1. Prenatal exposure to paracetamol and the risk of autism and attention-deficit/hyperactivity disorder: An umbrella review and meta-meta-analysis. Dev Med Child Neurol. 2026.

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2. Alon R, Harel-Gadassi A. Mental Well-Being Among Emerging Adults With and Without SLD/ADHD During War. Eur J Investig Health Psychol Educ. 2026; 16(10).

Emerging adulthood is marked by increasing independence and responsibility across educational, occupational, and social domains. During wartime, disruptions to daily routines, security, and perceived control may threaten mental well-being, understood as positive emotional, social, and psychological functioning. These challenges may be particularly salient for individuals with specific learning disabilities (SLD) and/or attention deficit hyperactivity disorder (ADHD), who may experience difficulties in executive functioning and maintaining everyday routines. This study examined differences in mental well-being between emerging adults with and without SLD and/or ADHD and assessed the contributions of executive functioning, health-promoting daily activities, psychological capital, and perceived social support during wartime. Participants were 317 Israeli emerging adults aged 18-28 years. Among the 316 participants with valid diagnostic-group classification, 115 reported SLD and/or ADHD and 201 reported neither condition. Emerging adults with SLD and/or ADHD reported lower mental well-being, greater executive functioning difficulties, and lower engagement in health-promoting daily activities than those without SLD and/or ADHD. Mental well-being was positively associated with psychological capital, health-promoting daily activities, and perceived social support, and negatively associated with executive functioning difficulties. In the hierarchical regression, diagnostic-group status was initially associated with mental well-being but was no longer significant after psychological capital, health-promoting daily activities and executive functioning were entered; perceived social support made a small additional contribution. The final model explained 37.2% of the variance in mental well-being. These findings highlight the relevance of cognitive-functional, psychological, occupational, and social factors to mental well-being during a prolonged national crisis.

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3. Hendry A, Begum Ali J, Johnson MH, Jones EJH, Charman T. Associations between Simple and Complex Executive Function skills and adaptive function in a sample of 3-year-olds enriched for variation in autism and ADHD traits. J Child Psychol Psychiatry. 2026.

BACKGROUND: Adaptive Functioning-including communication, socialization, and daily living skills-predicts outcomes and quality of life for individuals who are autistic or have ADHD, yet its cognitive underpinnings in early development remain poorly understood. Executive Functions (EFs) are a plausible mechanism linking developmental level or IQ to Adaptive Functioning, but prior work in preschoolers has relied largely on parent-reported EF measures, which are vulnerable to shared method variance with parent-reported Adaptive Functioning. Here, we examine associations between performance-based EF and parent-reported Adaptive Functioning among 3-year-olds enriched for variation in autism and ADHD traits. METHODS: One hundred and twenty-nine children (109 with a family history of autism and/or ADHD) completed six EF tasks, reduced through factor analysis to scores for Simple EF (pertaining to simple response inhibition, holding information in mind, and applying a rule) and Complex EF (involving complex response inhibition, shifting response in accordance with a new task set, and updating information). Adaptive Functioning was assessed using the Vineland Adaptive Behavior Scales-Second Edition. Autism traits, ADHD traits and developmental level were measured using the SRS-2, CBCL-Preschool, and MSEL, respectively. Hierarchical regression models tested whether each EF index was positively associated with Adaptive Functioning, and whether these effects remained after controlling for developmental level, autism traits, and ADHD traits. RESULTS: Both Simple and Complex EF were positively associated with Adaptive Functioning (β = .293, .316). While associations between Simple EF and Adaptive Functioning were accounted for by general developmental level, Complex EF showed associations with Adaptive Functioning above and beyond developmental level, autism, and ADHD traits. CONCLUSIONS: EFs in general, and Complex EF in particular, represent a promising, developmentally-sensitive target for early support in the toddler or preschool years, which could positively impact the day-to-day functioning of children with a family history of autism/ADHD, or already showing elevated autism traits.

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4. Hong H, Yu Z, Li H, Wang Y, Liu L, Qian Q. Heterogeneous decision-making in ADHD: computational subtypes and their distinct prefrontal connectivity patterns. Eur Child Adolesc Psychiatry. 2026.

Children with ADHD exhibit decision-making deficits characterized by lower efficiency in evidence accumulation and a preference for smaller, sooner rewards in intertemporal choices. This study aimed to preliminarily explore computational subtypes of ADHD in children and to investigate differences in prefrontal functional connectivity between ADHD subtypes. A total of 94 children with ADHD and 63 typically developing children matched for sex, age, and IQ were included. All participants completed the Two Choice Impulsivity Paradigm (TCIP) and the ADHD Symptom Rating Scale, and 43 children with ADHD underwent resting-state fMRI. A hierarchical drift diffusion model was applied to analyze TCIP task performance, followed by two-step cluster analysis to identify decision-making subtypes. Differences in prefrontal functional connectivity among ADHD decision-making subtypes were then compared. The ADHD group showed fewer square selections in the TCIP (p < 0.001), lower drift rates (pBayes < 0.001), and shorter non-decision times (pBayes = 0.002). Two decision-making subtypes were identified: a decision-making deficit subtype and a decision-making normal subtype, characterized by lower and higher drift rates, respectively. The ADHD decision-making deficit subtype exhibited stronger functional connectivity between the left medial superior frontal gyrus and both the right middle frontal gyrus and the right postcentral gyrus, as well as between the right medial superior frontal gyrus and the right postcentral gyrus (all p < 0.05). The results reveal decision-making deficits and internal heterogeneity in children with ADHD during intertemporal choice, with this heterogeneity possibly associated with abnormal functional connectivity between the medial superior frontal gyrus and the middle frontal gyrus/postcentral gyrus.

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5. Johnson B, Parker S, Hall W, Leung J, Chan G. General practitioner management of adult ADHD: Challenges and implications. Australas Psychiatry. 2026: 10398562261502219.

Queensland has recently allowed general practitioners (GPs) to diagnose and manage adult attention deficit hyperactivity disorder (ADHD), aiming to relieve pressure on specialist services. However, adult ADHD assessment is complex and requires multi-session evaluation, collateral information and differential diagnosis. Most GPs report limited time and training, and Medicare rebates favour brief over comprehensive consultations, making it difficult to deliver this level of care. As a result, the reforms may work paradoxically, increasing misdiagnosis risk and placing further strain on services. This viewpoint outlines these risks and proposes ways to implement reforms that enable guideline-level GP ADHD care.

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6. Kazgan Kılıçaslan A. Reconceptualising ADHD as a neurobiological spectrum: calibration-based perspective. BJPsych Bull. 2026: 1-3.

Although attention-deficit hyperactivity disorder (ADHD) diagnosis requires a categorical decision, phenotypic, twin and molecular genetic evidence indicates that ADHD traits are continuously distributed, with clinical ADHD at the functionally impairing end of this distribution. This paper proposes conceptualising ADHD as a neurobiological spectrum while treating categorical and dimensional approaches as complementary. A calibration perspective is proposed to describe graded differences in the regulation of attention, arousal, motivation and cognitive control, and their context-dependent expression. Genetic findings support dimensional continuity, whereas neurobiological and cognitive findings are consistent with graded regulatory variation. Functional impairment remains central to translating this dimensional framework into diagnosis and treatment decisions.

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7. Li Y, Wang W, Liu W. CNTN4: A Possible Candidate Gene for Microbiota-Gut-Brain Axis in Autism Spectrum Disorders and Attention-Deficit/Hyperactivity Disorder. Autism. 2026: 13623613261493643.

The gut microbiota plays a significant role in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD), though findings vary substantially across studies. Using gut microbiome data from a genome-wide association study of 5,959 participants and summary statistics from 46,351 ASD and 55,374 ADHD cases, we conducted bidirectional Mendelian randomization (MR) analyses with inverse variance weighting as the primary method. Reverse MR analysis assessed potential reverse causality. We annotated single nucleotide polymorphisms (SNPs) with SNP-nexus to identify associated genes, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses to characterize their functional roles. Seventeen gut microbial taxa showed causal associations with ASD risk, while 27 were linked to ADHD. Reverse MR analysis revealed associations between aSD and species Desulfovibrio piger as well as species Bacillus U, but no reverse causality was detected for ADHD. Biological annotation identified five novel conserved genes in host-microbiome interactions shared by ASD and ADHD, with CNTN4 emerging as a common candidate gene. These findings support a potential causal relationship between gut microbiota and ASD/ADHD risk while uncovering novel conserved genes implicated in host-microbiome interactions for both disorders.Lay AbstractDistinct gut microbiota profiles were observed in individuals with ADHD and ASD. Seventeen microbial species showed significant associations with ASD, while 27 were linked to ADHD. CNTN4 emerged as a potential candidate gene shared across both neurodevelopmental conditions and host-microbiome interactions.

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8. Papatheodorou S, Choi HM, Huybrechts KF, Hernandez-Diaz S, Liu Y, Zhang D, Shupler M, Leung M, Huang W, Qiu X, Wei Y, McDougle CJ, Papatheodorou E, Schwartz JD, Coull BA, Weisskopf MG, Zanobetti A. Prenatal Exposure to Wildfire PM2.5 and Risk of ASD and ADHD in Children Enrolled in Medicaid. JAMA Pediatr. 2026.

IMPORTANCE: Wildfires are an increasing source of fine particulate matter (PM2.5), yet evidence on prenatal wildfire smoke exposure and long-term neurodevelopmental outcomes remains limited. OBJECTIVE: To examine whether prenatal exposure to wildfire-related PM2.5 is associated with risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children. DESIGN, SETTING, AND PARTICIPANTS: This was a population-based cohort study of the US nationwide Medicaid population using Medicaid Analytic Extract (MAX) data from 2007 to 2014 with follow-up through childhood. Included were mother-child pairs with continuous enrollment and stable residential zip code during pregnancy. EXPOSURE: Weekly wildfire smoke-attributable PM2.5 at 1-km2 resolution, aggregated to the zip code level across pregnancy. MAIN OUTCOMES AND MEASURES: Incident ASD and ADHD identified using validated claims-based algorithms. Associations were estimated using Cox proportional-hazards models with distributed lag nonlinear models. RESULTS: A total of 893 212 mother-child pairs (mother mean [SD] age, 24.7 [5.9] years) were included in this analysis. Children entered the cohort at birth (452 218 [50.6%] male). Mean (SD) observed follow-up was 6.3 (2.4) years for children diagnosed with ASD and 7.1 (1.9) years for children diagnosed with ADHD. Among 893 212 children, 8357 were diagnosed with ASD and 22 302 with ADHD. The cumulative incidence until age 8 years was 1.9% for ASD and 10.4% for ADHD. An IQR increase in cumulative wildfire PM2.5 exposure (0.75 µg/m3) during pregnancy was associated with increased risk of ASD (hazard ratio [HR], 1.30; 95% CI, 1.07-1.59) but not ADHD (HR, 1.03; 95% CI, 0.91-1.17). Associations for ASD were strongest during midpregnancy to late gestation compared with early gestation. Results were robust to sensitivity analyses. CONCLUSIONS AND RELEVANCE: Results of this cohort study show that prenatal exposure to wildfire-related PM2.5 may be associated with increased risk of ASD but not ADHD. These findings highlight the potential neurodevelopmental impacts of wildfire smoke and underscore the need for strategies to reduce exposure during pregnancy as wildfire activity intensifies.

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9. Simpson AIF, Picco CZD, Agid O, Jones RM. Prescribing psychostimulants for persons with schizophrenia spectrum disorders and attention-deficit hyperactivity disorder: practice with little guidance. BJPsych Open. 2026; 12(6): e274.

Psychostimulant prescribing for individuals with comorbid attention-deficit hyperactivity disorder and schizophrenia spectrum disorders appears increasingly common despite limited evidence to guide the practice. This commentary highlights diagnostic and treatment challenges, critiques the current evidence base and argues for cautious prescribing, greater attention to substance use and the development of pragmatic clinical guidance.

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10. Yang Y, Qin W, Zhang W, Aremu TO. Examining Regulatory Classifications and Social Determinants of Health in Telehealth-Mediated ADHD Prescription Fulfillment Barriers. Med Sci (Basel). 2026; 14(6).

Background: Telehealth has expanded remote access to ADHD care, yet a prescription issued remotely must still be filled at a pharmacy-and whether telehealth resolves these downstream fulfillment barriers remains unclear. Federal regulatory distinctions between Schedule II controlled stimulants and non-controlled ADHD pharmacotherapies create structurally divergent procurement experiences, particularly under ongoing nationwide stimulant shortages. This study examined whether prescription fulfillment difficulty differs by medication regulatory classification among adults using telehealth for ADHD care, and identified social determinants of health (SDOH) associated with access difficulty. Methods: Data were drawn from Round 2 of the NCHS Rapid Surveys System (RSS-2; October-November 2023). The analytic sample comprised 141 adults with a current ADHD diagnosis who reported pharmacotherapy use and telehealth utilization for ADHD care, classified as controlled-exposed (n = 95) or non-controlled-exposed (n = 46) by medication regulatory class. Chi-square tests, multivariable logistic regression, and five machine learning algorithms were applied across 19 SDOH variables. Results: Prescription access difficulty was substantially more prevalent among controlled-exposed than non-controlled-exposed participants (75.8% vs. 45.7%, p < 0.001). Multivariable logistic regression identified controlled medication exposure (coefficient = 2.155, p < 0.001), difficulty paying medical bills (coefficient = 1.409, p = 0.034), and income (coefficient = 0.145, p = 0.042) as significant correlates. Random Forest permutation importance ranked controlled medication exposure and having a usual place for care as the two strongest predictors, although these exploratory rankings warrant caution given the small held-out test set (n = 28). Notably, all 13 participants reporting non-prescribed online medication purchases also reported access difficulty through formal channels, a pattern consistent with displacement toward unregulated supply chains. Conclusions: Prescription fulfillment barriers were strongly stratified by medication regulatory classification, with financial strain further compounding access difficulty. As federal telemedicine flexibilities approach their 31 December 2026, expiration, regulatory deliberations should weigh downstream fulfillment constraints-including the Schedule II refill prohibition under shortage conditions-alongside upstream telehealth access.

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