Autism Research最新文献

{"title":"From Misophonia Through Puberphonia: Window Toward Gender Dysphoria in Autism?","authors":"Gualberto Ruaño,&nbsp;Lavinia Carmen Uscătescu","doi":"10.1002/aur.70092","DOIUrl":"10.1002/aur.70092","url":null,"abstract":"<div>\u0000 \u0000 <p>Autism is characterized by distinct patterns of social communication, interests, and behaviors. Gender incongruence involves a mismatch between one's experienced and assigned gender, often accompanied by significant distress (i.e., gender dysphoria). Recent studies revealed that autistic individuals report gender dysphoria more frequently than the general population and are overrepresented in gender clinic settings. Autistic individuals also report hypersensitivity to certain sensory stimuli, which can elicit distress. When this distress is triggered by certain auditory stimuli (e.g., one's or others' biological sounds such as chewing or swallowing) it is categorized as misophonia. Misophonia appears to be highly prevalent in autism. We propose that a lesser-studied phenomenon, puberphonia, could exemplify an attempt to reduce the distress elicited by misophonia in a certain category of individuals. Puberphonia is characterized by an unusually high-pitched voice, predominantly in teenage boys and men, that can occur in the absence of identifiable physical causes. The psychogenic aspects of puberphonia are just beginning to be explored. We hereby propose an exploratory direction, suggesting that puberphonia may be an individual's attempt at diminishing a distressing auditory stimulus (misophonia) due to their deepening voice. This, in turn, may be an indicator of unrecognized gender dysphoria. Given that voice pitch has also been reported to be higher in autistic males compared to controls, we further ask whether autism is more prevalent among cases of psychogenic puberphonia. Finally, we wish to draw attention to the need for research on the epidemiology and overlap of puberphonia, gender dysphoria, misophonia, and autism.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1730-1733"},"PeriodicalIF":5.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Spindle Abnormalities in Preschool Children With Autism Spectrum Disability: Insights From Nap Polysomnography","authors":"Sasha D’Ambrosio,&nbsp;Daniele Gualandris,&nbsp;Davide Caputo,&nbsp;Francesco Donati,&nbsp;Ahmad Mayeli,&nbsp;Renata del Giudice,&nbsp;Fabio Ferrarelli,&nbsp;Alessia Mingarelli,&nbsp;Federico Raviglione,&nbsp;Maria Paola Canevini,&nbsp;Armando D’Agostino","doi":"10.1002/aur.70087","DOIUrl":"10.1002/aur.70087","url":null,"abstract":"<p>Sigma power and sleep spindles are key elements of Non-Rapid Eye Movement (NREM) sleep. They reflect anatomical and physiological properties of brain circuits, are linked with various behavioral outcomes in typically development (TD) children, and undergo significant modifications during development. Furthermore, recent studies have highlighted the potential of NREM sigma power and sleep spindles as early neurophysiological markers for autism spectrum disability (ASD). Here, we conducted polysomnography (PSG)/EEG recordings during afternoon naps on 50 children aged between 2 and 6 years, diagnosed with ASD or TD. EEG recordings from 19 scalp leads were analyzed, focusing on sigma power and sleep spindle parameters. EEG analyses revealed significant differences in power spectral density between ASD and TD children, particularly in the sigma band and adjacent alpha and beta bands, with increased power localized to anterior EEG leads in ASD children. Higher spindle amplitude and integrated spindle activity (ISA) were found in the ASD group, especially in frontal regions. Additional frequency-specific analyses (10–12 Hz, 12–14 Hz, 14–16 Hz) confirmed significant differences in spindle amplitude and distribution patterns, emphasizing the role of brain regions that are detectable from anterior EEG leads in ASD-related sleep abnormalities. No significant differences were found in spindle density, duration, or frequency outside specific clusters. These findings indicate that some sleep spindle parameters, particularly in frontal areas, are altered in ASD. The study highlights the feasibility of using afternoon nap PSG as a practical and effective method to detect these abnormalities in clinical settings. Future research should investigate the developmental trajectory of spindles in ASD and their potential role as neurophysiological biomarkers, offering valuable insights for diagnosis and prognosis.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1764-1774"},"PeriodicalIF":5.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ameliorating Gastrointestinal Symptoms in Children With Autism Spectrum Disorder by Modulating the Gut Microbiota: A Systematic Review and Meta-Analysis","authors":"Hsuan-Hsuan Lu,&nbsp;Ngan Thi Kim Nguyen,&nbsp;Roma Panwar,&nbsp;Ching-I Lin,&nbsp;Tzu-Wen L. Cross,&nbsp;Shyh-Hsiang Lin","doi":"10.1002/aur.70091","DOIUrl":"10.1002/aur.70091","url":null,"abstract":"<div>\u0000 \u0000 <p>Children with autism spectrum disorder (ASD) exhibit a high prevalence (55%) of gastrointestinal symptoms (GISs) and gut dysbiosis. Most studies involving children with ASD have focused on behavioral symptoms but not GISs. This systematic review and meta-analysis investigated the effects of gut microbiota–modulating interventions (GMMIs) on GISs and gut microbial composition in children with ASD. Five databases were searched for relevant domestic and international articles published from database inception until July 15, 2024. The meta-analysis included human trials wherein children with ASD received prebiotics, probiotics, synbiotics, or fecal microbiota transplantation. Intervention effects were measured on the basis of α-diversity, and genus- and phylum-level data were analyzed using a random-effects model and forest plots. This study included 19 trials (<i>n</i> = 1154). The results indicated that GMMIs significantly ameliorated GISs (<i>p</i> = 0.0017), reduced six-item Gastrointestinal Symptom Index scores by 1.86 points (<i>p</i> = 0.0187), and significantly increased the relative abundance of <i>Bifidobacterium</i> spp. (<i>p</i> = 0.0205). Longer interventions (≥ 8 weeks) were more effective in ameliorating GISs. Limitations in this investigation include the fact that the included studies neither incorporated any dietary control groups nor collected relevant dietary data, and the relatively small sample size (19 studies) may have hindered the identification of sources of heterogeneity in the pooled results. Overall, our findings suggest that GMMIs, especially probiotics, ameliorate GISs in children with ASD by modulating gut microbial composition, particularly by increasing the relative abundance of <i>Bifidobacterium</i> spp. These interventions may alleviate symptoms such as constipation, diarrhea, abnormal stool consistency and smell, flatulence, and abdominal pain. Our evidence supports that treatments involving GMMIs can be considered for children with ASD.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1877-1895"},"PeriodicalIF":5.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Evaluation of Two Adult Autism Screening Tools in Brazil","authors":"Louise do Nascimento Marques,&nbsp;Christopher Murray,&nbsp;Lucas Fortaleza,&nbsp;J. Landeira-Fernandez,&nbsp;Luis Anunciação","doi":"10.1002/aur.70089","DOIUrl":"10.1002/aur.70089","url":null,"abstract":"<p>Despite increasing rates of autism spectrum disorder (ASD) in many countries, substantial evidence suggests persistent underdiagnosis of ASD in many low and middle-income countries, such as Brazil. Underdiagnosis or misdiagnosis may be particularly prevalent among women who often present subtler social and behavioral characteristics, engage in camouflaging strategies, and exhibit different symptom expressions compared to men. This study evaluates two new instruments to improve screening for ASD among adults in Brazil: the Screening for Autism in Adults (SfA-A) and the Screening for Autism in Females (SfA-F). A sample of 3302 Brazilian adults (mean age = 37.55 ± 11.34 years) completed the SfA-A, while 7738 Brazilian adult women (mean age = 38.77 ± 10.28 years) completed the SfA-F. Exploratory Structural Equation Modeling was conducted. Reliability was assessed using Cronbach's alpha, McDonald's omega, and test–retest. Criterion validity was determined by the AQ-10 and two autism-related questions. Norms were established based on percentiles. Exploratory and confirmatory factor analyses indicated that the SfA-A and SfA-F exhibited strong model fit, high internal consistency (<i>α</i> &gt; 0.8), and initial evidence of criterion-related validity. The SfA-A and SfA-F were developed to address critical gaps in ASD screening among adults in Brazil. These tools hold promise for identifying ASD symptoms and can be used to initiate formal ASD evaluation.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1840-1850"},"PeriodicalIF":5.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Association Between Emotion Recognition and Social Functioning Mediated by Cognitive Empathy and Emotional Language? An Examination of School-Aged Autistic Children","authors":"Ifat Bar,&nbsp;Sigal Eden,&nbsp;Ofer Golan","doi":"10.1002/aur.70082","DOIUrl":"10.1002/aur.70082","url":null,"abstract":"<p>Children with autism spectrum disorder (ASD) face substantial challenges in understanding emotions, including difficulty in recognizing emotions through nonverbal cues, interpreting others' affective and mental states, and developing emotional vocabulary. Research suggests that the association between emotion recognition and social functioning is mediated by emotional language and cognitive empathy. However, this relationship remains underexplored in autistic children. Addressing this gap was the primary goal of this study, which comprised 116 autistic children (17 females), aged 7–10 (M = 8.26, SD = 0.76). Participants completed a comprehensive assessment battery, comprising multi-modal emotion recognition, cognitive empathy, and emotional language tasks. Social functioning was evaluated through naturalistic observations during free play, supplemented by a parent-reported standardized measure. Path analysis results revealed that after controlling for age, cognitive abilities, and autism severity, the relationship between emotion recognition and social functioning was mediated by cognitive empathy. Additionally, emotional language emerged as a contributing factor, enhancing cognitive empathy and further supporting its role in social functioning. These findings present an indirect path between emotion recognition and social functioning through emotional language and cognitive empathy, highlighting the importance of targeting these components in interventions aimed at promoting social communication and adaptive social skills in autistic children.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1830-1839"},"PeriodicalIF":5.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial Direct Current Stimulation of the Temporoparietal Junction in Autism Spectrum Disorder: Results of a Phase-IIa Randomized, Double-Blind, Sham-Controlled Feasibility Study","authors":"Christina Luckhardt,&nbsp;Magdalena Schütz,&nbsp;Andreas M. Mühlherr,&nbsp;Sara Boxhoorn,&nbsp;Christine Ecker,&nbsp;Hanna Mössinger,&nbsp;Julia Siemann,&nbsp;Fabienne Schlechter,&nbsp;Miguel Castelo-Branco,&nbsp;Helena C. Pereira,&nbsp;Marianne Latinus,&nbsp;Camille Ricou,&nbsp;Frederique Bonnet-Brilhault,&nbsp;Ricardo Salvador,&nbsp;Giulio Ruffini,&nbsp;Rafal Nowak,&nbsp;Michael Siniatchkin,&nbsp;Astrid Dempfle,&nbsp;Christine M. Freitag","doi":"10.1002/aur.70084","DOIUrl":"10.1002/aur.70084","url":null,"abstract":"<p>Activation of the temporoparietal junction (TPJ) is reduced in autism spectrum disorder (ASD) during social cognitive tasks. Therefore, anodal transcranial direct current stimulation (tDCS) of the TPJ may enhance social cognitive abilities in autistic individuals. In a multicenter, randomized, sham-controlled, double-blind parallel-group Phase-IIa trial, we investigated feasibility, safety, and effect sizes of 10 sessions of anodal tDCS of the bilateral TPJ at 2 mA as an add-on to computer-based social cognitive training in 10- to 17-year-old youth with autism. Feasibility of recruitment was low, with only 11% of screened individuals being randomized to tDCS (<i>N</i> = 12) or sham (<i>N</i> = 12). In contrast, retention in the study, data collection, intervention adherence, and technical feasibility were mostly excellent. No serious adverse events occurred, and stimulation was well tolerated. There were no differences in the prespecified primary outcome social responsiveness between sham and tDCS immediately after the intervention (standardized estimated effect size [ES] = 0.098; 95%-confidence interval [95% CI] −1.043;1.240), but the sham group showed a trend for better social responsiveness at the 4 week follow-up (ES = 1.106; 95% CI −0.054; 2.270). Secondary outcomes including questionnaires and event-related potentials showed improved compulsive behavior and quality of life by tDCS. High technical feasibility, participant retention, and safety highlight the potential of tDCS in autism and may inform future improvements in the feasibility of recruitment. The differential pattern of effect estimates indicates positive, but also potential negative effects of tDCS, which may vary due to tDCS stimulation parameters. The trial was prospectively registered in the German Clinical Trials Register (Deutsches Register für klinische Studien, DRKS, DRKS00014732).</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1861-1876"},"PeriodicalIF":5.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protein-Altering Variants' Analysis in Autism Subgroups Uncovers Early Brain-Expressed Gene Modules Relevant to Autism Pathophysiology","authors":"Gaia Scaccabarozzi,&nbsp;Luca Fumagalli,&nbsp;Maddalena Mambretti,&nbsp;Roberto Giorda,&nbsp;Marco Villa,&nbsp;Silvia Busti Ceccarelli,&nbsp;Laura Villa,&nbsp;Elisa Mani,&nbsp;Maria Nobile,&nbsp;Massimo Molteni,&nbsp;Uberto Pozzoli,&nbsp;Alessandro Crippa","doi":"10.1002/aur.70086","DOIUrl":"10.1002/aur.70086","url":null,"abstract":"<p>Understanding the functional implications of genes' variants in autism heterogeneity is challenging. Gene set analysis examines the cumulative effect of multiple functionally converging genes. Here we explored whether a multi-step analysis could identify gene sets with different loads of protein-altering variants (PAVs) between two subgroups of autistic children. After subdividing our sample (<i>n</i> = 71, 3–12 years) based on higher (&gt; 80; <i>n</i> = 43) and lower (<span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <mo>⩽</mo>\u0000 </mrow>\u0000 </semantics></math> 80; <i>n</i> = 28) intelligence quotient (IQ), a gene set variant enrichment analysis identified gene sets with significantly different incidence of PAVs between the two subgroups of autistic children. Significant gene sets were then clustered into modules of genes. Their brain expression was investigated according to the BrainSpan Atlas of the Developing Human Brain. Next, we extended each module by selecting the genes that were spatio-temporally co-expressed in the developing brain and physically interacting with those in modules. Last, we explored the incidence of autism susceptibility genes within original and extended modules. Our analysis identified 38 significant gene sets (FDR, <i>q</i> &lt; 0.05). They clustered in four modules involved in ion cell communication, neurocognition, gastrointestinal function, and immune system. Those modules were highly expressed in specific brain structures across development. Spatio-temporal brain co-expression and physical interactions identified extended genes' clusters with over-represented autism susceptibility genes. Overall, our unbiased approach identified modules of genes functionally relevant to autism pathophysiology, possibly implicating them in phenotypic variability across subgroups. The findings also suggest that autism diversity likely originates from multiple interacting pathways. Future research could leverage this approach to identify genetic pathways relevant to autism subtyping.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 8","pages":"1535-1549"},"PeriodicalIF":5.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aur.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional Arousal-Induced Episodic Memory Benefits Are Attenuated in Autism Spectrum Disorders, Especially in Older Age","authors":"Sidni A. Justus,&nbsp;Emily Hutson,&nbsp;Justin Summe,&nbsp;Audrey Duarte","doi":"10.1002/aur.70083","DOIUrl":"10.1002/aur.70083","url":null,"abstract":"<p>Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder associated with episodic memory impairment. Although emotional factors such as arousal, as well as age and depression symptoms, are known to influence episodic memory in neurotypical (NT) populations, how these factors affect memory processes in ASD, which is associated with a higher prevalence of depression, remains unclear. In this large-scale online study, 326 adults (ages 18–67) with or without ASD (<i>n</i> = 163 per group) and varying levels of depressive symptoms rated their experienced arousal of positive, negative, and neutral images and performed a recognition task 48 h later. Adults with ASD reported lower arousal for positive images and exhibited reduced arousal-enhanced memory benefits for both positive and negative images compared to NT adults, independent of depression severity. Age further exacerbated this reduced arousal memory benefit in the ASD group, specifically for positive stimuli. These findings underscore the role of atypical emotional arousal in ASD on episodic memory, with age-related declines suggesting accelerated vulnerability in positive memory retention.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 9","pages":"1817-1829"},"PeriodicalIF":5.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Soft Skills Interventions for Transition-Age Autistic Individuals","authors":"Heerak Choi,&nbsp;Hyun-Ju Ju,&nbsp;Connie Sung","doi":"10.1002/aur.70085","DOIUrl":"10.1002/aur.70085","url":null,"abstract":"<div>\u0000 \u0000 <p>There has been growing interest in developing and evaluating soft skills interventions for transition-age autistic individuals. While many interventions demonstrated effectiveness in improving social competence, there is limited evidence on the pooled effectiveness of these interventions. In response to the research gap, this study aimed to investigate the effectiveness of soft skills interventions in enhancing social competence among transition-age autistic individuals. A total of 18 articles consisting of eight randomized controlled trials and 10 pre- and post-intervention studies were identified after a systematic review, and the effectiveness of these interventions was examined using the <i>meta</i> package on R 4.4.1. The analysis revealed overall positive effects of soft skills interventions in social adjustment (<i>g</i> = 0.53, <i>p</i> &lt; 0.0001), social performance (<i>g</i> = 0.87, <i>p</i> &lt; 0.001), and social skills (<i>g</i> = 0.53, <i>p</i> &lt; 0.0001) among the autistic individuals. Moderation analyses indicated no significant impact of sample and intervention characteristics on soft skills outcomes. This meta-analysis highlights the importance of soft skills interventions for transition-age autistic individuals in preparing for successful careers.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 10","pages":"2104-2119"},"PeriodicalIF":5.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Substance Use Disorder Among Autistic Youth With and Without Co-Occurring Mental Health Conditions and a History of Trauma","authors":"Jeanette M. Garcia,&nbsp;Kristy A. Anderson,&nbsp;John R. Moore,&nbsp;Tanya Renn,&nbsp;Jessica E. Rast","doi":"10.1002/aur.70081","DOIUrl":"10.1002/aur.70081","url":null,"abstract":"<div>\u0000 \u0000 <p>There is limited research on the prevalence of substance use disorders (SUDs) in autistic youth. Additionally, while mental health conditions and history of trauma have been associated with a higher prevalence of SUD in non-autistic youth, the research in autistic youth is scarce. Therefore, the purpose of this study was to examine the prevalence of SUDs in autistic youth compared to non-autistic youth with co-occurring mental health conditions and adverse childhood experiences. Data from 22,828 autistic youth and 601,348 non-autistic youth were drawn from the Child and Caregiver Linked Utilization and Outcomes Database (CCOULD). SUDs were identified using categorized ICD-10 diagnostic codes, and mental health comorbidities included six conditions (ADHD, anxiety, depression, bipolar disorder, schizophrenia/psychotic disorders, trauma/stress-related disorders), substantiated maltreatment allegations, and placement history. Overall prevalence of SUD was lower among autistic youth (1.7%) compared to non-autistic youth (3.8%, <i>p</i> &lt; 0.001). Both mental health comorbidities and maltreatment allegations were significantly associated with having a SUD, regardless of autism diagnosis. Placement in out-of-home care significantly reduced the likelihood of SUD among non-autistic youth (UOR = 0.83, 95% CI: 0.80–0.87) but more than doubled the odds among autistic youth (UOR = 2.36, 95% CI: 1.88–2.97). While prevalence rates of SUDs are lower in autistic youth compared to non-autistic youth, the presence of co-occurring mental health conditions and adverse childhood experiences may increase SUD rates to a greater extent in autistic youth. Future research should further investigate the complex relationships among SUDs, adverse childhood experiences, and mental health conditions in autistic youth.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 8","pages":"1704-1713"},"PeriodicalIF":5.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}