Autism Spectrum Disorder (ASD) is a neurodevelopmental condition often accompanied by comorbid ear, nose, and throat (ENT) disorders, including hearing loss, otitis media, auditory processing deficits, and sleep-disordered breathing. These conditions can further impair communication and behavior, yet research at the ASD-ENT intersection remains scattered. This study presents the first bibliometric analysis of ASD-related ENT research to map trends, identify influential contributions, and guide future clinical integration. A systematic PubMed search identified 107 peer-reviewed articles addressing ENT conditions in ASD populations. Citation data and metadata were extracted from Web of Science and analyzed using descriptive statistics and visualization tools. Otology and audiology comprised 40% of publications, followed by cochlear implantation (15%) and speech or communication-focused studies (14%). The United States led in volume and citations, though contributions from China, Egypt, and Europe highlighted growing global interest. Institutional collaboration was common, with 75% of studies involving multiple centers. Thematic growth was observed in areas such as auditory hypersensitivity, vestibular dysfunction, and ENT-related sleep disorders. However, research remains primarily pediatric and observational, with limited focus on adolescent or adult populations. Our findings support routine ENT screening in individuals with ASD, especially for hearing and sleep-related concerns. Interdisciplinary approaches involving audiology, speech therapy, and neurodevelopmental care are essential for improving outcomes. This bibliometric analysis highlights the evolution of ASD-ENT research and underscores the need for expanded lifespan-inclusive studies to address these clinically significant comorbidities.
Developmental dyslexia (DD) is characterised by lower-than-average reading abilities and is diagnosed in approximately 10% of individuals. The societal barriers may limit professional fulfilment and psychological wellbeing of individuals with DD, calling for the development of effective interventions to counteract them. As DD is associated with challenges in both phonological and visuo-attentional domains, different longitudinal training approaches were developed to strengthen them. However, they require a considerable amount of personal, social and economic resources and the outcomes may vary depending on individual differences in behavioural and neurophysiological functionality. Hence, predicting training outcomes might help in developing personalised treatment protocols and optimising the use of resources. In the present work we applied machine learning to resting-state EEG to predict longitudinal training outcomes in adults with DD enrolled in a randomized clinical trial. In particular, one group received a visuo-attentional training combined with transcranial alternating current stimulation (tACS), another group received visuo-attentional training with sham/placebo stimulation, and the third group received a phonological training with sham/placebo stimulation. The improvement in text reading speed was associated with spectral power in low-beta and individual frequencies in the alpha (IAF) and beta (IBF) bands, while the improvement in pseudoword reading was associated with IBF. The findings highlight the potential of capturing neural markers of treatment responsiveness in DD. Future studies should focus on the generalisability of predictive models to real-world settings, while investigating whether specific EEG markers predict responsiveness to distinct remediation protocols, thus supporting the development of personalised interventions.
BACKGROUND:Developmental dyslexia (DD) and attention-deficit/hyperactivity disorder (ADHD) often co-occur, but the cognitive profile of their comorbidity and the mechanisms supporting reading performance remain unclear. This study aimed to characterize cognitive profiles associated with DD, ADHD, and their comorbidity, and to determine whether different cognitive mechanisms support reading performance across diagnostic groups. METHODS:A matched sample of 200 Mandarin-speaking children was selected from a screened cohort of 2003 students, including four groups: typically developing (TD), DD-only, ADHD-only, and comorbid DD and ADHD (n = 50 per group). Participants completed assessments of reading fluency and accuracy, orthographic knowledge, phonological awareness, morphological awareness, rapid automatized naming (RAN), visual attention, and processing speed. RESULTS:Children with DD showed broad impairments in reading-related measures compared with TD and ADHD-only children. Discriminant analyses revealed that phonological and morphological awareness primarily differentiated DD, whereas non-linguistic measures distinguished ADHD. Notably, RAN uniquely differentiated comorbid DD and ADHD from DD-only, with the comorbid group showing the greatest impairment. However, regression analyses revealed a dissociation between core cognitive deficits and reading mechanisms: the contribution of RAN to reading fluency was reduced in the comorbid group, whereas morphological awareness was a stronger predictor of character reading accuracy in the comorbid group. CONCLUSIONS:These findings suggest a distinct cognitive profile in comorbid DD and ADHD, with altered RAN-reading associations and greater reliance on morphological awareness. This pattern highlights the need for assessment and intervention approaches that address both core deficits and compensatory resources.
Purpose Exercise is an essential component for musculoskeletal care. However, there is no clear guideline for upper limb exercise for wheelchair users with cerebral palsy (CP). This study explored the influences of different modes and intensities of handgrip exercise on neuromuscular fatigue in adults with CP. Methods A total of 14 adults diagnosed with CP completed four handgrip exercise protocols: isometric and dynamic handgrip exercises at 15% and 30% of maximal voluntary contraction. The isometric handgrip exercises lasted 30 s, while the dynamic handgrip exercises were performed at a frequency of 1 Hz for 60 s to ensure an equivalent exercise load. Muscle fatigue was quantified using the median frequency and spectral moment ratio (SMR) from electromyography (EMG) of four forearm muscles (flexor digitorum superficialis (FDS), extensor carpi radialis (ECR), flexor carpi ulnaris (FCU), and extensor carpi ulnaris (ECU)). Two-way analysis of variance with repeated measures (ANOVA) was used to examine the interaction and main effects of the handgrip protocols. Results All four protocols were well tolerated in this sample, and no adverse events were reported. The results demonstrated a significant interaction effect for the median frequency of the ECR muscle (F=8.861, P = 0.013*, effect size: 0.446). All SMR conditions demonstrated a significant main effect handgrip intensity (P of FDS 0.049*, ECR 0.026*, FCU 0.016*, and ECU 0.031*). Two median frequency conditions also indicated a significant main effect of the intensity (P of FDS 0.071, ECR 0.068, FCU 0.006*, and ECU 0.012*). Conclusions The results demonstrated a significant main effect of the intensity factor of handgrip exercise on neuromuscular fatigue in adults with CP. The findings support the use of low-cost handgrip exercise of both isometric and dynamic modes for exercise training in adults with CP.
OBJECTIVE:To examine the longitudinal association between physical activity and social skills in children with autism and evaluate basic psychological need satisfaction in exercise as a potential longitudinal indirect pathway. METHODS:A three-wave longitudinal study was conducted in seven special education schools in Sichuan, Hunan, and Yunnan, China. Data were collected in November 2025, February 2026, and May 2026 at three-month intervals. Primary caregivers completed all questionnaires. After excluding attrition cases and invalid responses, 584 valid cases were retained. Physical activity, basic psychological need satisfaction in exercise, and social skills were assessed using validated Chinese scales. Measurement invariance testing and fixed-effect cross-lagged panel modeling were supplemented by a longitudinal latent-variable model, demographic- and physical-activity-scaling sensitivity analyses, and random-effects cross-lagged panel modeling. RESULTS:The preliminary bivariate CLPM showed inadequate global fit; therefore, its path coefficients were not used for substantive inference. In the primary three-variable longitudinal model, physical activity showed consistent positive prospective associations with social skills across both adjacent intervals (β = 0.274 and 0.169, respectively; both p < 0.001). T1 physical activity was positively associated with T2 basic psychological need satisfaction in exercise (β = 0.105, p = 0.002), which was subsequently associated with higher T3 social skills (β = 0.188, p < 0.001). This pathway yielded a small positive standardized indirect effect (effect = 0.020, 95% CI [0.007, 0.039], p = 0.015). The directly estimated association between T1 physical activity and T3 social skills also remained positive (effect = 0.137, 95% CI [0.068, 0.213], p < 0.001), indicating that basic psychological need satisfaction in exercise accounted for part, but not all, of the longitudinal association. The focal indirect effect was replicated in the longitudinal latent-variable, covariate-adjusted, and alternative physical-activity-scoring analyses, with estimates ranging from 0.022 to 0.029. The targeted random-effects model yielded a comparable point estimate (0.022), although with greater uncertainty (95% CI [-0.012, 0.056]). CONCLUSION:These findings position physical activity as a recurring developmental context associated with later social-skill development in children with autism and indicate that basic psychological need satisfaction in exercise may modestly help explain this longitudinal relationship. They further suggest that the social-developmental relevance of physical activity may depend partly on whether participation supports autonomy, competence, and relatedness, underscoring the importance of considering the psychological quality of participation alongside activity volume.
BACKGROUND:Individuals with Down syndrome (DS) often experience challenges in executive functioning (EF), including inhibitory control. Despite interest in EF research and intervention in DS, there is a lack of feasible and developmentally sensitive measures of EF for young children in this population. This study evaluated the feasibility, developmental sensitivity, and test-retest reliability of a modified Snack Delay task for children with DS aged 2-7 years. METHODS:The Snack Delay task was administered to 118 participants with DS (mean age = 5.21, SD = 1.53; 51.7% male). Three outcome metrics were evaluated for feasibility, developmental sensitivity, and preliminary psychometric properties. Feasibility was assessed by task completion rates. Distributional characteristics, including range and floor and ceiling effects, were examined. Intraclass correlation coefficients assessed test-retest reliability, and t-tests evaluated practice effects across a two-week period. Developmental sensitivity was evaluated as a function of chronological and mental age. RESULTS:The Snack Delay task was feasible for 89% of participants and captured meaningful variability in inhibitory control among children with DS aged 3-7 years. Floor effects ranged from 0% to 17.1% and ceiling effects from 20% to 56.2%. Test-retest reliability was moderate for one metric and strong for two. A small, non-significant practice effect was observed for one metric, with lower average waiting times at retest. Performance scaled with age and developmental level, though ceiling effects were observed in older children. Lack of motivation was more common among participants with younger chronological and mental ages. CONCLUSION:The Snack Delay task is a reliable, developmentally sensitive measure of inhibition in young children with DS and may be a valuable tool for assessing EF in this population.
Background Standardized motor batteries are widely used to assess motor competence in children with developmental coordination disorder (DCD), although it remains unclear whether they consistently capture the domains most affected by the disorder. Aims This systematic review and meta-analysis aimed to examine the motor competence domains in which children and adolescents with DCD differ from their typically developing (TD) peers, as assessed through standardized motor batteries. Methods and procedures A systematic search was conducted in four databases (PubMed, Scopus, Web of Science, and SPORTDiscus) up to November 12, 2025. Methodological quality was evaluated using the Mixed Methods Appraisal Tool. Outcomes and results Thirty studies were included, comprising 3934 participants (1663 DCD groups and 2271 TD peers). Most studies used the MABC, with eight using the MABC-1 and 18 the MABC-2; two the TGMD-2, one the BOTMP, and one the KTK. Overall, children with DCD consistently demonstrated lower motor skills across all domains. However, the relative pattern of impairment across the various subdomains was not consistent, particularly in the MABC. Meta-analytic findings indicated that manual dexterity was relatively more affected in the MABC-1, whereas aiming and catching emerged as the relatively more affected domain in the MABC-2, in both DCD and TD groups. Conclusion and implications These findings suggest that standardized motor batteries are useful for operationalizing Criterion A, but their results should be interpreted cautiously and within a broader clinical and functional framework rather than as sufficient markers in isolation.
Purpose Throughout their youth, non-autistic siblings of autistic individuals may begin considering their involvement in their autistic sibling’s life, which may affect their well-being. However, there is little research on how expectations for future involvement differ across cultures. Understanding why and how youth siblings’ expectations manifest may inform the design of family interventions that are appropriate for culturally-diverse samples. The present analysis examines how Latino and non-Latino youth siblings perceive their future supportive roles in their autistic sibling’s life. Methods Semi-structured qualitative interviews were conducted in English with 12 Latino and 9 non-Latino youth siblings (N = 21). Eligible families had at least one child diagnosed with autism and a non-autistic sibling between 8 and 17 years old. Audio-recorded interviews were transcribed verbatim and coded using a coding structure. Data were analyzed using applied thematic analysis and were both analyzed in aggregate and stratified by ethnic background. Results Two themes were identified: 1) expectations of evolving sibling roles and responsibilities into adulthood shape siblings’ visions of their future involvement and 2) without family support, anxiety about the future pushes siblings into action or avoidance. Driven by a sense of duty, Latino siblings were more certain of a support role in their autistic sibling’s life. Non-Latino siblings expressed more uncertainty and variability in their expectations for a future support role, feeling conflicted between prioritizing their autistic sibling or future family. Conclusion These themes are consistent with literature emphasizing how cultural values, such as familism and individualism, shape caregiving attitudes and expectations. These findings may inform the design of culturally-responsive family interventions.
\Phonological awareness, knowledge of grapheme-phoneme correspondences, working memory, and broader linguistic factors are well-established predictors of the acquisition of foundational reading skills in students with and without intellectual disabilities. However, empirical evidence remains limited regarding the specific factors that contribute to literacy learning difficulties in children with intellectual disabilities who rely on augmentative and alternative communication (AAC). The present study aimed to examine predictors of basic reading abilities in children with intellectual disabilities, both with and without spoken language, using standardized assessments and eye-tracking measures during word decoding tasks. A total of 71 children with mild to moderate intellectual disabilities participated, including 12 children who use AAC. Correlational and regression analyses were conducted to identify significant predictors. Performance in word decoding was significantly predicted by auditory memory, grapheme-phoneme correspondence knowledge, phonological awareness, and first fixation duration on target words within a "text-image choice" paradigm, the latter reflecting mechanisms of visual attention regulation. The variable "spoken language" did not account for additional variance beyond these predictors. The findings are discussed with regard to their implications for the design of evidence-based reading instruction. In particular, phonologically oriented interventions are recommended for children with mild to moderate intellectual disabilities, irrespective of their spoken language abilities.
PURPOSE:We compared bone and muscle strength and related factors between children with autism spectrum disorder (ASD) and typically developing children (TDC). METHODS:We included 15 male children with ASD (mean age: 10.3, SD: 2.7 years) and 45 TDC (11.4, 1.8), matched for sex, age, maturity, height and body mass. We used pQCT to assess bone strength, area, and content at the distal and shaft sites of the radius and tibia, as well as muscle area at the forearm and lower leg. We measured grip strength and long jump distance and recorded daily physical activity (PA) and vitamin D, calcium, and protein intakes. We used site-specific multivariate analyses of covariance to compare bone outcomes, adjusting for muscle area. We compared PA and nutrient intakes using multivariate analyses, and muscle area and performance outcomes using analysis of variance. RESULTS:Children with ASD had 13-31% lower bone strength, area, and content at the shaft sites of the radius and tibia, and distal tibia. They also had 26-33% lower grip strength and long jump distances, spent 76% more daily time in light PA, and accumulated 67% fewer bone impact counts compared with TDC. CONCLUSION:We report deficits in bone strength and content accompanied by lower muscle strength performance and fewer bone-impacting activities in male children with ASD. Future research should determine whether lower muscle strength and reduced bone-loading exposure contribute to bone deficits and may serve as targets to optimize bone development.
Screening children for Attention-Deficit Hyperactivity Disorder (AD/HD) often relies upon subjective behaviour ratings which are susceptible to biases. A brief (35-40 min) post-screening assessment that does not directly address symptoms, increases objectivity, and accurately discriminates children with AD/HD from typically developing peers, could serve as an adjunct to symptom-focussed screening to support decisions about referral for comprehensive specialist assessment. This study examined the classification performance of the subjective parent-reported SNAP-IV screening questionnaire and the multi-domain Neurocognitive Assessment Tool (NCAT), both alone and in combination, in children with and without AD/HD of the Combined presentation (AD/HD-C). The SNAP-IV and NCAT were administered to 46 children with AD/HD-C and 138 typically developing children. The NCAT assessed executive function performance, brain electrical activity, quality of life, psychological needs satisfaction, sleep habits, self-regulation and social behaviour. Discriminant function and receiver operating characteristic analyses evaluated classification performance for SNAP-IV, NCAT, and combined (NCAT+) models. The SNAP-IV (97.8% accuracy; 91.3% sensitivity; 100% specificity; AUC =.990) and NCAT+ (95.1%; 87.0%; 97.8%; AUC =.993) demonstrated high classification performance; the NCAT showed lower but robust performance (88.0%; 78.3%; 91.3%; AUC =.966). The SNAP-IV showed the highest classification performance based on subjective ratings of symptoms, which are susceptible to a range of biases. The NCAT exhibited strong classification, particularly in specificity, highlighting its capacity to discriminate children with AD/HD-C from typically developing children using objective measures and non-symptom-specific subjective assessments. Combining the SNAP-IV and NCAT yielded superior performance to NCAT alone, supporting integrated use as screening and decision-support tools to identify children warranting comprehensive specialist assessment. External validation in diverse clinical populations, including those with co-occurring diagnoses, is needed.
Attention-deficit/hyperactivity disorder (ADHD), specific learning disorder (SLD), and their comorbidity are associated with weaknesses in cognitive efficiency; however, the diagnostic utility of WISC-V index patterns remains unclear. This study examined WISC-V cognitive profiles in children with newly diagnosed ADHD, SLD, ADHD-SLD comorbidity, and typically developing controls (N = 133; 6-16 years), with emphasis on Working Memory and Processing Speed. Age-controlled ANCOVAs evaluated group differences across primary and composite indices, including the General Ability Index (GAI), the Cognitive Proficiency Index (CPI), and their discrepancy. Dimensional associations were analyzed using partial correlations and multiple regressions across informants, and multinomial logistic regression with leave-one-out cross-validation assessed classification performance. Clinical groups showed lower Processing Speed and Cognitive Proficiency relative to controls; however, neither the GAI-CPI discrepancy nor intraindividual profile configuration differentiated diagnostic categories. Inattention emerged as the most robust cognitive correlate, particularly for Processing Speed. Cross-validated accuracy was modest (accuracy =.32), only slightly exceeding chance. Findings support a shared-vulnerability framework and caution against interpreting WISC-V index patterns as disorder-specific markers.
OBJECTIVE:This study aims to examine the effects of exercise interventions on executive function in children with ASD and to investigate the dose-response relationship between exercise dosage and intervention effects. METHODS:We searched databases including PubMed, Web of Science, Embase, and the Cochrane Library to identify studies evaluating the effects of exercise interventions on executive function in children with ASD. Effect sizes were calculated using Hedges' g. Using the metafor package in R, we constructed a three-level random-effects model to account for inter-effect dependencies and conducted a multilevel meta-analysis. Furthermore, we employed a TPS model to assess the dose-response relationship between exercise interventions and executive function, and to identify the effects of potential moderating variables on executive function. RESULTS:This review included 21 studies from six countries, involving 742 participants aged 3-15 years. Three-level meta-analysis showed that exercise interventions significantly improved executive function in children with ASD (Hedges' g = 0.64, 95% CI [0.39, 0.88]), including inhibitory control (Hedges' g = 0.59, 95% CI [0.34, 0.84]), working memory (Hedges' g = 0.56, 95% CI [0.26, 0.87]), and cognitive flexibility (Hedges' g = 0.75, 95% CI [0.50, 1.00]). The TPS model suggested potential dose-response patterns, with the highest predicted effect near the upper boundary of the observed data. Age-moderated intervention effects. Given the low certainty of evidence, findings should be interpreted cautiously. CONCLUSIONS:Exercise interventions can significantly improve executive function in children with ASD, and there is a significant dose-response relationship between exercise and executive function.
Despite growing awareness, autism identification remains hindered by historical biases linking the condition to male populations and a limited understanding of the subtler female phenotype, which can delay timely educational referrals in schools. This study investigated how student gender (perceived binary gender: boy or girl) and autism phenotype (male or female behavioral profiles) affect autism identification by pre-service teachers. Using vignettes depicting children showing either a male or female autism phenotype, 709 pre-service teachers from six countries (Chile, Ecuador, France, Latvia, Spain, and the USA) considered possible diagnoses, confidence levels, and ranked likelihoods. Results revealed that student gender significantly influenced identification: autism was more frequently, confidently, and highly ranked when the vignette described a boy rather than a girl. The autism phenotype itself did not affect identification rates, though teachers showed greater confidence when judging the male phenotype. No interaction effects emerged between gender and phenotype. These findings suggest that pre-service teachers are still influenced by the stereotype of autism as a predominantly male condition. This study shows how teacher education training on gender bias in autism could be re-designed to promote earlier recognition and support for autistic girls who are often underdiagnosed or diagnosed late.
Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder that emerges during childhood, affecting approximately 5-8% of school-age children. Although it often persists into adulthood, there is a lack of standardized and validated tools for assessing DCD in adults in France. The Adult Developmental Coordination Disorder/Dyspraxia Checklist (ADC) is the most widely used questionnaire in DCD studies with adults and has been adapted in several countries. This study aimed to translate the ADC into French and to evaluate its psychometric properties. The questionnaire was translated following literature recommendations. A total of 209 participants aged 18-58 years were included (138 females, mean age: 24.49 ± 7.87 years, mean laterality quotient: 71.41% ± 45.85%), including 13 with a reported diagnosis of DCD or probable DCD. The psychometric properties related to evidence of validity and reliability were then assessed. The test of the questionnaire structure led to a 28-item modified version instead of the 40-item original one. Analyses of the other psychometric properties provided initial evidence based on test content, internal structure, relations with validated motor tests, and sensitivity to DCD. The ADC also showed acceptable to excellent internal consistency and test-retest reliability. Preliminary French thresholds and minimal detectable change values (e.g., following an intervention) were calculated. This article represents a first step in the validation process of the French ADC, in line with French and European recommendations on DCD. It also contributes to harmonizing diagnostic tools and supporting international research on adults with DCD.
BACKGROUND:Autism spectrum disorder (ASD) is characterized by early difficulties in language and social communication. While speech therapy is a core early intervention, music therapy has been increasingly applied to support social-emotional development. However, evidence regarding the additive effects of group-based music therapy combined with speech therapy in preschool children with ASD remains limited. METHOD:This exploratory randomized controlled trial enrolled (RCT) preschool children aged 3-5 years with ASD and language delay. Participants were randomly assigned to a Music Therapy group receiving group-based music therapy (60 min/week) plus individual speech therapy (30 min/week), or a Control group receiving speech therapy alone, for 8 weeks. The primary outcome was week 8 language performance assessed using the Preschool Language Scale (PLS). Secondary outcomes included autism-related characteristics, emotional and behavioral functioning, and parenting stress, assessed using the Checklist for Autism Spectrum Disorder-Chinese Version (CASD-C), Pervasive Developmental Problems scale of the Child Behavior Checklist for Ages 1½-5 (CBCL 1½-5 PDP), and Parenting Stress Index-Short Form (PSI-4-SF), respectively. The primary treatment effect was evaluated using a multiple imputation-based intention-to-treat (ITT) adjusted analysis accounting for sex and baseline outcome measures. Secondary outcome analyses were interpreted with Benjamini-Hochberg false discovery rate correction for multiple comparisons. Exploratory within-group analyses and generalized estimating equation (GEE) models were used to characterize observed changes over time. RESULTS:Forty participants were randomized, and 38 participants completed the week 8 assessment. The ITT analysis included all randomized participants. Observed PLS total scores increased significantly within both groups. Exploratory within-group analyses also showed reductions in CASD-C social interaction issues and emotional difficulties in the Music Therapy group, and CBCL 1½-5 PDP T-scores decreased within both groups. However, the primary adjusted ITT analysis did not demonstrate statistically significant superiority of adjunctive group-based music therapy over speech therapy alone for the primary language outcome (adjusted between-group difference, -1.65; 95% confidence interval, -7.52-4.21; p = 0.569). No statistically significant adjusted between-group differences were observed for secondary outcomes. Exploratory GEE analyses indicated time-related changes in PLS total score, CASD-C sensory difficulties, and CBCL 1½-5 PDP T-score, but no significant group-by-time interactions. CONCLUSION:In this exploratory RCT, group-based music therapy was feasible to integrate with speech therapy and was not associated with intervention-related adverse events. Although language performance and selected autism-related behavioral features showed improvements over time, adjunctive group-based music therapy did not demonstrate statistically significant superiority over speech therapy alone. Larger adequately powered trials are needed to evaluate its incremental benefit.
