Autism, ADHD, dyslexia and dyspraxia Research—What’s New in August
In this month’s research roundup, Ann Memmott explores a wide range of new studies on Autism, ADHD, dyslexia and dyspraxia. Topics covered include measuring Autistic burnout, photography as therapy for Autistic young people and dyslexia research priorities according to dyslexic people, plus reflections on how to navigate misleading stories in the press about Neurodivergence.
Use of gesture, expression and other nonverbal signals, by Autistic adults
What do we know about this? Not enough yet, despite it being one of the tick-boxes for an Autism diagnosis. Radford and team do some work to find out more, from Autistic adults.
Atypical nonverbal communication is required for a diagnosis of Autism, yet little is known about how Autistic adults use gestures, facial expressions, and other nonverbal behaviours in social interactions, especially from Autistic adults’ perspectives…Major themes included: (1) Cognitive differences resulting in Autistic adults requiring more time and energy to manage nonverbal communication in interactions; (2) Miscommunication related to nonverbal communication is bilateral; (3) Nonverbal communication differences can negatively impact the lives and wellbeing of Autistic adults; (4) Autistic adults use a range of skills and strategies to manage nonverbal communication; and (5) Autistic adults demonstrate variability in the production and interpretation of nonverbal cues.
So, for example, non-Autistic people are likely to misinterpret Autistic gestures and expressions, and we are likely to misinterpret theirs. This is further evidence of mismatch of understanding, and the genuinely different ways of communicating.
Radford, H., Reidinger, B., Kapp, S. K., & de Marchena, A. (2025). “There is just too much going on there”: Nonverbal communication experiences of Autistic adults. PloS one, 20(7), e0325465. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0325465
A need for routine and deep interests, for Autistic people.
Spackman and team looked at what we know about Autistic need for routine and predictability, and the Autistic deep focus on topics of great interest. Most of the checklists for these only consider frequency and ‘severity’ (often meaning e.g. parents have to make a guess, which is hard if they have no other cohort of Autistic children to compare this to). Few of the checklists ask why the Autistic individual chooses those actions, or whether they increase or decrease over time. What are the advantages and benefits for the Autistic people, rather than the ‘problems’?
The work, “highlight[s] the need for more comprehensive quantitative assessments that independently assess the frequency, intensity, and impact of behaviours. Further, findings reported here emphasise the need for ecologically valid measures that assess the contexts in which these behaviours occur and how their presentations can change within and across days.”
It would also be useful to ask the Autistic people, rather than just the parents, I’d say.
Spackman, E., Geng, A., Smillie, L.D. et al. Characterising Insistence on Sameness and Circumscribed Interests: A Qualitative Study of Parent Perspectives. J Autism Dev Disord 55, 2896–2908 (2025). https://doi.org/10.1007/s10803-024-06404-4
The HOPE(S) Programme, to end long-term segregation for Autistic people and people with a learning disability, in inpatient hospitals.
Teams often ask what the alternatives are to the Behaviourism models like Positive Behaviour Support. As we know, there are many hundreds of Autistic people and people with a learning disability who are ‘stuck’ on locked mental health wards, with teams unaware of ways to solve this with them and truly improve quality of life. This is a new, evidence-based approach that is having remarkable results in getting people out of long-term segregation (isolation/seclusion), successfully.
Long Term Segregation (LTS) reduced significantly: 129 people supported since May 2022; 86 (67%) exited LTS, and 40% of these were discharged into the community. Engagement in meaningful activity up 109%, fresh air/exercise up 84%. Restraint down 21%, seclusion down 33%, chemical restraint down 12% monthly. Staff burnout and trauma decreased, while compassion satisfaction increased. The analysis of the cost impact of the HOPE(S) intervention indicated a significant financial saving and Return on Investment (ROI) ratio of over 12:1 for every pound spent.
Fradley, K., Rajan, D. G., & Haines-Delmont, A. (2025). Evaluation of the National HOPE (S) Programme to end long-term segregation (LTS) for children and young people, Autistic adults and/or adults with a learning disability in inpatient hospital settings. https://www.merseycare.nhs.uk/hopes-model
Autism and co-ordination difficulties – known as DCD or Dyspraxia.
Development Co-ordination Disorder (DCD), often known as Dyspraxia, is common in Autism. Another term for these is ‘motor impairments’, though that can also occur with other diagnoses such as Cerebral Palsy. Kottakota and team asked 100 child neurologists what they knew about the overlap between Autism and motor impairments.
We found most child neurologists were not confident that motor impairments were an associated feature of Autism, do not frequently evaluate for motor impairments, lack sufficient tools for motor evaluations with Autistic children, face multiple barriers to providing interventions, and do not receive adequate clinical training regarding this topic. Conclusions: These preliminary findings suggest that substantial gaps in awareness about motor impairments in ASD persist among practicing child neurologists. Though child neurologists are trained to assess motor function, our results highlight a missed opportunity in the setting of ASD. Child neurologists would benefit from greater attention and resources to learn, evaluate, and treat motor impairments as part of holistic patient care for individuals with ASD.
This seems very relevant to anyone assessing someone for alleged ‘behaviour’ difficulties. Is it a choice of behaviour, or is it part of a very real set of difficulties with co-ordinating body and speech, and being able to plan actions ahead of time? Or perhaps exhaustion from having to do that extra planning/moving work all day?
Kottakota H, Hotez E, Wilson RB. Survey of Child Neurologists Highlights a Missed Opportunity for Identifying and Treating Motor Impairments in Autism. Pediatr Neurol. 2025 Jul 3;171:11-20. doi: 10.1016/j.pediatrneurol.2025.06.025. Epub ahead of print. PMID: 40737723. https://pubmed.ncbi.nlm.nih.gov/40737723/
Is there an empathy ‘deficit’ in Autism? Or is it a difference between neurotypes?
There are arguably three main ways to look at empathy:
Cognitive empathy, in which people work out how someone might feel, by thinking about it.
Affective empathy, where they e.g. feel sad because the other person seems sad.
Practical empathy, where they offer help and support, campaigning and action, in response to e.g. suffering.
It is important to work out which of these we are measuring when we say that someone ‘lacks’ empathy, therefore.
Cusson and team looked at over 200 studies of Autistic people and empathy, and consider some of the key work by e.g. Milton and Chown in this field.
The team were interested in which tests the original researchers had used to measure empathy, and what results they believed they had found. The evidence is contradictory, with a lot of the research showing minimal empathy differences between Autistic and non-Autistic people.
…Autistic individuals could seem unempathetic, whereas they might instead be struggling to regulate their empathic arousal… Finally, the empathy difficulties noted in Autism were observed using empathy measures generally developed by and for (neuro)typical individuals….(neuro)typical individuals indeed have more difficulties understanding the mental and emotional states of Autistic individuals than of typical individuals… Autistic individuals indeed empathise more…when reading sentences describing Autistic characters whereas typical individuals empathise more and have greater brain activation in empathy-related regions when reading sentences describing non-Autistic characters … Thus, these results raise the possibility that a mismatch in neurotype between two individuals may negatively impact empathy.
Cusson, N. M., Meilleur, A. J., Bernhardt, B. C., Soulières, I., & Mottron, L. (2025). A systematic review and meta-analysis of empathy in autism: The influence of measures. Clinical Psychology Review, 102623. https://www.sciencedirect.com/science/article/pii/S027273582500090X
Measuring Autistic burnout
Bougoure and team take a look at the checklist for Autistic burnout. This could be a very useful addition to the standard ‘toolkits’ for teams.
Autistic people have described Autistic burnout as an intense experience of physical, emotional, mental and social exhaustion impacting their ability to complete everyday tasks and contributing to poorer well-being. To identify and measure Autistic burnout in practice and research, we need a self-report measure that gives accurate and consistent results. In this study, 379 Autistic adults completed a recently developed measure of Autistic burnout online, the AASPIRE Autistic Burnout Measure. We analysed their ratings to determine whether the measure is reliable (i.e. ratings are consistent), valid (i.e. the tool measures what it says it measures), correctly identifies those currently experiencing burnout, and is associated with other relevant experiences, such as camouflaging, anxiety and depression. The Autistic Burnout Measure was found to be reliable and valid. Autistic adults reporting greater Autistic burnout also reported more camouflaging, Autistic traits and greater general burnout, depression, and anxiety. The Autistic Burnout Measure was accurate in identifying individuals who reported currently experiencing Autistic burnout and those who did not. Overall, our findings suggest that the Autistic Burnout Measure may be suitable for use in research and practice to identify and better understand experiences of autistic burnout.
Bougoure, M., Zhuang, S., Brett, J. D., Maybery, M. T., English, M. C., Tan, D. W., & Magiati, I. (2025). Measuring autistic burnout: A psychometric validation of the AASPIRE Autistic Burnout Measure in Autistic adults. Autism, 0(0). https://doi.org/10.1177/13623613251355255
Photography as an enjoyable therapy for Autistic young people
It’s lovely to see research asking Autistic young people to enjoy themselves with photography, and exploring what they found useful from it, in terms of wellbeing.
Past research has mostly focused on the challenges and negative mental health experiences of Autistic young people, leading to a lack of strategies aimed at increasing positive emotions and experiences. To address this gap in the literature, we developed a therapeutic photography intervention that aimed to increase positive aspects of well-being for Autistic youth. With the help of two Autistic advisors, we recruited 41 Autistic people, between the ages of 16 and 25 years, and asked them to take photos of positive experiences and write short reflections about their photos, for the duration of 4 weeks. We then asked participants about the benefits and challenges of the intervention. We also asked participants about any challenges they had in engaging with therapeutic photography and any changes and additional supports they would recommend for the intervention. Our results showed that Autistic young people found the intervention to be interesting, doable, acceptable, and practical. We also found some evidence for the potential benefits of the intervention for the wellbeing of Autistic youth. Participants had different ideas for adapting the design of the intervention to better meet the needs of Autistic youth in the future.
Charalampopoulou M, Ibrahim A, Prime H, Eddy N, Panetta L, Brown H, Desai S, Gray K, Lai MC, Langton P, Lunsky Y, McMorris C, Ritvo P, Tilleczek K, Tint A, Weiss JA. "It fostered a greater appreciation for my little corner of the world": A feasibility study of a therapeutic photography intervention for the well-being of Autistic youth. Autism. 2025 Aug 5:13623613251359196. doi: 10.1177/13623613251359196. Epub ahead of print. PMID: 40762099. https://journals.sagepub.com/doi/full/10.1177/13623613251359196
Are Autistic people taught to be pleasant to people who are violent/abusive to them?
Cooke and team look at interpersonal violence experiences of Autistic people. Important work for anyone involved in Autistic lives, and in particular for identifying and responding well to trauma and considering how to safeguard people against repeated acts of violence and abuse. It is of great concern that some teams are noting the compliance-based expectations, namely being expected to show no distress or anger, despite experiencing appalling events.
Findings provide strong evidence of lifelong negative outcomes associated with interpersonal violence experienced by Autistic people, providing evidence for the relevance of minority stress and intersectionality theories in understanding risk. Indeed, our results raise concerns that Autistic people, and particularly ..female [or] gender diverse individuals, [are] being conditioned to respond with social desirability, superficial adaptivity, and dissociation.
Cooke, K., Ridgway, K., Pecora, L., Westrupp, E., Hedley, D., Hooley, M., & Stokes, M. A. (2025). Outcomes of Experiencing Interpersonal Violence in Autism: A Mixed Methods Systematic Review and Meta-Analysis. Trauma, Violence, & Abuse, 0(0). https://doi.org/10.1177/15248380251357618
ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials
Zhang and team consider whether ADHD drug treatment has any useful outcomes for people. In a word, yes, potentially so. Whilst a personal choice, the research shows that:
…drug treatment for ADHD was significantly associated with reduced rates of all five outcomes.
These were suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality.
Another very useful paper for those reflecting on the purpose of diagnoses and whether to offer drug treatments.
Zhang, L., Zhu, N., Sjölander, A., Nourredine, M., Li, L., Garcia-Argibay, M., ... & Chang, Z. (2025). ADHD drug treatment and risk of suicidal behaviours, substance misuse, accidental injuries, transport accidents, and criminality: emulation of target trials. bmj, 390. https://www.bmj.com/content/390/bmj-2024-083658.abstract
What do dyslexia communities want researched?
It’s good to see this work by Manning and team. Dyslexia is a common Neurodivergence, affecting perhaps one in every ten people.
The British Dyslexia Association gives useful background information on the range of challenges and strengths.
Most funding for UK dyslexia research has been awarded to projects studying biology, brain and cognition.
Dyslexia community members felt that more research funding should go to other research areas, including those with clear practical relevance.
A survey revealed the community's top priorities were teacher training, educational supports, mental health and self-esteem, improving inclusion and cognition.
Community members perceived the study of genes and risk factors to be less important than other research areas.
Researchers and funders should align their own priorities with those of the dyslexia community to ensure research can benefit stakeholders.
Manning, C., Jennings, B., MacLennan, K., Rayat, R., Spiller, K., & Joseph, H. (2025). What are the research priorities for the dyslexia community in the United Kingdom and how do they align with previous research funding?. Dyslexia, 31(2), e70004. https://onlinelibrary.wiley.com/doi/full/10.1002/dys.70004
Does obesity in pregnancy ‘cause’ Autism? How to assess unusual claims made by some research teams.
Reading the news, there’s a steady stream of articles claiming that a research team has found the ‘cause’ of Autism, and therefore suggesting that we are on our way to a cure/treatment. This is deeply problematic for two main reasons:
Firstly, it buys into the idea that Autism is automatically a terrible thing that must be avoided. Most Autistic people enjoy their life, when society enables them to do so, and do not want a cure. Take a look at Autistic not weird’s website for the results of a huge survey of all kinds of Autistic people.Secondly, such papers are often based on research on mice, or Zebra fish, or rats, not people. Since Autism is a uniquely human thing, connected with e.g. how we relate to other people, clearly a mouse or fish cannot be ‘Autistic’ in human terms.
Let’s have a look at an example of a team that is arguably misquoted in the press. The research team did the right thing in saying that their research on mice has a lot of limitations. Limitations can be found by searching any research paper for the word ‘limitations’ and having a read. In this instance, the limitations stated “…relatively small sample set… analyses were restricted to male offspring due to the absence of observable Autism-like traits in female mice…In addition, our study focuses on a relatively short postnatal follow-up period… It remains unknown whether the observed behavioural and molecular phenotypes persist into adulthood or resolve over time.”
So, in this scenario within a small group of mice, only some male mice showed some ‘Autistic’ behaviours, and the team have no idea if it was a temporary behaviour change, or a longer term thing. This isn’t proof that being overweight in pregnancy equates to an Autistic human child, therefore. Yet, in the press, the headline is, “Pre-Pregnancy Obesity Linked to Autism Risk”. There’s even a picture on one article, showing a pregnant individual and a brain, to make the unproven link seem more real. It may lead people to panic about their weight for no good reason and is also inherently fatphobic. Such headlines may do real harm during pregnancy, and to the Autistic population who have to live in a world where we are seen as 'risk’' rather than loved fellow human beings bringing a lot to society.
Do check carefully before believing medical-based press articles which claim to summarise research findings.
Allan, N. P., Torres, A., Corley, M. J., Yamamoto, B. Y., Balaan, C., Yamauchi, Y., ... & Maunakea, A. K. (2025). Pre-Conception Maternal Obesity Confers Autism Spectrum Disorder-like Behaviors in Mice Offspring Through Neuroepigenetic Dysregulation. Cells, 14(15), 1201. https://www.mdpi.com/2073-4409/14/15/1201
Healthcare experiences of middle and older age Autistic women
More useful research by Gillions, O’Nions and team, looking at what happens for Autistic women when they reach middle age and beyond.
Four main themes came out of the analysis.
1. Participants expressed concerns that stigma and stereotypes associated with Autism led to poor healthcare experiences.
2. Participants’ confidence in seeking help was affected by having many negative experiences across their lives. Difficult interactions with healthcare providers also made them less confident in seeking help.
3. Navigating the healthcare system was a challenge for participants.
4. Participants thought a lot about the future. They had worries about ageing and what consequences this might have on their health and support needs. They also shared hopes for better healthcare in the future.Gillions, A., O’Nions, E., Mansour, H., Hoare, S., Mandy, W., & Stott, J. (2025). The healthcare experiences of middle and older age autistic women in the United Kingdom. Autism, 0(0). https://doi.org/10.1177/13623613251362265
Applied Behaviour Analysis (ABA)-based interventions: Perspectives of Autistic adults and parents
A very useful new study, examining what happened to people who experience ABA-based interventions.
Experiences included:
Forced to perform tasks or do uncomfortable things (e.g., making eye contact)
Forced/involuntary time-out or isolation
Exposure to unpleasant stimuli such as annoying sounds or lights
Taking away freedom
Holding or touching involuntarily
Yelling or saying mean things to the Autistic individual
Taking away needed objects
Restraint (limiting freedom of movement)
Physical punishments including hitting the individual.
There is also a comparison of the answers from Autistic people experiencing these interventions, and the answers from parents/carers. Two examples for contemplation:
"...the (ABA) intervention had a negative effect on my daily functioning"
25.9% of Autistic people said yes. Only 12.8% of the parents said yes."...the intervention had a positive effect on my daily functioning"
22.2% of the Autistic people said yes. 59.0% of the parents said yes.
Lots to reflect on, when we say that ABA and its related interventions ‘work’. Do they? Who says?
Jonkman, K.M., den Hartog, C., Sloot, B. et al. Experiences of Autistic Individuals, Caregivers and Healthcare Providers with ABA-Derived Therapies: a Sequential Exploratory Mixed Methods Study. J Autism Dev Disord (2025). https://doi.org/10.1007/s10803-025-06958-x
