1. Abadi MRH, Johnston JD, Kontulainen S. Bone and muscle strength deficits in male children with autism spectrum disorder. Res Dev Disabil. 2026; 176: 105359.

PURPOSE: We compared bone and muscle strength and related factors between children with autism spectrum disorder (ASD) and typically developing children (TDC). METHODS: We included 15 male children with ASD (mean age: 10.3, SD: 2.7 years) and 45 TDC (11.4, 1.8), matched for sex, age, maturity, height and body mass. We used pQCT to assess bone strength, area, and content at the distal and shaft sites of the radius and tibia, as well as muscle area at the forearm and lower leg. We measured grip strength and long jump distance and recorded daily physical activity (PA) and vitamin D, calcium, and protein intakes. We used site-specific multivariate analyses of covariance to compare bone outcomes, adjusting for muscle area. We compared PA and nutrient intakes using multivariate analyses, and muscle area and performance outcomes using analysis of variance. RESULTS: Children with ASD had 13-31% lower bone strength, area, and content at the shaft sites of the radius and tibia, and distal tibia. They also had 26-33% lower grip strength and long jump distances, spent 76% more daily time in light PA, and accumulated 67% fewer bone impact counts compared with TDC. CONCLUSION: We report deficits in bone strength and content accompanied by lower muscle strength performance and fewer bone-impacting activities in male children with ASD. Future research should determine whether lower muscle strength and reduced bone-loading exposure contribute to bone deficits and may serve as targets to optimize bone development.

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2. Akomolafe AF, Mahmood FR, Abdallah BM, Elshoeibi AM, Mahmoud E, Al-Khulaifi AA, Darwish N, Dweidri Y, Yousif D, Khalid H, Al-Theyab M, Azeem MW, Shahwar D, Kamal M, Alabdulla M, Khaled SM, Chivese T. Risk Factors for Autism Spectrum Disorder in the Middle East and North Africa Region: A Systematic Review and Meta-Analysis of Confounder-Adjusted Studies. J Autism Dev Disord. 2026.

PURPOSE: The etiology of autism spectrum disorder (ASD) is poorly understood, with sparse data from the Middle East and North Africa (MENA) region, which has a unique socio-epidemiological setting. This research investigated early-life developmental risk factors associated with ASD in the MENA region. METHODS: In this systematic review and meta-analysis, we searched the PubMed, Embase, Scopus, and CINAHL databases for observational studies that conducted adjusted analyses of ASD risk factors in the MENA region. We analyzed associations between ASD and factors related to conception, inheritance, maternal morbidity during pregnancy and adverse pregnancy outcomes. After study quality assessment, meta-analyses for each risk factor were carried out using a bias-adjusted inverse variance heterogeneity model. Heterogeneity was assessed using I(2) and publication bias using Doi plots and funnel plots. RESULTS: The systematic review included 19 case-control studies from eight countries within the MENA region. In overall synthesis, male sex (OR = 3.27, 95% CI: 2.39-4.48, I(2) = 40.9%), family history of ASD (OR=7.02, 95% CI 3.30-14.95, I(2) = 85.0%), and consanguinity (OR = 1.77, 95% CI: 1.38-2.28, I(2) = 57.1%) were associated with ASD. Although with limited studies, a review of the literature showed some possible associations between ASD and gestational diabetes, gestational hypertension, macrosomia, NICU admission, respiratory distress syndrome, cesarean delivery, gestational age, and older maternal age. CONCLUSION: These findings confirm the association between male sex, family history of ASD and consanguinity with ASD, potentially suggesting some inherited mechanism in the etiology of ASD in the MENA region. Some maternal co-morbidities during pregnancy and adverse pregnancy outcomes may contribute to higher ASD risk, although more studies are needed in the region. REGISTRATION: The protocol for this systematic review and meta-analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42024499837.

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3. Alam MS, Rashid MM, Roy R, Faizabadi AR, Gupta KD, Ahsan MM. RETRACTED: Alam et al. Empirical Study of Autism Spectrum Disorder Diagnosis Using Facial Images by Improved Transfer Learning Approach. Bioengineering 2022, 9, 710. Bioengineering (Basel). 2026; 13(8).

The journal retracts the article titled « Empirical Study of Autism Spectrum Disorder Diagnosis Using Facial Images by Improved Transfer Learning Approach » […].

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4. Bijle MA, Malawade M. Effectiveness of Reflex Integration Exercises on Sensory-Motor Outcomes in Children With Autism Spectrum Disorder: A Quasi-experimental Study. Cureus. 2026; 18(7): e111970.

Background Autism spectrum disorder (ASD) is a complex neurodevelopmental condition associated with impairments in sensory processing, motor coordination, and postural control. A prominent yet underappreciated contributor to these deficits is the persistence of primitive reflexes beyond the expected developmental timeline. Reflexes such as the asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR) are brainstem-mediated automatisms that, under typical neurodevelopment, integrate within the first year of life. In children with ASD, their persistence disrupts voluntary motor control, sensory modulation, postural stability, and behavioral regulation, thereby amplifying functional limitations across daily activities. Objective This study aimed to evaluate the effectiveness of a structured 12-week reflex integration exercise program on primitive reflex inhibition, motor proficiency, and sensory processing in children with ASD aged four to 10 years. Methods An experimental pre-post interventional design was employed with a sample of 27 children (mean age 6.69 ± 2.38 years; 74.1% male) diagnosed with mild to moderate ASD, recruited through convenience sampling from a single tertiary care pediatric physiotherapy setting. Participants underwent a structured 12-week reflex integration exercise program targeting the ATNR, STNR, and TLR, delivered across four sessions per week at progressive intensities through three distinct four-week phases. Outcome measures included the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) for motor outcomes; the Short Sensory Profile (SSP) encompassing Sensory and Behavior subscales for sensory outcomes; and the Sally Goddard Primitive Reflex Testing Protocol for reflex inhibition. Data were analyzed using paired samples t-tests, with Cohen’s d computed to quantify effect size. Statistical significance was set at p < 0.05. Results Post-intervention findings demonstrated statistically significant improvements across all outcome domains. Motor proficiency improved markedly, with BOT-2 scores increasing from a pre-intervention mean of 32.41 ± 5.38 to a post-intervention mean of 40.93 ± 4.50. Sensory processing difficulties decreased substantially, with SSP Sensory subscale scores reducing from 57.07 ± 6.29 to 44.67 ± 4.37 and SSP Behavior subscale scores declining from 82.37 ± 7.98 to 63.00 ± 7.50. Significant bilateral inhibition of retained reflexes was demonstrated for the ATNR, STNR, and TLR. Conclusion A structured 12-week reflex integration exercise program produced clinically meaningful and statistically significant improvements in motor proficiency, sensory processing, behavioral regulation, and primitive reflex inhibition in children with ASD aged four to 10 years. The large effect sizes observed across all outcome domains underscore the neurophysiological relevance of targeting retained primitive reflexes as a foundational mechanism for broader sensorimotor development in this population. These preliminary findings suggest that reflex integration exercises may hold promise as a therapeutic component in pediatric physiotherapy for children with ASD; however, randomized controlled trials with larger samples are warranted before definitive clinical recommendations can be made.

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5. Demopoulos C, Jesson X, Gerdes MR, Jurigova BG, Hinkley LB, Ranasinghe KG, Desai S, Findlay A, Nagarajan SS, Marco EJ. MEG resting state alpha and beta band functional connectivity in male children with autism and sensory processing dysfunction. J Neural Eng. 2026.

Abstract Objective: Sensory processing dysfunction not only affects most individuals with autism spectrum disorder (ASD), but at least 5% of children without ASD also experience sensory processing dysfunction (SPD). Our understanding of the relationship between sensory dysfunction and resting state brain activity is still emerging. The objective of this study was to examine group differences and behavioral associations with resting state alpha and beta oscillatory activity in ASD, SPD, and typically developing comparison (TDC) groups. Approach: This study compared long-range resting state functional connectivity of neural oscillatory behavior in 60 male children aged 8-12 years with autism spectrum disorder (ASD; N=18), those with sensory processing dysfunction (SPD; N=18) who did not meet ASD criteria, and typically developing control participants (TDC; N=24) using magnetoencephalography (MEG). Functional connectivity analyses were performed in the alpha and beta frequency bands, which are known to be implicated in sensory information processing. Group differences in functional connectivity and associations between sensory abilities and functional connectivity were examined. Main Results: Distinct patterns of functional connectivity differences between ASD and SPD groups were found only in the beta band, but not in the alpha band. In both alpha and beta bands, ASD and SPD cohorts differed from the TDC cohort. Distinct patterns of associations between imaginary coherence and performance-based measures of sensory processing and verbal abilities were identified across groups. Significance: These findings demonstrate distinct long-range alpha and beta band phase-lagged neural synchrony alterations in SPD and ASD that are associated with sensory processing abilities in male children. These measures could serve as potential candidate neurophysiological markers for ASD and SPD at the group level, and may provide mechanistic insights relevant to biomarker development. &#xD.

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6. K SR, Y LA. A Scoping Review of Machine Learning and Deep Learning Methods for Autism Spectrum Disorder Diagnosis and Analysis. J Vis Exp. 2026; (233).

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by diverse behavioral, cognitive, sensory, and communication profiles, making early diagnosis and personalized intervention challenging. Recent advances in machine learning (ML) and deep learning (DL) have enabled the development of computational tools for ASD screening, classification, severity assessment, and intervention monitoring. This review synthesizes findings from 50 recent studies that applied ML and DL techniques to ASD-related datasets, including electroencephalography (EEG), eye-tracking, behavioral video, microbiome, voice acoustic, demographic, and multimodal data. The review addresses three key questions: (i) which data modalities and computational approaches are most frequently used, (ii) how diagnostic performance is evaluated across different study designs, and (iii) what methodological challenges limit clinical translation. The literature is organized according to data modality, algorithmic approach, and clinical readiness. Approaches examined include conventional ML methods, convolutional neural networks, graph neural networks, hybrid deep learning architectures, federated learning, explainable artificial intelligence, topological data analysis, and multimodal fusion. The findings suggest that multimodal and graph-based approaches provide a more comprehensive representation of ASD phenotypes than single-modality methods. Explainability and privacy-preserving learning have also emerged as important considerations for clinical deployment. However, many reported high-performance models are based on small sample sizes, repeated use of the ABIDE dataset, class imbalance, single-site validation, or limited external testing, raising concerns regarding generalizability. Beyond diagnostic accuracy, this review evaluates model interpretability, calibration, scalability, validation rigor, and clinical applicability. Overall, the analysis highlights the need for standardized benchmarks, externally validated multimodal datasets, clinically relevant evaluation metrics, and decision-support systems that complement rather than replace expert clinical assessment in ASD diagnosis and management.

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7. Keller R, Marino G, Liloia D. Offenders with Autism Spectrum Disorder: A Clinical Case Series and Diagnostic Considerations in Forensic Psychiatry. Psychol Res Behav Manag. 2026; 19: 628728.

PURPOSE: Autism spectrum disorder (ASD) is increasingly recognized in adulthood, including in forensic settings, where its diagnostic and medico-legal implications remain insufficiently defined. Current evidence does not support a simple association between ASD and offending; rather, offender presentations in autistic individuals appear heterogeneous and are likely shaped by the interaction between core autistic features, intellectual and adaptive functioning, comorbidity, developmental adversity, and contextual stressors. PARTICIPANTS AND METHODS: This clinical-forensic case series describes seven offenders with ASD assessed within the Italian forensic psychiatric context. The cases encompassed multiple offending domains, including homicide, stalking, and persecutory acts, alleged sexual offending, property-related offending (arson), and domestic abuse. In several instances, ASD was identified for the first time during forensic evaluation in adulthood, often in the context of atypical presentations, variable cognitive functioning, and overlapping psychiatric or personality features. RESULTS: Across cases, offending-related conduct appeared to arise through different psychopathological and developmental pathways, including rigidity and restricted interests, social naivety, impaired contextual understanding, concrete or idiosyncratic interpretations of interpersonal situations, emotional dysregulation, interpersonal vulnerability, and co-occurring psychopathology. The series also highlighted substantial diagnostic challenges in forensic practice, particularly where autism had remained previously unrecognized. These findings suggest that the forensic relevance of ASD lies not in diagnosis alone, but in the specific way autistic characteristics interact with cognition, adaptation, and contextual demands in shaping the behaviour under examination. CONCLUSION: This case series supports the need for a clinically integrated, developmentally informed, and individualized forensic psychiatric assessment of offenders with ASD. Standardized instruments may be informative, but only when interpreted within a broader formulation incorporating developmental history, cognitive and adaptive functioning, psychiatric comorbidity, and contextual factors. Improved recognition of underdiagnosed or atypical adult presentations may enhance diagnostic accuracy and support more appropriate decisions regarding criminal responsibility, risk management, and treatment planning.

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8. Mazer-Amirshahi M, Siebert JR, Calello DP, Fox ER, Yin S, Stolbach A. ACMT Position Statement: Current Evidence Does Not Support Routine Use of Leucovorin for Autism Spectrum Disorder. J Med Toxicol. 2026.

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9. McGrath M, Li X, Jacobson LP, Leventhal B, Aschner JL, Baker B, Garcia KC, Dickerson AS, Elliott AJ, Ganiban J, Goodrich A, Horton DB, Jarnecke M, Keim S, Lee BK, Lynch CD, Klebanoff M, Mutaru AM, Nguyen RHN, Schmidt RJ, Shin HM, Shuffrey LC, Slaughter JL, Stroustrup A, Zhu Z, Tobian AAR, Grabowski MK. Neonatal Medical Male Circumcision and Child Autism Diagnosis. JAMA Pediatr. 2026.

IMPORTANCE: Public concern and speculation have emerged around a possible link between neonatal male circumcision (NMC) and autism spectrum disorder (ASD). Evidence is limited and inconsistent. OBJECTIVE: To examine associations between NMC and child ASD and autism-related traits and behaviors. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study was conducted among cohort sites participating in the Environmental Influences on Child Health Outcomes (ECHO) Cohort between February 2003 and September 2025. Statistical analyses were conducted from November 2025 to February 2026. The analysis included male, singleton children with data on NMC status and child ASD. EXPOSURE: NMC status within 28 days of birth at a medical facility. MAIN OUTCOMES AND MEASURES: ASD diagnosis was based on parent report of diagnosis by a medical professional or documentation of criterion standard clinical assessments. Social Responsiveness Scale (SRS-2) T-scores assessed the presence and distribution of autism traits, and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) Autism Spectrum Problems subscale T-scores from the Child Behavior Checklist (CBCL) 1.5/5 assessed the occurrence of child autism-related behaviors. RESULTS: The sample included 2771 male children from 14 ECHO sites, of whom 1840 (66%) were circumcised before hospital discharge, and 192 (7%) had an autism diagnosis. Among 1840 circumcised males, 108 (6%) had autism, compared with 84 of 931 uncircumcised males (9%). Mean (SD) age at autism diagnosis was 3.8 (2.2) years. Among circumcised males, 31 (4%) were administered acetaminophen during the procedure, and 128 (7%) within the 30 days after birth. After adjusting for confounders, there was no association between NMC and ASD diagnosis (odds ratio [OR], 0.83; 95% CI, 0.59-1.17). After stratification by region, preterm birth, and neonatal intensive care unit admission, an inverse or no association was observed between NMC and ASD diagnosis. Adjusted analyses showed no associations between NMC and SRS-2 continuous (β = -0.62; 95% CI, -1.46 to 0.22) or binary (OR, 0.75; 95% CI, 0.48-1.15) T-scores. Similarly, no associations were observed between NMC and CBCL 1.5/5 continuous (β = 0.01; 95% CI, -0.54 to 0.56) or binary (OR, 1.30; 95% CI, 0.75-2.26) T-scores. Overall, inverse or no associations were observed across all strata for SRS-2 and CBCL 1.5/5 outcomes. CONCLUSIONS AND RELEVANCE: This cohort study yielded no evidence that NMC was associated with ASD risk, whether assessed by parent report of medical professional diagnosis or validated instruments measuring autism-related traits and behavior. These findings may provide reassurance for families who are considering or have elected NMC for their child.

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10. Miller ZA, Conner CM, Chang JC, Mazefsky CA. Navigating Mixed-Neurotype Dialogue: Environmental and Affective Influences on Autistic Speakers. Autism. 2026: 13623613261469909.

In this reflective report study, we examined communication challenges for autistic adults by examining the influences of emotional state and environmental context across neurotype conversation partners. Using the Neurotype Communication and Assistive Technology Survey (NCATS), we surveyed 165 autistic adults (18-35 years old) and analyzed 154 responses to capture both quantitative ratings and qualitative descriptions of past contextual conversations. The majority of the participants noted that environmental factors, such as crowdedness, noise levels, and familiarity, at least somewhat impacted their communication. Autistic adults reported that noisy or unpredictable settings were associated with word loss, scripting, and social withdrawal, while quiet and familiar spaces facilitated openness and authentic self-expression. In addition, participants stated that conversations with allistic (non-autistic) partners required more conscious effort, social masking, and cognitive load than conversations with autistic partners, consistent with the Double Empathy Problem. Finally, survey responses revealed that negative emotions such as stress, frustration, and anxiety may worsen communication difficulties regardless of the conversation partner’s neurotype, whereas positive emotions such as happiness and calmness were found to improve fluency, confidence, and intersubjectivity. These results indicate that partner neurotype, emotional states, and other environmental factors can affect communication challenges for autistic adults.Lay AbstractIn this study, autistic adults reflected on their conversational experiences and described what helped communication go well and what made it more difficult. We asked 165 autistic adults (18-35 years old) to complete a survey about how they communicate in different situations based on people and places and received 154 responses. We focused on how communication changed whether the other person is autistic or allistic (non-autistic). Within that, we focused on two main factors: the type of environment they were in (e.g., home, work, school) and how their emotions (feeling happy, sad, angry) affected their communication. The majority of autistic adults said that the place they were in at least somewhat affected their communication. Autistic adults said that loud or unpredictable places often made communication harder, leading to things like losing words, repeating scripts, or pulling back from the conversation. Quiet and familiar spaces, on the contrary, made it easier to share thoughts openly. Talking with allistic people usually took more effort and sometimes led to masking, or hiding one’s natural way of communicating. This fits with the Double Empathy Problem, which says that communication struggles often come from mismatched understandings between autistic and allistic people. Emotions were also important. Stress, anxiety, or frustration made conversations harder, while happiness and calmness made conversing easier and improved confidence. Overall, our findings suggest that reducing sensory stress, supporting emotional well-being, and encouraging mutual understanding can make conversations better for both autistic and allistic people.

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11. Pascoe MI, Vincent J, Lai MC, Desarkar P, Vitopoulos N, Lunsky Y, MacKinnon KR, Lam JSH. Addressing Methodological Concerns Regarding a Recent Study on Autism and Gender Diversity in a Canadian Gender Identity Clinic. Can J Psychiatry. 2026: 7067437261474299.

Plain Language SummaryResponding to concerns regarding the methods and findings of a study on autism and gender diversity in CanadaDinu and colleagues wrote a letter to the editor about a recently published study that looked at differences in characteristics between autistic and non-autistic adults who were seen by clinicians at a Canadian gender identity clinic. Dinu and colleagues encouraged interpreting the findings of the original article with caution, because they were concerned about the type of data, the method of analyzing the data, and the interpretations that the authors made. In this response, we address their concerns and clarify the goals and findings of our original study. Like all retrospective chart review studies, our original study has important limitations. We agree that these limitations should be considered when interpreting our findings, but they do not change the main conclusions of the study. Dinu and colleagues interpreted our study as recommending specific approaches to care for autistic adults. Our response clarifies that our study described autistic transgender and gender diverse adults attending an adult gender identity clinic as having substantial mental health needs and did not recommend specific approaches to care. We conclude that further research and service planning are needed to improve access to individualized mental health and gender-related care for autistic transgender and gender-diverse adults. Responding to concerns regarding the methods and findings of a study on autism and gender diversity in CanadaDinu and colleagues wrote a letter to the editor about a recently published study that looked at differences in characteristics between autistic and non-autistic adults who were seen by clinicians at a Canadian gender identity clinic. Dinu and colleagues encouraged interpreting the findings of the original article with caution, because they were concerned about the type of data, the method of analyzing the data, and the interpretations that the authors made. In this response, we address their concerns and clarify the goals and findings of our original study. Like all retrospective chart review studies, our original study has important limitations. We agree that these limitations should be considered when interpreting our findings, but they do not change the main conclusions of the study. Dinu and colleagues interpreted our study as recommending specific approaches to care for autistic adults. Our response clarifies that our study described autistic transgender and gender diverse adults attending an adult gender identity clinic as having substantial mental health needs and did not recommend specific approaches to care. We conclude that further research and service planning are needed to improve access to individualized mental health and gender-related care for autistic transgender and gender-diverse adults. eng.

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12. Pirbhoy PS, Steward O. Assessment of sex-dependent cognitive flexibility in a mouse model of fragile X syndrome. Learn Mem. 2026; 33(6-7).

Fragile X syndrome (FXS) is a leading inherited cause of intellectual disability. FXS is caused by a trinucleotide repeat expansion in the fragile X messenger ribonucleoprotein 1 (fmr1) gene, which results in transcriptional silencing, and loss of its protein product, FMRP. One symptom of FXS is cognitive inflexibility, but there is no generally accepted way to test this in rodents. Tests of reversal learning or extinction paradigms have been used as measures of cognitive flexibility, but these are indirect, require substantial training and experimenter effort, and often yield inconsistent results. This study tests male and female Fmr1 knockout (KO) and wild-type (WT) mice in a « puzzle box » specifically designed to assess cognitive flexibility. The Puzzle Box is a two-chambered apparatus with a brightly illuminated area and an enclosed goal area. Novel obstacles block the underpass to the goal area, requiring that mice adopt new strategies. Results reveal that female, but not male, Fmr1 KO mice exhibit impaired performance compared to WT controls. Analysis of behavioral measures during novel obstacle presentation revealed a behavioral phenotype consistent with increased anxiety-like and hyperactivity behaviors, as well as altered engagement with novel obstacle conditions, in female Fmr1 KO mice compared to WT controls. Overall, the Puzzle Box test shows promise as a rapid screening test for cognitive flexibility impairments in FXS or other rodent models of neurological disorders.

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13. Rodríguez-Armendariz E, Ábalos Z, Castroviejo E, Vicente A. Adaptive Functioning in Expressively Nonverbal and Minimally Verbal Autistic Children: Nonverbal Intelligence as a Predictive Factor. Autism Dev Lang Impair. 2026; 11: 23969415261465246.

BACKGROUND AND AIMS: Adaptive functioning is a strong predictor of long-term outcomes for autistic individuals, yet evidence regarding its association with ADOS-2 comparison scores, nonverbal IQ (NVIQ), and early language development remains inconsistent. Findings on the contributions of IQ and ADOS-2 comparison scores are mixed, and early linguistic abilities have received comparatively less attention. This study examined how receptive language delay, NVIQ, and ADOS-2 comparison scores relate to later adaptivity in nonverbal and minimally verbal autistic children. METHODS: Participants were 4- to 12-year-old autistic children (N = 44) who completed ADOS-2 Module 1 at baseline, indicating limited expressive language but variability in age and developmental profiles. Baseline assessments included ADOS-2 comparison scores, NVIQ (Leiter-3), and receptive vocabulary (PPVT-III). Adaptive functioning was measured 2 to 3 years later using Vineland-3 subscales. To examine the contribution of each variable, we fitted multiple linear regression models with Vineland-3 scores as the dependent variable and standardized test scores as continuous predictors, while controlling for children’s age (in months) and the testing interval between the ADOS-2 and the Vineland-3. We first fitted separate models for each predictor, followed by additive models including the three predictors. Additional models included interaction terms between NVIQ and ADOS-2 comparison scores, PPVT-III scores and ADOS-2 scores, NVIQ and PPVT-III scores, and their three-way interaction. Model comparisons were conducted to determine which model provided a better fit for the data. RESULTS: NVIQ emerged as the only significant predictor of adaptive functioning. Although ADOS-2 comparison scores and receptive vocabulary were significantly associated with adaptivity in the simpler models, these effects were no longer significant once NVIQ was included, suggesting that their predictive value was largely accounted for by NVIQ. Unlike earlier reports, higher NVIQ in this sample was not associated with greater adaptive difficulties, which suggests this relationship is not uniform across subgroups of autistic children. Interaction analyses did not reveal significant moderation effects, although some interactions involving NVIQ or receptive language delay and ADOS-2 approached conventional significance thresholds. These effects require confirmation in larger samples. CONCLUSIONS: Adaptive functioning in autistic children with limited expressive language abilities is predicted more strongly by NVIQ than by ADOS-2 comparison scores, receptive language delay or the interaction of these three variables. IMPLICATIONS: These findings indicate that early NVIQ remains a meaningful predictor of adaptive functioning in minimally verbal autistic children, underscoring the importance of including nonverbal cognitive assessments in early prognostic evaluations. The absence of meaningful associations with ADOS-2 comparison scores and receptive vocabulary delay when NVIQ was accounted for suggests that adaptive outcomes may depend less on trait profile or linguistic comprehension than may be assumed, and that autistic children may successfully compensate for early marked autistic traits and comprehension difficulties.

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14. Saito YE, Turner J, Messias E, Lin PI. Early Screen Time and Behavioral Symptom Trajectories in Children With Autism and ADHD: A Longitudinal Cohort Study. J Autism Dev Disord. 2026.

PURPOSE: Children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) may be especially sensitive to early screen exposure due to sensory and emotional vulnerabilities. This study examined whether early screen time differentially affects behavioral trajectories in ASD, ADHD, and neurotypical children. METHODS: Using data from the Longitudinal Study of Australian Children, linear mixed-effects models assessed outcomes. Screen time before age 2 was categorized as ≥ 14 vs. <14 h/week. Hyperactivity and emotional problems were measured at ages 4, 6, and 8, with ASD and ADHD diagnoses tested as moderators. RESULTS: ASD was linked to higher baseline hyperactivity and emotional problems and steeper increases in both outcomes over time. ADHD was associated with higher baseline hyperactivity and steeper symptom growth in hyperactivity and emotional problems over time. Greater early screen time was associated with steeper increases in emotional problems scores across all subgroups. However, no significant interaction between screen time, age, and diagnosis was found, indicating that screen exposure did not disproportionately worsen trajectories in ASD or ADHD compared to neurotypical peers. CONCLUSION: Early screen exposure is associated with a statistically significant but small increase in emotional problem scores but does not uniquely amplify risks in ASD or ADHD. While both conditions independently show steeper behavioral symptom growth, these patterns are not exacerbated by screen time. Findings support universal, rather than disorder-specific, screen time guidelines.

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15. Sherwood KL, Erickson D, Burke-Miller J, Smith MJ. « I Try to Act Like a Neurotypical so it Makes Customers More Comfortable »: A Mixed Methods Analysis of Autistic Camouflaging at Work. J Autism Dev Disord. 2026.

PURPOSE: As many as 75% of autistic individuals report camouflaging to appear less autistic, with workplace camouflaging linked to poor mental health, thwarted advancement, and early job departure. However, few studies have investigated why and how autistic adults camouflage at work. METHODS: This mixed-methods study explored workplace camouflaging frequency and experiences among N = 131 employed autistic adults. Linear regression examined whether camouflaging differed across identity groups, logistic regression tested whether camouflaging predicted changes in coworker behavior, and reflexive thematic analysis was used to analyze qualitative data. RESULTS: Overall, 86% of participants reported camouflaging often or sometimes at work. More camouflaging was associated with being female (B=0.94, p<.001), non-binary (B=0.78, p=.011), and transgender (B = 1.10, p=.007) compared to male identity, but was not associated with race, ethnicity, sexual orientation, or autism disclosure. More frequent camouflaging was associated with nearly three times greater likelihood of noticing changes in others' behavior. Thematic analysis revealed five themes: camouflaging as a response to encountering prejudice or abuse, as a way of coping, as a response to being silenced, as compulsory production of extra labor, and as forced repression of identity. Mixed-methods integration indicated that gender minority participants reported being silenced and compulsory extra labor at higher within-group rates, and non-disclosed participants relied on active coping strategies at more than double the rate of disclosed participants. CONCLUSION: These findings underscore the importance of understanding camouflaging within workplace contexts, where social expectations and identity dynamics shape autistic employees' experiences and inform efforts to reduce stigma and support authentic self-expression. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05949086.

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16. Silva L, Silva F, Lima R, Montenegro ACA. Clinical impact of the Development of Communication Skills in Autism (DHACA) on the development of social skills in children with autism. Codas. 2026; 38(5): e20250202.

PURPOSE: To evaluate the clinical impact of the DHACA® method on the development of social skills in children with Autism Spectrum Disorder (ASD). METHODS: This longitudinal quantitative intervention study conducted with 23 children with ASD, aged 3 to 6 years, who were nonverbal or minimally verbal. Individual intervention sessions using the DHACA® method were held weekly for 20 weeks. Social skills were assessed before and after the intervention using the ACOTEA-R protocol. Data were statistically analyzed using the Wilcoxon test. RESULTS: There was a significant improvement (p < 0.05) in ten of the sixteen skills assessed, including "responds to name," "eye contact," "shared attention," and "symbolic play." Other skills, such as "responds to 'no'" and "takes turns," showed a tendency toward clinical improvement, although not statistically significant. Only three skills did not show relevant progress. CONCLUSION: The DHACA® method proved effective in promoting social skills in children with ASD, contributing to greater autonomy and social participation. The results reinforce its clinical potential as a therapeutic resource in both educational and healthcare settings.

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17. Sun M, Wang X, Zhang Q, Wang Z, Luo J, Xu J, Li X. Xylitol ameliorates ASD-like behavior in Chd8(+/-) mice via modulations of the gut microbiome, neurotransmitters, and dendritic spine morphology. Food Funct. 2026; 17(15): 6758-73.

Autism spectrum disorder (ASD) is a neurodevelopmental condition with complex etiology involving gut-brain axis interactions. It remains elusive how prebiotics modulate this axis to alleviate ASD symptoms. This study aimed to investigate whether xylitol, a potential prebiotic, improves behavioral and neural deficits in Chd8(+/-) mice, a genetic model of ASD, and to explore the associated roles of the gut microbiome, neurotransmitters and synaptic morphology in these effects. We found that Chd8(+/-) mice exhibited disrupted gut microbiota and imbalanced levels of key neuromodulators including indole-3-lactic acid (ILA), asparagine (Asn) and glycine (Gly), as well as reduced dendritic spine density and maturity in the mPFC and hippocampal CA1 regions and diminished c-Fos activation in response to social stimuli. Xylitol supplementation significantly ameliorated social deficits, restored microbial composition and neurotransmitter metabolite profiles, and rescued synaptic maturation and neuronal activity in these mice. These findings suggest that xylitol may act via the gut-brain axis to reverse ASD-like phenotypes, although direct causal evidence remains to be established. Nonetheless, this work supports the potential of xylitol as a dietary intervention for ASD.

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18. Vogelsang L, Vogelsang M, Li CE, Kjelgaard M, Cardinaux A, Nelson CA, Sinha P. Intact Visual Correlation Detection in Autistic Adults. Autism Res. 2026: e70339.

The ability to detect recurring temporal co-occurrence, or temporal correlation, of sensory events is fundamental for organizing perceptual input into coherent representations. Although past work has revealed differences across several aspects of temporal processing in autism, it is unknown whether autistic and non-autistic individuals differ in the key computation of correlation detection. Here, we examined this question in the visual domain using an online task. A total of 143 age- and sex-matched adults (73 autistic, 70 non-autistic) viewed sequences in which three visual elements stochastically alternated between bright and dark states. Two of these were disks, and the third was a surrounding annulus. Participants indicated which of the two disks co-occurred more reliably with the annulus. Accuracy increased systematically with correlation strength in both groups, but there were no significant group differences and no negative association between performance and autistic trait scores when controlling for nonverbal IQ. These findings suggest that visual correlation detection, under the conditions tested here, is preserved in autistic adults. This points to a key aspect of temporal processing in autism that may provide a stable foundation for perceptual organization even amid challenges reported in other timing-related domains, such as higher-level temporal prediction. These results set the stage for future research to identify the mechanisms underlying both preserved and divergent temporal processes, and to translate these findings into evidence-based support that builds on the observed strengths of autistic individuals.

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