Exploring the association between physical activity and life satisfaction among college students.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interactions, repetitive and stereotyped behaviors []. In recent years, the prevalence of ASD has been rapidly increasing worldwide. Data published by the Centers for Disease Control and Prevention (CDC) in 2021 indicates that the prevalence of ASD in children is higher than 2.27%, meaning that one in every 44 children is diagnosed with ASD []. This reflects a growing impact on the health and social functioning of an increasing number of children, imposing significant economic burdens on their families and the society [, ]. Despite a steady improvement in public awareness of ASD [, ], misconceptions persist, such as the belief that individuals with ASD often possess exceptional abilities or talents. In reality, a substantial proportion of individuals with ASD also suffer from intellectual disabilities (ID), at a rate significantly higher than that of the general population. Recent epidemiological studies suggest that approximately 56% of individuals with ASD have an IQ below 70, with 31% of children with ASD classified as having ID, 25% in the borderline range (IQ 71–85), and 44% scoring in the average to above-average range (i.e., IQ > 85) []. ASD is a disorder with high heterogeneity, and differences in IQ are one of the sources of the heterogeneity. IQ is associated with the ability to acquire and apply specific skills for dealing with everyday situations, organizing, planning, and acting, and adapting flexibly to changing environments [, ]. Thus, Children with autism require tiered management and intervention tailored to their IQ levels []. Children with ASD who have an average level of intelligence are more likely to attend integrated schools where they can be exposed to general peers from whom they can learn complex social interactions [–]. In fact, children who “lose” their diagnosis (i.e., the severity of their symptoms reduces to the point that they no longer meet the criteria for an autism diagnosis) tend to have an average level of intelligence and to have been placed in inclusive educational settings [–], and received more intensive behavioral treatment between the ages of 2 and 3 years old []. In contrast, ASD children with ID may have more comorbidities, such as epilepsy or self-injury and other behavioral problems [, ], which exacerbate core symptoms and lead to greater difficulties in social adjustment, as well as greater healthcare costs []. Meanwhile, there is a dose-response relationship between the duration of weekly intervention (dose) and IQ (response), indicating that children with ASD and comorbid ID may benefit from intensive intervention to improve their IQ level []. Therefore, early identification of children with ASD and prediction of their intellectual levels can help optimize intervention plans and promote the implementation of personalized, precise interventions. Numerous clinical studies have confirmed that early, comprehensive, and intensive intervention can yield significant and long-term benefits for children with ASD []. However, to date, ASD is considered the result of a combination of genetic and environmental factors, with a high degree of heterogeneity and an unclear pathogenesis, lacking accurate biomarkers []. Therefore, clinical practice relies heavily on the child’s behavioral symptoms and information provided by caregivers for diagnosis. This dependence on the experience of a team of specialists and the time spent observing the child necessitates the use of standardized neuropsychological diagnostic tools, such as the Autism Diagnostic Observation Schedule (ADOS), which is regarded as the “gold standard” for ASD diagnosis, and the Autism Diagnostic Interview-Revised (ADI-R), which is the most commonly used diagnostic tool for ASD. Additionally, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ID is characterized by a deficiency in intellectual and adaptive functions across conceptual, social, and practical domains, which manifests during the developmental period. Intellectual dysfunction, as confirmed through clinical evaluation and individualized, standardized intelligence assessments, is one of the diagnostic criteria for ID, and the Wechsler Intelligence Scale for Children (WISC) is the most commonly used standardized tool for assessing IQ [], also applicable to children with ASD. However, most clinicians will not diagnose ID in preschool-aged children, it is typically referred to as developmental delay until at least school age. Meanwhile, the intellectual assessment results of ASD children in early childhood are not stable []. Therefore, there is a need for a simple and effective diagnostic method to aid in the early identification of preschool children with ASD who may have comorbid ID.