Pragmatic language disorders as predictors of psychopathological trajectories in childhood and adolescence: a systematic review.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by symptoms that appear in early development. It involves persistent deficits in social communication and interaction, along with restricted, repetitive patterns of behavior, interests, or activities (American Psychiatric Association, ). In addition, ASD may be associated with a range of comorbidities, including psychiatric and medical conditions (Micai et al., ) such as anxiety, ADHD, and depressive disorder (Lai et al., ), dermatitis (Tsai et al., ), food allergy (Li et al., ), diabetes (Cortese et al., ) and cardiometabolic diseases (Dhanasekara et al., ). Understanding the differential risk of these comorbidities is clinically important, as early recognition supports more timely assessment and management (Cortese et al., ; Micai et al., ). One area of growing concern is the relationship between ASD and abnormal body weight. Both elevated and low body weight can have substantial effects on health and quality of life across the lifespan, and their prevention and management are key public health aims (Kolotkin & Andersen, ; Lorem et al., ). Individuals with ASD may be particularly vulnerable to the consequences of abnormal body weight because these difficulties interact with core features and common comorbidities of the condition (Dhaliwal et al., ; Kahathuduwa et al., , ). Excess weight can exacerbate cardiometabolic problems, reduce mobility, and worsen sleep disturbances (Figorilli et al., ), issues that are already more prevalent in autistic populations (Sammels et al., ) and can further impair daily functioning and participation. Obesity may also exacerbate gastrointestinal symptoms and fatigue, contributing to increased sedentary behavior and challenging behavioral patterns (Bora et al., ; Eslick, ). Conversely, low body weight may lead to nutrient deficiencies, weakened immunity, and reduced bone and muscle development (Allen & Saunders, ). In children and adolescents, underweight can also negatively affect growth, energy levels, and cognitive development (Roberts et al., ), potentially amplifying existing developmental vulnerabilities associated with ASD. Together, these consequences highlight the clinical relevance of monitoring and addressing both overweight and underweight in individuals with ASD across the lifespan.