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Monogenic conditions, such as neurofibromatosis type 1 (NF1), provide a unique opportunity to study autism within a known molecular pathway. This study estimated the prevalence of autism in a large international NF1 cohort and examined how autistic traits relate to cognitive, behavioral, and adaptive functioning. In this cross-sectional study, 202 children with NF1 and 106 typically developing controls (aged 3-15 years) completed standardized cognitive testing and parent-reported behavioral measures. NF1 participants scoring ≥ 60 on the Social Responsiveness Scale-2 were evaluated using the Autism Diagnostic Observation Schedule-2 and Autism Diagnostic Interview-Revised, with DSM-5-TR autism diagnoses established by multidisciplinary consensus. Neurodevelopmental profiles were compared across NF1 subgroups (autism, broader autistic traits, no-autistic-traits) and controls. Autistic traits were elevated and continuously distributed in NF1. An estimated 28% (95%CI: 21.7%-34.3%) met DSM-5-TR criteria for autism and 22% exhibited a broader autistic phenotype, with comparable rates in males and females. Children classified as autistic and those with broader autistic traits showed similarly marked behavioral and adaptive challenges, whereas NF1 children without autistic traits showed milder difficulties. Findings establish NF1 as a condition in which autism is common and clinically significant. Autistic features in NF1 occur across the cognitive spectrum and are accompanied by overlapping behavioral and functional impairments that challenge categorical diagnostic boundaries. The cross-sectional design precludes conclusions about developmental trajectories. The absence of genotype data prevented exploration of genotype-phenotype correlations and the influence of polygenic risk factors outside the NF1 locus. Findings provide strong support for routine, early screening for autism in NF1 and the recognition that subthreshold traits can be similarly impairing. NF1 provides a powerful model for investigating how a monogenic condition contributes to diverse neurodevelopmental profiles and informs precision-medicine approaches in autism.

Wandering - or leaving a supervised space and/or care of a responsible person - disproportionately affects children with autism and can lead to serious injury. We describe parent-reported wandering in children with autism in early childhood and adolescence and characterize wandering in adolescence. Of 258 teens with autism enrolled in the Study to Explore Early Development, caregivers reported that 45% never wandered, 41% wandered only in early childhood, and 14% wandered at least once in adolescence (including 9% that wandered at both time points). Childhood externalizing behavior problems were positively associated with wandering only in early childhood and at least once in adolescence compared to never wandered (both p&#x2009;<&#x2009;.01). Adolescents who wandered most often left public places (58.3%). To address wandering, caregivers most often added home locks/alarms (30.6%) and least often placed a tracking device (8.3%) on the adolescent. In conclusion, wandering is less common among adolescents than young children with autism but still presents opportunities for intervention. These findings can help partners communicate that childhood externalizing behavior problems are associated with wandering regardless of age and promote awareness of and access to interventions that can improve health and safety.Lay AbstractWandering occurs when a child leaves a safe space. Children with autism wander more than other children. This can lead to serious injury. We describe wandering in children and adolescents with autism. In total, 258 teens with autism were included in the analysis. Caregivers reported that 45% never wandered, 41% wandered only in early childhood, and 14% wandered at least once in adolescence (including 9% that wandered at both time points). Children with behaviors like hyperactivity were more likely to wander in both early childhood and adolescence. Adolescents who wandered most often left public places (58.3%). To address wandering, caregivers most often added home locks/alarms (30.6%) and least often placed a tracking device (8.3%) on the adolescent. In sum, wandering is less common among adolescents than young children with autism. However, we can still help families with adolescents with autism who wander. One way to help these families is to educate people that behavior problems like hyperactivity are associated with wandering regardless of age. Another way to help these families is to increase ways to address wandering away from the home to keep adolescents with autism safe.

The diagnostic term, autism spectrum disorder, encompasses the full range of impairments associated with the autism spectrum, a significant change from earlier DSM definitions that identified various subtypes of autism. However, the majority of autism-related research and cultural representations in recent years has focused on autistic individuals with strong language and cognitive abilities. In 2021, the administrative term Profound Autism (PA) was proposed by a Lancet Commission to draw attention to autistic people whose impairments require lifelong, round-the-clock care. The initial definition of PA included a minimum age and requiring 24/7 access to an adult to ensure safety, and suggested considering IQ, and verbal ability when defining this group. However, researchers have subsequently utilized widely varying criteria in studies of this group, producing results that are difficult to compare and limit the potential for the identification of this group to advance knowledge about their strengths and needs. To address the need for studies that use comparable samples and increase clarity in communication and interpretation of results, we carried out a systematic, multi-stage Delphi consensus study with over 70 participants who identified as researchers, caregivers, autistic individuals, and clinicians, to measure consensus on components of a research definition of PA. A series of questions was developed for the primary domains of interest. After two rounds of review and voting, 76% of the respondents agreed on a research definition of PA of: adaptive functioning well below age level, requiring adult supervision to ensure physical and mental health, safety and well-being, being at least 8 years old, diagnosed with ASD, and having severely impaired cognitive abilities (reflected by IQ score below 50) and/or not verbally communicating other than single words or fixed phrases used predominantly to have their basic needs met. Variations in access to measurement tools, as well as access to services across the world, limit the utility of this definition outside research practices, and a response rate of 58% yielded a final round sample size of 78 that may underrepresent portions of the stakeholder community and was overwhelmingly composed of respondents from the United States. Based on these findings, a new working research definition of profound autism is proposed. Adoption of this definition could improve comparability across research studies, enhance the impact and generalizability of results, and better target interventions and supports for this high-needs group.

Autism and ADHD, two of the most common neurodevelopmental conditions, are defined by challenges in daily functioning but are also associated with strengths and can vary substantially in their manifestation across individuals. Yet, diagnostic criteria alone fail to capture their full complexity, particularly on the individual level. A holistic understanding of functioning requires moving beyond defining clinical features to consider the interaction between individual functioning and contextual influences. The International Classification of Functioning, Disability, and Health (ICF) provides a biopsychosocial framework where functioning is understood as the dynamic interplay between the individual's (dis)abilities and the contexts in which they occur. Previously, the ICF has been adapted for tailored use in autism and ADHD using Core Sets, but an important contextual component-personal factors-has been neglected. For a truly holistic understanding of autism and ADHD, including taking into account community perspectives, these personal factors cannot be disregarded. This protocol describes the multi-phase process that will be undertaken to identify and develop shortlists of personal factors most relevant to functioning in individuals diagnosed with autism and ADHD. These shortlists of personal factors will be added to the existing ICF CoreSets platform for autism and ADHD to support a more comprehensive and person-centered approach to autism and ADHD.

Individuals with autism experience many barriers to receiving high-quality healthcare. With 1 in 31 children now being diagnosed with autism, a number that has only been increasing over the last decade, it is imperative to address these barriers. One of the most prevalent barriers is communication. Social communication challenges are a defining characteristic of autism, but there exists a wide spectrum of communication abilities that can be difficult for healthcare providers to understand. This tutorial introduces the differences in informational processing experienced by those with autism with practical guidance on how healthcare providers can individualize their approach to communication when providing patient-centered care. The three levels of autism support are used as a framework, with suggestions specific to each level to help healthcare providers better understand the differences seen in autism and how they can more readily address the needs of each patient.

Prior studies suggest that autistic individuals have a lower health-related quality of life (HRQoL) than non-autistic populations. However, few studies have compared autistic individuals to peers with mental disorders. Furthermore, little is known about HRQoL in autistic individuals in Latin America, where distinct social, cultural, and health system contexts may substantially determine well-being and access to support. This cross-sectional study compared HRQoL across three groups of community-dwelling adolescents and young adults aged 16-39&#xa0;years from Chile, enrolled between 2022 and 2023: autistic (n&#xa0;=&#xa0;102), with mental disorders (n&#xa0;=&#xa0;464), and without autism or mental disorders (n&#xa0;=&#xa0;478). HRQoL was assessed using the EuroQol-5D-3L and compared across groups using linear regression. Autistic participants reported more problems with mobility (9.8% vs 4.3% and 2.3%), self-care (7.8% vs 1.7% and 0.6%), usual activities (28.4% vs 18.1% and 3.1%), and pain/discomfort (53.9% vs 50.2% and 27.8%) versus those with mental disorders and without autism or mental disorders, respectively. Participants with mental disorders reported more anxiety/depression (81.2%) than autistic participants (56.9%) and those without autism or mental disorders (49.3%). The mean&#xa0;&#xb1;&#xa0;SD HRQoL index was 72.3&#xa0;&#xb1;&#xa0;17.7, 69.8&#xa0;&#xb1;&#xa0;19.9, and 84.8&#xa0;&#xb1;&#xa0;14.4 among autistic participants, those with mental disorders, and those without autism or mental disorders, respectively (p-value <0.001). The multivariable-adjusted difference in HRQoL index associated with autism and mental disorders was -6.53 (95%CI -10.41, -2.64) and -9.63 (95%CI -11.77, -7.59), respectively. Autistic adolescents and young adults in Chile experience a low HRQoL with distinct functional and emotional impairments, underscoring the need for inclusive and contextually relevant interventions.

In autism spectrum condition (ASC), altered priors/predictions or prediction errors have been hypothesized to increase the influence of bottom-up sensory input, relative to top-down prior knowledge. Such alterations could account for several autistic features, but their empirical basis is unclear. In neurotypical (NT) individuals, multiple neuroimaging meta-analyses have aimed to outline domain-general prediction networks of the brain. However, there has not been a similar meta-analysis in autism. We performed a literature search for functional magnetic resonance imaging and magnetoencephalography studies with autistic participants. The contrasts that explicitly or implicitly involved the processing of priors/predictions and prediction errors were selected. Contrasts were divided into those that reported stronger activation in ASC compared with NT groups (ASC > NT; 8 contrasts; 139 ASC, 150 NT) and vice versa (NT > ASC; 13 contrasts; 261 ASC, 289 NT). The convergence of differences between the groups was then tested using activation likelihood estimation meta-analysis. We also identified 37 contrasts without significant group differences. ASC > NT did not result in significant convergence. NT > ASC converged in a cluster in the medial frontal gyrus/cingulate gyrus. We found converging NT > ASC activation differences in an area associated with error monitoring and uncertainty estimation. Our results are generally consistent with notions of altered predictions or prediction errors in autism, pointing to differences at high levels of the information-processing hierarchy. However, we recommend a cautious interpretation, given the limited number of available contrasts and the high proportion of null results. Several features of autism have been hypothesized to be related to alterations in the way the brain predicts upcoming events and inputs. In this meta-analysis of fMRI studies, we show that when autistic and neurotypical groups engage in tasks and activities that directly or indirectly involve predictions, converging brain activation differences are observed in the anterior cingulate cortex, a region involved in uncertainty estimation and error detection. While this finding could be consistent with hypotheses of prediction-related differences in autism, we also find that over half of fMRI experiments do not detect reliable group differences.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and interaction, with early identification playing a crucial role in improving outcomes. Parental knowledge is central to recognizing early signs and seeking timely intervention. This study aimed to assess parental knowledge of ASD and its determinants among parents of children under 3 years attending a tertiary care center in Sikkim, India. A cross-sectional study was conducted among 300 parents attending the pediatric outpatient department of a tertiary care hospital. Data were collected using a sociodemographic pro forma and the Parent Knowledge Questionnaire on Autism (PKQA). Nonparametric tests and multivariable linear regression were used to identify factors associated with parental knowledge. Only 46.7% (n = 140) of participants had heard of autism. The median PKQA score was 9 [interquartile range (IQR): 0-12], indicating suboptimal knowledge levels. In bivariate analysis, knowledge was associated with multiple sociodemographic factors, including education, occupation, residence, age, and family income (p < 0.05). However, in multivariable analysis, paternal occupation, maternal occupation, and place of residence remained significant independent predictors (p < 0.05), with higher knowledge observed among parents engaged in salaried occupations and those residing in urban areas. The PKQA demonstrated excellent internal consistency (Cronbach's &#x3b1; = 0.926). Parental knowledge of ASD in this population was limited. While several sociodemographic factors were associated with knowledge, occupation and place of residence emerged as key independent determinants. Targeted, context-specific awareness interventions are needed to improve early recognition and facilitate timely intervention for ASD.

This study aimed to investigate cerebellar volumetric and cortical-thickness differences in adults with autism spectrum disorder (ASD) using automated segmentation techniques, with a particular focus on sex-based anatomical patterns. A total of 100 participants from the Autism Brain Imaging Data Exchange database were included, comprising 48 adults with ASD (20 females, 28 males) and 52 healthy controls (23 females, 29 males). T1-weighted structural magnetic resonance imaging scans were processed using the CERES (CEREbellum Segmentation) module of volBrain to obtain lobule-specific cerebellar volume and thickness measures. Group comparisons were performed separately for males and females using non-parametric statistical tests. Adults with ASD exhibited global cerebellar volumetric enlargement alongside lobule-specific reductions and altered pseudo-cortical thickness (PCT) across multiple lobules, most prominently within anterior sensorimotor and posterior cognitive regions. Several lobules demonstrated reversed asymmetry patterns relative to controls. Sex-stratified analyses suggested differential morphometric patterns between females and males with ASD; however, these findings should be interpreted as exploratory given subgroup sample sizes. These findings demonstrate distinct cerebellar morphometric alterations in adults with ASD and support the utility of automated cerebellar segmentation for region-specific anatomical characterization. The results indicate group-level neuroanatomical differences involving the cerebellum, while emphasizing cautious interpretation regarding clinical or group-level distinguishing feature implications. Cite this article as: Karaka&#x15f; AB, Akbulut Y. Neuroanatomical cerebellar patterns in autism spectrum disorder. Eurasian J Med. 2026, 58(4), 1008, doi: 10.5152/eurasianjmed.2026.251008.

Zinc Finger Protein 711 (ZNF711) is a Kr&#xfc;ppel-type zinc finger transcription factor highly expressed in the brain and whose mutations have been associated with neurodevelopmental disorders such as intellectual disability, autism spectrum disorder, and epilepsy. While most pathogenic variants previously described affect the C-terminal DNA-binding domain, we report two siblings carrying a rare hemizygous missense variant in the N-terminal transactivation domain, NM_001330574.2: c.65&#xa0;T&#xa0;>&#xa0;C (p.Ile22Thr), inherited from their heterozygous unaffected mother. Patient #1 presents with autism spectrum disorder, epilepsy, moderate intellectual disability, and mild facial dysmorphisms, whereas Patient #2 shows milder autism spectrum disorder traits and no clinical seizures, although electroencephalogram abnormalities are present. In silico analyses predict that this variant, affecting a highly conserved residue, may disrupt protein structure and thus impair its proper function. The recurrence of this variant in the two siblings reported here and in those reported in Minerva et al. (2025) sharing overlapping phenotypes strengthens its potential pathogenicity, despite current classification as a variant of uncertain significance.

Arbutin is a natural glycoside that protects neurons and is useful in a variety of neurological conditions. There is a need to further explore its scientific properties as arbutin regulates mitochondrial function, control apoptotic proteins, lowers oxidative stress, enhance behavioral and cognitive outcomes and thus may be considered a potential target for Parkinson's, Alzheimer's, neuroinflammation, epilepsy and Huntington's disease. Arbutin via PI3K/Akt/mTOR and Nrf2 signaling pathways, helps to balance redox equilibrium, mitochondrial integrity and neuronal survival, plays a major role in mediating these effects. Autism Spectrum Disorder (ASD) is closely associated with dysfunction of these pathways, which cause oxidative2 stress, synaptic deficits and neuroinflammation. While reducing NF-&#x3ba;B mediated pro-inflammatory cytokines including TNF-&#x3b1;, IL-1&#x3b2; and IL-6, arbutin increases Akt phosphorylation and Nrf2 nuclear translocation, activating antioxidant enzymes like SOD, GSH, HO-1 and NQO1. These coordinated molecular processes may help preserve neuronal homeostasis, inhibit apoptosis and decrease ROS induced neuronal damage. Arbutin may enhance synaptic plasticity and potentially modulate the pathogenic pathways underlying ASD and other neurodevelopmental disorders by concurrently regulating oxidative stress, mitochondrial dysfunction and neuroinflammation. Taken together these finding suggest arbutin may act as a promising therapeutic candidate capable of restoring neuronal homeostasis and translating mechanistic understanding into potential therapeutic applications. Arbutin is a promising phytochemical with potential relevance for autism and associated neurological diseases due to its combined molecular actions. However, direct experiment and clinical evidence supporting the role of arbutin in ASD remains limited.

NPTN encodes human neuroplastin (hNp), a transmembrane immunoglobulin (Ig)-superfamily glycoprotein and a subunit of the plasma membrane calcium (Ca2+)-ATPases (PMCA). The critical importance of hNp and its associations with PMCA in the human brain remains unknown. Here, we describe de novo NPTN variants in individuals with autism and mild-to-severe DD/ID and evaluate their effects using animal models and in silico, molecular, and cellular approaches. Four individuals present variants affecting the two hNp isoforms, hNp55 and hNp65. Other four variants affect only the hNp65 isoform. Two individuals independently carry the same loss-of-function nonsense variant, predicted to cause haploinsufficient production of all hNp isoforms. Haploinsufficient Nptn+/- mice displayed reduced levels of Np and PMCA and exhibited altered social behavior. Insufficient Np55/65 production in neurons resulted in reduced PMCA expression and function. Two missense variants caused particular structural and thermodynamic abnormalities and lower expression of hNps in human embryonic kidney (HEK) cells. In primary neurons, these hNp variants failed to regulate cytosolic Ca2&#x207a; transients. In Drosophila, a missense mutation affecting the PMCA interaction failed to prevent the lethal phenotype caused by hNp ortholog elimination. We show that a novel neurodevelopmental disorder characterized by intellectual disability and autism originates from haploinsufficient NPTN gene dosage or insufficient functionality of mutant hNp related to PMCA hypofunction.

Motor impairments in autism are prevalent yet understudied, especially complex skills like jumping. This study compared jump performance and lower-limb kinematics between children with autism spectrum disorder (ASD) and typically developing (TD) peers. Ten children with ASD (aged 3-6&#xa0;years) and ten age-matched TD children performed two-legged jumps in a biomechanics laboratory. Jump distance, height, and sagittal-plane hip, knee, and ankle kinematics during preparatory and loading phases were measured. Group differences were analyzed using one-way multivariate analysis of covariance, with age included as a covariate. One-way ANCOVA, controlling for age, revealed a significant decrease in jump distance in the ASD group compared to the TD group (mean difference&#xa0;=&#xa0;-0.18&#xa0;m, p&#xa0;=&#xa0;0.043, &#x3b7;p2=0.219). Jump height did not differ between groups (p&#xa0;=&#xa0;0.463). During the preparatory phase, the ASD group demonstrated significantly lower hip flexion (mean difference&#xa0;=&#xa0;-10.30&#xb0;, p&#xa0;=&#xa0;0.019, &#x3b7;p2=0.285). Peak knee flexion (p&#xa0;=&#xa0;0.138) and peak ankle dorsiflexion (p&#xa0;=&#xa0;0.349) were not significantly different. At take-off, ankle plantarflexion was also comparable between groups (p&#xa0;=&#xa0;0.485). In the loading phase, the ASD group showed significantly reduced peak hip flexion (mean difference&#xa0;=&#xa0;-14.03&#xb0;, p&#xa0;=&#xa0;0.050, &#x3b7;p2=0.208) and peak knee flexion (mean difference&#xa0;=&#xa0;-10.70&#xb0;, p&#xa0;=&#xa0;0.034, &#x3b7;p2=0.238). Peak ankle dorsiflexion during landing was not significantly different (p&#xa0;=&#xa0;0.374). Children with ASD demonstrate altered jumping mechanics, characterized by shorter jumps and restricted lower-limb flexion, which may reflect coordination challenges distinct from general developmental delay. These findings underscore the importance of assessing and addressing motor skills in ASD to support physical activity and participation.

A recent KFF poll prompted concern that many Americans believe it is definitely or probably true that Tylenol use in pregnancy causes autism. However, the poll actually asked a slightly different question: whether Tylenol use increases the risk of autism, raising questions about how such phrasing is interpreted. We conducted a preregistered experiment (N&#x2009;=&#x2009;1957) comparing three phrasings that appeared in news coverage of the poll: increases risk, causes, and a mere link. Overall, differences in phrasing had minimal impact on endorsement. Instead, responses varied substantially by respondent characteristics, particularly political party, replicating the poll's finding that Republicans were more likely than Democrats to endorse the relationship. The only evidence of a phrasing effect was conditional on education: among more educated respondents, endorsement was lower when the relationship was described as explicitly causal, but similar for the increases-risk and mere-link phrasings. These results suggest that caution is warranted when interpreting the public's causal beliefs, and further work is needed to develop measures that more clearly distinguish beliefs about association from beliefs about causation.

Autism spectrum disorder (ASD) affects tens of millions of families worldwide, yet parents confront abundant but unreliable online advice and limited access to timely, empathetic guidance. To address this critical gap, we developed Starmate ( http://kefeng.mpu.edu.mo/starmate ), a 1.5B-parameter, domain-tuned AI assistant for ASD caregivers, using a rigorous user-centered mixed-methods framework. Informed by in-depth interviews ([Formula: see text]) and a Kano survey ([Formula: see text]) that identified "Hands-on guidance" as a must-have caregiver requirement, we engineered a novel modular architecture that integrates sentiment analysis, expert-vetted knowledge-graph-augmented retrieval (LightRAG), and a domain-fine-tuned Qwen2.5-1.5B model. In a blinded, side-by-side comparison against leading commercial LLMs, Starmate demonstrated improved performance across key metrics within this evaluation framework (86.76 vs 78.43-83.84; [Formula: see text]) and showed specific advantages in Empathy, Hands-on guidance, and Logical clarity (all [Formula: see text]). Automated benchmarking corroborated these results, with top scores for Professional accuracy (86.18), Empathy (86.79), and Hands-on guidance (82.58). These findings demonstrate the technical feasibility of a lightweight, privacy-conscious, domain-specific LLM to generate accurate, empathetic, and actionable responses in benchmarked scenarios, laying the groundwork for future real-world usability and clinical testing.

Fecal microbiota transplantation (FMT) is increasingly used in children with autism spectrum disorder (ASD) and is generally considered to have an acceptable safety profile. However, the risk and mechanisms of severe adverse events in the high-risk subgroup of children with ASD complicated by multiple food intolerances (FI) have not been reported, and clinical strategies for risk prevention and management remain lacking. This article reports two cases of children with ASD and multiple FIs who developed anaphylactic shock following FMT, representing the first such report in the pediatric field. Case 1 presented with early-stage shock, which was considered to be associated with IgG-mediated type III hypersensitivity. Case 2 developed classic anaphylactic shock with a biphasic course characterized by relapse after initial resolution, raising the possibility of biphasic anaphylaxis. Both children improved after standardized anti-allergy and anti-shock treatment, and one child successfully completed subsequent FMT using a low-dose regimen. FMT carries a risk of anaphylactic shock in children with ASD and multiple FIs, who have underlying susceptibility due to impaired intestinal barrier function and immune dysregulation. Refined risk stratification, close monitoring throughout the procedure, individualized transplantation protocols, and standardized emergency procedures can effectively enhance the safety and feasibility of FMT in this high-risk subgroup.

This case-control study assessed symptom severity and prevalence of obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) in children attending a headache clinic compared to controls. We included 343 patients (5-19 years) and 130 controls (6-19 years; no prior headache diagnosis/medical contact for headache) between October 2018 and January 2024. Controls were divided into CH+&#x2009;(experiencing headaches) and CH- (headache-free). Severity was assessed using scores from questionnaires, and prevalence was defined by prior diagnosis or symptom scores above clinical cutoffs, therefore indicating symptom burden over confirmed diagnoses. Patients had more severe symptoms of OCD, ADHD, and ASD than CH-. CH+&#x2009;had the most severe symptoms of OCD and ADHD. OCD, ADHD, and ASD research diagnoses were present in 20.8%, 17.3%, and 10.1% in patients; 27.8%, 18.8%, and 4.4% in CH+; 1.7%, 7.0%, and 1.8% in CH-. Headache in youth, even in non-clinical settings, is linked to psychiatric symptoms; hence, routine screening is recommended.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by persistent deficits in social communication and interaction, restricted and repetitive patterns of behavior, and sensory processing alterations, frequently accompanied by anxiety, emotional dysregulation, and other psychiatric comorbidities. Despite advances in behavioral and pharmacological interventions, effective treatments for core ASD symptoms remain limited. Psychedelic compounds have recently emerged as potential therapeutic agents in psychiatry because of their ability to modulate serotonergic and glutamatergic signaling, enhance neuroplasticity, reorganize large-scale brain networks, and influence neurobiological pathways implicated in ASD. In this narrative review, we examine the mechanistic rationale supporting psychedelic-based approaches in ASD, including 5-HT2A receptor activation, oxytocin-serotonin interactions, excitation-inhibition dynamics, functional connectivity, and glutamatergic modulation associated with ketamine and related compounds. We also summarize current clinical and preclinical evidence involving substances such as psilocybin, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, and ketamine. Particular attention is given to the distinction between core ASD symptoms and associated symptom domains. Current evidence does not support the direct treatment of core social communication deficits or restricted and repetitive behaviors; however, psychedelics may hold greater potential for dimensions such as social anxiety, emotional dysregulation, cognitive rigidity, and co-occurring mood symptoms. Ethical, regulatory, and developmental safety considerations are also discussed, particularly regarding neurodivergent populations and the absence of robust pediatric evidence. Although direct clinical studies in ASD remain scarce, psychedelic-assisted interventions represent a promising translational avenue that warrants further rigorous investigation through carefully designed clinical trials.

The sensory gating paradigm has gained traction in child and adolescent psychiatry for assessing sensory processing deficits. However, its test-retest reliability in pediatric clinical populations remains unclear. This study evaluated the reliability of sensory gating measures in neurotypical and clinical children. Fifty-three children (26 females, ages 8-14) participated, including neurotypical children and children with attention-deficit/hyperactivity disorder or autism spectrum disorder. Auditory P50 event-related potentials were recorded at Cz using baseline-to-peak and peak-to-peak methodology. Difference and ratio scores between paired stimuli were computed. Generalized eigendecomposition (GED) was applied as an alternative to Cz-based extraction. Reliability was assessed using intraclass correlation coefficients (ICCs). The first stimulus showed moderate-to-good reliability with both Cz and GED. The second stimulus showed poor-to-moderate reliability for Cz, but moderate-to-good for GED. Difference scores yielded moderate-to-good reliability; ratio scores showed poor-to-moderate reliability. GED produced significantly higher ICCs than Cz (mean difference = 0.15, p = 0.018). Only GED-based measures for the first stimulus consistently revealed group differences. In sum, GED enhances the test-retest reliability of P50 gating outcomes while maintaining sensitivity to group differences. Sensory gating in children can achieve reliable short-term measurements. GED offers a robust alternative to Cz-based methods, potentially improving statistical power and reliability in clinical research.