Known influences on tic severity include medical, biological and contextual factors.

We aimed to further understanding of contextual factors by exploring if tic severity is influenced by calendar month.

This study used data from the Calgary Child Tic Registry. Children are extensively clinically phenotyped at their first visit and followed prospectively until adulthood. We evaluated the mean Yale Global Tic Severity Scale-Revised (YGTSS-R) total tic severity score based on the calendar month. Multivariable linear regression models were fit to assess the individual months adjusted for age, gender, comorbidity and tic treatment variables.

The study included 370 participants, with 549 assessments of tic severity performed. In the univariable analysis based on calendar month, August had the lowest tic severity, with a mean YGTSS-R total tic severity score of 15.68 (95% CI 13.41–17.95). This was significantly lower than the month with the highest tic severity, February, with a mean score of 20.41 (95% CI 18.19–22.63). In multivariable models adjusted for age, gender, comorbidity and treatment for tics, the omnibus test for whether month contributes to a better fit were not significant (YGTSS-R total tic score P-value: 0.495). The only significant predictors of increased tic severity were treatment for tics (P < 0.0001), diagnosis of depression (P = 0.003) and diagnosis of obsessive–compulsive disorder (P = 0.02).

While our univariate analysis of tic severity by calendar month supported significantly lower tic severity in August compared with February, this association was no longer statistically significant when controlling for other variables known to impact tic severity.

Parental prenatal mood and anxiety disorders (PMADs) are linked to child neurodevelopmental disorders (NDDs), but evaluations of the magnitude and mechanisms of this association are limited. This study estimates the strength of the association and whether it is impacted by genetic and environmental factors.

A systematic search of PubMed, CENTRAL, PsycINFO, OVID, and Google Scholar was performed for articles published from January 1988 to September 2025. Of 2,420 articles screened, 74 met the inclusion criteria. Meta-analyses were conducted on 21 studies, and 53 were included in the narrative synthesis. We conducted random-effects meta-analyses, along with tests for heterogeneity (I2) and publication bias (Egger’s test). The review followed PRISMA and MOOSE guidelines.

Maternal PMADs were associated with a significantly increased risk of attention-deficit/hyperactivity disorder (ADHD; odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45–2.52) and autism spectrum disorder (ASD; OR 1.75, 95% CI 1.43–2.14) in children. Paternal PMADs were also associated with the risk of NDDs, with combined odds for ASD and ADHD (OR = 1.23, 95% CI 1.14–1.33). Several studies suggested that the link between parental PMADs and offspring NDDs might be impacted by both genetic and environmental factors, including the impact of ongoing parental depression on child behavior.

Parental PMADs are associated with increased risk of NDDs in children. These findings likely reflect a combination of inherited liability and environmental processes; clarifying mechanisms will require genetically informed designs. Regardless of mechanism, offering optional, family-centered developmental support may help promote child well-being in families where a parent is experiencing PMADs.

Benzodiazepine receptor agonists (BZRAs), including benzodiazepines and Z-drugs, are frequently prescribed during pregnancy but their long-term neurodevelopmental safety remains uncertain.

To investigate whether prenatal BZRA exposure is associated with an increased long-term risk of neurodevelopmental disorders (LNDDs) in offspring.

This nationwide, population-based cohort study used Korean National Health Insurance Service data on all live births from 2011 to 2014, followed until 2023. Prenatal BZRA exposure was defined as maternal prescriptions during pregnancy. Propensity score matching (1:10) was applied to balance covariates. Sensitivity analyses in the full cohort evaluated exposure intensity (0, 1–6, 7–29 and ≥30 cumulative days), drug class (benzodiazepines versus Z-drugs), trimester of exposure and discordant sibling comparisons with mother fixed effects.

Among 1 553 505 eligible births, 5949 BZRA-exposed and 55 015 matched unexposed children were analysed. LNDD incidence was 13.9% in the exposed group versus 11.4% in the unexposed (odds ratio 1.25, 95% CI: 1.16, 1.35). In the full cohort, risks increased with exposure intensity: 1–6 days (odds ratio 1.16, 95% CI: 1.05–1.28), 7–29 days (odds ratio 1.19, 95% CI: 1.04–1.36) and ≥30 days (odds ratio 1.18, 95% CI: 1.01–1.38). By trimester, risks were higher with second- (odds ratio 1.30, 95% CI: 1.07–1.59) and third-trimester (odds ratio 1.27, 95% CI: 1.09–1.48) exposure. Class-specific analyses showed stronger associations for benzodiazepines only (odds ratio 1.19, 95% CI: 1.15–1.23) than for Z-drugs only (odds ratio 1.06, 95% CI: 1.04–1.08). In a discordant sibling analysis including 2572 children this association persisted (odds ratio 1.29, 95% CI: 1.05–1.60), indicating that neither familial nor genetic confounding fully explains the observed effects.

Prenatal BZRA exposure was associated with increased long-term risks of LNDDs in offspring, with evidence of dose–response and class-specific effects, and persistence in sibling analyses.

Rett Syndrome (RTT) is an X-linked neurodevelopmental disorder, characterized by the gradual loss of motor, verbal and social skills. This study describes the epidemiology and healthcare resource utilization (HCRU) of RTT in Ontario, Canada.

Rett Syndrome (RTT) cases (≥ one ICD-10-CA code F84.2) were identified utilizing the Institute for Clinical Evaluative Sciences (ICES) data. Incident cases were identified between September 2017 and August 2023, while prevalent cases were captured from April 2002 to August 2023. Prevalent cases identified before September 2017 were indexed on that date. Demographic and clinical characteristics were collected and analyzed descriptively. Prevalence and incidence were calculated. Healthcare resource utilization (HCRU) was analyzed as the number of cases with at least one touchpoint and the number of touchpoints.

In total, 246 RTT cases were indexed; 40% from central Ontario, 95% female, median age 21 years. From September 2017 to August 2023, 57 incident cases and 257 prevalent cases were reported in Ontario. Common comorbidities included developmental disability (85.4%), epilepsy (49.6%) and gastrointestinal symptoms (42.3 %). Most patients had at least one outpatient visit (primary care 96.7%, specialist 86.6%), emergency department visit (76.8%) and inpatient hospitalization (54.5%). During the 5-year follow-up period, most cases (95.1%) had at least one public claim for all-cause medication. Disease-specific medication claims included antibiotics (69.1%) and anti-seizure medications (73.6%).

This study provides population-based estimates of RTT in Ontario. Findings highlight the high burden of illness in RTT in terms of comorbidity prevalence and HCRU. Further research may identify opportunities to improve healthcare outcomes in this population.

Adult cohorts with generalised joint hypermobility (GJH) report higher rates of neurodevelopmental problems (NDPs). However, the prevalence of GJH in community-dwelling children and its association with NDPs remains unexplored.

This study aimed to (a) assess the prevalence of GJH, (b) examine its link to musculoskeletal pain and (c) explore associations with NDPs in 11-year-old Swedish children.

An in-school study was conducted as part of the 4th grade health check-up. It included a structured physical examination using the Beighton score (range 0–9) and a comprehensive neurodevelopmental assessment based on behavioural ratings, maternal interviews, medical records and academic performance.

Of 348 eligible children from eight schools, 223 (64%) participated, with Beighton scores measured in 207 (59%). The median Beighton score was 1 (interquartile range 0–2), with no significant gender differences (Wilcoxon test, P = 0.17). A Beighton score of ≥6 approximated the 95th percentile in both sexes. No significant association was found between high Beighton scores and NDPs. Few children with GJH reported weekly pain, indicating a low prevalence of hypermobility spectrum disorders in this age group.

Our findings validate the age-specific Beighton score cut-off and suggest that GJH in children of this age is not linked to NDPs, differing from findings in adults. This may reflect developmental changes during puberty. Additionally, the high prevalence of weekly pain (42%) in the cohort warrants further investigation into its causes and impact.

Constipation is a significant problem for people with intellectual disabilities, with a prevalence of 33–50%, causing at least five deaths annually in England. Individualised bowel care plans (IBCP) are recommended in England and Wales.

We evaluated the feasibility and impact of IBCPs for people with intellectual disabilities who are in in-patient psychiatric units, and the effect on clinical outcomes.

People with intellectual disabilities who were at risk of constipation were recruited from four specialist in-patient psychiatric units in England and Wales. A constipation questionnaire was used to capture relevant data to devise IBCPs. Baseline, 3- and 6-monthly Health of the Nation Scales – Learning Disability (HoNOS-LD) were completed after the intervention. Descriptive statistics, Wilcoxon signed-rank, Mann-Whitney U, repeated-measures analyses of variance, with Bonferroni adjustment and Mauchly’s tests were conducted. Significance was taken at P < 0.05.

Of 24 people with intellectual disabilities recruited from four units, all three data points were available for 18 patients. Constipation rates showed no statistically significant decline. The total HoNOS-LD score (18 items) did not decline. HoNOS-LD item 12 for physical functioning showed significant improvement for PwID with constipation compared with those without, between baseline and 6 months.

This quality improvement project suggests that a bigger study of IBCPs is feasible. Most outcomes examined via the HoNOS-LD, particularly those linked with mental illness, challenging behaviour and quality of life, did not show significant change, possibly because of the small sample size. However, people with intellectual disabilities and constipation showed positive changes in their physical functioning outcomes compared with those without constipation. Further in-depth evaluation of this intervention is needed.

To truly understand the efficacy of attention-deficit hyperactivity disorder (ADHD) psychoeducation, we need to know what is commonly included in it. This scoping review aims to describe the content of psychoeducation interventions for ADHD in published research. A literature search was conducted to identify relevant papers. Descriptions of psychoeducation aimed at children, parents/carers, adults and teachers were identified and compared narratively.

After screening, 57 papers were identified for data extraction and coding. Content themes included ‘information about ADHD’; ‘practical advice’; ‘impact of ADHD’; ‘treatment of ADHD’; ‘co-occurrence’; and ‘self-image/self-esteem’. ‘Information about ADHD’ and ‘practical advice’ were the most common themes, with variance on inclusion of other themes. Most of the identified research involved psychoeducation for parents of children with ADHD.

This review provides greater understanding of the content and delivery of ADHD psychoeducation. Further research could use this understanding to ascertain the efficacy of different content themes in supporting those with ADHD.

To examine the relationship between children’s adaptive functioning and neighborhood resources – such as school quality, access to healthy food, green spaces, and housing quality – using a large, diverse clinical outpatient sample.

Pediatric outpatients (N = 6,942; age M = 10.44 years; 67.0% male; 50.3% White; 33.9% Medicaid), aged 1-18, who underwent neuropsychological or psychological evaluation were included if their caregiver completed the Adaptive Behavior Assessment System, 3rd Edition (ABAS-3) and had a nationally normed Child Opportunity Index (COI) score, a composite measure of 29 geo-coded neighborhood characteristics.

Children from higher-opportunity neighborhoods demonstrated significantly stronger adaptive functioning across conceptual, social, and practical domains. Those in the top 40% of neighborhood advantage exhibited stronger adaptive skills than those in the bottom 60%. Neighborhood resources and family financial resources were associated with greater adaptive skills beyond child age, sex, and racial/ethnic background.

Neighborhood resources are linked to children’s adaptive functioning, possibly due to increased opportunities to practice these skills in safer, more supportive environments. These findings emphasize the importance of considering environmental factors in assessing adaptive skills and highlight the need for public health investments and legislation related to community resources.

Parents of children with autisma demonstrate elevated traumatic stress symptoms, but seldom receive diagnoses of post-traumatic stress disorder (PTSD) or complex PTSD. An accurate assessment of Criterion A is essential for a valid diagnosis of these disorders, yet it is uncertain whether Criterion A, as defined by the two primary international diagnostic systems (DSM-5-TR and ICD-11), yields consistent interrater reliability, when psychologists rely solely on self-report from these parents for assessing PTSD or complex PTSD.

This study aims to investigate interrater reliability across psychologists when assessing Criterion A events against the ICD-11 and DSM-5-TR.

Ten Australian psychologists rated parents’ self-reported traumatic events related to parenting, using the Life Events Checklist for DSM-5-TR and ICD-11 Criterion A. Data from 200 randomly selected parents of children, all meeting symptom thresholds for PTSD or complex PTSD, were analysed. Bootstrapping calculated kappa coefficients, differences between ICD-11 and DSM-5-TR criteria, and self-reports of threat/no threat, with 95% confidence intervals for these differences.

Interrater reliability varied from poor to moderate. The ICD-11 had significantly higher reliability than the DSM-5-TR for Criterion A (κdifference = 0.105, 95% CI 0.052–0.153, P < 0.001). The interrater reliability was lower when parents reported life threat, serious injury or death (κdifference = 0.096, 95% CI 0.019–0.176, P = 0.007).

This study highlights challenges in assessing PTSD and complex PTSD Criterion A in parents of children with autism, using DSM-5-TR and ICD-11 criteria with the Life Events Checklist, revealing less than adequate interrater reliability.

Reliable and specific biomarkers that can distinguish autism spectrum disorders (ASDs) from commonly co-occurring attention-deficit/hyperactivity disorder (ADHD) are lacking, causing misses and delays in diagnosis, and reducing access to interventions and quality of life.

To examine whether an innovative, brief (1-min), videogame method called Computerised Assessment of Motor Imitation (CAMI), can identify ASD-specific imitation differences compared with neurotypical children and children with ADHD.

This cross-sectional study used CAMI alongside standardised parent-report (Social Responsiveness Scale, Second Edition) and observational measures of autism (Autism Diagnostic Observation Schedule-Second Edition; ADOS-2), ADHD (Conners) and motor ability (Physical and Neurological Examination for Soft Signs). The sample comprised 183 children aged 7–13 years, with ADHD (without ASD), with ASD (with and without ADHD) and who were neurotypical.

Regardless of co-occurring ADHD, children with ASD showed poorer CAMI performance than neurotypical children (P < 0.0001; adjusted R2 = 0.28), whereas children with ADHD and neurotypical children showed similar CAMI performance. Receiver operating curve and support vector machine analyses showed that CAMI distinguishes ASD from both neurotypical children (80% true positive rate) and children with ADHD (70% true positive rate), with a high success rate significantly above chance. Among children with ASD, poor CAMI performance was associated with increased autism traits, particularly ADOS-2 measures of social affect and restricted and repetitive behaviours (adjusted R2 = 0.23), but not with ADHD traits or motor ability.

Four levels of analyses confirm that poor imitation measured by the low-cost and scalable CAMI method specifically distinguishes ASD not only from neurotypical development, but also from commonly co-occurring ADHD.

Differences in social behaviours are common in young people with neurodevelopmental conditions (NDCs). Recent research challenges the long-standing hypothesis that difficulties in social cognition explain social behaviour differences.

We examined how difficulties regulating one's behaviour, emotions and thoughts to adapt to environmental demands (i.e. dysregulation), alongside social cognition, explain social behaviours across neurodiverse young people.

We analysed cross-sectional behavioural and cognitive data of 646 6- to 18-year-old typically developing young people and those with NDCs from the Province of Ontario Neurodevelopmental Network. Social behaviours and dysregulation were measured by the caregiver-reported Adaptive Behavior Assessment System Social domain and Child Behavior Checklist Dysregulation Profile, respectively. Social cognition was assessed by the Neuropsychological Assessment Affect-Recognition and Theory-of-Mind, Reading the Mind in the Eyes Test, and Sandbox continuous false-belief task scores. We split the sample into training (n = 324) and test (n = 322) sets. We investigated how social cognition and dysregulation explained social behaviours through principal component regression and hierarchical regression in the training set. We tested social cognition-by-dysregulation interactions, and whether dysregulation mediated the social cognition–social behaviours association. We assessed model fits in the test set.

Two social cognition components adequately explained social behaviours (13.88%). Lower dysregulation further explained better social behaviours (β = −0.163, 95% CI −0.191 to −0.134). Social cognition-by-dysregulation interaction was non-significant (β = −0.001, 95% CI −0.023 to 0.021). Dysregulation partially mediated the social cognition–social behaviours association (total effect: 0.544, 95% CI 0.370–0.695). Findings were replicated in the test set.

Self-regulation, beyond social cognition, substantially explains social behaviours across neurodiverse young people.

Nearly 3% of adults have attention-deficit and hyperactivity disorder (ADHD), although in the UK, most are undiagnosed. Adults with ADHD on average experience poorer educational and employment outcomes, worse physical and mental health and are more likely to die prematurely. No studies have yet used mortality data to examine the life expectancy deficit experienced by adults with diagnosed ADHD in the UK or worldwide.

This study used the life-table method to calculate the life-expectancy deficit for people with diagnosed ADHD using data from UK primary care.

A matched cohort study using prospectively collected primary care data (792 general practices, 9 561 450 people contributing eligible person-time from 2000–2019). We identified 30 039 people aged 18+ with diagnosed ADHD, plus a comparison group of 300 390 participants matched (1:10) by age, sex and primary care practice. We used Poisson regression to estimate age-specific mortality rates, and life tables to estimate life expectancy for people aged 18+ with diagnosed ADHD.

Around 0.32% of adults in the cohort had an ADHD diagnosis, ~1 in 9 of all adults with ADHD. Diagnoses of common physical and mental health conditions were more common in adults with diagnosed ADHD than the comparison group. The apparent reduction in life expectancy for adults with diagnosed ADHD relative to the general population was 6.78 years (95% CI: 4.50 to 9.11) for males, and 8.64 years (95% CI: 6.55 to 10.91) for females.

Adults with diagnosed ADHD are living shorter lives than they should. We believe that this is likely caused by modifiable risk factors and unmet support and treatment needs in terms of both ADHD and co-occurring mental and physical health conditions. This study included data from adults with diagnosed ADHD; the results may not generalise to the entire population of adults with ADHD, the vast majority of whom are undiagnosed.