1. Akaki Y, Nakamura Y, Nakanishi Y, Okuyama Y, Fujita K. Embedding virtual reality social skills training into return-to-work care for depression: A single-arm feasibility pilot with exploratory autistic-trait moderation. PCN Rep;2026 (Mar);5(1):e70289.

AIM: To assess the feasibility of embedding virtual reality-based social skills training (SST-VR) into a return-to-work day-care program for major depressive disorder (MDD) and to estimate pre-post change in self-reported social skills, with exploratory moderation by autistic traits. METHODS: In this single-arm, add-on pilot at a Japanese psychiatric day-care Re-Work center, 20 adults with MDD (18 men) received six 90-min SST-VR sessions every 2 weeks over approximately 3 months plus the standard Re-Work program. The primary outcome was Kikuchi’s Social Skills Scale-18 (KiSS-18); secondary outcomes were social adaptation, social anxiety, and depressive symptoms (self-report). A linear mixed-effects model tested the effects of Time (pre vs post), baseline Autism-Spectrum Quotient (AQ; mean-centered), and their interaction. Feasibility was assessed via attendance and attrition. RESULTS: Attendance was 94.2% with no attrition. KiSS-18 increased from 49.7 ± 10.6 to 53.5 ± 12.4 (p = 0.028; r = 0.56). The model showed significant effects of Time (χ²(1) = 8.11, p = 0.004) and Time × AQ (χ²(1) = 4.46, p = 0.035), suggesting smaller gains at higher AQ (exploratory; restricted AQ range). Emotional processing and stress management subscales improved; secondary outcomes showed no significant change. Bootstrap analyses were consistent with the mixed-model findings. CONCLUSION: SST-VR was feasible. Because the single-arm add-on design cannot isolate SST-VR-specific effects from concurrent care and nonspecific influences, the KiSS-18 change is hypothesis-generating. Controlled comparisons with Re-Work alone in larger, more diverse samples should test efficacy, include objective behavioral and vocational outcomes, and prospectively evaluate moderation.

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2. Biggs K, Gomez de la Cuesta G, Kingsley E, McPherson J, Murray F, Laurie M, Bursnall M, Coates E, Barr A. Lessons learnt about implementing LEGO based therapy (Play Brick Therapy) based on fidelity data and experience from a large school-based randomised controlled trial. PLoS One;2026;21(2):e0336952.

INTRODUCTION: LEGO® based therapy, a social skills program for autistic children and young people, involves collaborative LEGO® building with adult guidance. This paper examines how well the program was delivered in a recent school randomised controlled trial and explores areas for improvement in implementation. The main trial results are published elsewhere. METHODS: The I-SOCIALISE trial investigated LEGO® based therapy for autistic children in schools. Researchers recruited 98 schools and randomly assigned them to deliver LEGO® based therapy or usual care. LEGO® based therapy sessions lasted one hour per week for 12 weeks with groups of 3 children. Schools received a 3-hour training session and a manual. Researchers measured fidelity to the LEGO® based therapy programme using self-reported checklists and video analysis. Research team insight and experience of the delivery of the training and intervention are included in this paper. RESULTS: LEGO® based therapy was delivered to autistic children in schools with high fidelity according to facilitators and independent reviewers. Most groups (69%) received all 12 sessions, and nearly all groups received the minimum dose of 6 sessions (93%). Sessions typically lasted about an hour and had 1-2 autistic children. Facilitators were mostly teaching assistants with moderate experience in autism. Over 90% of sessions included core elements like group building and social interaction. There were disagreements between facilitators and reviewers on adherence to some program elements like rewards and discussing roles. DISCUSSION: LEGO® based therapy was delivered with high fidelity in a large school trial, but there were areas for improvement, such as facilitator training and focus on social interaction for and between children. The authors suggest that facilitators may have been more focused on completing LEGO® builds than on facilitating meaningful social interaction and play between children. Three hours of training may not have been enough to prepare facilitators for their role. The study also did not capture young people’s experience of the program, which is important for understanding its effectiveness and impact. Future research should explore how to better measure these aspects and develop a stronger theory of how LEGO® based therapy works.

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3. Cary AE. Towards the equal recognition of autism in girls and women. Bmj;2026 (Feb 4);392:s120.

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4. Chen YJ, Lin HY, Chu CL, Wu CC, Lin TL, Ni HC, Liu JH, Hou YM, Chiang CH. Urban-Rural Differences and Sex-Specific Cognitive Effects on Autism Symptom Trajectories: A Longitudinal Study of Autistic Children in Taiwan. Autism Res;2026 (Feb 3)

Few longitudinal studies have mapped autism symptom trajectories outside Western contexts. This study aimed to characterize trajectories of autism symptoms, assessed using the Autism Diagnostic Observation Schedule (ADOS), and associated child and family factors among autistic children from two regions in Taiwan that differ by urbanicity. Another aim was to examine the time-varying effects of children’s cognitive abilities on autism symptoms, which remain understudied due to prior reliance on baseline proxies. Children with a confirmed autism diagnosis (n = 180, 87.8% male) were followed across three waves of data collection from ages 2 to 11 years. Linear multilevel growth models with random intercepts and slopes were used to estimate symptom trajectories at the total and domain levels of the ADOS. On average, total and social-affect symptoms increased significantly with age, while restricted and repetitive behaviors (RRBs) remained stable. Children from urban areas showed higher baseline RRBs and smaller increases in social-affect symptoms compared to those from rural areas. Additionally, children diagnosed under DSM-5 criteria showed lower baseline symptoms but greater increases in total/social-affect symptoms over time than their DSM-IV counterparts. A sex interaction effect was observed in the time-varying associations between IQ (particularly verbal IQ) and total/social-affect symptoms, with girls showing stronger negative IQ-symptom associations. These findings highlight the developmental complexity underlying the manifestation of autism symptoms, particularly at the intersection of sex and cognition. The distinct patterns by urbanicity also underscore the need to mitigate urban-rural disparities in service access to better support autistic children’s long-term outcomes. This study followed 180 autistic children in Taiwan over 9 years and found that autism symptoms changed with age in ways that varied by children’s place of residence, sex, and IQ. Children from rural areas showed greater increases in social difficulties, whereas those from urban areas showed higher levels of restricted and repetitive behaviors. Higher IQ was associated with fewer social challenges over time—but only among girls, not boys. These findings highlight the need to consider both individual and environmental factors, such as the child’s cognitive abilities, sex, and urban–rural contexts, when assessing and supporting the long‐term development of autistic children. eng

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5. Duan C, Yu Z, Li X, Sakai M, Maejima Y, Shimomura K, Furuyashiki T, Kikuchi S, Kobayashi N, Sasaki K, Matsuki T, Komatsu H, Hino M, Kunii Y, Kasahara T, Ishikuro M, Murakami K, Orui M, Abe T, Nagami F, Fuse N, Ogishima S, Kinoshita K, Yamamoto M, Nakaya N, Hozawa A, Obara T, Kuriyama S, Tomita H. Sex differences in the risk of autistic-related traits in toddlers born to mothers with perinatal depression: Evidence from human cohort and mouse study. Mol Psychiatry;2026 (Feb 4)

Maternal perinatal depression (MPD) is associated with reduced maternal plasma oxytocin (OXT) levels and an increased risk of autism spectrum disorder (ASD) in offspring. Using data from 23,218 Japanese mother-child pairs, we evaluated the relationship between MPD-assessed with the Kessler Psychological Distress Scale (K6) and the Edinburgh Postnatal Depression Scale (EPDS)-and autistic-related traits (ART) in toddlers, measured by the Tokyo Autistic Behavior Scale (TABS). We also tested the potential causal relationship of maternal stress exposure on OXT, its receptor (OXTR), and offspring outcomes using a prenatal stress-exposed mouse model. In the human cohort study, higher K6 or EPDS scores during pregnancy and postpartum were significantly associated with increased TABS scores in toddlers. Offspring of mothers with MPD (K6 or EPDS score ≥ 9) during pregnancy or postpartum exhibited a higher risk of ART (TABS score ≥ 15; P < 0.05). This risk was particularly pronounced in female toddlers exposed to MPD during pregnancy and postpartum (ORs: 5.805-9.367; P < 0.05). Female toddlers born to mothers with MPD also had lower birth weight, and their ART were positively correlated with K6 scores during mid-gestation and with impaired maternal bonding postpartum. In the mouse model, chronically stressed dams displayed depressive-like behaviors, and their female juveniles exhibited increased self-grooming and impaired social interaction. Furthermore, OXTR mRNA levels were significantly reduced in the prefrontal cortex of female juveniles from stressed dams. These findings suggest that MPD increases the risk of ART, particularly in females, highlighting potential sex-specific mechanisms underlying ASD susceptibility.

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6. Dupas SJ, Parada GE, Li JD, Brown KR, Moffat J, Blencowe BJ. Splice isoform-perturbation coupled to single cell transcriptome profiling reveals functions of microexons in neurogenesis and autism-linked pathways. Nat Commun;2026 (Feb 3);17(1):1217.

A major goal of biomedical research is to assign functions to the myriad alternative RNA and protein isoforms. This challenge is particularly relevant to the mammalian nervous system, which produces complex repertoires of alternative splicing events. Here, we describe CHyMErA-seq, a platform that couples systematic deletion of exons to a single cell transcriptomics read-out, and apply this method to investigate a critical program of brain-specific microexons. Perturbation of microexons during neurogenesis reveals convergent roles in the temporal regulation of gene expression programs that direct signaling pathways and morphogenesis. We further observe microexons, including those in the Bin1, Clasp1, Gfra1, Med23, Ptprf and Ralgapb genes, that are required for the correct timing of autism-linked gene expression. Collectively, we describe a flexible system for isoform-resolution perturbation at a single cell level, together with insights into the roles of microexons in the developmental timing of neurogenesis transcriptomic signatures linked to brain disorders.

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7. Ferreira IL, Mazalo JV, Prates-Baldez D, Kapczinski F, Quarantini LC. Prevalence of autism in African countries: a systematic review and meta-analysis. Trends Psychiatry Psychother;2026 (Feb 4)

BACKGROUND: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulties in communication, deficits in social interaction, and repetitive behavioral patterns. Global prevalence estimates range from 1% to 2%, with variations attributed to cultural, social, and methodological factors. In Africa, research remains limited and highly heterogeneous, largely due to scarce diagnostic resources, persistent stigma, and the absence of consistent public policies. METHODS: A systematic search was conducted across PubMed, Embase, Scopus, and PsycInfo for articles published up to May 2025. Cross-sectional studies conducted in school-based or community populations were included. The analysis followed PRISMA guidelines, and the protocol was registered with PROSPERO (CRD420251138668). A random-effects model using the Freeman-Tukey transformation for variance stabilization was employed for statistical synthesis. RESULTS: Seven studies from Egypt, Kenya, Uganda, and Nigeria, comprising 71,341 participants, were included. Across included studies, reported ASD prevalence ranged from 0.54% to 23.8%. When pooled and stratified by methodological criteria, clinically confirmed ASD prevalence was 1% (95% CI, 0.0-1.0%), whereas high-risk screening prevalence was 4% (95% CI, 0.0-16.0%), with very high between-study heterogeneity (I² = 99.8%). CONCLUSION: Despite substantial methodological heterogeneity, ASD prevalence estimates in Africa appear comparable to those reported in high-income countries. The marked disparity between high-risk screening prevalence and confirmed diagnoses highlights the urgent need to expand diagnostic confirmation services and strengthen training for primary healthcare professionals to bridge the gap between risk identification and definitive diagnosis across the continent.

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8. Foster SJ, Dunn D, Patel S, Pinkham AE, Ackerman RA, Sasson NJ. Discrepancies between feeling and expressing: Perceptions of autistic and non-autistic emotional expressions by non-autistic observers. Autism;2026 (Feb 3):13623613251415129.

Non-autistic observers often interpret autistic emotional expressions more negatively, though it is unclear whether this reflects observer bias or genuine differences in autistic people’s emotional experience and expression. To examine this, 20 autistic and 20 non-autistic adults reported the intensity of their felt emotion while re-experiencing video-recorded events eliciting mild and strong happiness, sadness, and anger. A total of 379 non-autistic observers, half blind to diagnostic status, viewed the recordings and identified the emotion and its intensity. iMotions emotion recognition software also classified the emotional valence of the expressions. Overall, autistic and non-autistic participants reported comparable levels of felt emotion, although differences emerged in how their expressions were perceived. Observers more accurately identified happiness in non-autistic participants and sadness and anger in autistic participants. They also judged autistic participants as expressing sadness and anger more intensely. Informing observers of the diagnostic status of participants largely did not modulate effects. iMotions more often classified mild autistic expressions as neutral and mild non-autistic expressions as positive. Because observer and iMotion findings emerged despite autistic and non-autistic participants not differing in felt emotion, they suggest that non-autistic observers and emotion recognition algorithms differentially interpret authentic autistic and non-autistic emotional expressions, which may contribute to misinterpretations of autistic people.Lay AbstractAutistic people may express emotions in ways that differ from non-autistic people, and non-autistic people sometimes misinterpret them as flat, overly intense, or hard to read. This misunderstanding can affect how autistic people are judged in everyday life, including in job interviews, friendships, and other important situations. In this study, we wanted to know how well non-autistic people-and emotion recognition software-can identify emotions on the faces of autistic and non-autistic people when they are actually feeling emotion. To do this, autistic and non-autistic adults were videotaped while recounting personal experiences that made them feel mild and strong happiness, sadness, and anger. They rated how strongly they felt each emotion during the videotaping. Later, short video clips of their facial expressions were shown (without sound) to a large group of non-autistic viewers, who identified the emotion and rated its intensity. Some viewers were told whether the person in the video was autistic or not. We found that autistic and non-autistic people reported feeling emotions at comparable levels, but non-autistic viewers were better at recognizing happy expressions in non-autistic people compared to autistic people, and better at recognizing sad and angry expressions in autistic people compared to non-autistic people. Viewers tended to rate autistic expressions, especially sadness and anger, as more intense than those of non-autistic people, even though the computer software rated autistic expressions as more neutral compared to non-autistic participants. These results suggest that autistic people feel emotions just as deeply as non-autistic people, but differences in expressive style and non-autistic biases may lead to misinterpretation. These findings highlight the need for greater awareness of communication differences in autism and for reducing misinterpretations in how autistic people are perceived.

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9. Fyfe C, Winell H, Dougherty J, Gutmann DH, Kolevzon A, Marrus N, Tedroff K, Turner TN, Weiss LA, Yip BHK, Yin W, Sandin S. Time trends in the male to female ratio for autism incidence: population based, prospectively collected, birth cohort study. Bmj;2026 (Feb 4);392:e084164.

OBJECTIVES: To examine changes in the male to female ratio in diagnoses of autism spectrum disorder (ASD) over a 35 year period, providing temporal trends in diagnosis (incidence rate), the male to female ratio, and the age-cohort specific cumulative male to female ratio (cMFR). DESIGN: Population based, prospectively collected birth cohort study. PARTICIPANTS: 2 756 779 liveborn children recorded in the Swedish medical birth register between 1985 and 2020. SETTING: Sweden. MAIN OUTCOME MEASURE: Age-period cohort analysis investigating associations between ASD and age at diagnosis, calendar period, birth cohort, and sex, quantified by incidence rate ratios and associated two sided 95% confidence intervals. RESULTS: Among 2 756 779 individuals born in Sweden between 1985 and 2020, ASD was diagnosed in 78 522 (2.8%) by the end of follow-up (2022). The incidence rate for ASD increased with each five year age interval throughout childhood, peaking at 645.5 (per 100 000 person years) for the male cohort at age 10-14 years and 602.6 for the female cohort at age 15-19 years in 2020-2022, and then decreased. Age specific incidence of ASD increased for each calendar period and birth cohort between 1985 and 2020. The male to female ratio decreased with increasing age at diagnosis and, for those older than 10 years, by calendar period. For the final year of follow-up in 2022, the cumulative male to female ratio for incidence of ASD was 1.2 by age 20 years. Further projection of these trends suggested that the cumulative male to female ratio would reach parity at age 20 years by 2024. CONCLUSION: Findings indicate that the male to female ratio for ASD has decreased over time and with increasing age at diagnosis. This male to female ratio may therefore be substantially lower than previously thought, to the extent that, in Sweden, it may no longer be distinguishable by adulthood. This finding highlights a need to investigate why girls and women receive diagnoses of ASD later than boys and men.

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10. Hedderly T, Malik O. Tics in autism spectrum and in intellectual disability. Handb Clin Neurol;2026;215:127-134.

Tourette syndrome (TS) is a neuropsychiatric and a neurodevelopmental disorder often presenting alongside other neurodevelopmental conditions such as attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), learning difficulties, and dyspraxia. TS shares genetic and neurobiologic features with ASD and ADHD, suggesting common underlying mechanisms. Recent diagnostic frameworks such as the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, APA, 2013) allow for multiple co-occurring diagnoses, reflecting the complex overlap among neurodevelopmental disorders. Whilst there are several studies stating high rates of TS in ASD and vice versa, the data about the nature of tics in those with ASD is sparse; nevertheless, it shows that they are probably not different in nature to tics present in TS. Tics in individuals with ASD can be diagnostically challenging due to overlapping motor behaviors like stereotypies. Intellectual disability (ID) further complicates tic identification, given communication difficulties and co-occurring behaviors. A pragmatic, needs-focused clinical approach is recommended, emphasizing prioritisation of presenting problems over an accumulation of diagnostic labels. This strategy facilitates targeted interventions where needed. In children with ID, differentiating between tics and stereotypies is important to avoid inappropriate management.

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11. Jiang H, Rodriguez-Cruces R, Xie K, Kebets V, Wang Y, Weber CF, He Y, Kember J, Sweatman H, Tabuenca ZG, Poline JB, Bzdok D, Hong SJ, Bernhardt B, Chai X. Morphometric dissimilarity in association cortices linked to autism subtype with more severe symptoms. Neuroimage;2026 (Feb 4):121775.

Autism spectrum disorder (ASD) is a prevalent and heterogeneous neurodevelopmental condition marked by atypical brain connectivity. Understanding ASD neural subtypes at the network level is critical for clarifying its neuroanatomical heterogeneity. Morphometric similarity networks (MSNs), derived from region-to-region similarity across multiple anatomical features, offer a powerful approach for capturing individual-level neural architecture. In this study, MSNs were estimated from seven anatomical features in 348 individuals with ASD and 452 typically developing (TD) controls. Across all ASD participants, the first principal component of MSN values was negatively correlated with social and communication severity. Three ASD subtypes with distinct MSN patterns were identified. Subtype-1, characterized by weaker morphometric similarity values in frontotemporal association regions compared to TD individuals, exhibited the most severe symptoms in social, communication and repetitive behaviors, and displayed hyperconnectivity between the salience and visual networks, and between language and visual networks. Subtype-2 showed greater values of morphometric similarities than TD and less severe social symptoms compared to subtype-1, along with hyperconnectivity between default and salience networks relative to TD. Subtype-3 displayed morphometric similarity values largely comparable to TD and the least severe symptoms out of the three subtypes. Transcriptomic analysis revealed that GABAergic parvalbumin and glutamatergic intratelencephalic-projecting neurons were key cell types differentiating subtypes. These findings suggest the existence of distinct ASD neuroanatomical subtypes defined by regional morphometric similarity, each linked to unique behavioral, functional, and transcriptomic profiles. Morphometric dissimilarity in association regions may serve as a neural signature for ASD subtypes characterized by more severe clinical manifestations.

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12. K CR, Patel NR, Thurmon A, Kantor BL, Lorino MG, Tiemroth AS, Morrison V, Akumuo M, Shenoy A, Blanco-Fernandez X, Baccini V, Siddika MA, Gu C, Meadows SM, Galazo MJ. Loss of Zmiz1 in mice leads to impaired cortical development and autistic-like behaviors. Biol Psychiatry;2026 (Feb 1)

BACKGROUND: De novo mutations in transcriptional regulators are emerging as key risk factors contributing to the etiology of neurodevelopmental disorders. Human genetic studies have recently identified ZMIZ1 and its de novo mutations as causal of a neurodevelopmental syndrome strongly associated with intellectual disability, autism, ADHD, microcephaly, and other developmental anomalies. However, the role of ZMIZ1 in brain development or how ZMIZ1 mutations cause neurological phenotypes is unknown. METHODS: We generated forebrain-specific Zmiz1 mutant mice (Zmiz1-KO) to assess ZMIZ1 function in cortical development. Neural progenitors, excitatory neurons, and glia were assessed using immunolabeling. Neuron-specific reconstruction was applied to callosal projection neurons to analyze dendritic arborization and projection through the corpus callosum. Behavioral tests assessed motor activity, anxiety, communication, and social interactions. RNA sequencing at multiple developmental stages and ChIP revealed molecular pathways and targets regulated by ZMIZ1. RESULTS: Loss of ZMIZ1 leads to cortical microcephaly, corpus callosum dysgenesis, and abnormal differentiation of upper-layer cortical neurons. Zmiz1-KO mice show alterations in motor activity, anxiety, communication, and social interactions with strong sex differences, resembling phenotypes associated with autism. Zmiz1 mutation leads to transcriptomic changes disrupting neurogenesis, neuron differentiation programs, and synaptic signaling. We identified Zmiz1-mediated downstream regulation of key neurodevelopmental genes, including Lhx2, Auts2, and EfnB2. Importantly, reactivation of ephrin-B2 pathway rescues the dendritic outgrowth deficits in Zmiz1 mutant cortical neurons. CONCLUSIONS: Our in vivo findings provide insight into Zmiz1 function in cortical development and reveal mechanistic underpinnings of ZMIZ1 syndrome, thereby providing valuable information for future studies on this neurodevelopmental disorder.

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13. Kashiwagi H, Hirabayashi N. Case Report: Death penalty versus indefinite imprisonment in Japan: a case note of two court judgments involving autism spectrum disorder and autistic traits. Front Psychiatry;2025;16:1690300.

The World Psychiatric Association condemns the sentencing to death and execution of individuals with mental illness or intellectual and developmental disabilities. However, in Japan, death sentences have been confirmed in individuals diagnosed with delusional disorders and autism spectrum disorder (ASD). We report two Japanese court cases in which medical professionals with ASD or autistic traits committed multiple homicides. Although ASD characteristics were acknowledged, one defendant received the death penalty while the other was sentenced to indefinite imprisonment. This case note aims to analyze how psychiatric evaluations and judicial reasoning distinguished between these two outcomes. We highlight the reliance on subjective assessments of remorse and the limited standardization in evaluating rehabilitation potential when distinguishing between the death penalty and indefinite imprisonment in defendants with ASD traits. Psychiatric expertise should contribute to fairer and more evidence-based sentencing.

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14. Kinjo M, Tamura S, Sugiyama S, van Weert E, Oribe N, Tsuchimoto R, Mitoma R, Takai Y, Honda S, Nakajima S, Hirano Y, Uhlhaas PJ, Noda Y. A systematic review and meta-analysis of the auditory steady-state response in schizophrenia, bipolar disorder, and autism spectrum disorder. Mol Psychiatry;2026 (Feb 3)

BACKGROUND: The 40-Hz auditory steady-state response (ASSR) is a potential biomarker for schizophrenia (SZ), bipolar disorder (BD), and autism spectrum disorder (ASD). However, the specific differences in ASSR across these disorders remain unclear. Moreover, the neurophysiological characteristics of the stimulation frequency in ASSR have not been fully elucidated. Hence, we conducted meta-analyses to comprehensively analyze 20-Hz, 40-Hz, and 80-Hz ASSR in individuals with SZ, BD, and ASD. METHODS: We included the studies published until January 2025, identified through a literature search in PubMed and the reference lists of relevant studies. We analyzed 52 studies, including 2116 patients with SZ, 271 individuals at clinical high-risk for psychosis (CHR-P), 110 first-degree relatives of patients with SZ (FDR-SZ), 294 patients with BD, 117 patients with ASD, and 2758 healthy controls (HC). RESULTS: The analyses indicated pronounced reductions in power and inter-trial phase coherence (ITPC) of 40-Hz ASSR in SZ, BD, and power reduction in ASD compared with HC. In addition, reduced power and ITPC were also observed in 40-Hz ASSR in FDR-SZ but not in CHR-P. Power reductions in 80-Hz ASSR were noted in individuals with SZ, while ITPC of 20-Hz ASSR was reduced in the SZ group but not in the BD group. CONCLUSIONS: These findings indicate that 40-Hz ASSR serves as a potential biomarker for psychotic disorders, whereas deficits at 20 Hz and 80 Hz may be specific to schizophrenia, reflecting distinct neural dysfunctions across diagnostic categories. Further studies are warranted to confirm these results.

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15. Klinner C, McCormack B, Young A, Newman CE, Szanto T, Brogan D, Carter A. Improving School Vaccinations for Adolescents With Intellectual and Developmental Disabilities: A Person-Centred Approach. J Adv Nurs;2026 (Feb 4)

AIMS: This article investigates school vaccination for adolescents with intellectual and developmental disability through the lens of person-centred care principles. DESIGN: This is a theoretical framework analysis in which qualitative interview data were mapped to the principles of a Person-Centred Practice Framework. DATA SOURCES: Data were drawn from Vax4Health, an empirical study that aims to improve vaccination uptake and experiences for adolescents with disabilities. METHODS: Our four-step process included: identifying elements of the school vaccination programme that relate to the Framework domains; mapping programme capacities and challenges by each domain; identifying key factors influencing person-centredness; and synthesising these key influencing factors into three themes. RESULTS: We extrapolated three themes: (1) Parents and students expressed strong support for the programme, but there is potential to enhance their participation in vaccination decision-making processes. (2) Nurses bring high levels of motivation, clinical experience, empathy and creativity to vaccinate students, but opportunities remain to enhance disability-specific training and knowledge of individual students’ needs. (3) Special schools are committed to supporting families and facilitating the programme, but limited resourcing and unclear responsibilities present challenges that need addressing. We discuss how these themes relate to the five domains of the Framework. Key considerations for vaccination programme improvement towards a more person-centred approach are highlighted. CONCLUSION: Applying the Framework to the findings of the Vax4Health study identified a range of opportunities to improve person-centred school-based vaccination for adolescents with IDD. Future research could involve engagement with all stakeholders to co-design interventions aimed at applying person-centred care principles to vaccinating students with IDD. IMPACT: The findings from this analysis could be used to inform future implementation research into person-centred approaches to school vaccination aiming for positive outcomes for adolescents with IDD, their families and schools and health professionals.

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16. Luginsland LA, Barrett KB, Bennett HJ. Examination of inertial measurement units to evaluate lower body segmental angles in persons with autism. J Biomech;2026 (Jan 22);197:113172.

Inertial measurement units (IMU’s) have been used to collect human movement data in practical, real-world environments in both non-pathological and pathological gait. IMU sensors have produced strong results for their validity and repeatability compared to the gold-standard of motion capture, specifically in college-aged populations. Due to their small size and lightweight design, IMU’s can be very convenient for the collection of movement data across various populations. Given the unique movement patterns reported in persons with autism (i.e., variability both intra- and inter-subject), the purpose of this proposed study was to compare gait events and segmental angles of the foot, shank, and thigh during gait via IMU’s compared to the « gold standard » of motion capture. Gait events were calculated using the superior-inferior acceleration/anterior-posterior acceleration (SIacc/APacc) methodology and the 10 N vertical ground reaction force (vGRF) methodology. Gait event detection was matched between SIacc/APacc and vGRF methods for heel strike yet significantly different for toe off. Our results support the existing literature suggesting an agreement in sagittal plane lower extremity segmental angles between IMU’s and motion capture, with less agreement between modalities in the frontal and transverse planes. However, these findings should be approached with caution and accompanied by recommendations that take into account the attributes of each participant (e.g. stimming, sensitivities). Future work investigating specific functional tasks to define the axis system and limit out-of-plane motion is needed in this population.

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17. Perera-Murcia GR, Prior-González M, Gutiérrez-Vera B, López-Huerta VG, Gómez-Martínez C, Contreras-López R, Tenorio Hernández L, Ramiro-Cortés Y. Altered Structural Plasticity Mediated by mGlu and NMDA Receptors and Impaired Cognition in a Genetic ASD Model (Shank3(+/-) Mice). J Neurosci;2026 (Feb 4);46(5)

Dendritic spine morphology is strongly associated with neurodevelopmental disorders. Synaptic plasticity alters spine volume, a phenomenon known as structural plasticity, which influences information processing within neuronal circuits. Structural changes at dendritic spines are linked to autism spectrum disorders, particularly those involving gene mutations that result in synaptopathy. Loss of a single copy of the Shank3 gene leads to Phelan-McDermid syndrome, a synaptopathy, as Shank3 encodes SHANK3, a scaffold protein in the postsynaptic density of glutamatergic neurons. In this study, the structural plasticity of dendritic spines was evaluated in male and female Shank3(+/-) and wild-type mice in response to synaptic plasticity. Two-photon imaging and glutamate uncaging were employed in organotypic hippocampal cultures. Cognitive function in adult Shank3(+/-) mice was also assessed using a novel object recognition test. The results indicate that Shank3(+/-) mice exhibit altered structural plasticity in response to long-term depression and display a heterosynaptic response in neighboring spines. Increased GluN2B expression and N-methyl-d-aspartate currents underlie these effects and may influence object recognition memory in Shank3(+/-) mice. These findings suggest that Shank3 haploinsufficiency induces synaptic alterations during postnatal development that impact memory in adulthood.

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18. Potasiewicz A, Popik P, Nikiforuk A. Analysis of rat vocalizations as a tool for assessing the effects of α7nAChR PAMs in a neurodevelopmental model of autism. Behav Brain Res;2026 (Feb 4);497:115876.

Autism spectrum disorder (ASD) is commonly associated with impairments in communication, and ultrasonic vocalizations (USVs) in rodents serve as a translational tool to probe such deficits. We examined the effects of positive allosteric modulators (PAMs) of the α7 nicotinic acetylcholine receptor (α7nAChR), compounds CCMI and PNU120596, on vocal communication in a rat model of ASD induced by prenatal valproic acid (VPA) exposure. Leveraging a multimodal analytic framework, we investigated not only conventional acoustic variables but also temporal structure, syntactic organization, and cluster-based vocal repertoires. Analyses revealed that male but not female offspring exposed to VPA emitted fewer USVs and showed reduced vocal activity, reflected in fewer bouts and fewer calls per bout. Temporal analysis revealed persistent reductions across testing sessions in males, whereas females exhibited reductions in the late phase of calling. PAM treatments did not restore USV quantity or vocal activity in VPA-exposed males but partially normalized inter-call intervals, indicating selective effects on temporal dynamics. Acoustic features such as duration, bandwidth, and peak frequency remained largely unaltered by VPA or PAMs, except for a modest bandwidth reduction in VPA-exposed females. Cluster-based and syntax analyses confirmed sex-specific vocal profiles and revealed that PAMs modulated vocal syntax in both control and VPA-exposed animals, with compound- and context-dependent effects. These included increased usage of canonical trill calls and reductions in low-frequency or complex transitions, partially restoring disrupted communication patterns. The present study highlights a multimodal approach to USV profiling in animal models of socio-communicative deficits and suggests that α7nAChR PAMs exert subtle yet beneficial effects on the vocal timing and syntactic structure of communication, with implications for addressing syntactic disruptions in ASD-related vocal behaviors.

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19. Rabiei H, Begnis M, Lemonnier E, Ben-Ari Y. Treating autism with Bumetanide: Identification of responders using Q-Finder machine learning algorithm. Transl Psychiatry;2026 (Feb 3);16(1):66.

Bumetanide, a specific NKCC1 co-transporter inhibitor, restores deficient GABAergic inhibition implicated in various brain disorders, including Autism Spectrum Disorders (ASD). In keeping with this mechanism, nine successful phase 2 clinical trials, conducted by seven independent teams using an identical protocol, have shown significant improvements in ASD symptoms among individuals treated with Bumetanide. Despite these promising results, two large phase 3 clinical trials (over 400 children recruited in approximately 50 centers and covering age groups 2-6 and 7-17 years) failed with no significant difference between patients treated by placebo or Bumetanide. This failure may stem from the substantial heterogeneity of ASD symptom profiles across the study population, potentially diluting the overall observed treatment effect. To address this, we reanalyzed the phase 3 data using Q-Finder, a supervised machine learning algorithm, aiming to identify subgroups of patients who responded to the treatment. This analysis was based on clinical parameters collected at the baseline of trial and used the same standard endpoints and success criteria defined in the original phase 3 protocol. It enabled the identification of responder subgroups showing a statistically significant difference between placebo and Bumetanide treatment arms. We report detailed descriptions and statistical evaluations of these subgroups. The discovered responder subgroups, representing up to 40% of participants, were cross validated between the two study populations. These findings suggest that meaningful treatment responses can be uncovered within negative phase 3 trials, highlighting the limitations of a one-size-fits-all approach for heterogeneous conditions such as ASD. Machine learning appears to be a promising tool to support this precision medicine strategy.

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20. Rava A, Feo A, Bagnato G, D’Oria V, Pezzullo M, Petrini S, Buzzelli V, Ascone F, Di Trapano M, Peruzzi B, Trezza V. Hippocampal glial alterations are associated with Lamin B1 dysregulation and abnormal nuclear morphology in a rat model of fragile X syndrome. Neurobiol Dis;2026 (Feb 4);220:107304.

Fragile X syndrome (FXS) is the most common inherited intellectual disability and the leading monogenic cause of autism spectrum disorders (ASD). Although the pathological mechanisms underlying this neurodevelopmental disorder are challenging, recent studies have increasingly highlighted the involvement of glial cells in the pathogenesis of both ASD and FXS. Microglia and astrocytes are critical for brain development and homeostasis; thus, understanding glial dysfunction in both the developing and adult brain in these disorders may reveal novel therapeutic targets beyond the neuro-centric perspective. In this study, we demonstrated that the loss of function of Fmrp leads to phenotypic changes in both microglia and astrocytes within the hippocampus of the recently validated Fmr1-(∆)exon 8 rat model of FXS without a significant induction of pro-inflammatory cytokines. For the first time, we also provide evidence that these non-inflammatory changes in glia are associated with dysmorphic nuclei and a reduced expression of Lamin B1, a key component of the nuclear envelope and an important modulator of brain development and aging, in the hippocampus of young adult Fmr1-(∆)exon 8 rats. Collectively, our findings strengthen existing evidence of the glial contribution to FXS and identify Lamin B1 loss and nuclear abnormalities as potential early markers of hippocampal pathology, providing a novel potential molecular target which should be furtherly considered.

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21. Russell A, Cremen C, Rainbow E, Melia R. Suicide prevention interventions and supports for the Autistic community: a scoping review protocol. BMJ Open;2026 (Feb 4);16(2):e099614.

INTRODUCTION: Suicide is a leading cause of death among Autistic adults globally. Autistic people are up to six times more likely to die by suicide than people in the general population. Research highlights a lack of appropriate support for Autistic individuals experiencing suicidal thoughts and behaviours. METHODS AND ANALYSIS: A scoping review will be conducted to map available literature on Suicide Prevention Interventions and Supports used with the Autistic community. This scoping review will use the methodological guidelines set out by the Joanna Briggs Institute Manual for Evidence Synthesis. The searches will be conducted in January 2025. The following electronic databases will be searched; PubMed, CINAHL Ultimate, PsycINFO and EMBASE, as well as the reference lists of included articles and grey literature (including conference abstracts, PhD theses, grey literature databases and preprints). The search strategy will be used to identify literature with an aim of preventing suicide in Autistic individuals. Only literature published in English will be included. Two reviewers will independently screen all literature based on predetermined inclusion and exclusion criteria. Data extraction will be piloted by two reviewers and continued by one reviewer. The extracted data will be checked for accuracy by a second reviewer. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. A narrative summary of findings will be conducted. Results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review statement. ETHICS AND DISSEMINATION: Ethics approval is not required for this study as it is protocol for a review of published literature and does not involve human participants or private data. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal. TRIAL REGISTRATION NUMBER: This protocol has been registered on the Open Science Framework (https://osf.io/bpxnf/overview).

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22. Siminghalam M, Shanbehzadeh S, Karamali Esmaeili S, Miri Lavasani N, Parvizy S, Alizadeh Zarei M. Psychometric Properties of the Persian CASP in Adolescents With Autism Spectrum Disorder. OTJR (Thorofare N J);2026 (Feb 3):15394492251407629.

The Child and Adolescent Scale of Participation (CASP) requires further psychometric validation across languages to assess participation in adolescents with autism spectrum disorder (ASD). This study evaluated the psychometric properties of the Persian CASP in adolescents with ASD. The study involved 100 adolescents with ASD and 50 typically developing peers, assessing reliability and validity using Persian CASP, confirmatory factor analysis (CFA), discriminant, and convergent validity. The Persian CASP showed excellent internal consistency (Cronbach’s α = 0.94) and test-retest reliability (ICC = 0.95). CFA with the diagonally weighted least squares estimator supported a one-factor model, with moderate fit: comparative fit index = 0.925, normed fit index = 0.895, goodness-of-fit index = 0.750, root mean square error of approximation = 0.108, chi-square/degree of freedom ratio = 3.05. Factor loadings ranged from 0.45 to 0.78. Participation differed significantly between groups (p < 0.001). Strong PedsQL correlations supported convergent validity. The Persian CASP demonstrates good reliability and validity, though CFA results indicate only moderate model fit. Psychometric Properties of the Persian Version of the CASP in Adolescents With ASDThis study aimed to evaluate the psychometric properties of the Persian version of the Child and Adolescent Scale of Participation (CASP) in adolescents with autism spectrum disorder (ASD). The results indicated that the Persian CASP demonstrated strong reliability, internal consistency, and validity. The scale effectively differentiated between adolescents with ASD and their typically developing peers, revealing significant differences in participation levels. The confirmatory factor analysis showed a satisfactory fit for the proposed factor structure, reinforcing the scale’s construct validity. Strong positive correlations between the CASP and the Pediatric Quality of Life Inventory confirm its convergent validity. In addition, excellent test–retest reliability was observed, with all subscales showing strong consistency over time. The findings highlight the effectiveness of the CASP as a tool for assessing participation in adolescents with ASD, making it suitable for use in clinical and research settings across various languages and cultures. eng

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23. Singer A. Urgency with integrity: Why the profound autism community needs brain organoids now. Neuron;2026 (Feb 4);114(3):387-389.

The profound autism community must support brain organoid research, and scientists must hurry up and build ethical guardrails so that this new technology can be put to work to improve lives.

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24. Taniguchi E, Kim SJ. A Review of Management Strategies for Aggression and Self-Injury in Youth With Autism Spectrum Disorder. Pediatr Ann;2026 (Feb);55(2):e71-e75.

Aggression and self-injury are common challenges for youth with autism spectrum disorder (ASD), often impacting safety, ability to access services and community resources, and quality of life for children, adolescents, and their families. As pediatricians and other pediatric primary care physicians are often tasked with managing these problems, this review outlines the evidence and potential strategies in both the assessment and management of aggression and self-injury for youth with ASD. Assessment begins with evaluating safety risks and identifying contributing factors, such as medical conditions, communication difficulties, environmental stressors, reinforcement patterns, and psychiatric comorbidities. Evidence-based behavioral interventions, including applied behavior analysis, functional behavioral analysis, functional communication training, and parent training programs, form the foundation of treatment, supplemented by school-based and protective equipment interventions where appropriate. Pharmacologic interventions may be considered when behavioral approaches are insufficient, but they show variable efficacy in managing aggression or self-injury.

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25. Travis LM, Prasad S, Khan FA, Samineni AV, Mei C, Grottkau B. Impact of Pediatric Neuropsychiatric Disorders on Postoperative Outcomes Following Common Nonspine Orthopedic Surgeries. J Pediatr Orthop;2026 (Mar 1);46(3):e288-e296.

BACKGROUND: Pediatric fractures are common injuries, and the increasing prevalence of neuropsychiatric conditions like ADHD, autism, anxiety, and depression may complicate postoperative outcomes. Understanding how these diagnoses affect surgical recovery is essential for optimizing care in this vulnerable population. METHODS: This study analyzed data from the 2019 and 2022 Kids Inpatient Database. Children undergoing common nonspine orthopedic procedures were identified and matched one-to-one by age, sex, ethnicity, and severity of illness. Primary outcomes included postoperative complications, such as infection and mechanical implant failures; secondary outcomes were length of stay and total hospital charges. Logistic regression models were used to adjust for potential confounders. RESULTS: Among 4931 ADHD-matched pairs, patients with ADHD had longer mean hospital stays (5.07 vs. 4.69 d, P=0.041) and significantly increased risk of osteomyelitis (OR: 1.42, P=0.0017) and soft tissue infection (OR: 1.39, P=0.009). For 5673 anxiety-matched pairs, anxiety correlated with higher mean length of stay (7.16 vs. 5.54 d, P<0.01) and elevated odds of soft tissue infections (OR: 1.55, P<0.01), mechanical implant complications (OR: 1.28, P=0.036), and constipation (OR: 2.03, P<0.01). Depression (2950 matched pairs) was associated with longer stays (8.31 vs. 6.00 d, P<0.01) and greater risk of osteomyelitis (OR: 2.04, P<0.01). Among 2322 autism-matched pairs, autism did not significantly impact length of stay but increased pneumonia risk (OR: 1.76, P=0.025) and postoperative ileus (OR: 1.71, P=0.040). CONCLUSION: These findings demonstrate the significant impact of neuropsychiatric comorbidities on pediatric orthopedic recovery. Behavioral factors, such as impulsivity or anxiety-driven movement avoidance, and physiological mechanisms, including altered immune function, may drive elevated complication rates. Tailored perioperative management, including mental health screening, specialized communication strategies, and enhanced caregiver support, could improve adherence and reduce morbidity for these patients. Further research should focus on targeted interventions, medication considerations, and strategies that foster cooperation among orthopedic, mental health, and rehabilitative services. Addressing these challenges can ultimately enhance the quality of care and reduce disparities for pediatric patients with coexisting orthopedic injuries and neuropsychiatric diagnoses. LEVEL OF EVIDENCE: Level III-retrospective comparative study.

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26. Westerberg B, Jacobson K, Unenge Hallerbäck M, Bejerot S, Holländare F. Communicative Behaviors in an Internet-Based Intervention for Individuals With Autism: Mixed Methods Analysis. J Med Internet Res;2026 (Feb 4);28:e76527.

BACKGROUND: To meet the needs of individuals diagnosed with autism, internet-based interventions have been developed with a variety of objectives. A deeper understanding of the mechanisms of change may help tailor interventions to individual needs. The communicative behaviors of individuals with autism participating in text-based internet-based interventions remain largely unexplored, as do their potential relations to clinical outcomes. An improved understanding of participants’ behaviors may help therapists better tailor support, promote engagement, and enhance treatment outcomes. OBJECTIVE: This study aimed to explore the communicative behaviors of individuals with autism participating in an internet-based intervention and to examine whether different behavioral patterns were associated with treatment outcomes or treatment adherence. METHODS: Messages from 34 participants enrolled in an 18-week internet-based cognitive behavioral therapy program were analyzed using abductive qualitative content analysis. Correlational analyses were used to examine the relationships between qualitative categories and change scores on outcome measures and rates of module completion. RESULTS: Fourteen behavioral categories were identified and grouped into three overarching domains: (1) « This is me, » which encompasses the participants’ narratives on identity, personality, autistic functioning, current and past circumstances, and worldview; (2) « Working with the treatment, » which included statements related to engagement with the treatment process; and (3) « I struggle, » which comprised of past and present negative experiences and challenges. Correlational analyses revealed associations between several behavioral categories and improvements in quality of life and treatment adherence. CONCLUSIONS: The findings highlight the importance of self-narrative formulation among individuals with autism and suggest that certain communicative behaviors-particularly those involving identity reflection and recognition of treatment-related gains-were positively associated with therapeutic outcomes. The findings enhance our understanding of how individuals with autism engage in internet-based cognitive behavioral therapy and may serve as a valuable source of information for therapists when guiding expectations regarding client outcomes and identifying participants who may benefit from additional support. TRIAL REGISTRATION: ClinicalTrials.gov NCT03570372; https://clinicaltrials.gov/study/NCT03570372.

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27. Widiastuti AA, Kurniawan M, Wijayaningsih L, Rahardjo MM, Listyaningrum EM, Wijayanti TD. From adherence to sustainability: Why parental well-being matters in autism interventions. J Pediatr Nurs;2026 (Feb 4);87:400-401.

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28. Zoromba MA, El-Gazar HE. Motivations for self-care in caregivers of children with autism spectrum disorder: A phenomenological study. J Pediatr Nurs;2026 (Feb 4);87:392-399.

BACKGROUND: The rising prevalence of Autism Spectrum Disorder (ASD) places increasing demands on family caregivers. While the barriers to self-care are well-documented, the motivations that drive caregivers to prioritize their own health remain underexplored. This gap is particularly evident in culturally distinct settings like Saudi Arabia, where societal norms and religious beliefs shape caregiving dynamics. AIM: This study aimed to explore the motivations for self-care among Saudi mothers of children with ASD. METHODS: A descriptive phenomenological design, grounded in Husserl’s philosophy, was employed to investigate the lived experiences of 12 Saudi mothers. Participants were recruited via criterion-based purposive sampling. Data were collected via semi-structured, in-depth interviews conducted and analyzed using Colaizzi’s method to distill thematic insights. Rigor was ensured through bracketing, interpretive member checking, and investigator triangulation. RESULTS: Four key categories emerged: (1) Personal Values and Beliefs, highlighting intrinsic maternal duty and spirituality as a primary sustainer; (2) Social Support, emphasizing family and professional encouragement; (3) Barriers to Self-Care, identifying time constraints and guilt rooted in cultural expectations; and (4) Perceived Impact on Caregiving, linking self-care to enhanced resilience and child well-being. Spirituality and collectivist support systems uniquely influenced motivations, while cultural norms posed distinct challenges. CONCLUSION: Motivation for self-care among Saudi mothers is not driven by a desire for personal indulgence, but by a pragmatic and spiritual imperative to maintain caregiving capacity. Findings advocate for culturally tailored interventions, such as « Self-Care Prescriptions, » that leverage spirituality and family networks to overcome barriers and enhance caregiver well-being.

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