1. Abdelgayoum Ahmed MO, Khiri Ahmed EA, Ahmed Elnour SE, Mohamed Elamin AM, Mohamed Elamin HE, Mohamed Elawad SAO, Elbakry Abdelmahdy NE, Alquhazi AS. Diagnostic Yield and Clinical Utility of Chromosomal Microarray Analysis (CMA) in Children With Developmental Delay, Intellectual Disability, and Autism Spectrum Disorder: A Systematic Review. Cureus. 2026; 18(8): e115483.

Children with unexplained developmental delay (DD), intellectual disability (ID), and autism spectrum disorder (ASD) frequently undergo chromosomal microarray analysis (CMA). Two distinct questions arise: how often CMA identifies a causative variant, and whether that result changes clinical care. The purpose of this systematic review is to synthesize contemporary primary evidence on (i) the diagnostic yield of CMA in children with DD, ID, and/or ASD and the determinants of that yield, and (ii) the downstream clinical utility of a CMA result. Four electronic databases were searched from 1 January 2021 to 26 June 2026, with no language or country restriction. Eligible studies were original primary cohort or case-series analyses reporting patient-level diagnostic yield of postnatal CMA in pediatric DD/ID/ASD populations; non-original publication types were excluded. Methodological quality was appraised using a validated critical appraisal checklist for case series with pre-specified decision rules, and findings were synthesized narratively. Of 434 records identified, 13 studies met the eligibility criteria, comprising 11,535 children from nine countries. Study-level yield of pathogenic and likely pathogenic copy number variants ranged from 11.0% (95% CI 9.4-12.9) to 37.2% (95% CI 27.3-48.3); the median study-level yield was 18.5%, and 11 of 13 cohorts fell between 14% and 23%. Yield was lower in ASD (3.3-15.2%) than in DD/ID phenotypes (17.1-33.6%) and reached 27.4% where DD/ID co-occurred with multiple congenital anomalies. Variants of uncertain significance affected 2.7-12% of children. In the single cohort testing both modalities in the same patients, CMA yield exceeded karyotype yield (16.0% vs 7.0%). Seven studies were at low risk of bias, two at moderate risk of bias, and four at high risk of bias. No included study prospectively documented a change in clinical management. Study-level CMA yields were broadly consistent across diverse health systems, with a median of 18.5%. Yield is strongly phenotype-dependent, supporting pre-test phenotypic stratification rather than undifferentiated testing. Because no included cohort measured downstream management change, the clinical utility of CMA could not be quantified from contemporary evidence and remains a priority for prospective study.

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2. Doruk O, Adsız G, Ünsal S, Elgörmüş MN. Video-Based Analysis of Language and Pre-Pragmatic Skills for Identifying Autism Risk in Infancy: A Case-Observation Study. J Autism Dev Disord. 2026.

PURPOSE: Early childhood is a critical period for optimizing developmental outcomes. Although early social-communication differences may be observable before a formal diagnosis of autism spectrum disorder (ASD), clinical diagnosis often occurs around age three. This study compared retrospective home-video indicators of pre-pragmatic, receptive-language, and expressive-language behaviors in infants aged 0-12 months who were later diagnosed with ASD and typically developing (TD) peers. The aim was to identify group-level candidate early behavioral indicators rather than to evaluate diagnostic or screening accuracy. METHODS: A single-center retrospective case-control design was used. Home videos recorded from birth to 12 months were analyzed for 30 children (ASD, n = 15; TD, n = 15). Communication behaviors were coded as present or absent using structured checklists across three domains: receptive language (61 items), expressive language (41 items), and pre-pragmatic skills (19 items). Item-level between-group differences were tested using two-sided Fisher’s exact tests; effect sizes were estimated as odds ratios (ORs) with 95% confidence intervals (CIs). Benjamini-Hochberg false discovery rate (FDR) correction was applied within each domain. RESULTS: Of the 121 assembled outcomes, 120 were analyzable. Overall, 63 of 120 items (52.5%) differed between groups at p < .05, and 55 of 120 (45.8%) remained significant after FDR correction. The highest proportion of FDR-significant differences was observed in receptive language (35/61, 57.4%), followed by expressive language (15/41, 36.6%) and pre-pragmatic skills (5/18, 27.8%). Directionality was highly consistent, with 54 of 55 FDR-significant items showing lower endorsement in the ASD group. CONCLUSIONS: Infants later diagnosed with ASD showed lower endorsement across a broad range of pre-pragmatic and early language behaviors, particularly in receptive language. These findings identify candidate early behavioral indicators and support the potential adjunctive value of retrospective home-video review in developmental history taking. They do not validate a screening or diagnostic method.

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3. Erdal K, Larson T, Billstedt E. Building recurring public and patient involvement in adult autism psychiatry and neurodevelopmental research: lessons from the first year of a patient panel and advisory board. Res Involv Engagem. 2026; 12(1).

Public and patient involvement (PPI) is increasingly emphasized in health and autism research, yet involvement is often organized around individual research projects. Less is known about the practical and organizational processes involved in developing recurring PPI structures across clinical and academic settings. This paper describes and critically reflects on the establishment, implementation, and first-year experiences of two recurring PPI structures in western Sweden: a Patient Panel linked to an adult autism psychiatry service and a Neurodevelopmental Disorders (NDD) Advisory Board based at the University of Gothenburg. The two structures followed different implementation pathways. The Patient Panel was initially anchored to an ongoing research programme and involved autistic adults receiving psychiatric care, whereas the NDD Advisory Board was established from the outset as a broader forum bringing together researchers and representatives of patient and user organizations. First-year activities included review of research materials, ethical and methodological reflection, intervention development, discussion of research findings and clinical service development, and input into broader neurodevelopmental research questions. Contributor input resulted in identifiable changes to research procedures and intervention content, although involvement remained predominantly advisory and final decision-making authority remained with researchers, project leads, or clinical management. Implementation highlighted the importance of institutional context, organizational support, preparation, accessibility, compensation, and mechanisms for follow-up. Establishing the clinically embedded Patient Panel required iterative development of procedures concerning recruitment, data protection, compensation, and organizational responsibilities, whereas the university-based Advisory Board was administratively more straightforward to establish. Across both structures, governance, systematic documentation and follow-up of recommendations, and shared decision-making remained underdeveloped. Considered in relation to AASPIRE principles, several participatory practices were established, while important gaps remained in governance, accessibility procedures, and involvement across research stages. These experiences demonstrate that recurring PPI activities can be established in both clinical and academic settings, while highlighting that their establishment should not be equated with long-term sustainability or institutionalization. Developing sustained PPI requires ongoing attention to organizational procedures, resources, accountability, accessibility, and the distribution of decision-making authority.

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4. Lopes F, Rodrigues F, Diz S, Monteiro D, Amaro N, Matos R, Antunes R, Jacinto M. Testing the Reliability of the Short Physical Performance Battery in Institutionalized Individuals With Intellectual and Developmental Disabilities. J Intellect Disabil Res. 2026.

BACKGROUND: This study aimed to evaluate the reliability of the Short Physical Performance Battery (SPPB) in institutionalized adults with intellectual and developmental disabilities. METHODS: The final sample consisted of 32 individuals with intellectual and developmental disabilities (15 men and 17 women), with a mean age of 35.31 ± 15.93 years and all participants were institutionalized. RESULTS: The total SPPB score exhibited excellent internal consistency (α = 0.929) and excellent test-retest reliability (ICC = 0.931; p ≤ 0.001), indicating a high degree of measurement stability for the composite score. CONCLUSIONS: It is concluded that the SPPB may be a reliable tool for assessing physical function in institutionalized individuals with intellectual and developmental disabilities, although specific adaptations may be necessary to maximize its reliability. However, results should be interpreted as preliminary considering the relatively small and heterogeneous sample.

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5. Pace-Tonna C, Murtaza M, Rodak T, Farb N, Ryan W, Lai MC. Flow and Similar Attentional States in Autism and ADHD: A Scoping Review of Similarities and Differences. Perspect Psychol Sci. 2026: 17456916261470783.

Flow is a state of optimal engagement. Autistic individuals and individuals with attention-deficit/hyperactivity disorder (ADHD) might have variations in flow-like experiences, such as hyperfocus, autistic inertia, and monotropism, that diverge from traditional or typical definitions. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically reviewed 43 publications, including empirical studies, reviews, and other literature, to examine these constructs. Results showed that attentional experiences associated with neurodivergence overlap with, but also differ notably from, typical flow. Autistic inertia hinders task initiation and transitions, in contrast to flow’s seamless engagement. Monotropism involves rigid, directed focus and repetitive, tenacious engagement, whereas flow allows for flexible adaptations to challenges. Hyperfocus is like flow regarding intense concentration and immersion but is often involuntary, lacks clear goals, and is associated with emotional dysregulation. Although commonalities exist across these attentional experiences, the greatest overlap occurs within autistic inertia, monotropism, and hyperfocus. Attention in autistic and ADHD individuals might be more dynamic than previously believed, with potential for transitions between these experiences. This fluidity can enhance focus and productivity but may also lead to negative outcomes, such as overly rigid fixation or difficulty engaging with and disengaging from tasks. Clarifying these differences and overlaps can inform tailored interventions and supports, helping neurodivergent individuals manage focus, reduce task-related stress, and optimize productivity.

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6. Poole K, Visone J, Srivastava S, Whitehill K. Pediatric Institutions’ Instagram Response to the 2025 Acetaminophen-Autism Controversy. Hosp Pediatr. 2026.

Objective: To describe the timing, frequency, and accessibility of Instagram posts from pediatric health institutions during the 2025 acetaminophen-autism controversy.Methods: Cross-sectional audit of public Instagram accounts of 62 pediatric health institutions from September 22 to November 15, 2025. The a priori sampling frame comprised the top 50 US children’s hospitals for pediatric behavioral health, the top 10 Honor Roll children’s hospitals (US News and World Report), 5 national medical societies, and health departments of the 10 states with the largest pediatric populations. Posts were extracted with a web-scraping tool and manually verified. Two reviewers independently coded relevant posts for prespecified content and accessibility features. Readability was assessed with two validated measures.Results: Twelve of 62 institutions (19%) posted relevant content. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists posted on day 0, while hospital time to first post ranged from 3 to 51 days. No state health department posted. Nonresponding institutions remained active: 1 hospital published 108 unrelated posts. The 26 relevant posts had a mean Flesch-Kincaid Grade Level of 11.4 and SMOG Index of 10.2. Among coded features, 88% included resource links, 73% directed audiences to a health care provider, 46% featured a named clinician, 42% discussed risks and benefits, and none were multilingual.Conclusions: Most sampled institutions published no relevant content during an active health controversy despite remaining active. Readability of relevant posts exceeded recommended targets, and none were multilingual. These gaps in institutional communication infrastructure could be addressed.

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7. Reichow B, Barton EE, Song J. Umbrella Review of Meta-Analyses of Comprehensive Applied Behavior Analytic Interventions for Young Children With Autism Spectrum Disorder. J Autism Dev Disord. 2026.

PURPOSE: The purpose of this review was to conduct an umbrella review of systematic reviews with meta-analytic syntheses of comprehensive applied behavior analytic interventions for young autistic children. METHOD: We searched six electronic databases and conducted supplemental searches through December 2025. We examined two primary outcomes (IQ, adaptive behavior) and four secondary outcomes (communication, social, daily living skills, and symptomatology), conducted assessments for risks of bias, and examined primary study overlap using the corrected covered area (CCA). RESULTS: We included six systematic reviews with meta-analytic syntheses including 36 unique studies (CCA = 20.56%) with 2,241 child participants with ASD in this umbrella review. For IQ, three meta-analyses reported standardized mean difference effect sizes (SMD) greater than 0.50 and three meta-analyses reported mean difference effect sizes (MD) greater than 11.98 (on a scale with a SD = 15). For adaptive behavior, three reviews reported SMD greater than 0.35 and three reviews reported MD equal to 5.92 or greater. Effects on secondary outcomes were reported less frequently across reviews with greater variability in findings. CONCLUSION: The findings of this umbrella review demonstrated consistent, replicated evidence that comprehensive early interventions based on the technologies of applied behavior analysis. Autistic children receiving the intervention had superior outcomes to autistic children in the comparison conditions for IQ and adaptive behavior for a majority of the participants who received the intervention. PROTOCOL REGISTRATION: PROSPERO CDR#42,024,568,638.

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8. Shivers CM, Lee CE. Mediating Role of Emotion Regulation and Sibling Relationship Quality Among Young Adult Siblings of Individuals With and Without Autism Spectrum Disorder. J Autism Dev Disord. 2026.

PURPOSE: Siblings of autistic individuals (ASD-Sibs) report, on average, significantly less closeness and warmth in sibling relationships than siblings of non-disabled individuals (ND-Sibs). However, findings on other aspects of life satisfaction on well-being between ASD-Sibs and ND-sibs is more mixed. Therefore, understanding some potential mechanisms by which aspects of the sibling relationship relate to well-being for ASD-Sibs and ND-Sibs is needed. In particular, understanding how aspects of emotion regulation may relate to the sibling relationship may provide pathways for future support strategies. METHODS: The current study compared 42 non-disabled young adult siblings of autistic individuals to 145 non-disabled young adult siblings of non-disabled individuals. Participants completed an online survey with measures of sibling warmth and closeness, emotional reappraisal and emotional suppression, gratitude, life satisfaction, distress, and optimism. Moderated mediation analysis examined whether pathways amongst variables differed between ASD-Sibs and ND-Sibs. RESULTS: The ASD-Sibs reported significantly lower levels of warmth and closeness and significantly higher levels of distress. ASD-Sibs also reported greater use of emotional suppression. Both emotional suppression and reappraisal partially mediated the relationships between the sibling relationship and well-being variables, though such relationships did not significantly differ by group. CONCLUSION: The current results indicate that strategies of emotional regulation may impact the relationship between sibling closeness/warmth and well-being among ASD-Sibs. More research is needed to determine how changes in emotional regulation may help improve both the relationship and well-being.

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9. Song AY, Wang Y, Dickerson AS, Braun JM, Burris HH, Croen LA, Dunlop AL, Friedman C, Hooper SR, Hipwell AE, Leve LD, Lyall K, Karr CJ, Kloog I, Liang D, Loftus CT, McCann ME, McEvoy CT, O’Connor TG, Oh J, O’Shea M, Santos HP, Jr., Schmidt RJ, Stroustrup A, Straughen JK, Szpiro A, Wright R, Ghassabian A, Volk H. Role of Neighborhood Vulnerability and Opportunity in the Association Between Prenatal Air Pollution and Autism-Related Traits in the ECHO Cohort. Environ Res. 2026: 125777.

Limited studies have explored the modifying role of neighborhood factors in the association between prenatal air pollution exposure and child neurodevelopment. We investigated whether the relationship between prenatal ambient air pollution and autism-related traits differed by neighborhood-level opportunity and vulnerability. This study drew data from 8,598 mother-child pairs from 35 sites participating in the Environmental influences on Child Health Outcomes (ECHO) Cohort. Ambient air pollutants, including fine particulate matter (PM(2.5)), nitrogen dioxide (NO(2)), and ozone (O(3)), were estimated at residential addresses during pregnancy. The Social Vulnerability Index (SVI) and Child Opportunity Index (COI) at the census tract level were linked to residential addresses at birth. The associations of pregnancy average and trimester-specific air pollution with autism-related traits, as measured by the Social Responsiveness Scale (SRS), stratified by SVI and COI quintiles were evaluated using generalized estimating equation models with a p-value <0.10 for the interaction term as suggestive evidence of signficance. There was evidence of interaction between prenatal exposure to O(3) with SRS by SVI (interaction p=0.07) and by COI (interaction p=0.01). Prenatal exposure to O(3) during pregnancy was associated with higher SRS score in the lowest SVI (β=0.05, 95% CI: -0.005, 0.10) and highest COI (β=0.04, 95% CI:0.00, 0.08). Differential associations of trimester-specific O(3) and PM(2.5) by SVI and COI were also observed (interaction p<0.10), although stratified associations within each SVI and COI category were not statistically significant. Our findings suggest that neighborhood level social factors may modify the associaitons between prenatal air pollution and autism-related traits and warrant further consideration of neighborhood factors in environmental epidemiological studies.

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