The authors analyze the 2024 US Court Case concerning a civil action brought by the mother of an American adolescent affected by Asperger syndrome who, after developing an emotional dependency on an artificial intelligence-based chatbot, died by suicide using his stepfather's firearm. The action was brought against the software developer on grounds related to the design and deployment of the application. The case highlights the correlation between psychological risk factors and insufficient protective measures in the context of neurodivergent autism spectrum conditions and excessive, unregulated internet use. The analysis considers the interaction between the minor's psychological vulnerability in engaging with the software and the lack of adequate control and safety mechanisms within the technological device. Parental responsibility also emerges, in relation to the mother's failure to supervise her son's digital activities and the stepfather's breach of the legal duty to properly secure a firearm. A comparative perspective between the United States and Italy allows consideration of regulatory similarities and converging legal principles.

Autistic children can experience elevated levels of emotional and behavioural problems, which adversely impact their psychosocial functioning. Positive parenting behaviours can significantly shape children's emotional and behavioural developmental trajectories. However, for autistic children, these parenting behaviours may vary depending on their social, sensory and intellectual profiles. Literature on the association between parenting behaviours and autistic children's internalising and externalising symptoms has been mixed. Thus, the main objective of this study will be to conduct a systematic review and meta-analysis of studies evaluating the effect of parenting behaviours on autistic children's internalising and externalising symptoms.

A 10-year-old patient was admitted to the pediatric sub-intensive care unit due to massive rectal bleeding and severe acute anemia. His medical background included Asperger syndrome and a history of chronic constipation not adequately addressed by medical therapy. Colonoscopy showed two deep ulcers in the rectum and sigmoid colon of approximately 4 cm in diameter, which were diagnosed as stercoral ulcers related to stercoral colitis, a rare inflammatory form of colitis that occurs in patients with refractory constipation. Stercoral colitis has been mainly described in elderly patients with dementia or in bedbound patients and only occasionally in adults with psychiatric disorders. To the best of our knowledge, this is the first case of massive rectal bleeding from stercoral ulcers in a pediatric patient.

Hypoglycemia is a rare but potentially serious adverse effect of second-generation antipsychotics (SGAs). Most studies have focused on SGA-induced hyperglycemia and metabolic syndrome, while hypoglycemia in non-diabetic adults remains underreported. We describe a case of severe hypoglycemia following risperidone initiation, demonstrating diagnostic challenges and safety concerns. A 41-year-old woman with treatment-resistant schizophrenia, Asperger's syndrome, and attention-deficit/hyperactivity disorder was admitted for worsening commanding auditory hallucinations and persecutory delusions. Risperidone was started at 2 mg nightly and increased to 3 mg after four days. The patient developed recurrent episodes of severe hypoglycemia (random blood glucose levels 35-50 mg/dL; hypoglycemia defined as <70 mg/dL), accompanied by hypotension, tachycardia, nausea, vomiting, dizziness, and altered mental status, shortly after increasing the dose of risperidone. Extensive laboratory and imaging evaluations were unremarkable except for persistent hypoglycemia. The episodes continued despite aggressive glucose replacement and supportive medical treatment. After risperidone was discontinued, blood glucose levels gradually normalized within 48-72 hours, and no further hypoglycemic episodes occurred. To contextualize this case, a systematic literature search was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, PubMed Central, PsycINFO, Embase, and Google Scholar, with keywords including "risperidone", "second-generation antipsychotics", and "hypoglycemia", as well as MeSH terms. Studies involving adult non-diabetic psychiatric patients with antipsychotic-associated hypoglycemia were included. Nine relevant case reports and case series were identified and evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports. Existing literature shows that hypoglycemia associated with SGAs is rare but has been reported with several agents, including risperidone, quetiapine, olanzapine, paliperidone, clozapine, and aripiprazole. Proposed mechanisms include hyperinsulinemia and impaired counter-regulatory responses related to antipsychotic receptor effects. Because symptoms such as confusion, dizziness, and weakness may mimic psychiatric symptoms or medication side effects, diagnosis may be delayed. This case highlights that risperidone can rarely cause severe hypoglycemia even in non-diabetic adults. Although limited by a single case and lack of insulin measurements, this study emphasizes the need for early recognition, glucose monitoring during SGA use, and multidisciplinary care to prevent serious complications. Further research is needed to better understand the underlying biological mechanisms and identify potential risk factors.

Autism Spectrum Disorder (ASD) is a collective term for neurodevelopmental disorders with core features of social communication impairment, restricted and repetitive behaviors, and narrow interests. These include classic autism, Asperger's syndrome, and pervasive developmental disorder not otherwise specified. ASD is currently managed with behavioral interventions, rehabilitation training, and family support, but there is no curative medication. Recent studies suggest that some patients with ASD may experience gastrointestinal symptoms. Perhaps this is associated with the disturbances of gut microbiota. Increasing evidence has demonstrated that the composition of gut microbiota in ASD individuals is different from that in normal population and may be associated with neurodevelopmental processes via the gut-brain axis. This article reviews the evidence for the association between gut microbiota and ASD, describes the characteristics of microbial changes, and analyzes the mechanism by which changes in the composition of the microbiota affect the occurrence and development of ASD. Finally, we review recent advances in microbiota-targeted therapeutic strategies, including probiotics, prebiotics, and fecal microbiota transplantation, which provide new approaches to alleviate and improve autism-related symptoms and point out the future research direction.

With publication of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) in 2013, autism's prevalence in the United States nearly doubled to more than 2% of the population. In reconceptualizing the condition, DSM-5 collapsed 4 diagnoses into 1 diagnosis: autism spectrum disorder. What the 4 had in common were deficits in 2 broad areas: restricted, repetitive behaviors or interests; and deficits in social communication. Three of the 4 were severe forms easily recognized in childhood. The fourth, constituting most of the increase in prevalence, was Asperger disorder, or high-functioning autism, frequently going undiagnosed until adulthood. These patients typically have fluent language, intact intellect, and highly developed compensatory strategies including social "masking." The adult diagnosis is manifested in struggles to maintain employment or friendships both platonic and intimate. Nonpsychiatric providers are likely to encounter patients with autism spectrum disorder seeking care for myriad comorbid psychiatric and physical problems. Complicating matters is that many adult psychiatrists are unfamiliar with what was until recently the purview of child psychiatrists. Autism has neither cure nor specific pharmacologic treatments, but addressing comorbidities, with psychiatric and medical referrals where indicated, mitigates suffering. Services targeting employment and educational support, occupational therapy focused on activities of daily living, and skill-based psychotherapies that aim to improve social interactions can reduce stress and anxiety while enhancing function, reducing isolation, and encouraging satisfying relationships.

Autism spectrum disorders are typically considered a disqualifying factor for military service due to their high demands on the environment. This case study describes the implementation of a social skills training program for a military candidate with Asperger's syndrome. The intervention employed four strategies: Social Stories, which used structured scenarios to teach appropriate social responses; Social Autopsy, which analyzed real-life interactions to identify strengths and areas for improvement; Role-Playing, which provided guided practice of social interactions; and a Cardboard Game, designed to promote empathy and perspective-taking. An individualized plan was created to enhance emotional intelligence and core social communication skills during military service. Following the intervention, the participant demonstrated improvements in social communication and increased self-confidence. Though this is a single-case study, its findings suggest that targeted social skills interventions can enable autistic individuals to participate successfully in structured environments such as the military. The expansion of similar programs can be used to foster integration, personal development, and inclusion in settings that were previously restrictive.

PURPOSE: Increasing numbers of individuals diagnosed with autism spectrum disorder (ASD) in childhood are now reaching adulthood, yet knowledge of their long-term outcomes remains limited. This study evaluated adult clinical characteristics, outcomes, and prognostic factors in individuals diagnosed with ASD in childhood. METHODS: Eighty-seven adults participated, including five (5.7%) in whom loss of autism diagnosis (LAD) was identified. The remaining participants (n = 82) were classified by their initial childhood diagnoses: autistic disorder (49.4%), pervasive developmental disorder–not otherwise specified (20.7%), and Asperger’s syndrome (24.7%). Adult outcomes were assessed using a structured functional and psychosocial rating system. RESULTS: Subtypes differed significantly in age at first sentence, regression history, age at diagnosis, and initiation of special education. Individuals with Asperger’s syndrome and LAD had higher university attendance and graduation rates. Overall outcomes were very poor (5.7%), poor (55.2%), fair (24.2%), good (8%), and very good (6.9%), with significant group differences. Poor outcomes were significantly more frequent among individuals with intellectual disability (ID), regression history, co-occurring psychiatric conditions, and older age at first sentence. ID and regression significantly predicted poor outcomes, while absence of ID predicted LAD. CONCLUSION: Findings highlight the heterogeneity of ASD trajectories across the lifespan. While some individuals lose the diagnosis, outcomes vary widely depending on individual characteristics and diagnostic subtype. ID and regression emerged as key predictors for poorer outcomes. These findings offer clinically relevant insights by clarifying prognostic markers and long-term outcomes, informing diagnostic assessment and intervention planning, and emphasizing the need for tailored support strategies.

Deficits in emotion knowledge can impact children's social-emotional interactions, which are particularly evident in children with autism spectrum disorders (ASD). However, consistent evidence regarding emotion knowledge and its individual components across ASD subtypes, as defined by ICD-10, remained limited. This study investigates emotion knowledge development - both as a whole and in seven specific components - in children with ASD, categorized by subtype, and compares them with a matched group of children without ASD using nearest neighbor matching based on gender, age, and language background. The sample includes 79 children with ASD (68 boys, 11 girls; ages 5-10): Childhood Autism (n = 33), Atypical Autism (n = 15), and Asperger's Syndrome (n = 31). Participants completed the Adaptive Test of Emotion Knowledge for Three- to Nine-year-olds (ATEM 3-9). A control group of 152 children without ASD was drawn from the ATEM 3-9 norming sample. Results reveal significant differences in emotion knowledge development across ASD subtypes. Children with Childhood Autism scored significantly lower than children without ASD, whereas children with Asperger's Syndrome or Atypical Autism showed no significant differences compared to the control group. These findings suggest that emotion knowledge deficits in ASD are subtype specific. Future research should account for these distinctions when examining emotional development in children with ASD.

This article critically examines Hans Asperger’s legacy in relation to contemporary autism diagnostics. While “Asperger’s syndrome” is widely discussed, few have engaged with Asperger’s original work or the broader historical literature, including Grunia Sukhareva, Leo Kanner, George Frankl, and Lorna Wing. The paper reviews Asperger’s contributions (1938–1980) to clarify his view of autism as a distinct neurotype with specific strengths and challenges. It then contrasts this with Wing’s reinterpretation, particularly her 1979 study and 1981 introduction of “Asperger’s syndrome”, which emphasized social and communication deficits and blurred lines between autism and intellectual disability. The article concludes with an analysis of the removal of Asperger’s syndrome from the DSM-V, arguing that the DSM-IV construct reflected Wing’s adaptation, not Asperger’s writings. This change is situated within a broader shift toward cognitive diversity and depathologization, suggesting that debates over the syndrome’s existence are more complex than often assumed.