Spontaneous visual perspective-taking is fundamental to real-world social interactions but remains understudied in young autistic children, partly due to methodological limitations. The traditional dot-perspective task imposes substantial cognitive demands, limiting its suitability for developmental populations. The present study adapted a simplified paradigm to address this issue. Study 1 investigated whether the adapted task reliably elicits interference effects and is suitable for use in preschool children (N = 59). Study 2 then compared 34 autistic and 29 age- and IQ-matched non-autistic children. Results showed reliable altercentric and egocentric interference in both groups, with autistic children exhibiting larger interference effects than non-autistic children. These effects persisted even in a self-perspective-first design that minimized potential carryover from prior other-perspective trials. Together, these findings indicate that young autistic children spontaneously process others' visual perspectives, alongside increased difficulty in suppressing their own perspective, suggesting that autistic children may exhibit preserved or even heightened sensitivity to social information rather than reduced social attentional engagement.
Social disengagement and empathizing difficulties are common in autism and have been linked to various socioemotional outcomes. Yet, their relationship remains understudied. This study addresses this gap by examining associations among different forms of social disengagement and empathy in autistic children and adolescents, as well as their interactive effects in predicting concurrent emotion problems. Parents of 689 autistic youth aged 5-17 years (M [SD] = 11.23 [3.56]; 76% male) completed questionnaires: the Child Social Preference Scale assessed shyness, unsociability, and social avoidance; the Children's Empathy Quotient measured cognitive and affective empathy; and the Strengths and Difficulties Questionnaire assessed emotion problems. Results showed that all forms of social disengagement were associated with difficulties in both cognitive and affective empathy, with social avoidance showing the strongest associations. Furthermore, the interplay between different forms of social disengagement and empathy contributed to variability in emotion problems. Specifically, the links between unsociability and social avoidance and elevated emotion problems were stronger among youth with higher levels of empathy. In contrast, the positive association between shyness and emotion problems was not influenced by empathy. These findings underscore the importance of considering the multifaceted nature of social disengagement and its association with empathy, offering directions for future research.
Autistic individuals face an increased risk of experiencing traumatic events and of being significantly affected by them, whether these events are life-threatening or social in nature. Emotion regulation (ER) difficulties are central to both conditions, yet their role in this neuropsychiatric co-occurrence remains under-researched. This study examined ER's mediating role in the association between autism and posttraumatic stress symptoms (PTSS). Participants included 68 autistic and 101 nonautistic adults who completed the PCL-5 regarding life-threatening and social triggers, alongside the Difficulties in Emotion Regulation Scale (DERS) and a sociodemographic questionnaire. Autistic adults reported significantly higher PTSS following both event types and greater ER difficulties compared to controls. ER difficulties fully mediated the association between autism and PTSS for both life-threatening and social triggers. Specifically, the lack of emotional clarity subscale emerged as a distinct, significant mediator for both trauma types. These findings identify ER difficulties, particularly challenges understanding one's emotions, as a core mechanism linking autism and trauma-related distress. Trauma-focused interventions for autistic individuals should integrate modules enhancing emotional clarity to improve resilience and treatment outcomes.
Reduced social attention (SA) is a hallmark feature of autism that is foundational to social communication and interaction. However, emerging evidence suggests that reduced SA may not be uniformly expressed across the autism spectrum. Sex and cognitive ability (IQ) have been identified as relevant stratification variables, potentially moderating SA in autistic children. We examined differential patterns of SA stratified by sex and cognitive ability in a large, longitudinal sample of autistic and neurotypical (NT) children (ages 6-11 years) from the Autism Biomarkers Consortium for Clinical Trials (ABC-CT), examining SA across four measurement timepoints (Baseline, 6 weeks, 6 months, and 4 years). SA was measured using the oculomotor index of gaze to human faces (OMI) derived from standardized eye-tracking (ET) assays, with children stratified by sex (male, female) and IQ (IQ ≥ 85, IQ < 85). Linear mixed-effects models were used to evaluate the effects of sex, IQ, and timepoint on SA, with additional analyses assessing the stability and clinical associations of OMI. Autistic females did not exhibit lower OMI scores compared to autistic males; however, relative to sex-matched NT children, autistic females showed approximately twice the reduction in OMI observed in autistic males. Likewise, the reduction in OMI associated with autism (i.e., ASD < NT) was larger in autistic children with below-average IQ than in those with average or above-average IQ. These differences were relatively stable across measurement timepoints, and OMI was more strongly associated with clinical features like face memory and adaptive behavior in autistic males and the average or above-average IQ autism subgroup. While reduced SA is a general feature of autism, its expression is stratified by sex and cognitive ability. These findings highlight the importance of subgroup stratification to better understand heterogeneity in autism and improve the utility of SA as a therapeutic biomarker.
Sleep disturbances affect 40%-80% of children with autism spectrum disorder (ASD) and are associated with impaired attention and daytime functioning. We conducted a preliminary randomized controlled trial to evaluate the effects of a short-term interval-based aerobic exercise combined with parent behavioral education (IAE-PBE) program on sleep and related outcomes in children with ASD and sleep disturbances. Twenty-eight children were randomly assigned to either the IAE-PBE group or the parent behavioral education (PBE)-only group for a 2-week intervention. Sleep was assessed using actigraphy, and attention was evaluated using age-appropriate Conners' Continuous Performance Tests. The primary outcome was sleep efficiency. Secondary outcomes included caregiver-reported sleep disturbances, attention, autism-related symptoms, and adaptive behavior. Compared with the PBE-only group, the IAE-PBE group showed greater improvement in sleep efficiency (group × time interaction, p = 0.035; within-group p = 0.026, Hedges' g = 0.89). Significant group × time interactions were also found for caregiver-reported sleep disturbances (p = 0.003) and perseverative responses on the attention test (p < 0.001), with greater improvements in the IAE-PBE group. Favorable changes were also observed in autism-related symptoms, whereas adaptive behavior did not differ between groups. These preliminary findings suggest that a short-term interval-based aerobic exercise program combined with parent behavioral education is feasible and may improve objectively measured sleep efficiency while also providing benefits for attention in children with ASD. Further studies with larger samples and longer follow-up are needed to confirm these findings. Trial Registration: ClinicalTrials.gov identifier: NCT07381504.
To investigate the long-term risk of rheumatoid arthritis (RA) among individuals with autism spectrum disorder (ASD), addressing potential immune comorbidity in ASD populations. A population-based matched cohort was assembled using Swedish registers, including 46,164 individuals diagnosed with ASD between 1987 and 2017, matched to 4,634,895 controls by sex and birth year. Cohort members were followed from age 18 until RA diagnosis, death, emigration, or end of follow-up, providing up to 30 years of observation into adulthood. Cox proportional hazards models estimated hazard ratios (HR) for RA, with sensitivity analyses adjusting for parental autoimmune, psychiatric history, and socioeconomic status. RA diagnosis rates were similar between individuals with ASD (n = 58, 0.13%) and controls (n = 5484, 0.12%), with no increased risk: overall HR = 1.06 (95% CI 0.82-1.37), seropositive HR = 1.00 (0.67-1.48), and seronegative HR = 1.12 (0.79-1.57). Complementary analyses adjusting for parental psychiatric history, autoimmune conditions, and socioeconomic factors yielded consistent null findings (HR = 1.34, 95% CI 0.97-1.84). Sensitivity analyses, including accelerated failure time models and alternative RA subtype definitions, confirmed these results. This large-scale population study does not suggest an increased RA risk in individuals with ASD. Despite suggested immune dysfunction in ASD and shared genetic pathways with autoimmune conditions, we did not observe evidence that ASD is associated with elevated RA risk during adulthood; In conclusion, these findings inform understanding of autoimmune comorbidity patterns in autism and may guide evidence-based clinical monitoring for autistic adults.
The DSM-5/DSM-5-TR includes clinician-reported severity levels to help individualize autism spectrum disorder (ASD) diagnoses. Severity levels for the two core autism domains of social communication and interaction (SCI) and restricted and repetitive behaviors (RRBs) are assigned using a 3-point Likert scale, with higher levels indicating greater symptom severity. Research examining the consistency of DSM-5-TR severity-rating agreement has been limited. Four doctoral-level clinicians independently evaluated 49 toddlers, ages 16-31 months, with each child receiving both a telehealth and an in-person (IPA) comprehensive diagnostic assessment. Previous research using this cohort demonstrated high agreement between clinicians for overall ASD diagnostic outcome. The present study examined agreement in clinician-assigned DSM-5-TR severity levels. Agreement between assessment protocols was fair for SCI (κ = 0.318, 95% CI [-0.114, 0.352]) and slight for RRB (κ = 0.195, 95% CI [-0.046, 0.436]). Further analyses revealed no significant differences in severity ratings based on individual clinician, clinical team, or assessment protocol. These findings suggest that factors beyond the core ASD symptom domains may influence clinicians' assignment of DSM-5-TR severity levels despite guidance that ratings should reflect impairment within SCI and RRB. The relatively low agreement observed for severity ratings, despite previously demonstrated high agreement for ASD diagnostic classification, suggests that assigning a diagnosis and determining the level of support needed represent distinct clinical decisions. Improving the consistency and transparency of DSM-5-TR severity level assignment may strengthen clinical communication, treatment planning, and equitable access to services while enhancing the reliability and clinical utility of these specifiers across diagnostic settings.
Overt maternal hypothyroidism during pregnancy has been associated with cognitive impairment in offspring, but less is known about effects of subclinical hypothyroidism and other maternal thyroid conditions on autism spectrum disorder (ASD). This study examined the relationships between maternal thyroid dysfunction during pregnancy and child neurodevelopmental outcomes. Participants were from a high ASD likelihood pregnancy cohort (MARBLES). Maternal thyroid dysfunction (hypothyroid or hyperthyroid compared to euthyroid) was measured in up to one blood sample per trimester. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) were also examined as exposures. Outcomes were child ASD diagnosis, non-typical development (non-TD), typical development and standardized scores from the Social Responsiveness Scale (SRS). Outcomes were confirmed by study psychometricians. Multinomial logistic and quintile regressions were used to examine associations of maternal thyroid dysfunction (using trimester-specific reference ranges) with developmental outcomes and SRS scores. Among 285 pregnancies, 83.9% were categorized as euthyroid, 9.5% hypothyroid, and 6.7% hyperthyroid. Of 285 children included in analyses, 28.8% were diagnosed with ASD (n = 82; female = 27) and 14.7% with non-TD (n = 42; female = 19). Maternal hypothyroid conditions were associated with increased ASD:TD odds (adjusted RRR = 3.40, 95% CI: 1.22, 9.45; p = 0.02). Significant relationships were also found between hypothyroid conditions and non-TD, and between first trimester TSH and ASD. There was no evidence of a relationship between either TSH or FT4 and preschool SRS scores. Findings suggest that maternal hypothyroid conditions during pregnancy are associated with greater chances of their children developing ASD and other neurodevelopmental differences among children with high familial likelihood of ASD.
Social pain sensitivity refers to the tendency to detect and react strongly to cues of social exclusion. Frequent social adversities and specific characteristics may make individuals with autism more sensitive to social pain, yet evidence remains inconsistent. To enhance our understanding, autistic adults aged ≥ 16 years (n = 1425; Mage = 47.3, SD = 14.2) and allistic adults (n = 187; Mage = 51.4, SD = 14.6) enrolled in the Netherlands Autism Register (NAR) completed the Social Pain Questionnaire (SPQ). A two-way ANOVA demonstrated that autistic adults reported significantly higher social pain sensitivity than allistic adults, with a small effect size (η2 p = 0.02). Women reported higher social pain sensitivity than men across both groups (η2 p = 0.01), and this gender difference was comparable for autistic and allistic adults. Within the autistic group, in a subset of participants with complete data (n = 234), a hierarchical multiple regression analysis showed that social pain sensitivity was moderately associated with lower self-esteem (β = -0.47), but not with cognitive empathy or sensory sensitivity. Exploratory analyses further indicated that self-esteem fully accounted for the association between autism diagnosis and social pain sensitivity. Consistent with sociometer theory, these results suggest that heightened social pain sensitivity in autistic adults may reflect reduced perceived social acceptance. Our findings highlight the relevance of social adversities for autistic adults and underscore the need for supports that strengthen belonging and reduce socially painful experiences.
This study explored the interactions between emotional and behavioral symptoms in preschool children with autism spectrum disorder (ASD) and identified potential clinical subtypes based on these interrelationships. A total of 1886 preschool children with ASD and 285 age-matched typically developing (TD) children were assessed using the Child Behavior Checklist for ages 1.5-5. Symptom networks were estimated using the EBICglasso algorithm, and group differences were evaluated via network comparison tests. Subgroups within the ASD sample were identified using Individual Difference Symptom Networks (IDSN) with k-means clustering. The results revealed distinct network structures between the ASD and TD groups, with emotional reactivity demonstrating the highest centrality in the ASD network. Two distinct ASD subgroups (ASD-A and ASD-B) were identified, which showed significant differences from the TD group across all emotional and behavioral dimensionsin the CBCL 1.5-5. The subgroups differed significantly in overall network strength and specific edge connections, particularly between aggressive behavior and withdrawal problems. The findings indicate that emotional reactivity may play a central role in the symptom network of preschool children with ASD. The identification of two clinical subgroups with distinct symptom connectivity patterns provides valuable insights for developing more individualized and targeted intervention strategies. ASD-A subgroup points to the potential value of comprehensive early intervention programs, whereas ASD-B subgroup highlights the need for functional communication training and social engagement strategies.
Developmental regression during childhood is inconsistently defined and measured, resulting in delayed diagnostic discovery and intervention. This study aimed to examine published definitions and measures for developmental regression. A comprehensive search strategy was applied to Medline, Embase, Cochrane, and PsycINFO databases. Reviewers independently screened relevant studies according to the Preferred Reporting Items for Systematic reviews. The number and percentages of definition use, their primary features, and measures were reported. Of 19,099 potential publications, 157 were included. Thematic analysis identified four condition groups: Neurodevelopmental disorders (n = 118); Progressive neurodegenerative conditions (n = 17); Developmental epileptic encephalopathies (n = 8); and Genetic conditions (n = 14). Most studies (n = 124, 79.0%) used an operational definition, and most specified types of skills lost (n = 147, 93.6%). Age of onset was specified in 67.5% (n = 106), and duration was specified in 34.4% (n = 54). Measures designed to specifically assess developmental regression were infrequently used (n = 5, 3.2%). We concluded that developmental regression is inconsistently defined and measured. A consistent approach is vital to ensure that all children are identified as early as possible. This will allow timely diagnostic discovery, enhance research rigor, and promote the collaboration that is needed to advance our understanding of causal mechanisms and effective interventions for affected children and their families.
Language trajectories in autism are highly heterogeneous and cannot be captured by unidimensional classifications. Research and clinical practice often rely on verbal/non-verbal or speaking/non-speaking labels, but these categories, when used in isolation, obscure distinct linguistic profiles. Spoken language is also frequently used as a proxy for structural language skills, despite evidence that speech may not be generative or productive. A multidimensional perspective is therefore needed to determine whether verbal skills, spoken output, and linguistic generativity reflect dissociable aspects of language in autism, and whether variation across these dimensions can be explained by non-verbal cognition or autism characteristics. Participants were 167 autistic children aged 2-6 years from the Dutch- and French-speaking regions of Belgium. Verbal skills were assessed using standardized tests. Speaking status was quantified as the proportion of linguistic segments in spontaneous productions recorded at home. Generativity was measured using a similarity index derived from semantic embeddings. Associations with non-verbal Intelligence Quotient (IQ) and autism characteristics were examined using age-controlled linear models. Overlap between the three dimensions, Verbal, Speaking, and Generativity, was only partial. Some children with little or no speech showed relatively strong structural language abilities, whereas others produced abundant but non-generative speech and had limited structural skills. Both non-verbal IQ and autism characteristics were related to all three dimensions, with IQ explaining a larger proportion of variance. Overall, one-dimensional labels fail to capture language variability in autism; assessing Verbal, Speaking, and Generativity as complementary dimensions may better identify uneven linguistic profiles in autistic children.
A growing body of work on robot-mediated therapy suggests that robots can elicit engagement and novel social behaviors among users with autism. In this narrative review, we trace the full historical arc of this field to date, from its inception in 2001 to 2024, covering 304 studies that present a robot for autism support. Early work largely consisted of short, highly structured sessions conducted in controlled laboratory or clinical environments. More recent research has shifted toward longer-term, real-world deployments in which robots operate with greater autonomy and engage users over multiple days or weeks. However, evidence for lasting and generalized benefits is still limited. The literature also remains focused primarily on children, with comparatively little research involving adults or individuals across a wider range of support needs. Despite rapid growth over these past two decades, the research remains fragmented across disciplinary boundaries, with robotics and clinical communities advancing similar goals without a cohesive, shared research framework. To address this, we offer a translational roadmap that details what interventions work, for whom, under which conditions, and why. We highlight current methodological gaps, outline key design considerations, and propose priorities for future research.
Autism spectrum disorder (ASD) presents substantial challenges for individuals and families, particularly through elevated parenting stress. Previous research has established that parenting stress is influenced by multiple interrelated factors, including parental attitudes toward ASD and parent-reported autism symptoms. Yet, the structural relations among these factors remain poorly understood. This study applied network analysis to delineate the interconnections among parenting stress, parental attitudes, and parent-reported autism symptoms in 997 parents of children and adolescents with ASD (aged 1-18 years). Network structures were compared across subgroups defined by mild, moderate, and severe levels of autism symptoms. Using Gaussian Graphical Models with EBICglasso, the analysis identified central and bridge nodes. In the overall network, "Difficult Child" showed the highest node and bridge strength. Network structure, global strength, and node strength did not differ significantly across severity subgroups after correction for multiple comparisons, which is consistent with a broadly stable network organization of parenting stress across autism severity levels. Across all severity groups, "Difficult Child" consistently emerged as the most central node, highlighting it as a potentially shared intervention-relevant target for supporting families of children with ASD across the autism severity spectrum.
The ability to detect recurring temporal co-occurrence, or temporal correlation, of sensory events is fundamental for organizing perceptual input into coherent representations. Although past work has revealed differences across several aspects of temporal processing in autism, it is unknown whether autistic and non-autistic individuals differ in the key computation of correlation detection. Here, we examined this question in the visual domain using an online task. A total of 143 age- and sex-matched adults (73 autistic, 70 non-autistic) viewed sequences in which three visual elements stochastically alternated between bright and dark states. Two of these were disks, and the third was a surrounding annulus. Participants indicated which of the two disks co-occurred more reliably with the annulus. Accuracy increased systematically with correlation strength in both groups, but there were no significant group differences and no negative association between performance and autistic trait scores when controlling for nonverbal IQ. These findings suggest that visual correlation detection, under the conditions tested here, is preserved in autistic adults. This points to a key aspect of temporal processing in autism that may provide a stable foundation for perceptual organization even amid challenges reported in other timing-related domains, such as higher-level temporal prediction. These results set the stage for future research to identify the mechanisms underlying both preserved and divergent temporal processes, and to translate these findings into evidence-based support that builds on the observed strengths of autistic individuals.
Autistic individuals frequently report heightened sensitivity to visual stimuli, often described as discomfort in environments with bright or flickering lights. These experiences are hypothesized to reflect underlying differences in sensory gain or neural hyperexcitability; however, findings across studies have yielded mixed results, likely due to methodological variability. This study aimed to evaluate whether group differences in contrast-dependent neural and behavioral responses to a visual stimulus would be observed across complementary methods: psychophysics, fMRI, and EEG. Thirty-one autistic and twenty-seven non-autistic adults completed experimental sessions in which they passively viewed bilaterally presented 6 Hz counterphase flickering checkerboards at high (100%) and low (2%) contrast. Neural responses were measured using the blood oxygenation level-dependent (BOLD) signal from fMRI and steady-state visual evoked potential (SSVEP) from EEG. Contrast robustly modulated responses across experiments, eliciting higher neural responses; however, no group differences emerged in BOLD or behavioral thresholds. The only significant group difference was observed in SSVEP amplitudes, with autistic individuals showing significantly higher neural entrainment to the flickering stimulus than their non-autistic counterparts. Moreover, SSVEP amplitudes were associated with BOLD responses to the same low contrast visual stimulus, suggesting convergence between frequency-locked EEG responses and hemodynamic activity. SSVEP amplitudes were additionally associated with self-reported measures of hypersensitivity, linking heightened neural entrainment to individual differences in sensory experiences. They also showed a differential relationship with perceptual thresholds across groups. These findings show that differences between autistic and non-autistic participants were more evident in frequency-locked neural responses to periodic visual input, as measured by SSVEPs, and that these responses were meaningfully related to visual cortical BOLD activity and sensory hypersensitivity.
Although bilingualism is now recognized as having no adverse effects on language outcomes in autistic children, little is known about how it manifests in early development, particularly in minimally speaking children who may show unique patterns of bilingual expression. The present study used naturalistic language sampling to characterize bilingual language use in minimally speaking autistic children and their caregivers. Video recordings of 31 minimally speaking autistic children interacting with their caregivers during two separate sessions of the Brief Observation of Symptoms of Autism (BOSA)-one in English and one in Spanish-were transcribed and analyzed for language skills (mean length of utterance in words, number of different words), speaking rate (utterances per minute), and use of English, Spanish, or mixed-language utterances. We found that children were slightly more proficient in English than in Spanish, especially in the number of different words. Both children and caregivers produced similar rates of speech across the English and Spanish BOSA sessions, suggesting that language choice did not quantitatively impact their interaction. Finally, children aligned with their caregivers' language use more consistently in English than in Spanish. Although they responded in Spanish when caregivers used Spanish, they also switched into English a lot during the Spanish BOSA. These findings suggest that minimally speaking autistic children flexibly adapt to their caregiver's language while showing an early advantage or preference for their societally dominant language.
Early intensive intervention for autistic children aims to support developmental progress in social and communication domains. Although outcomes are typically assessed using standardized measures of child development, parental perspectives during early intervention remain largely understudied. Here, we examined parental perceptions after 6 months of intensive Early Start Denver Model (ESDM) intervention. Participants were parents of 104 autistic children aged 1.3-3.5 years enrolled in an individualized therapist-delivered ESDM intervention following diagnosis confirmation. Child development was assessed at entry (baseline) and 6 months later (follow-up). At follow-up, parents completed an 18-item questionnaire capturing their perceptions of child progress across twelve domains as well as changes in parenting skills, personal well-being, and family life. Descriptive analyses, item-level correlations, and principal component analysis (PCA) were conducted to identify underlying components. Parents generally indicated improvements across all domains, with aggravation rarely reported. PCA revealed three intercorrelated components (Social Communication, Nonverbal Social Engagement, and Positive Parental Experience), each showing distinct associations with child or parent measures. Parental perceptions of child development were strongly correlated with standardized developmental assessments, particularly in social communication. While parents also reported enhanced parenting skills and positive personal and familial impacts, these experiences were not associated with child developmental gains but with parental education and the number of siblings in the household. These findings underscore the importance of integrating parental perspectives alongside clinical assessments when evaluating early intervention outcomes. Future research should investigate how parental perceptions evolve over longer periods and how they may inform family-centered care and post-intervention support.
To examine the associations between community environmental barriers and support and the participation of autistic children, and to interpret these findings from the perspective of caregivers engaged as research partners. This cross-sectional observational study employed a mixed-methods design. The first phase comprised analytical and exploratory quantitative analyses. Caregivers of autistic children aged 5-12 years reported participation outcomes-frequency, involvement, and desire for change-using the Brazilian version of the Participation and Environment Measure for Children and Youth (PEM-CY) and CARS-BR with 80 caregivers of children aged 5-12. Phase 1 involved path analysis to test associations between community environment, income, autism severity, and participation (frequency, involvement, desire for change). Phase 2 employed a constructivist-interpretivist approach, where five caregivers acted as research partners to interpret quantitative results via reflexive thematic analysis. Quantitative analysis showed no statistically significant associations between environmental factors and participation outcomes, despite frequent reports of barriers. In Phase 2, research partners identified social inclusion, safety, and logistical constraints as critical. They highlighted that low participation often stems from unwelcoming contexts and limited informal peer interaction, rather than a lack of desire to engage. Integrating findings from both phases, the study suggests that the low participation of autistic children in community settings may reflect, at least in part, protective choices adopted in response to contexts perceived as unwelcoming, unsafe, and insufficiently supportive, rather than a lack of desire for participation.
The prevalence of substance use disorders (SUD) among autistic people is substantial and growing. This unaddressed public health challenge is particularly important given the lack of knowledge about SUD service needs among people on the spectrum. This paper presents the first national-level study of SUD-related clinical outcomes and service use among US-based autistic Medicaid enrollees with SUD (N = 50,487) compared to matched neurotypical enrollees with SUD (N = 151,461). The analyses reveal that overdose, hospitalizations, and some polysubstance use risks are elevated among autistic people with SUD compared to neurotypical SUD patients. Analyses also suggest that autistic people with SUD use fewer SUD services compared to their neurotypical counterparts. Results highlight the need for integrative, evidence-based autism-tailored SUD service solutions.
