Effective training in functional analysis is essential in applied behavior analysis, yet traditional methods may not include adequate practice opportunities. Researchers evaluated an automated virtual reality (VR) simulation designed to teach novice clinicians to implement functional analysis procedures. Six participants completed immersive VR training with automated prompting followed by baseline probe, feedback, and treatment-extension phases. Two participants achieved mastery through VR training alone, whereas four required brief feedback to reach criterion. Immediate performance improvements were observed across participants, and those receiving feedback continued to display mastery-level performance in live role plays during a treatment extension. Results suggest that VR training may enhance procedural fidelity in functional analysis protocols while reducing training risks. Findings support VR as a promising tool for scalable, safe, and effective training in applied behavior analysis practices.

Differences in social communication may shape how autistic children use language with different interaction partners. This study examined lexical diversity during free play interactions with a friend and an acquaintance among 50 preschoolers (21 autistic and 29 typically developing). Each child participated in separate play sessions with the two partners. Overall, autistic children produced less lexically diverse language than TD children. TD children also demonstrated greater lexical diversity with friends than with acquaintances, whereas no systematic partner effect emerged for the autistic group. However, individual profiles based on total word production provided a more nuanced picture: most autistic children varied their verbal output across partners, but the direction of this difference was heterogeneous, with some producing more words with a friend and others with an acquaintance. Thus, autistic children's verbal output appeared sensitive to the interaction partner, although not in the relatively consistent direction observed among TD children. Associations between verbal abilities and lexical diversity were found only during interactions with acquaintances. These findings suggest that social context relates to children's language production in different ways across and within diagnostic groups and may inform individualized peer mediated interventions by supporting the selection of interaction partners who facilitate each child's communication, followed by practice across multiple partners to promote flexible language use and generalization.

Thyroid hormones regulate embryonic and fetal neurodevelopment, with the maternal thyroid gland exclusively producing these hormones for the first half of gestation and then a combination of maternal and fetal production occurring during the second half of gestation. Hypothyroidism during pregnancy is common in humans, particularly due to the additional demand put on the thyroid gland as pregnancy proceeds. Epidemiological studies have linked maternal hypothyroidism to an increased risk of attention-deficit/hyperactivity disorder and autism spectrum disorder diagnosis in these children, as well as cognitive deficits and delays. Rodent models have been extensively used to model developmental hypothyroidism and study the long-term effects on offspring. Increases in activity, reductions in anxiety, cognitive impairments, and social alterations have been observed. In this review, I discuss the current understanding of the organizational impacts of hypothyroidism on activity, affective behaviors, cognition, and social behaviors in humans and animal models, paying special attention to critical periods that may underlie these effects. I also review potential interactions between thyroid hormones and steroid hormones known to be important for organization of the brain and behavior during perinatal and adolescent development. Understanding the effects of developmental hypothyroidism is critical, as early developmental exposure to many endocrine-disrupting chemicals may alter behavior through reducing thyroid hormone signaling, and the final section of the paper reviews these interactions. Understanding the organizational effects of thyroid hormones is important for decisions related to screening and interventions during pregnancy.

In clinical practice, objectively distinguishing children with autism spectrum disorder (ASD) from those with typical development (TD) and other neurodevelopmental conditions with overlapping symptoms, such as global developmental delay (GDD), is critical for improving developmental outcomes. This study aimed to investigate the feasibility of eye-tracking-based machine learning (ML) models in distinguishing children with developmental concerns (ASD + GDD) from TD children, and in further differentiating ASD from GDD. A total of 168 toddlers (45 ASD, 56 GDD, and 67 TD; aged 18-48 months) viewed a socially dynamic "hide-and-seek" video. Both conventional area-of-interest (AOI)-based features and combined features derived from AOI combinations were used to train five ML classifiers. A two-stage classification framework was adopted, and SHapley Additive exPlanations (SHAP) analysis was used to interpret feature contributions. Combined features consistently outperformed isolated AOI features. For TD versus clinical classification, the random forest model achieved the highest accuracy of 80.36% (sensitivity = 84.16%, specificity = 74.63%). In differentiating ASD from GDD, the k-Nearest Neighbors model achieved the highest accuracy of 79.21% (sensitivity = 71.11%, specificity = 85.71%). SHAP analysis indicated that cross-regional attention features contributed substantially to model performance. These findings suggest that eye-tracking-based ML models may provide a promising approach for early screening of developmental conditions and ASD-GDD differentiation. Combined features reflecting cross-regional attention distribution demonstrated higher discriminative value than conventional AOI measures. Future studies should validate these findings in larger, multicenter, and more balanced samples with richer dynamic eye-tracking representations.

It has been suggested that deviations from typical patterns of social behavior in individuals with autism spectrum disorder (ASD) may stem from a failure to experience social interactions as sufficiently rewarding (Chevallier et al., 2012). This study evaluated a behavioral economic measure of sensitivity to social rewards in 30 autistic children, 19 nonautistic children with developmental disabilities, and 19 neurotypical children between the ages of 3 and 12 years old. Participants worked for 30 s of access to social interactions with a novel adult or a leisure item in separate sessions. Each reward was delivered on a progressive ratio schedule of reinforcement, in which the number of work responses required to access the reward increased across trials. Social reward was less valuable for autistic participants compared to their neurotypical peers, but differences in nonsocial reward value were not observed. No statistically significant differences in social reward value were obtained when comparing the nonautistic developmental disability group to either autism or neurotypical group. These findings suggest that differences in reward value may be unique to autism and isolated to social stimuli. Implications for future research investigating the role of social motivation in autism are discussed.

Cerebral folate deficiency (CFD) has recently emerged as a potentially relevant contributor to developmental difficulties in a subset of individuals with autism spectrum disorder (ASD). CFD is characterized by reduced central nervous system folate availability despite adequate systemic folate status and has been commonly linked to folate receptor-α autoantibodies (FRAAs), which impair folate transport across the choroid plexus. Disruption of folate-dependent one-carbon metabolism may adversely affect neurodevelopment through multiple mechanisms. Leucovorin (folinic acid) represents a potential therapeutic option for CFD associated with FRAAs, and interest in its clinical use has grown in recent years. This narrative review summarizes the biological mechanisms linking CFD to developmental disturbances in ASD and synthesizes current clinical evidence regarding the use of leucovorin as a therapeutic intervention. Despite a compelling mechanistic basis, clinical evidence remains limited. Long-term safety and efficacy data are lacking, and existing studies have rarely incorporated biologically informed patient selection or biomarker-based stratification, whilst the inherent heterogeneity of ASD further complicates interpretation of treatment outcomes. Larger, well-designed studies are necessary to determine the intervention's efficacy and identify responsive sub-groups, thereby informing clinical practice. Nevertheless, given the limited developmental window during which treatment for CFD would offer tangible developmental benefits and the inaccessibility of laboratory evaluations for CFD or FRAA positivity in many settings, this review also discusses an alternative pragmatic approach involving a therapeutic trial through shared decision making.