1. Bajaa SAH, Allozy B, Hautzinger M, Godde B, Lang T, Karim AA. The impact of the Schmetterling NBI Program on selective eating behavior: evaluation of creative therapeutic interventions across three families of children with autism spectrum disorder. J Eat Disord;2026 (May 2);14(1)

Children with autism spectrum disorder (ASD) frequently exhibit selective eating behaviors characterized by food refusal and limited dietary variety, which can lead to nutritional deficiencies and impaired family functioning. This study evaluated the effectiveness of the Schmetterling Nutritional Behavior Intervention (NBI) Program, a creative behavioral intervention integrating established behavioral strategies with innovative components, including imitation chaining, shaping, and therapist-guided exoskeleton modeling. Three children (YW, RA, and JK) diagnosed with autism spectrum disorder (ASD) participated in a single-case experimental design. The study employed the Childhood Autism Rating Scale, 2nd Edition (CARS-2) assessing autism symptom severity, while the Child Eating Behavior Questionnaire (CEBQ) measured changes in eating behavior. Substantial increases in food acceptance were observed across all participants, with the highest improvements in food responsiveness, enjoyment of food, and food fussiness. Tau-U analysis revealed large and significant intervention effects for both therapist-implemented and parent-implemented sessions. Although CARS-2 scores remained within the ‘severe’ classification range, notable percentage reductions suggested clinically relevant improvements in core autism symptoms. These findings support the Schmetterling NBI Program as an individualized, evidence-based approach to enhancing dietary diversity and reducing maladaptive feeding behaviors in children with ASD. Children with autism spectrum disorder (ASD) commonly demonstrate selective eating patterns, including food refusal and restricted dietary repertoire, which may contribute to nutritional deficits and compromised family dynamics. This investigation examined the efficacy of the Schmetterling Nutritional Behavior Intervention (NBI) Program, a novel behavioral intervention that synthesizes established behavioral methodologies with innovative components such as imitation, shaping procedures, and therapist-guided training. Utilizing a single-case experimental design, three children diagnosed with ASD (YW, RA, and JK) were assessed with the Childhood Autism Rating Scale, Second Edition (CARS-2) to evaluate autism symptom severity, and the Child Eating Behavior Questionnaire (CEBQ) to measure alterations in feeding behavior. Results indicated substantial improvements in food acceptance across all participants, with pronounced enhancements in food responsiveness, enjoyment of food, and reductions in food fussiness. Tau-U statistical analysis demonstrated large and significant intervention effects for both therapist-administered and parent-implemented sessions. Although CARS-2 scores remained within the severe classification range, notable percentage reductions indicated clinically meaningful improvements in core autism symptomatology. These findings support the Schmetterling NBI Program as an individualized, evidence-based intervention for promoting dietary diversity and reducing maladaptive feeding behavior among children with ASD. Replicating our preliminary findings in a larger sample and finding evidence-based tailored interventions for children with ASD pose important challenges for future research. eng

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2. Catalano F, Bigi A, Troilo F, Gabriele F, Pistoia G, Asteriti IA, Angelucci F, Giardina G, Chiti F, Travaglini-Allocatelli C, Di Matteo A. Unraveling in vitro phase separation and aggregation properties of the structured region of FMRP and the impact of Fragile X syndrome-linked mutations. Febs j;2026 (May 2)

Fragile X messenger ribonucleoprotein 1 (FMRP) is a multidomain RNA-binding protein highly expressed in neurons. It comprises a structured N-terminal region (NTR) containing five RNA/protein interaction domains and a large intrinsically disordered C-terminal region. A limited number of fragile X syndrome (FXS)-associated point mutations have been identified in the NTR, leading to the expression of mutated protein variants. Here, we show that the destabilizing effects of these mutations on the NTR region are less severe than those previously observed in the isolated domains, suggesting the presence of inter-domain interactions that stabilize the overall NTR architecture. Moreover, we demonstrate that the NTR structured region has an intrinsic propensity to undergo liquid-liquid phase separation (LLPS) and amyloid fibril formation in vitro, depending on protein concentration, and we characterize how three FXS-associated mutations (R138Q, G266E, and I304N) affect these processes. We show that the mutations either destabilize the entire NTR (G266E/I304N), markedly affect the kinetics of LLPS and suppress the droplet liquid nature (R138Q/G266E), or promote solid or gel-like non-amyloid aggregation (G266E), thus providing mechanistic insights into how they may alter protein function, contributing to the pathogenic mechanism. These findings suggest that the interplay between protein stability, LLPS, and fibrillization is finely regulated and may be critical for understanding FMRP function and its dysfunction in disease.

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3. Herrebrøden M, Marentakis G, Dechsling A, Esposito G, Dimitriou D, Nordahl-Hansen A. Advantages and disadvantages of noise-cancelling headphones for autistic students in educational settings. Res Dev Disabil;2026 (May 1);173:105301.

This perspective article explores the various advantages and disadvantages of using noise-cancelling headphones in educational settings for autistic students with auditory sensory differences. Although noise-cancelling headphones can have several advantages for autistic students in educational settings, it is important that use of such assistive technological tools should not be implemented without a plan and tailoring at an individual level.

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4. Lim K, Shin H, Kim SN. Potential contribution of age-related and methodological factors to limited reproducibility in autism spectrum disorder blood miRNA biomarker studies: an exploratory meta-analysis. Sci Rep;2026 (May 2)

Cross-study inconsistencies in autism spectrum disorder (ASD) blood microRNA biomarker studies suggest that methodological heterogeneity may substantially limit reproducibility. We conducted an exploratory meta-analysis of publicly available ASD blood miRNA datasets from the Gene Expression Omnibus, applying rigorous inclusion criteria and standardized analytical protocols. Three datasets were included (GSE89596, GSE67979, GSE222046) comprising 614 miRNAs across 90 participants (45 ASD, 45 controls). Random-effects meta-analysis was performed using Hedges’ g effect sizes, with comprehensive heterogeneity assessment and leave-one-dataset-out cross-validation. No miRNAs survived multiple testing correction (Benjamini-Hochberg FDR < 0.05), though seven candidate signals showed consistent evidence with unadjusted p < 0.01 and large effect sizes. These candidates demonstrated near-zero between-study heterogeneity and consistent directionality across validation analyses. Potential age-related and platform-related differences were observed, with near-zero correlation between adult and pediatric effect sizes (Kendall's τ = -0.022); however, these two sources of variability were fully confounded in the available data and could not be separated. Some miRNAs exhibited extreme between-study variability (I² > 80%), indicating substantial methodological differences. Cross-validation revealed that excluding the single adult dataset reduced sign consistency from 89.9% to 68.9%. Our findings suggest that age-related and methodological factors, including technical platform differences, may contribute to limited reproducibility in ASD blood miRNA research, and that blood-derived signals should be interpreted as potentially reflecting peripheral physiological states rather than central disease mechanisms. A supplementary cross-tissue analysis using post-mortem prefrontal cortex data (GSE59286; n = 45) provided direct empirical support for this interpretation: the majority of blood candidate miRNAs showed no corresponding expression in brain tissue, with only hsa-miR-29c-5p demonstrating directional concordance across both tissues. These findings suggest that age stratification, platform harmonization, and cross-tissue validation should be considered essential prerequisites for reliable ASD miRNA biomarker discovery, rather than optional refinements.

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5. Liu T, Chen X, Zheng X, Ren H, Xie Y, Fu Z, Zhao Y, Yang L, He Y, Liao X. Heterogeneous functional state dynamics and its structural substrates in male individuals with autism spectrum disorder. Mol Psychiatry;2026 (May 2)

Neuroimaging studies have revealed altered functional connectome dynamics in autism spectrum disorder (ASD) and linked these alterations to clinical symptoms. However, most studies have emphasized population-level contrasts, leaving interindividual variability in connectome dynamics and its structural underpinnings poorly understood. To address this gap, we analyzed resting-state functional and structural MRI data from 939 male participants (440 with ASD, 499 typically developing controls) across 18 sites in the Autism Brain Imaging Data Exchange (ABIDE). Whole-brain functional state dynamics was characterized using five leading activity modes and their expressions via eigen-microstate analysis. Age-related trajectories of mode expressions were constructed for typically developing controls using normative modeling, enabling quantification of individual-level deviations in functional dynamics. Compared with controls, ASD individuals showed greater interindividual variability in functional deviation profiles. Unsupervised clustering of these profiles identified two robust ASD subtypes with distinct mode-specific dysfunctions. One subtype primarily involved the visual, default-mode, frontoparietal, and dorsal attention networks, whereas the other subtype primarily involved the somatomotor, visual, frontoparietal, and ventral attention networks. These subtypes were clinically dissociable, differing in restricted and repetitive behaviors and social impairments, and exhibited mode-specific brain-symptom associations. Furthermore, the subtypes exhibited distinct cortical thickness alterations, and individual subtype membership was predicted with high accuracy (83%) using a random forest classifier based on cortical thickness. The main findings were replicated in an independent cohort outside ABIDE. This study delineates two reproducible and clinically dissociable ASD subtypes and links functional connectome dynamics to structural substrates, offering novel insights into the neurobiological basis behind ASD heterogeneity.

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6. Meltzoff KK, Alexander C, Hoffman A, Blacher J. A Telehealth Diagnostic Tool for Autistic Children With Phrased and Fluent Speech: Comparison to In-person Diagnosis. J Autism Dev Disord;2026 (May 2)

PURPOSE: Given the existing barriers to timely ASD diagnosis and the potential of telehealth to mitigate these barriers, it is critical to create and validate telehealth autism diagnostic instruments. Existing instruments largely focus on children under 3 and/or those with minimal verbal speech. We created and investigated the accuracy and validity for two novel instruments: Tele-ASD-KIDS, phrased speech (TAK-PS), and Tele-ASD-KIDS, fluent speech (TAK-FS) alongside an existing measure for minimally verbal children -the Tele-ASD-PEDS (TAP). METHODS: We assessed 39 children for autism in a university-based free clinic, both in-person and using telehealth, with blinded assessment teams- TAP (n = 10; M = 47.5 months), TAK-PS (n = 7, M = 74 months), TAK-FS (n = 22, M = 102.77 months). Data were analyzed for diagnostic accuracy and social validity for each telehealth instrument separately. RESULTS: Our findings suggest that the TAK-PS is highly accurate, whereas the TAK-FS is accurate for some children but not others. Older children, those with behaviors unrelated to ASD that may affect social-communication abilities, and those with ADHD appear least likely to benefit from telehealth diagnostic assessments. For social validity, caregivers were largely satisfied with both TAK versions. CONCLUSIONS: The TAK-PS and TAK-FS are, to our knowledge, the first telehealth diagnostic measures for ASD in children with phrased or fluent speech that have been systematically compared to in-person assessments using blinded clinical teams and randomized assessment order. Although the initial accuracy and validity of these measures are promising, more research on these measures is needed.

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7. Monnier M, Michelon C, Rattaz C, Redlinger F, Peyre H, Baghdadli A. Coping Profiles of Parents at the Time of Their Child’s Autism Diagnosis: Differences Between Mothers and Fathers, and Associations With Family Mental Health. J Autism Dev Disord;2026 (May 2)

PURPOSE: Given theoretical and methodological criticisms surrounding coping strategies, this study examines coping profiles and differences between mothers and fathers at the time of their child’s autism diagnosis. METHODS: Multi-group confirmatory factor analyses (MG-CFAs) were conducted to improve construct validity of the French Ways of Coping Checklist-Revised in 554 parents in France and to test measurement invariance between mothers and fathers. Linear mixed models were performed to examine parental status (mother vs. father) differences in coping strategies. Dyadic latent profile analysis (LPA) was used to identify distinct coping profiles and the R3STEP approach to examine differences in latent profile membership by parental status. RESULTS: MG-CFAs supported four coping dimensions (problem solving-positive reappraisal, seeking social support, wishful thinking, and self-blame) and demonstrated configural and metric invariances, with partial scalar invariance between mothers and fathers. Fathers reported a significantly lower use of all coping strategies except wishful thinking. LPA identified three coping profiles -Varied Coping, Adaptive-Dominant Coping, and Maladaptive-Dominant Coping-with no significant differences in latent profile membership between mothers and fathers. In both parents, coping profiles differed by anxiety symptoms; additionally, maternal profiles were associated with socio-economic status, stress levels, and the child’s internalizing difficulties, and paternal profiles with depressive symptoms. CONCLUSIONS: These findings provide a more nuanced understanding of mother-father differences in coping among parents of autistic children and underscore the need for tailored, profile-based interventions in clinical practice and future research.

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8. Moon H, Sloofman L, Avila MN, Klei L, Devlin B, Buxbaum JD, Roeder K. A framework to infer de novo exonic variants when parental genotypes are missing enhances association studies of autism. Bioinformatics;2026 (May 3);42(5)

MOTIVATION: Gene-damaging mutations are highly informative for studies seeking to discover genes underlying developmental disorders. Traditionally, these de novo variants are recognized by evaluating high-quality DNA sequence from affected offspring and parents. However, when parental sequence is unavailable, methods are required to infer de novo status and use this inference for association studies. RESULTS: We use data from autism spectrum disorder to illustrate and evaluate methods. Separating de novo from rare inherited variants is challenging because the latter are far more common. Using a classifier for unbalanced data and variants of known inheritance class, we build an inheritance model and then a de novo score for variants when parental data are missing. Next, we propose a new Random Draw (RD) model to use this score for gene discovery. Built into an existing inferential framework, RD produces a more powerful gene-based association test and controls the false discovery rate. AVAILABILITY AND IMPLEMENTATION: Codes are available at Github (https://github.com/HaeunM/TADA-RD) and Zenodo (DOI: https://doi.org/10.5281/zenodo.18531769).

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9. Motta M, Sarno L, Colacurci D, Terracciano D, Visentin S, Cosmi E, Grelloni C, Ciavattini A, Giannubilo SR, Maruotti GM. Fetal MRI Biomarkers and the Prenatal Origins of Autism Spectrum Disorder: A Narrative Review. J Clin Med;2026 (May 3);15(9)

Objectives: Autism spectrum disorder (ASD) is increasingly conceptualized as a neurodevelopmental condition with prenatal origins. Advances in fetal magnetic resonance imaging (MRI), including high-resolution structural imaging and resting-state functional connectivity analysis, now enable in vivo characterization of the developing human brain before birth. This review examines whether fetal MRI biomarkers are associated with later ASD diagnosis or autistic traits. Methods: We conducted a PRISMA-informed narrative review of human studies identified through MEDLINE, EMBASE, SCOPUS, and Web of Science. Eligible studies included original human investigations using fetal MRI to assess brain structure and/or function, with postnatal ASD diagnosis or standardized autistic-trait outcomes. Results: Eight eligible studies provide converging evidence that neurodevelopmental divergence associated with ASD may be detectable in utero. Structural analyses consistently report prenatal volumetric alterations, particularly enlargement of the insular cortex between the second and third trimesters. Additional findings of regional overgrowth and hemispheric asymmetries suggest distributed deviations in cortical maturation. Functional fetal MRI studies further demonstrate atypical large-scale network organization prior to birth. Altered connectivity within cingulate, prefrontal, temporal, and cerebellar circuits has been prospectively associated with later autistic traits, indicating that network-level integration may diverge before behavioral symptoms emerge. Evidence from high-risk conditions, including isolated ventriculomegaly and tuberous sclerosis complex, reinforces the association between prenatal structural abnormalities and increased ASD risk. Conclusions: Current evidence suggests that structural and functional brain alterations identifiable by fetal MRI may precede the clinical manifestation of ASD. These findings support a model of ASD as a condition potentially rooted in prenatal neurodevelopmental divergence. However, larger, standardized, multicenter studies are required before fetal MRI biomarkers can be translated into predictive or clinical applications.

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10. Roos M, Storm H, Zimmer L, Schuwerk T. Participatory Development and Psychometric Evaluation of the Introspective Predictive Processing Inventory: A Self-Report Measure for Autistic and Non-Autistic Adults. Autism;2026 (May 3):13623613261443728.

Traditional self-report autism measures are often constructed from an « outside view » by non-autistic researchers rather than reflecting authentic autistic experiences. Predictive processing theory offers a framework for understanding autism, but comprehensive tools assessing the subjective manifestations of predictive processing differences and associated challenges have been lacking. This study aimed to develop and validate the Introspective Predictive Processing Inventory (IPPI), a self-report measure assessing predictive processing characteristics and their subjective consequences in everyday life. Through community-led, participatory research, we developed an initial 65-item version in German and English, and employed a five-stage validation approach across three samples (N = 790). We used network-based item optimization, exploratory and confirmatory factor analyses, measurement invariance testing, and convergent validity assessment. Network optimization reduced the scale to 18 items while maintaining excellent reliability and improved discriminative power. Exploratory factor analysis revealed a stable two-factor structure: « Prediction Integration and Interpretation » and « Prediction Error Sensitivity and Stability Needs ». The IPPI demonstrated exceptional discriminative validity (area under the curve >0.97), strong convergent validity with established measures, measurement invariance across groups, and independence from general cognitive abilities. It provides a tool for assessing predictive processing experiences and their daily consequences, advancing autism research that bridges predictive processing theory with lived experiences.Lay AbstractMost questionnaires used to understand autism are created by non-autistic researchers who imagine what autism might be like, rather than capturing what autistic people actually experience. Scientists have a theory called « predictive processing » that suggests our brains are constantly trying to predict what will happen next in our environment. When these predictions don’t match reality, it can cause stress and difficulties in daily life. However, there was no good way to measure these internal experiences and daily challenges that autistic people face. To address this gap, an autistic researcher worked with autistic community members and non-autistic researchers to create a questionnaire called the Introspective Predictive Processing Inventory (IPPI). They started with 65 questions, developed both German and English versions, and tested it with 790 autistic and non-autistic adults from mostly Germany and the United Kingdom. Using advanced statistical methods, they refined it down to 18 key questions that capture two main areas: difficulties understanding and integrating information from social situations and the environment, and sensitivity to unexpected changes with strong needs for predictability, causing distress when things don’t go as expected. The final 18-question IPPI was highly reliable and could accurately distinguish between autistic and non-autistic people 97% of the time. Importantly, these differences were not related to intelligence levels. These findings provide researchers and clinicians with a new tool to understand the internal experiences of autistic people from their own perspective. This could help develop better support strategies, improve quality of life, and advance autism research that truly reflects autistic experiences rather than outside assumptions about autism.

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11. Soltys SM, Wilson T, Botchway A, Groesch K, Diaz-Sylvester P, Campbell P, Loret de Mola JR. Epidural Anesthesia, Intrapartum Use of Synthetic Oxytocin and the Odds of Autistic Disorder. Arch Med Res;2026 (May 1);57(5):103432.

BACKGROUND: Epidural anesthesia (LEA) can block the Ferguson reflex, which stimulates the release of maternal oxytocin during labor. LEA may increase the need for synthetic oxytocin (sOT) to augment labor. Recent research has demonstrated an association between a elevated odds of autism spectrum disorder (ASD) and higher doses and durations of sOT. AIMS: To examine the associations between the duration of LEA, sOT dosing, the duration of sOT exposure, and a diagnosis of ASD. METHODS: Delivery data from 115 adolescents with ASD were compared to a reference population of 114 adolescents without ASD. The key variables examined were epidural duration (h), the cumulative dose of sOT (milliUnits), and sOT exposure duration (h). RESULTS: The mothers of children with ASD had significantly longer exposure to sOT and LEA with significantly higher cumulative sOT dosage than those in the non-ASD group. Mothers in the ASD group received sOT for a longer time period prior to LEA administration than those in the non-ASD group. This suggests that factors other than LEA impacted sOT usage. Mothers in the ASD group had significantly higher body mass indices, which are associated with the need for higher intrapartum sOT dosing. CONCLUSIONS: Any association between LEA and ASD could be due to other variables affecting sOT use, leading to longer durations of both sOT and LEA use, rather than a direct impact of LEA on SOT use. Future studies examining the association between anesthesia or sOT dosing and ASD must include quantitative data on sOT and LEA dosing and exposure duration.

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12. Xu D, Zhang L, Wang X, Zeng X, Huang L, Qing Y, Zhou M, Li Q, Yang X, Zhao W, Yao S, Le J, Kendrick KM. Advantages of combining multiple eye-tracking paradigms for distinguishing young autistic from non-autistic children. Mol Autism;2026 (May 2)

BACKGROUND: Single-paradigm, single-measure eye-tracking protocols have demonstrated utility in distinguishing between autistic and non-autistic children although effect sizes and reproducibility vary. There is a need for brief, scalable digital behavioral biomarkers that integrate complementary information from multiple eye-tracking paradigms and achieve improved accuracy in combination. METHODS: 74 autistic and 63 non-autistic children aged 24-72 months performed five different eye-tracking paradigms (facial emotion processing, gaze-following, dynamic social versus geometric patterns, social interaction, and spinning) lasting 3.25 min in hospital or kindergarten settings. A broad set of fixation-based metrics was extracted from each paradigm. We compared discrimination performance of single-paradigm models versus a combined multi-paradigm model using random forest (RF) classifiers. In the autistic group, symptom severity was assessed using standardized clinical measures. We further evaluated whether paradigms contributed complementary information, estimated potential clinical value of multi-paradigm models, and conducted exploratory subgrouping analyses to examine whether eye-tracking-defined profiles aligned with symptom-based groupings. RESULTS: All individual paradigms distinguished between autistic and non-autistic children, but RF models found a combined paradigm-based model performed best, achieving an AUC of 95% and an accuracy of 90%. Representational similarity analysis indicated that paradigms contributed partially distinct information rather than reflecting a single redundant dimension of social attention. Decision curve analysis demonstrated that the multi-paradigm model provided added net benefit across clinically relevant threshold probabilities compared with strategies based on treating all or no children as autistic. Clustering of eye-tracking features revealed three autistic subgroups with distinct visual preference profiles, whereas clustering based on clinical symptoms alone identified only two subgroups. LIMITATIONS: Sex imbalance and group differences in developmental quotient may have confounded some effects. Models were only internally cross-validated in a single cohort and decision curve analysis relied on assumed clinic prevalence, so external validation and testing in larger, more diverse and high-risk samples, including other neurodevelopmental conditions, are needed. CONCLUSIONS: A brief multi-paradigm eye-tracking battery yields robust case-control discrimination and non-redundant behavioral readouts, suggesting that it may complement symptom-based approaches and provide a scalable behavioral framework for future studies seeking to bridge molecular findings with observable autistic profiles.

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