of infants at high familial likelihood of autism due to having an older autistic sibling. Among all participants at high familial likelihood for autism (n=428), parent-reported regression was observed in 2.8% (n=12) and was associated with 2.77 times higher odds of receiving an autism diagnosis. Measure-defined regression was observed in 8% (n=36) and was associated with 1.21 times higher odds of autism diagnosis. These rates of regression are expectedly lower than estimates collected in autistic samples. Neither of these elevated odds was statistically significant and there was low concordance between these groups with only one participant present in both. Nearest-neighbor comparison samples of non-autistic infants at high and low likelihood for autism without language regression were selected to assess differences in language growth trajectories associated with regression. Infants with parent-reported language regression showed comparable language development to a matched high-likelihood sample while infants with measure-defined language regression showed slower overall language development than matched peers. Taken together, our results show that parent-report and direct measurement of regression capture unique aspects of child language development that may not be predictive of an autism diagnosis but may indicate delayed language growth in early toddlerhood. These language outcomes support previous findings of wide heterogeneity among those with regression and continued language growth after loss of skills. Key PointsO_LILanguage regression can be captured through parent-report or decrease in raw scores on repeated language assessment and is reported in approximately 20% of autistic toddlers. C_LIO_LIMost research on language regression uses retrospective report of regression in autistic children, but this study prospectively examines regression in toddlers at high familial likelihood for autism who do and do not receive later diagnoses. C_LIO_LIParent-reported and measure-defined regression in this high-likelihood sample have low concordance indicating that these may be different events in language development. C_LIO_LIThe presence of language regression was not associated with significantly higher odds of receiving an autism diagnosis. C_LIO_LIChildren who exhibit language regression continue growing and developing language and those with parent-reported regression display comparable language skills to children without language regression at three years of age. C_LI

Despite their relevance to outcomes in autism, little is known about how social drivers of health affect communication, especially in transition-aged autistic adolescents and young adults with structural language impairment. This knowledge gap limits our understanding of developmental trajectories and the ability to develop supports. This cross-sectional study examined the role of social drivers of health in communication abilities of minoritized autistic individuals ages 13 to 30. Participants (N = 73) completed language, nonverbal cognitive assessments, and social drivers of health (sense of community, unmet services, barriers to services) measures. Data were analyzed descriptively and using mixed-effects modeling. More unmet service needs, more barriers to services, and lower sense of community were associated with greater social communication impairment. In turn, both unmet service needs and barriers to services were negatively associated with functional communication. In regression modeling, language scores contributed to functional communication, and sense of community to social communication impairment. Findings support the relevance of language and social drivers of health in communication. Future work should focus on possible bidirectional relationships between these variables and explore and real-world translation. Lay AbstractWhere people live, work, and spend their time is important. Environments can have more or less services or differ in how much they help people feel like they belong to their community. These parts of the environment are called social drivers of health. Social drivers of health are important for outcomes in autism, but we do not know much about them in racially and ethnically minoritized autistic teens or young adults. We recruited 73 minoritized autistic teens and young adults (ages 13 to 30 years) and 52 caregivers to our study. Autistic teens and young adults did language and NVIQ tests on Zoom. Autistic teens, young adults, and caregivers also answered questionnaires. Sense of community was important for social communication impairment, and language was important for real-world communication. These findings tell us two things. First, thinking about how to create supportive communication environments for autistic teens and adults is important. Second, understanding how social drivers of health shape outcomes is important. In the future, we should focus on how improving environments can help minoritized autistic teens and adults meet their communication goals.

PurposeThough co-occurring structural language impairment (LI) in autism is common and predicts long-term outcomes, little is known about LI in autism beyond childhood. One challenge to closing this gap is that there is no consensus definition of LI. This study focuses on LI in autistic adolescents and young adults, asking to what extent clinical classification differs by definition and examining performance across language measures, nonverbal intelligence (NVIQ), and autism traits. MethodParticipants (N = 75; ages 13-30) varying in levels of autism traits completed norm-referenced measures of overall expressive language, overall receptive language, receptive vocabulary, expressive vocabulary, nonword repetition, and NVIQ. Scores were compared to epidemiological definitions for LI varying in criteria and cutoffs from -1 SD to -1.5 SD. Data were analyzed using descriptives and clustering. ResultsMore stringent definitions yielded a greater proportion of participants meeting LI criteria, and more stringent cutoffs for LI yielded greater overall consistency in clinical classification across individual language measures, but there was no one-to-one ratio between cutoff and clinical classification. Clustering indicated three profiles differentiated on the basis of language and nonverbal cognitive skills, but each cluster was heterogeneous. Individual performance also varied across language measures. DiscussionFindings support multi-domain approaches to characterizing language skills in autistic adolescents and adults, including those with LI. Future work is needed to understand language skills in autism beyond childhood and how to develop effective assessment practices.

BackgroundAutism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication and restricted, repetitive behaviors emerging in early childhood. Given rising diagnostic rates and substantial lifelong impacts, accurate global prevalence estimates are essential for health policy, resource planning, and early intervention. This systematic review and meta-analysis synthesized global observational evidence to estimate ASD prevalence across world regions and examine factors influencing heterogeneity. MethodsFollowing PRISMA guidelines, searches were conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar for observational and registry-based studies published from 2004-2025. Twenty-two studies met inclusion criteria. Random-effects models (REML) estimated pooled global and regional prevalence. Heterogeneity was assessed using Q, I{superscript 2}, {tau}{superscript 2}, Baujat plots, and influence diagnostics. Subgroup analyses and meta-regressions evaluated moderators including geographic region, mean age, and prevalence per 1,000. Sensitivity analyses assessed model robustness. ResultsThe pooled global prevalence of ASD was 1.8% (95% CI: 0.8-3.7%). Substantial heterogeneity existed across studies (Q p <.001; {tau} = 1.64), with prediction intervals ranging from 0.05% to 37.8%. Regional estimates ranged from 0.65% in the Middle East to 3.4% in North America, though subgroup differences were not statistically significant. Meta-regression suggested significant moderation by mean age and prevalence per 1,000 (R{superscript 2} = 59.35%), although sensitivity analyses revealed that these effects were largely driven by one influential study. Publication bias was minimal. ConclusionGlobal ASD prevalence remains around 1%-2%, consistent with contemporary epidemiological data; however, considerable heterogeneity indicates that methodological and contextual factors likely drive observed regional differences. Standardized diagnostic criteria, enhanced surveillance, and early detection systems are needed to improve global prevalence accuracy and inform public health planning.

BackgroundThe 1.6 Mb 3q29 deletion is associated with neurodevelopmental and neuropsychiatric phenotypes, including a 19-fold increased risk for autism spectrum disorder (ASD). Previous work by our team identified elevated social disability in this population via parent-report questionnaires. However, clinical features of ASD in this population have not been explored in detail. Methods31 individuals with 3q29 deletion syndrome (3q29del, 61.3% male) were evaluated using two gold-standard clinical ASD evaluations: the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Autism Diagnostic Interview, Revised (ADI-R). Four matched comparators for each subject were ascertained from the National Database for Autism Research. Item-level scores on the ADOS-2 and ADI-R were compared between subjects with 3q29del and matched comparators. ResultsSubjects with 3q29del and no ASD (3q29del-ASD) had greater evidence of social disability compared to typically developing (TD) comparison subjects across the ADOS-2. Subjects with 3q29del and ASD (3q29del+ASD) were largely indistinguishable from non-syndromic ASD (nsASD) subjects on the ADOS-2. 3q29del+ASD performed significantly better on social communication on the ADI-R than nsASD (3q29+ASD mean = 11.36; nsASD mean = 15.70; p = 0.01), and this was driven by reduced deficits in nonverbal communication (3q29+ASD mean = 1.73; nsASD mean = 3.63; p = 0.03). 3q29del+ASD reported significantly later age at first two-word phrase compared to nsASD (3q29del+ASD mean = 43.89 months; nsASD mean = 37.86 months; p = 0.01). However, speech delay was not related to the improved nonverbal communication in 3q29del+ASD. LimitationsThere were not enough TD comparators with ADI-R data in NDAR to include in the present analysis. Additionally, our relatively small sample size made it difficult to assess race and ethnicity effects. Conclusions3q29del is associated with significant social disability, irrespective of ASD diagnosis. 3q29del+ASD have similar levels of social disability to nsASD, while 3q29del-ASD have significantly increased social disability compared to TD individuals. However, social communication is reasonably well-preserved in 3q29del+ASD relative to nsASD. It is critical that verbal ability and social disability be examined separately in this population to ensure equal access to ASD and social skills evaluations and services.

BackgroundRacially and ethnically minoritized (minoritized) autistic individuals face intersectional disparities in services access in the transition to adulthood. Our understanding of disparities is limited by systematic exclusion from research and inadequate approaches to characterizing services. To address these gaps and effect advocacy, this study: 1) examined services received, unmet service needs, and barriers in minoritized autistic adolescents and adults, and 2) determined if language, NVIQ, and autism traits predict services when deployed as binary or continuous variables. MethodAcademic and community partners tailored CBPR to a local context. Participants (N = 73, ages 13-30) completed a behavioral assessment protocol. Participants and caregivers provided information on services received, unmet service needs, and barriers to services. Data were analyzed using descriptives and regression. ResultsParticipants received multiple services yet had multiple unmet service needs and barriers. Effects of services differed by approach. Language impairment, but not language scores, predicted receiving more services. High levels of autism traits and autism trait scores predicted more unmet service needs. ImplicationsWhile the number of services and unmet service needs were similar to prior work, differences in individual service variables and effects support attention to heterogeneity. Findings support intersectional approaches to CBPR and autism research. Learning outcomesAfter reading the article, the learner will be able to: 1) summarize knowledge gaps about access to services; 2) explain the relevance of tailoring CBPR to a local context; and 3) describe implications of findings for clinicians and autistic individuals.

People with autism spectrum disorder (ASD) frequently exhibit challenging behaviors throughout the lifespan, which can have pervasive effects on quality of life. Challenging behaviors have been shown to change over time as a function of various individual-level factors (e.g., cognitive ability), yet research is primarily limited to parent-reported measures. To expand upon this work, the present study aimed to examine trajectories of teacher- and parent-reported challenging behaviors (i.e., hyperactivity, irritability, social withdrawal) and to test whether predictors including ASD features, verbal intelligence quotient, and consistency in reporter impact these trajectories among individuals with ASD or non-spectrum delays from ages 9 to 18. Multilevel models revealed that, according to both teacher and parent report, participants showed the greatest improvement in hyperactivity, less but still notable improvement in irritability, and stable levels of social withdrawal over time. Higher cognitive ability and fewer ASD features emerged as important individual differences related to fewer challenging behaviors. The multi-informant perspective and longitudinal design provide novel insight into the manifestations of these challenging behaviors across different contexts and across time. Findings highlight the importance of addressing challenging behaviors as these behaviors tend to persist throughout development in both home and school contexts, especially for children with particular diagnostic and cognitive profiles. Lay SummaryAccording to both teacher and parent report, youth with autism showed the greatest improvement in hyperactivity, less but still notable improvement in irritability, and stable levels of social withdrawal from school-age to adolescence. Fewer autism features and greater cognitive ability were related to fewer challenging behaviors. This studys use of multiple reporters (e.g., teachers and parents) across time provided insight into the persistence of challenging behaviors in the home and school settings and across development.

PurposeAutism (ASD) and attention-deficit/hyperactivity disorder (ADHD) are chronic developmental disorders that have drastically increased in prevalence and co-occurrence over the past two decades. In previous research, ADHD has been correlated with low income and autism with high income, but it is uncertain how gender affects this. This analysis tests each of these income correlations, socioeconomic status (SES) confounders, and income modality against both diagnoses in girls. MethodsCross-sectional data from the 2020 National Survey of Childrens Health was analyzed. Multiple logistic regressions tested for correlations between each diagnosis and income, bimodal diagnosis patterns were tested at low and high income, and posttest analyses compared the respective odds ratios against both diagnoses. ResultsThis analysis was unable to detect any of the previously researched relationships between diagnosis in girls and income, nor a significant bimodal correlation of either diagnosis with income. Low income was linearly associated with autism diagnosis (odds ratio: 0.997, p = 0.011) while ADHD was not correlated with income. A peak in both diagnoses was observed near 138% of the federal poverty limit (FPL). Compared with White girls, only Hispanic Asian girls showed higher odds of autism in this analysis (OR: 8.2, p = 0.023). ConclusionPreviously observed trends between SES and ASD or ADHD did not appear specifically in girls. Instead, girls experience income, SES, and ethnoracial trends unique to them. A peak in diagnoses near 138% FPL suggests that expanded Medicaid eligibility may play a larger role for autism diagnosis in girls than expected.

Caregivers raising a child with autism experience increased parental burden, though many have positive experiences as well. Perceived negative impact, a form of parental burden, is the degree to which a caregiver reports negative financial, social, and emotional experiences associated with having a child with a disability. This longitudinal study defined parental perceived negative impact trajectory classes across time, determined predictors, and explored the relationship between functional adult outcomes and impact class. Participants (n = 209) were comprised of caregivers whose child received an ASD diagnosis or had developmental delay. Latent class growth modeling defined three trajectory classes (e.g., low [n = 68, 32.54%], medium [n = 98, 46.89%], and high [n = 43, 20.57%]). Regressions revealed the low impact trajectory class had more caregivers who were racial minorities, less educated, and more socially supported. Membership in the high negative impact class was associated with increased childhood hyperactivity, irritability, autism symptomology, and poor adaptive skills. The low negative impact trajectory class was associated with young adults achieving more functional outcomes. Overall negative impact declined over time all for all classes, though never completely subsided. Possible implications for clinical practices are discussed

BackgroundThere is striking heterogeneity in long-term outcomes associated with an autism diagnosis, and the role of language in outcomes has not been sufficiently characterized. This study characterized the roles of structural language ability and early language milestones in long-term social-emotional, educational, and vocational outcomes in individuals with autism and individuals who have lost the autism diagnosis (LAD) relative to neurotypical (NT) peers, over and above the potential confounding role of social skills. MethodsParticipants were individuals with autism (n = 39) or LAD (n = 32) and NT peers (n = 38) age 12-39 years. Participants completed standardized and survey-based measures of social-emotional functioning and educational and vocational attainment. Language measures were an experimental structural language task (grammaticality judgement) and caregiver-report of early language milestones. Linear and generalized linear models tested how groups differed in the association between language and outcomes. ResultsLanguage was associated with certain outcomes for all groups, though there were group differences in the nature of these associations. In autism relative to LAD and NT peers, structural language was differentially associated with anxiety/depression, and language milestones were differentially associated with social relationships, quality of life, educational attainment, and full-time employment status. ConclusionsFindings suggest unique pathways of influence between language and outcomes in individuals with autism versus LAD and NT peers. This evidence suggests that current language and early language development must be considered in social-emotional functioning and in educational and vocational supports from childhood through adulthood for individuals diagnosed with autism in childhood.

PurposeAutism Spectrum Disorder (ASD) prevalence rates vary greatly across regions and studies. Some countries, such as Argentina, have unknown rates. Due to this high heterogeneity in ASD prevalence worldwide, it is important to study its prevalence and characteristics in such countries to develop effective policies. Methodswe analyzed official data from the Unique Disability IDs (UDIDs) issued for individuals with ASD in the Autonomous City of Buenos Aires from 2016 to 2021, examining age, gender, and diagnosis. Resultsmost UDIDs were issued for males, for Pervasive Developmental Disorders, and almost half to individuals over 8 years old, with these trends remaining stable over these years. However, UDID issuance abruptly dropped in 2020. Conclusionsour findings highlight epidemiological aspects of the autism population in Argentina, including challenges such as delayed diagnosis and high prevalence of broad diagnosis categories. Addressing these challenges requires further research and intervention to improve the quality of life of individuals with ASD.

There is a critical lack of exploration into the first-hand experiences of autistic children in the psychological literature. We sought to address this using baseline data from a wider mixed-methods study. 136 autistic children (mean age=10.35) completed an online questionnaire. Questions explored childrens understanding of autism, their feelings about being autistic in different contexts, and challenges experienced. Quantitative data revealed limited autism knowledge and understanding in some. Challenges included talking about being autistic and self-advocating for needs, especially with non-family members. Children generally recognised both strengths and challenges of being autistic, although concerns about feeling/being different were widespread, and masking common. Strikingly, although most children felt positive about being autistic at home, significantly fewer felt this to be true when around peers or teachers. Using reflexive thematic analysis, four main themes were developed: (1) Overwhelming Experiences, (2) Unsafe People, (3) Sanctuary, (4) Autistic Identity. Overall, the children felt safest at home with family and/or with autistic/neurodivergent/understanding friends, but most unsafe at school with their teachers and neurotypical peers, where victimization was rife. These findings offer valuable insights into the lives of autistic children, and demand we explore how places of education can be transformed into safe spaces for autistic children.

BackgroundMost preschool autistic children exhibit substantial language delays, yet only [~]25% remain minimally verbal (MV) throughout life. Previous studies have demonstrated that development of expressive language abilities is crucial for improving long-term outcomes. This study aimed to identify early predictors of later expressive language development specifically in MV preschool autistic children. MethodsWe analyzed prospective data collected from 99 MV autistic children, who were 27.7 months old at diagnosis, on average. All children completed an ADOS-2 assessment at diagnosis and again 12-24 months later. We classified children into three expressive language groups at follow up: MV, one-word phase, and phrases phase. Logistic regression analyses were used to identify significant predictors of expressive language abilities at follow up. Predictors included ADOS-2 social affect (SA) calibrated severity scores (CSS), ADOS-2 restricted and repetitive behavior (RRB) CSS, cognitive scores, and joint attention (JA) scores, derived from a summation of six ADOS-2 items. ResultsChildren who successfully developed expressive language abilities at follow-up (i.e., were in the one-word or phrases groups) had significantly lower ADOS-2 SA CSS and JA scores at diagnosis. Logistic regression analyses demonstrated that both ADOS-2 SA CSS and JA scores at diagnosis predicted expressive language outcomes while cognitive scores and ADOS-2 RRB CSS did not. Moreover, concurrent improvements in JA were significantly larger in children who developed expressive language. ConclusionsPreschool MV autistic children with better social abilities, and specifically JA abilities, at diagnosis were more likely to develop expressive language within 1-2 years. JA scores derived from the ADOS-2 offer an easily accessible and widely available measure with important prognostic value for these children.

Self-determination plays an important role in outcomes in autism and shows intersectional disparities. Yet, little is known about the role of individual differences or social drivers of health in the development of self-determination. Understanding these factors is key for developing effective supports. This mixed-methods convergent study examined self-determination in racially and ethnically minoritized autistic individuals and caregivers. Participants ages 13 to 30 (N = 73) varying widely in language and cognitive ability and caregivers (n =52) completed the Self-Determination Inventory. Autism traits and sense of community predicted caregiver report of self-determination, and autism traits and language predicted self-report of self-determination, consistent with DisCrit and Diversity Science. Self-Determination Inventory interviews of a subset of participants (n = 13) and caregivers (n = 9) were analyzed using inductive thematic analysis. Themes pointed to the role of the intersection of race and disability in shaping self-determination. Altogether, findings point to the importance of these frameworks, environmental influences, and multi-informant perspectives in characterizing self-determination. Future work should focus on the impact of environmental factors in self-determination in minoritized autistic individuals during the transition to adulthood.

BackgroundDespite receiving autism diagnoses in early life, autistic children are not routinely supported to understand these diagnoses post-diagnostically (1). Consequently, they typically grow-up lacking an accurate understanding of what it means to be autistic on both a collective and individual level (2). Without this foundational knowledge, childrens understanding of autism is garnered from how others perceive their autism, resulting in an understanding of autism, and of themselves, that is inherently negative (3). This lack of appreciation of their own individual needs, also denies them the important self-understanding afforded by the diagnosis in the first instance, alongside the opportunity to effectively self-advocate for themselves when these needs go unmet. AimsHere we sought to directly assess the benefit of a pre-recorded, online autistic-led psychoeducation course about autism and the lived experience of being autistic (i.e., NeuroBears https://www.pandasonline.org), for childrens understanding of autism and their autistic experiences, their feeling about being autistic, their communication with others about their autistic experiences, and their confidence to self-advocate for their needs. MethodsUsing a concurrent embedded mixed-methods, repeated-measures design, autistic children (aged 8-14 years), completed a bespoke questionnaire exploring the above topics, both before and after completing NeuroBears at home with a nominated safe adult. A total of 63 children (mean age=10.57 years) completed sufficient content to be included in the analysis. ResultsSignificant benefit was observed across a range of areas, including a significant improvement in the childrens knowledge and understanding of being autistic and of their unique strengths and challenges, a significant rebalancing of how the children viewed being autistic, evidence of emerging positive autistic identities and a growing sense of belongingness, a significant change in the childrens abilities to communicate about being autistic, and evidence of strengthening self-advocacy skills. ConclusionLearning about autism in a neutral and non-stigmatizing manner, and presented through the lens of autistic lived experience, conferred numerous benefits on autistic childrens self-understanding, emergent autistic identity, sense of belonging, and on their communication/self-advocacy skills. Future work is needed to establish the downstream benefits on wellbeing and quality of life.

Aimto evaluate if autism symptoms and diagnoses are raised in children with neurofibromatosis type 1 (NF1), to which levels, and to determine if co-occurring symptomatology accounts for this elevation. MethodWe interrogated our hospital electronic medical records. We collected parental reports of autism symptomatology, adaptive behavior, and co-occurring behavioral and emotional problems on a subsample of 45 children (9 years 2 months, 49% male). Age- and sex-matched controls with (N=180) or without ASD (N=180) were drawn from the Simons Simplex Collection and compared cross-sectionally to participants with NF1. ResultsDiagnoses of ADHD (8.8%), not of ASD (2.1%), were raised among 968 children with NF1 identified through electronic search. Mean Social Responsiveness Score (55.9) was below the cut-off of 60 for significant autism symptoms. Participants with NF1 had significantly more autism and behavioral symptoms than typically developing (TD) controls, and significantly less than controls with autism, with one exception: ADHD symptom levels were similar to those of autistic controls. When emotional, ADHD, and communication scores were covaried, the difference between participants with NF1 and TD controls disappeared almost entirely. InterpretationOur results do not support an association between NF1 and autism, both at the symptom and disorder levels. What this paper addsO_LIDiagnoses of ADHD, not of ASD, were raised among children with NF1. C_LIO_LIIncreases in autism symptoms did not reach clinically significant thresholds. C_LIO_LICo-occurring ADHD symptoms accounted for increased autism questionnaire scores. C_LIO_LIAdaptive behavior in NF1 participants showed normal socialization but lower communication proficiency. C_LI

BackgroundEvidence supporting the association between breastfeeding patterns and ASD is inconsistent. This study examined sociodemographic and birth factors related to breastfeeding duration and ASD, compared to a typically developing (TD) cohort, using a data-driven approach based on electronic health and developmental records (EHR). MethodsDemographics, feeding preferences (breastfeeding, bottle or both), breastfeeding duration as reported by parents during routine baby wellness visits, were analyzed for a cohort of 11,766 (1.9%) children with ASD and a random subsample of 12,000 (2.03%) TD children. The designation of ASD versus TD was based on a national ASD registry and assigned after EHR were completed. Pre-term, very low birth weight, multiple births, and infants with complex medical comorbidities were excluded. ResultsInfants with ASD were breastfed for an average of 5.0 months, 1.5 months shorter than TD. Fewer ASD infants were exclusively breastfed in the first year of life. Two-way ANOVAs indicated a significant effect of socioeconomic status (SES) and ASD on breastfeeding duration, and a significant interaction with ASD. Post-hoc comparisons showed that the Low SES ASD and TD groups were breastfed longer than all other groups (p<.001). For the Low-Medium, Medium-High and High SES groups, infants with ASD were breastfed less than TD. ConclusionsShorter breastfeeding duration among ASD was confirmed in this representative cohort, calling for closer monitoring for ASD in infants with breastfeeding difficulties. These challenges were independent of birth parameters; however, influenced by socioeconomic factors.

Longitudinal, prospective analyses of marital status in parents of individuals with autism are needed. We describe the timing of divorce, and the factors that contribute to divorce in a longitudinal sample of families of individuals with autism. Participants included parents of 219 children, initially referred for autism and other developmental delays, followed to age 30 years. Approximately 36% of individuals with autism in our sample experienced a parental divorce by age 30. Higher rates of divorce were associated with maternal education, race and age at childs birth, as well as autism symptom severity and diagnosis. Divorces were most common in early years (under age 5) and also in the teenage years and beyond (over age 15). After age 15, higher risk was associated with higher cognitive ability and daily living skills, and being a multiplex family. Results suggest that divorce risk in families of children with autism remains high through childhood into early adulthood. Understanding factors related to changes in marital status may help us better support families across time.

This study comprehensively examines maternal and perinatal conditions associated with autism spectrum disorder (ASD) in a total population sample with individually confirmed diagnoses from South Sweden. Following thorough review of medical records, 996 cases were ascertained and classified based on level of intellectual disability, ASD severity and family-history of ASD. 10 controls per case were randomly selected from the population (N=9,960). Multiple maternal and perinatal conditions were associated with increased risk for ASD, but associations varied by ASD comorbid conditions. Only high maternal BMI was associated with ASD risk across all ASD sub-groups. Results suggest differences in ASD etiology by comorbid subgroups and highlight potential modifiable risk factors.

BackgroundAutism spectrum disorder (ASD) is frequently associated with speech and language difficulties, yet empirical data from Central Asian countries remain scarce. This study examined the association between a diagnosis of childhood autism (ICD-10: F84.0) and the presence of speech development difficulties in a clinical sample from Tajikistan MethodA retrospective cross-sectional study was conducted using clinical records of 85 patients (36 with F84.0; 49 with other psychiatric diagnoses) at the Insight Mental Health Center in Dushanbe, Tajikistan (December 2025-January 2026). Speech difficulties were identified through systematic review of clinical notes. Between-group comparisons were performed using Pearsons {chi}2 test, odds ratios (OR), relative risk (RR), and effect size measures ({varphi} coefficient, Cohens h). ResultsSpeech difficulties were present in 72.2% of the autism group versus 36.7% of the comparison group. The association was statistically significant ({chi}2 = 10.47, p <.01). Children with autism had substantially higher odds of speech difficulties (OR = 4.48, 95% CI [1.76, 11.38]), with a large effect size (Cohens h = 0.73). ConclusionsAutism diagnosis was significantly associated with elevated rates of speech difficulties in this Tajik clinical sample. Practical implicationsThese findings support the systematic inclusion of speech-language assessment and intervention within autism care protocols, particularly in Central Asian healthcare settings where such integration remains limited. HighlightsO_LISpeech difficulties were identified in 72.2% of children with autism (F84.0) in a Tajik clinical sample. C_LIO_LIChildren with autism were 4.5 times more likely to present with speech difficulties than those with other diagnoses (OR = 4.48, 95% CI [1.76, 11.38]). C_LIO_LIThe most prevalent speech pattern was complete absence of expressive speech (nonverbal presentation). C_LIO_LIFindings support the integration of speech-language assessment into standard autism care protocols in Central Asia. C_LIO_LIThis is one of the first empirical reports on autism and speech profiles from Tajikistan. C_LI