1. Bakul F, Stallworth H, Deshpande G, Kana RK. Post-mortem and high field MRI and MR spectroscopy insights into the neurobiology of autism. Neuroscience;2026 (Nov 3);615:249-256.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by persistent challenges in social communication and the presence of restricted, repetitive behaviors. Neuroimaging and post-mortem research have consistently shown that ASD is associated with atypical brain connectivity and microstructural alterations. However, no singular neurobiological marker has been reliably established for diagnosis, and autism diagnoses depend primarily on behavioral evaluations, which may result in delayed or imprecise identification. The biological complexity and heterogeneity of ASD suggest that no single measure is likely to be sufficient, and instead calls for a multidimensional approach that integrates microstructural, neurochemical, and metabolic information. Advanced neuroimaging techniques, particularly ultra-high-field 7 Tesla MRI and phosphorus-31 magnetic resonance spectroscopy ((31)P MRS), offer promising avenues for detecting subtle neuroanatomical, neurochemical, and metabolic changes in autism. Because studies using 7 T scanners remain sporadic, this review combines a systematic search with a narrative synthesis to assess the current evidence. It brings together post-mortem histological findings with in-vivo ultra-high-field MR evidence across three domains: cortical layer connectivity, excitation-inhibition balance, and bioenergetics. Post-mortem studies establish layer-specific and E/I alterations, while emerging 7 T MRI and MRS findings begin to capture comparable cortical-layer, neurochemical, and bioenergetic differences in living individuals. Because these domains are interdependent, examining them together yields more complete insight than any one in isolation. By showing where these lines of evidence converge, this narrative review identifies directions toward a combination of biologically grounded markers of autism and improved understanding of its neurobiology.

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2. Bonfim CB, de Araujo JAP, Castro-de-Araujo LF, Vasudevan V, Barreto ML, Machado DB. Mortality rates among hospitalized individuals with autism spectrum disorder over a 10-year period in the 100 Million Brazilian Cohort. J Bras Psiquiatr;2026;75

INTRODUCTION: This study aims to investigate the main causes of mortality among individuals hospitalized with Autism Spectrum Disorder (ASD) and to estimate the association between ASD hospitalization and mortality rates over a 10-year period (2008-2018). METHOD: This is a population-based cohort study using linked administrative health data and social assistance system (CadÚnico) records from the 100 Million Brazilian Cohort. The study included 948 individuals hospitalized with an ASD diagnosis and 99,904 non-hospitalized individuals. Cox proportional hazards regression was estimated using propensity scores to allow balanced comparisons between groups (ASD / non-ASD). RESULTS: Individuals hospitalized with ASD died more frequently from respiratory (24%) and neurological (20%) diseases, whereas non-hospitalized individuals died more from circulatory diseases (27.8%) and neoplasms (17.1%). Hospitalized individuals with ASD had an overall higher risk of death (HR = 1.78, 95%CI = 1.20-2.66, p = 0.005), particularly females (HR = 3.48, 95%CI = 1.95-6.19, p < 0.001), those aged 11-24 years (HR = 3.20, 95%CI = 1.45-7.06, p = 0.004), and those without comorbidities (HR = 2.27, 95%CI = 1.48-3.48, p < 0.001). CONCLUSION: These findings reflect poor healthcare quality, indicating a gap in care for individuals with ASD, particularly those living in socially vulnerable contexts.

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3. Chiem E, Wagner L, Hernandez LM, Green S, Dapretto M. Early sleep and sensory over-responsivity relate to insular functional connectivity with sensorimotor cortices and cerebellum in infants at varying likelihood for autism. J Neurodev Disord;2026 (Aug 4);18(1)

Sleep problems and sensory over-responsivity (SOR) are common, co-occurring, and early emerging features of Autism Spectrum Disorder (ASD). Yet, the early neural mechanisms underlying these symptoms remain unclear. Here, we used resting-state fMRI data from the Infant Brain Imaging Study (IBIS) to examine how functional brain connectivity at 6 months may relate to parent-reported measures of sleep-onset problems and SOR in infants at varying familial likelihood for ASD. The right anterior insula (rAI) – a key hub of the salience network – was used in ROI-ROI analyses to investigate functional connectivity to cortical and cerebellar regions previously implicated in sleep disruption, sensory processing challenges, and ASD. Infants at high (HL) and low (LL) likelihood for ASD displayed divergent patterns of rAI connectivity with sensorimotor cortex, as well as cerebellar regions involved in sensorimotor processing and higher-order functions. Furthermore, stronger rAI connectivity with sensorimotor cortices and cerebellar regions was associated with worse sleep-onset problems and SOR in HL infants. In contrast, stronger rAI-cerebellar connectivity was related to fewer sleep-onset problems and SOR in LL infants. Our findings indicate that altered rAI connectivity may result in over-attribution of attention to sensory stimuli and highlight aberrant sensory prediction learning, which may underlie worse sleep problems and higher SOR in HL infants.

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4. Cowley S, Quadt L, Russo A, Page LA, Dew R, Wickramasinghe V, Critchley HD, Stone JM, Eccles JA. Autism screening outcomes in a mental health crisis population: findings from a service evaluation. BJPsych Open;2026 (Nov 3);12(6):e284.

We evaluated proportions of autism screening outcomes among adults accessing crisis mental health services in Sussex, UK, and examined associations with quality of life and joint hypermobility as an indicator of physiological complexity. Fifty-five participants (mean age 35.7 years, 56% male, 85% White) completed autism and hypermobility screening questionnaires and the Mental Health Quality of Life Questionnaire. Forty-three participants (78%) scored above screening threshold for autism, although only eight had a prior diagnosis, and 27% scored above the published autistic median. Higher Ritvo Autism and Asperger Diagnostic Scale (RAADS-14) scores were associated with lower quality of life (p < 0.001) and poorer well-being (p < 0.01). Those screening positive for hypermobility also had higher RAADS-14 scores (p = 0.01), suggesting a possible biological contribution to distress. Findings indicate high frequency of possible autism in crisis services and a need for tailored, biopsychosocially informed support.

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5. de Los Reyes-Ramírez L, Bergadà-Martínez A, Martínez-Torres S, Martínez-Gallego I, Losada-Ruiz P, Arboleya S, González-Matute A, Gueimonde M, Maldonado R, Rodríguez-Moreno A, Ozaita A. A serotonergic mechanism is involved in the pro-cognitive effect of AM6545 treatment in a mouse model of fragile X syndrome. Transl Psychiatry;2026 (Aug 20);16(1)

Fragile X syndrome (FXS) is the principal monogenic syndrome leading to inherited intellectual disability and autism. It is caused by the silencing of FMR1 gene that leads to the loss in the expression of its encoded protein, the fragile X messenger ribonucleoprotein 1 (FMRP). In synapses, FMRP has a key role in local mRNA modulation to maintain synaptic plasticity. The Fmr1 KO (FX) mouse model shows cognitive impairment and some of the synaptic traits present in individuals with FXS, together with alterations in gut microbiota. Previous studies revealed that pharmacological and genetic cannabinoid type-1 receptor (CB1R) inhibition significantly prevented central key alterations in FX mice. Here, we aimed to evaluate the effect of a sub-chronic treatment with the largely peripherally-restricted CB1R antagonist AM6545. We found that AM6545 reduced memory deficits and restored enhanced hippocampal mGluR5-dependent long-term depression and aberrant dendritic spine density in FX mice. At the peripheral level, AM6545 modified altered FX mice fecal microbiota composition and intestinal Muc2 expression, while in the hippocampus AM6545 treatment upregulated hippocampal Htr4, the gene encoding for serotonin receptor 4 (5-HT4R). This upregulation, also observed in cecum, positively correlated with memory performance. Notably, acute pharmacological blockade of 5-HT4R abolished AM6545 pro-cognitive effect. Our results suggest that repeated peripheral CB1R inhibition ameliorates key central and peripheral alterations in FXS mouse model and modifies the expression of serotonergic receptors important for cognitive performance. Together, this evidence points to the peripheral targeting of CB1R as an approach to alleviate cognitive dysfunction in the FXS context.

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6. Habiballah LK, Abu-Akel A. Parenting Autistic Adolescents Among Palestinian Citizens of Israel: A Reflexive Thematic Analysis. Autism;2026 (Nov 3):13623613261498497.

Adolescence represents a critical developmental transition for Autistic youth, yet limited research has examined how minoritized families experience parenting during this period within mainstream educational settings. This qualitative study explored how Palestinian parents who are citizens of Israel understood and experienced raising Autistic adolescents at the intersection of developmental transition, religious meaning-making, and broader social and structural conditions. Semi-structured interviews were conducted in Arabic with 33 parents (28 mothers and five fathers) of Autistic adolescents aged 13 to 16 years enrolled in mainstream middle schools. Transcripts were analyzed using reflexive thematic analysis. Four interrelated themes were generated: (a) living in persistent vigilance; (b) balancing protection and autonomy; (c) negotiating stigma and belonging; and (d) reconstructing parental identity. The findings suggest that caregiving demands extended beyond autism-related support needs and were also shaped by institutional inequality, social judgment, and contested belonging. Parenting was experienced as a socially embedded process rather than as a series of isolated stressors. These findings challenge deficit-oriented understandings by foregrounding the interaction of developmental, sociocultural, and structural contexts and highlight the need for culturally responsive educational inclusion, consistent anti-bullying procedures, and equitable transition planning.Lay AbstractParenting an Autistic adolescent can involve challenges that extend beyond everyday caregiving. However, little is known about how Palestinian families in Israel experience this stage of their children’s lives. In this study, we interviewed 33 Palestinian parents (28 mothers and five fathers) of Autistic adolescents aged 13-16 years attending mainstream middle schools. Parents described four interconnected aspects of their experiences: remaining constantly attentive to their children’s changing needs, balancing protection with growing independence, dealing with stigma and concerns about social belonging, and developing a changing sense of themselves as parents. Parents explained that supporting their adolescents often required ongoing emotional effort, communication with schools, and advocacy for appropriate services and educational opportunities. Religious beliefs and family relationships sometimes provided reassurance and meaning, while social judgment and unequal access to support created additional difficulties. These findings highlight the importance of listening to parents’ experiences and providing culturally responsive school support, effective anti-bullying measures, and better planning for the transition toward adulthood.

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7. Hutchins TL, Knox SE, Fletcher EC. Rethinking Gestalts and the Natural Language Acquisition Framework: Advancing Construction Grammar Approaches for Autistic AAC-Aided Language Learners. Autism Dev Lang Impair;2026 (Jan-Dec);11:23969415261487032.

BACKGROUND & AIMS: The Natural Language Acquisition (NLA) framework and discourse on « gestalt language processing » (GLP) have gained substantial visibility in clinical communities and are increasingly shaping intervention for autistic children, including recommendations for augmentative and alternative communication (AAC). Despite this uptake, NLA’s definitions, theoretical assumptions, and developmental claims remain contested in the spoken domain and have not been empirically examined in AAC. MAIN CONTRIBUTION: In this article, we examine three assumptions central to NLA: (1) that words are the fundamental building blocks of language, (2) that autistic learners are « gestalt » processors, and (3) that neurotypical « analytic » processors acquire language one word at a time. We contrast these assumptions with a Construction Grammar (CXG) account of language acquisition, challenge the NLA-informed AAC recommendation to program « gestalts » onto a single AAC button, and outline the potential unintended consequences that make this practice highly concerning. Finally, we evaluate the implications of exporting other NLA treatment recommendations to AAC (e.g., restrictions on verbs, grammar, recasts) and outline how a CXG-informed approach better guides the development of AAC supports. CONCLUSIONS AND IMPLICATIONS: Transferring NLA protocols to AAC introduces avoidable clinical risks. By contrast, a CxG-informed approach aligns with prevailing language acquisition theory and established AAC best practices by emphasizing robust systems, morphosyntactically complete modeling, recasts, sentence diversity, and structured interaction that makes constructions salient and extendable. We conclude that the relevant clinical task is not to classify learners as gestalt or analytic processors but to design interactional environments that accommodate learner and device constraints to make salient and accessible the patterns replete in language to support language development.

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8. Kenworthy L, Bertollo JR, Pugliese CE, Candy C, Armour AC, Csumitta KD, Reimann GE, Fritz MS, Wallace GL. Adaptive Behavior Challenges Increase Into Young Adulthood and Are Predicted by Parent-Reported Executive Function in Autistic Youth. Autism Res;2026 (Nov 3)

Everyday adaptive behavior skills are a strong predictor of independence, mental health, and quality of life for autistic people. However, autistic individuals’ adaptive skills are typically below expectation for their age and their intellectual abilities. Executive function is related to concurrent adaptive behavior, but few longitudinal studies have evaluated it as a predictor of adaptive behavior development over time. This study examines the trajectories of parent-reported adaptive behavior skills in autistic youth from early childhood to young adulthood and their relationship to parent-reported flexibility, working memory, and inhibition challenges. Leveraging a longitudinal sample of 313 participants (age range = 2-25 years; 64 females; Full Scale IQ: M = 103.3, range = 52-159; number of visits per participant: M = 3.01, range = 2-9) across a total of 941 visits, we examined trajectories of adaptive skills and their relationship to executive function challenges using multilevel growth curve modeling. Age-related adaptive skills decline with age in autistic people from 2 to 25 years old, regardless of parent education level. Parent-reported executive function challenges predict adaptive behavior scores across all adaptive skill domains. Adaptive behavior challenges endure across development for autistic people. Executive function is a key factor in adaptive outcomes, making it an important target for intervention and environmental supports.

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9. Lai S, Wu J, Zhang J, Yang X, Liu Y, Chen L, Fu P, Tang S, Tang C. Sensory processing profiles, social responsiveness, and behavioral symptoms in children with autism spectrum disorder: a retrospective clinical study with subscale and exploratory indirect-effect analyses. Brain Dev;2026 (Nov 3);48(6):104616.

BACKGROUND: Sensory and behavioral symptoms co-occur in autism spectrum disorder (ASD) but overlap among caregiver-reported scales complicates interpretation. AIM: To characterize associations among social responsiveness, sensory processing, and behavioral symptom scores in children with confirmed ASD receiving rehabilitation. METHODS: This retrospective cross-sectional study included 312 children with available total and subscale scores on the Social Responsiveness Scale (SRS), Short Sensory Profile (SSP), and Autism Treatment Evaluation Checklist (ATEC). Spearman correlations and multivariable regression examined score associations. Post hoc content-deletion analyses and exploratory association products were also evaluated. RESULTS: SRS total score correlated positively with ATEC total score (ρ = 0.711), whereas SSP total score correlated negatively with ATEC (ρ = -0.510) and SRS total scores (ρ = -0.506; all P < 0.001). SSP domains were intercorrelated (ρ = 0.242-0.582). After adjustment for SRS total score, the other six SSP domains, age, and sex, underresponsive/seeks sensation was associated with ATEC total score (B = -0.851; 95% confidence interval, -1.414 to -0.289; Benjamini-Hochberg-adjusted P = 0.022). The other SSP domains did not meet the adjusted significance threshold. In two post hoc analyses excluding selected potentially overlapping ATEC items, the corresponding coefficients were - 0.668 and - 0.631 (both adjusted P = 0.016). CONCLUSION: Sensory, social responsiveness, and behavioral questionnaire scores were associated in this selected clinical sample. Item-deletion analyses did not resolve potential bias from overlapping content and shared measurement formats. These cross-sectional associations do not establish domain-specific sensory-behavior relationships, causal mechanisms, or priorities for rehabilitation.

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10. Li HM, Chen Z. A structural vulnerability model of autism derived from symptom-ability network analysis. Front Psychiatry;2026;17:1837552.

BACKGROUND: While Autism Spectrum Disorder (ASD) is increasingly understood through a developmental systems lens, the structural properties that confer vulnerability remain poorly defined. This study aimed to formalize and test a « Structural Vulnerability Model » by comparing the symptom-ability network architectures of preschool children with and without ASD. METHODS: Utilizing a large dataset (N = 1,502 ASD; N = 570 Typically Developing [TD]), we constructed Gaussian Graphical Models and Directed Acyclic Graphs (DAGs) from ten variables spanning core symptoms, adaptive behaviors, and cognitive abilities. We performed a multi-level comparison of network topology, node centrality, gender-specific patterns, and conditional-dependence structures. RESULTS: The ASD and TD networks differed in global strength and in the pattern of prominent edges. Communication (COM) had the highest strength centrality in TD, whereas Receptive Language (RL) had the highest strength in ASD. Exploratory bridge-centrality analyses identified RL and COM as prominent cross-domain connectors in ASD. The cross-sectional DAG analysis summarized conditional-dependence structures and was not interpreted causally. CONCLUSION: The findings provide preliminary, network-based support for a Structural Vulnerability Model, interpreted as a pattern of concentrated associations rather than a validated causal or prognostic mechanism. Longitudinal, externally replicated, and covariate-adjusted studies are needed before intervention implications can be drawn.

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11. Meng L, Cheung WC, Lin CW, Zhang Q, Jan YK. Comparison of rhythmic auditory and visual cueing on neuromuscular coordination in autistic children: an exploratory study. Dev Neurorehabil;2026 (Nov 3):1-12.

OBJECTIVE: Children with Autism Spectrum Disorder (ASD) exhibit motor control deficits linked to atypical sensorimotor synchronization, impacting daily function. While rhythmic sensory cueing is a promising intervention, prior studies often rely on behavioral measures, failing to elucidate the underlying neuromuscular efficiency. This study aimed to explore the comparative effects of auditory cueing (AC) or visual cueing (VC) to determine which is more effective for enhancing neuromuscular coordination. METHODS: Recruitment and physiological testing in children with ASD present significant challenges in sensory sensitivities and task tolerance; therefore, a within-subjects, counterbalanced crossover design was used to maximize statistical power and control for inter-individual heterogeneity. Nine children ultimately completed the full protocol. Participants performed a rhythmic handgrip task at 15% of maximal voluntary contraction under AC and VC. Surface electromyography was recorded from the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles. Intermuscular coherence in the 8-12, 15-35, and 35-60 Hz bands, as well as muscle activation and fatigue metrics of root mean square (RMS), median frequency (MDF), and mean frequency (MNF) were calculated. RESULTS: The primary finding indicates a significant effect between cueing modalities on intermuscular coherence in the 15-35 Hz (β) band. Maximal coherence was significantly higher during AC compared to VC (Z = -2.192, p = .028). In contrast, no significant differences were found for RMS, MDF, nor MNF for FDS (p = .960, 0.175, 0.257, respectively) or ECR (p = .139, 0.359, 0.242, respectively). CONCLUSION: The dissociation between improved neural coordination and unchanged physiological cost preliminarily suggests that AC may enhance motor command quality. Clinically, AC appears to be a promising strategy for interventions targeting motor stability in ASD, though the observed individual variability necessitates a personalized approach.

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12. Narzisi A, Fabbri-Destro M, Foti E, Cristofani C, Manetti G, Accorinti I, Muccio R, Berloffa S, Fantozzi P, Valente E, Viglione V, Avanzini P, Carta A, Sotgiu S, Bartolini E, Milone A, Masi G. In-person UCLA-PEERS(®) program for adolescents with autism spectrum disorder in Italy: study protocol for a pilot and feasibility randomized controlled trial with pragmatic features and exploratory EEG markers of treatment response. Front Psychiatry;2026;17:1988518.

BACKGROUND: Adolescents with Autism Spectrum Disorder (ASD) Level 1 frequently experience persistent difficulties in peer relationships and social functioning that become more evident as social demands increase. Group-based social skills trainings represent a key evidence-based intervention for this population, yet its availability in routine clinical services is still limited. The Program for the Education and Enrichment of Relational Skills (PEERS(®)) is one of the most empirically supported interventions for autistic adolescents. In Italy, telemedicine delivery has shown promising results, but the effectiveness and implementation of the in-person format in real-world services have not yet been evaluated. In addition, predictors of individual response to psychosocial interventions remain largely unknown. METHODS: This study is designed as a two-arm pilot and feasibility randomized controlled trial incorporating pragmatic features, including delivery within a routine tertiary clinical service, comparison with Treatment as Usual (TAU), and allowance for ongoing concomitant clinical, educational, and pharmacological treatments. It will compare the in-person Italian adaptation of UCLA PEERS(®) with Treatment as Usual (TAU) at IRCCS Fondazione Stella Maris (Pisa, Italy). Thirty-six adolescents aged 11-13 years with ASD (DSM-5-TR) and Full-Scale IQ >85 will be assessed at baseline (T0) and after the 16-week intervention (T1). Randomization will use block allocation with allocation concealment until completion of baseline assessments; outcome assessors and independent ADOS-BOSCC video coders will remain blind to group assignment. The intervention includes sixteen weekly 90-minute group sessions delivered by certified providers, with parallel caregiver sessions and structured teacher contacts to promote generalization. The primary focus of this pilot trial is feasibility, assessed through recruitment, retention, session attendance, and treatment fidelity. Clinical outcomes will be examined exploratorily to provide preliminary estimates of treatment effects. The QSQ-R will serve as the prespecified principal clinical outcome for estimating change in social functioning from baseline to T1. Parent- and adolescent-report versions will be analyzed separately, considering the Social Initiative and Social Reciprocity dimensions as distinct outcomes rather than deriving a composite total score. Key secondary outcomes include social knowledge (TASSK-R), autism-related social responsiveness (SRS-2), social motivation (SSDS), social anxiety (SAS), and observational change in social-communication behaviors (ADOS-BOSCC). Emotional-behavioral functioning (CBCL; YSR) will be explored as additional secondary outcomes. Baseline electroencephalography (EEG) recorded during a gesture-word integration task will be used to derive the N400 congruency effect and to explore whether individual differences in this measure are associated with treatment response. As a pilot and feasibility trial, the study is not powered for definitive efficacy testing and will estimate feasibility, acceptability, fidelity, and preliminary effect sizes to inform future multicenter trials. DISCUSSION: This study will provide the first evaluation of in-person PEERS(®) in the Italian clinical context and test the generalizability of previous telemedicine findings in routine care. The integration of clinical and behavioral outcomes may contribute to mechanism-informed, personalized psychosocial interventions for autistic adolescents and guide the design of future confirmatory studies. TRIAL REGISTRATION: (ClinicalTrials.gov – NCT07207213 – October, 3, 2025).

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13. Nuzhnyi EP, Illarioshkin SN. [Nosological spectrum of disorders characterized by the combination of cerebellar ataxia and parkinsonism]. Zh Nevrol Psikhiatr Im S S Korsakova;2026;126(10. Vyp. 2):56-65.

The differential diagnosis of disorders characterized by the combination of cerebellar ataxia and parkinsonism presents significant challenges. This combination is observed across a wide range of sporadic and hereditary neurodegenerative disorders, metabolic diseases, and acquired (secondary) conditions. Multisystem atrophy represents the most common disorder manifesting both ataxia and parkinsonism. Additional common conditions include fragile X-associated tremor/ataxia syndrome (FXTAS), Wilson-Konovalov disease, and autosomal-dominant spinocerebellar ataxias types 1, 2, 3, 17, and 27B. Other nosological entities are considerably less prevalent. This review provides concise descriptions and emphasizes the most relevant differential diagnostic features of disorders presenting with cerebellar ataxia and parkinsonism.

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14. Rahman RMA, Sayed MM, Samei AMA, El Sheikh MM, Mohamed MY. Outcomes of sensory integration therapy in children with autism spectrum disorder: a non-randomized pre-post intervention study. BMC Pediatr;2026 (Oct 22);26(1)

BACKGROUND: Sensory processing abnormalities have been linked to autism symptoms. Sensory integration therapy (SIT) affects autism symptom severity, sensory profile and related socio-demographic/clinical variables. METHODS: Thirty patients, aged 3 to 10 years, meeting autism spectrum disorder (ASD) case definition were recruited from SIT clinic, Child and Adolescent Psychiatry Department, Okasha Institute of Psychiatry, Ain Shams University, Cairo, between May 2023 and January 2025, assessed by socio-demographic/clinical questionnaire, Arabic versions of Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version, Stanford-Binet Intelligence Scale Fifth Edition, Childhood Autism Rating Scale (CARS), and Sensory Profile Caregiver Questionnaire. Participants received a 12-week SIT program (one 30-minute session weekly), then post-intervention reassessment using CARS and Sensory Profile. RESULTS: The most common age was 3-5 years (46.66%), with males comprising 80%. Most participants (73.33%) IQ scores were 60-64. Mean CARS scores decreased from 33.9 ± 3.42 to 31.95 ± 3.4, mild autism increasing to 76.67%, moderate decreasing to 10% and unchanged severe cases. Mostly affected domains were vestibular processing, emotional/social responses, behavioural outcomes of sensory processing and fine motor/perceptual. Post-intervention, the most improved were vestibular processing, emotional/social response, emotionally reactive, inattention/distractibility (p-value < 0.001), auditory processing, modulation of body position and movement affecting activity level (p-value 0.001). The least were sensory processing related to endurance/tone and low endurance/tone. CONCLUSION: SIT effectively reduced autism severity and improved key sensory and behavioural domains of sensory processing, particularly in mild to moderate cases. TRIAL REGISTRATION: ClinicalTrials.gov NCT06882642, registered March 2025 (retrospectively registered).

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15. Resnik JB, Lane RT, Turnacioglu SO. Integration of an FDA-Authorized Digital Autism Diagnostic Tool Into an Outpatient Developmental Pediatrics Workflow: Preliminary Quality Improvement Study. JMIR Form Res;2026 (Nov 3);10:e98697.

BACKGROUND: Long wait times and specialist shortages delay autism spectrum disorder (ASD) diagnosis, often beyond the period when early intervention is most effective. Digital diagnostic tools may help increase diagnostic capacity by supporting clinicians in delivering timely autism evaluations within routine outpatient care. OBJECTIVE: This study aimed to conduct a preliminary assessment of the integration of a digital autism diagnostic device (Canvas Dx) into an outpatient developmental pediatrics workflow, including a descriptive evaluation of agreement between device outputs and specialist clinical diagnoses and an exploration of clinician and caregiver experience. METHODS: A single-center, prospective quality improvement study evaluated the implementation and performance of Canvas Dx in a specialty developmental pediatrics clinic. Canvas Dx is a Food and Drug Administration (FDA)-authorized digital ASD diagnostic device approved for use in children aged 18 to 72 months with caregiver or health care provider concern for developmental delay. Eligible children were consecutively prescribed Canvas Dx during the study period and completed the assessment as part of routine clinical care. Device diagnostic outputs were compared with the final specialist clinical diagnoses. Clinician and caregiver feedback was collected to explore their experience with the assessment process and perceived workflow impact via poststudy surveys that captured both structured quantitative questions and open-ended qualitative questions. RESULTS: A total of 28 children were included (mean age 52.2, SD 13.8 months; 7/28, 25% female), with an autism prevalence of 67.9% (19/28) based on specialist diagnosis. The device generated a determinate result for 22 (78.6%) participants. Among participants with determinate device results, sensitivity was 94.1% (95% CI 73%-99%) and specificity was 80% (95% CI 37.6%-96.4%). Positive predictive value was 94.1% (95% CI 73%-99%), and negative predictive value was 80% (95% CI 37.6-96.4%) when compared with specialist diagnosis. These estimates were imprecise, particularly for specificity and negative predictive value, because of the small number of participants without an ASD diagnosis. Clinicians reported improved insights and ease of use during evaluation visits, and caregivers reported high satisfaction with the assessment process. CONCLUSIONS: This preliminary quality improvement assessment demonstrates the feasibility of integrating Canvas Dx into a routine outpatient developmental pediatrics workflow and provides initial descriptive data on agreement with specialist diagnostic determinations and clinician and caregiver experience. Given the small sample size and resulting imprecision of diagnostic performance estimates, these findings should be interpreted as preliminary and used to inform larger prospective evaluations of diagnostic performance and workflow impact.

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16. Rodriguez L, Gillespie-Smith K, Duffy F, Sharpe H, Nimbley E, Austin A. Protocol: Research Priorities in Autism and Eating Disorders Research: An Evidence and Gap Map of Primary Studies and Systematic Reviews. Campbell Syst Rev;2026 (Sep);22(3):18911803261486747.

This is a protocol for a Campbell Evidence and Gap Map (EGM) focused on identifying the number, types and quality of evidence that exists on research priorities identified in Keller et al. (2024) and Nimbley et al. (2024). The specific objectives are to: (1) Identify and map all existing primary studies and systematic reviews (published and unpublished) on the research priorities identified in the body of research on autism and eating disorders. (2) Provide a comprehensive, descriptive overview of the existing research in these research priorities areas by targeted age groups, country, gender, sex, ethnicity, eating disorder diagnosis and autism status (diagnosis or trait) and (3) Determine the type of evidence available in these research priorities identified, as well as ascertain the quality of the evidence of systematic reviews and RCTs. For this purpose, a search strategy will be developed in conjunction with an expert subject librarian and piloted. A systematic search will be carried out using the following platforms and specific databases: Scopus, Web of Science Core Collection, Ovid (PsycINFO and Medline(r) All), ProQuest (Applied Social Science and Index Abstracts (ASSIA) and Social Science Database) and Overton. This EGM will consider primary studies, systematic reviews and meta-analyses, both published and unpublished, as well as grey literature in English and Spanish. Data extraction will be conducted in duplicate. Data required for AMSTAR 2 (systematic reviews) and the Cochrane Risk of Bias Tool 1 will be used to evaluate the quality of randomised control trials.

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17. Sadik A, Lundberg M, Khandaker GM, Pardiñas AF, Lee BK, Madley-Dowd P, Magnusson C, Rai D. Changes in the profile of adults diagnosed as autistic since 2010: population-based studies in the UK and Sweden. BMJ Ment Health;2026 (Nov 3);29(1)

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18. Savarese G, Carpinelli L, Mandia R, Diavoletto A, Piscitelli M, Impemba F, Di Siervi A, Vertullo A, Bottiglieri F, Sessa M, Corrivetti G. Selective change in personal autonomy associated with motor sensory room training in children with autism: an exploratory controlled pre-post study. Front Psychol;2026;17:1933418.

BACKGROUND: Structured sensory-motor environments are increasingly used with children with Autism Spectrum Disorder (ASD), but it remains unclear whether their effects extend across multiple functional domains. OBJECTIVE: This exploratory controlled pre-post study examined the pattern and specificity of behavioral and sensory change associated with a 12-week Motor Sensory Room (MSR) program. METHODS: The analyzed sample comprised 54 children: 44 received MSR plus treatment as usual (TAU), and a 10-child comparison cohort received TAU alone. Ordinal behavioral items were directionally recoded into eight composites. Time x Group interactions were tested across two time points, with Bonferroni correction applied separately to the behavioral and sensory outcome families. RESULTS: Personal autonomy was the only behavioral domain showing a correction-resistant differential improvement, F(1, 52) = 17.72, p < 0.001, Bonferroni-adjusted p < 0.001, partial eta squared = 0.254. No other behavioral interaction survived correction. Significant interactions were identified for four raw sensory items (rough, smooth, and soft surfaces and warm sensations); however, these primarily represented different group trajectories and could not be interpreted as clinical improvement without individual baseline hypo-/hyper-reactivity classifications. CONCLUSION: The findings do not support a generalized effect of MSR across behavioral or sensory functioning. They provide preliminary evidence of a selective MSR-associated change in personal autonomy that requires confirmation using randomized designs and validated adaptive-functioning measures.

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19. Van der Burg E, Jertberg RM, Geurts HM, Chakrabarti B, Begeer S. Reduced Positive Bias in Autistic Adults’ Intelligence Self-Assessments. Autism;2026 (Nov 3):13623613261495453.

Judging one’s own cognitive ability is a core aspect of self-reflection, yet most people overestimate their intelligence. We investigated whether autistic (n = 284, 18-77 years old) and non-autistic (n = 63, 18-76 years old) adults differ in this bias. Participants, all naïve to prior IQ testing, completed a brief online cognitive test and provided self-estimates of intelligence. Across groups, self-estimates modestly correlated with test scores (r = .33). Nearly all non-autistic participants (93.6%) overestimated their ability, whereas autistic participants were more divided: 75.7% overestimated and 24.3% underestimated, yielding a weaker positivity bias overall. This suggests two distinct forms of inaccuracy: a systematic positivity bias in non-autistic individuals versus more variable, sometimes unduly negative self-views in autistic individuals. These could be shaped by stereotypes or social experiences and/or a result of general metacognitive imprecision. These findings highlight both reduced ego-enhancing bias and an overlooked vulnerability, offering a nuanced view of autistic self-perception.Lay AbstractUnderstanding how people judge their own intelligence can tell us a lot about self-confidence and self-perception. In this study, we explored the possible differences between autistic and non-autistic adults in this area. The study included 284 autistic and 63 non-autistic participants, all aged between 18 and 77 years. We removed any participants who reported taking an IQ test in the past to get a more authentic idea of what they thought of themselves and avoid any bias from potentially unreliable online tests. Everyone first rated how intelligent they believed they were and then completed a short online cognitive test capturing the different facets of intelligence. Overall, people’s self-estimates were only moderately related to their actual test scores. The vast majority of non-autistic participants (almost 94%) overestimated their intelligence. Autistic participants showed a different pattern: While the majority (about 76%) also overestimated their intelligence, nearly one in four underestimated it. This means that non-autistic adults tended to show a very strong and consistent « positivity bias »-a common tendency to see oneself in a more favorable light. Autistic adults, however, showed more variation. Most still overestimated their abilities, but others judged themselves harshly relative to their actual performance. The weaker overall self-enhancing bias seen among autistic adults could be seen as a strength, in that it could allow a more realistic self-assessment. However, it could also translate into vulnerability, especially given the finding that autistic individuals showed overly negative self-perceptions more frequently, which could reflect the impact of stereotypes, social experiences, or difficulties with judging their own performance. Overall, the results offer a more nuanced picture of how autistic adults view their own intelligence and highlight often-overlooked vulnerabilities in self-evaluation.

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20. Waite M, Bahmei B, Iarocci G, Arzanpour S, Birmingham E. Testing an AI-Driven Sound Management Technology for Autistic Individuals With Decreased Sound Tolerance in Virtual Reality Environments. J Autism Dev Disord;2026 (Nov 3)

PURPOSE: The current study tested the acceptability and perceived benefit of a developing auditory technology for Autistic individuals with decreased sound tolerance (DST) as part of an iterative design process. METHODS: Twenty Autistic youth and adults (ages 12 to 47 years) with DST evaluated an auditory technology that detects aversive sounds and automatically activates one of three sound management techniques. Sound management interventions included active noise cancellation (ANC), masking, or an AI-based selective filtration feature. Participants rated their comfort during a series of auditory trials in virtual reality (VR) environments and provided feedback on the technology. RESULTS: Participants reported greater comfort when using the technology to manage aversive sounds compared to hearing the same sounds unaltered. Their feedback supported the utility of the technology and underscored the importance of flexible, customizable sound management solutions. Participants also offered actionable suggestions for design improvements to guide further development. CONCLUSION: Findings provided preliminary support for the acceptability and perceived benefit of a responsive, customizable auditory technology that includes AI-based sound detection and AI-based selective filtration. All tested interventions improved comfort relative to unaltered sound for Autistic participants with DST. Ongoing user testing and feedback will continue to guide the technology’s development.

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21. Wang J, Pollick F, Delafield-Butt J. The Red Nucleus in Motor Control and Autism Spectrum Disorder. Neurosci Biobehav Rev;2026 (Nov 3):107077.

Neuromotor differences of motor coordination, timing, postural regulation, and prospective motor control are common and emerge early in autism spectrum disorder (ASD). However, their underlying neural mechanisms remain incompletely understood, with existing research emphasising cortical and cerebellar systems. This review re-examines the red nucleus (RN), a midbrain structure embedded within cortical, cerebellar, and olivary motor pathways, as an underexplored component of distributed sensorimotor networks. We synthesise evidence from comparative neuroanatomy, animal experiments, human neuroimaging, movement disorders, and autism research, distinguishing direct RN findings from broader circuit-level inferences. Neuroimaging studies have reported RN-region susceptibility differences in autistic children, including an exploratory association with fine-motor development, but reproducible links to specific motor processes and RN-related causal mechanisms remain unestablished. We therefore propose a testable hypothesis that differences in RN structure, function, or connectivity may be associated with specific dimensions of motor function in autism. Error-related sensorimotor adaptation provides a primary experimental target, complemented by prospective motor control. Future investigations combining RN-sensitive neuroimaging, quantitative motor assessment, and transdiagnostic comparisons with developmental coordination disorder may determine whether RN-related measures provide explanatory information beyond sensorimotor systems. This framework positions the RN as a candidate component of autism-related motor networks.

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22. Wang Q, Tang B, Wu Z, Zoghbi HY, Tang J. Forniceal deep brain stimulation improves memory in Rett syndrome mice by promoting the maturation of newborn hippocampal neurons. Proc Natl Acad Sci U S A;2026 (Nov 3);123(44):e2535887123.

Deep brain stimulation (DBS) is associated with an increase in hippocampal neurogenesis and memory benefits, but the causal mechanism is unclear. Here, we use a mouse model of Rett syndrome, a severe learning disability syndrome caused by MECP2 loss of function, to find that DBS promotes the maturation and integration of newborn dentate granule cells (DGCs) into the neural circuit. Suppressing hippocampal neurogenesis prevented DBS from improving learning and memory. Newborn methyl-CpG-binding protein 2 (MeCP2)-deficient DGCs in Rett syndrome mice showed attenuated development and synaptic dysfunction, but DBS rescued DGC dendritic arborization, synaptogenesis, and long-term synaptic plasticity. DBS achieves this, at least in part, by increasing the protein level and shifting the phosphorylation of potassium chloride cotransporter 2, thereby restoring the conversion of GABAergic signaling from depolarization to hyperpolarization, a process that is otherwise delayed by MeCP2 deficiency. This study pinpoints one mechanism by which chronic DBS promotes neuronal maturation and enhances memory.

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