Background: Autism Spectrum Disorder (ASD) is characterized by social communication deficits, restricted/repetitive behaviors, sensory processing atypicalities, and impaired adaptive functioning. Neuropsychomotor Therapy of Early Development (TNPEE) integrates motor, cognitive, and socio-emotional domains, promoting functional skills, while Therapy in Aquatic Motor Activities (TAMA) targets motor and sensory engagement. This multicenter, 18-month study compared TNPEE, TAMA, and their combination, hypothesizing that TNPEE would drive core symptom and adaptive improvements, with TAMA providing complementary benefits. Methods: Seventy-seven children with Autism Spectrum Disorder (31.6% females) were recruited from four Italian centers (Palermo, Perugia, Sarno, Messina) and allocated to three groups: TAMA only, TNPEE combined with TAMA, and TNPEE only. Assessments included the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the Childhood Autism Rating Scale, Second Edition (CARS-2), Vineland Adaptive Behavior Scales, Sensory Processing Measure and HAARS at baseline, 6, 12, and 18 months. Results: By 18 months, children receiving TNPEE, alone or combined with TAMA, exhibited significant reductions in autism severity, significant improvements in adaptive functioning, and enhanced sensory processing. In contrast, the TAMA-only group demonstrated improvements in aquatic competence (HAARS) but no statistically significant changes in ASD severity or adaptive functioning. Conclusions: TNPEE was the intervention most consistently associated with improvements in ASD severity, adaptive functioning, and sensory processing, whereas TAMA alone showed a more limited impact on broader developmental outcomes.

Background: Autism Spectrum Disorder (ASD) can be conceptualized not as a static condition but as a dynamic disorder of developmental regulation, in which neuroplastic potential is translated into functional gains only through structured, experience-dependent therapeutic input. Neuropsychomotor Therapy of Early Development (TNPEE) and Therapy in Aquatic Motor Activities (TAMA) have shown differential efficacy in children with ASD, but whether chronological age moderates the magnitude of therapeutic response—or whether the characteristics of the intervention itself are the stronger determinant of outcome—has not been systematically examined. Methods: This was a non-randomized, exploratory secondary stratified analysis of a multicenter 18-month longitudinal cohort (N = 77 children with ASD, age 4–12 years) allocated to three groups: TAMA only, TNPEE combined with TAMA (TAMA+TNPEE), or TNPEE only. Participants were stratified into a younger (≤6 years, n = 16; TAMA n = 8, TAMA+TNPEE n = 3, TNPEE n = 5) and an older (>6 years, n = 61; TAMA n = 18, TAMA+TNPEE n = 22, TNPEE n = 21) subgroup. Adaptive functioning was assessed with the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) at baseline and 18 months. Between-stratum comparisons used the Mann–Whitney U test; Spearman rank correlations and ANCOVA models with Age × Treatment interaction terms were used to test age moderation within a neuroplasticity-recruitment framework. Results: In the TAMA-only group, younger children showed significantly smaller adaptive gains than older children across the Composite (2.22 ± 1.14 vs. 3.53 ± 0.76, p = 0.012), Communication (p = 0.041), and Socialization (p = 0.016) subscales, with significant positive Spearman correlations between age and adaptive gains (r = 0.397–0.437). Simple slope analysis confirmed a significant age effect within the TAMA group (b = 0.231, SE = 0.083, p = 0.010) but not in the TNPEE (b = 0.133, p = 0.157) or TAMA+TNPEE (b = 0.135, p = 0.198) groups. The formal Age × Treatment interaction term in the ANCOVA did not reach statistical significance (all p > 0.18). As this interaction test is the formal statistical test of differential age moderation, the simple-slope pattern above should be regarded as exploratory rather than confirmatory. Treatment group accounted for the large majority of variance in adaptive gains (partial η² = 0.78–0.95), whereas age explained only a small proportion of outcome variability. ASD severity level transitions were comparable across age strata in TNPEE-based groups. Conclusions: In this exploratory secondary analysis, TNPEE-based interventions were associated with adaptive gains that did not differ significantly by age across the 4–12 year age range, whereas aquatic therapy alone showed an age-dependent pattern favoring older children. These findings are hypothesis-generating and consistent with a neuroplasticity-recruitment model in which therapeutic architecture—rather than chronological age alone— may be associated with how effectively latent plastic potential is translated into developmental gains, although the non-significant Age × Treatment interaction and the small, imbalanced subgroups (including n = 3 in the youngest TAMA+TNPEE stratum) mean these findings require confirmation in adequately powered, prospectively designed studies, with implications for clinical decision-making regarding therapy timing and design.

Introduction: Fear-themed digital media exposure is increasingly common in school-aged children, yet its developmental implications remain insufficiently understood. Rather than conceptualizing frightening content as inherently pathogenic, emotionally intense media may act as a mild arousal stimulus within a neurodevelopmental system characterized by heightened limbic reactivity and still-maturing regulatory control. The present study examined whether fear-themed exposure is associated with dimensional variability in sleep regulatory sensitivity, consistent with a tentative developmental PhenoSleep construct. Methods: This cross-sectional study included 132 children aged 5–11 years (mean age = 8.69 years, SD = 2.01), divided into an exposed group ( n = 66) and a non-exposed control group (n = 66). Engagement with fear-themed content (Huggy Wuggy) was assessed using an ad hoc exposure questionnaire (TOT_HW). Emotional-behavioral functioning was measured with the Child Behavior Checklist (CBCL), and sleep regulation with the Sleep Disturbance Scale for Children (SDSC). Independent-sample t -tests and Pearson's correlations were performed. Results: Compared to controls, exposed children showed higher CBCL Total Problems and SDSC Total Scores. Domain-specific differences were modest and not uniformly distributed across subscales. Within the exposed group, engagement intensity showed small positive associations with selected social, cognitive, and sleep-related measures, consistent with dimensional variability rather than overt dysfunction. Conclusion: The findings do not support a deterministic psychopathological effect of fear-themed digital exposure. Instead, they are compatible with the interpretation that emotionally salient media may function as a mild environmental probe revealing interindividual differences in sleep regulatory sensitivity. We tentatively introduce the PhenoSleep construct to describe developmental variability in sleep continuity and arousal modulation in response to emotionally intense stimuli. Longitudinal and physiologically informed studies are required to further examine and refine this developmental regulatory model.

Background and Objectives: Toe walking (TW) is frequently observed in children with Autism Spectrum Disorder (ASD), yet its clinical significance remains incompletely understood. While previous studies have linked TW to ASD severity and multisystem involvement, its relationship with the behavioral phenotype of repetitive behaviors has not been systematically explored. Materials and Methods: This study analyzed a cohort of 289 children with ASD who underwent comprehensive clinical assessment, including motor evaluation, sleep assessment using the Sleep Disturbance Scale for Children (SDSC), feeding behavior using the Brief Autism Mealtime Behavior Inventory (BAMBI), and detailed behavioral characterization through the Repetitive Behavior Scale-Revised (RBS-R) at the item level. Statistical analyses included non-parametric group comparisons, Spearman correlation analyses, and multivariable regression models. Results: TW was observed in 27.3% of participants. Children with TW showed significantly higher scores in stereotyped behaviors (7.71 ± 2.09 vs. 4.26 ± 2.06, r = 0.756, p_FDR < 0.001), ritualistic/sameness behaviors (11.78 ± 3.21 vs. 7.05 ± 3.03, r = 0.709, p_FDR < 0.001), and total RBS-R scores (25.52 ± 4.51 vs. 15.88 ± 4.64, r = 0.867, p_FDR < 0.001). Correlation analyses revealed a strong association between TW and stereotyped behaviors (ρ = 0.588, p < 0.001) and a moderate association with ritualistic/sameness behaviors (ρ = 0.549, p < 0.001). RBS-R total scores were also correlated with sleep disturbances (ρ = 0.532, p < 0.001). In the multivariate linear model, TW was associated with an adjusted mean increase of 7.77 points in the RBS-R Total Score (B = 7.771, 95% CI 6.603–8.939, p < 0.001, β = 0.551). In the multivariate logistic model, the combined Ritualistic/Sameness behavior domain independently predicted the presence of TW (OR = 1.549, 95% CI 1.366–1.757, p < 0.001). Conclusions: In children with ASD, TW was associated with specific domains of repetitive behavior, particularly stereotyped and ritualistic/sameness patterns. These cross-sectional findings suggest a phenotypic association between motor and behavioral features, without establishing specificity, causality, or a shared underlying mechanism. This multidimensional perspective may support future studies investigating the clinical and biological correlates of TW in ASD.

Purpose of Review: Suicidal ideation and behavior during the postpartum period are increasingly recognized as important contributors to maternal morbidity and mortality, particularly in high-income countries. Although postpartum depression is a well-established risk factor, emerging evidence suggests that suicidality may also occur independently and therefore remain underrecognized in clinical practice. This systematic review aimed to synthesize current evidence regarding the prevalence of suicidal ideation and behavior in the postpartum period and to identify associated risk factors. Recent Findings: A systematic search of PubMed, Web of Science, EMBASE, and PsycINFO was conducted up to March 2025 following PRISMA guidelines. Twenty studies met inclusion criteria, encompassing 352,726 postpartum women across diverse international settings. Reported prevalence of suicidal ideation ranged from 2.2% to over 50%, depending on the population studied and assessment methods used. The most frequently identified risk factors included postpartum depression, anxiety, trauma history, intimate partner violence, unplanned pregnancy, low socioeconomic status, low social support, and adverse childhood experiences. Notably, several studies reported suicidal ideation even in the absence of clinical depression. Only a limited number of studies addressed preventive interventions. Summary: Postpartum suicidality appears to be a multifactorial phenomenon that cannot be explained solely by depressive symptomatology. The findings highlight the need for broader screening strategies that incorporate psychosocial and trauma-related factors in addition to depression. Integrated and trauma-informed approaches to screening and prevention may improve early identification of at-risk individuals. Future research should prioritize longitudinal designs and culturally sensitive investigations to better inform prevention and intervention strategies.