1. Avramiea AE, Juarez-Martinez EL, Garcés P, Hipp JF, Poil SS, Diachenko M, Mansvelder HD, Jones E, Mason L, Murphy D, Loth E, Oakley B, Charman T, Banaschewski T, Oranje B, Buitelaar J, Bruining H, Linkenkaer-Hansen K. Qualitative EEG abnormalities in ASD reflect inhibition-dominated brain dynamics. Sci Rep;2026 (Apr 3)

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2. Bruni O, Mammarella V, Breda M, Gringras P, Malow BA, Schaer M, Schroder CM, Weiss SK. Sleep as a viable target for early intervention in children with autism spectrum disorder: A narrative review informed by a systematic literature search. Sleep Med Rev;2026 (Apr 4);87:102286.

Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by communication and social challenges, and repetitive behaviors. Early integrated developmental and behavioral interventions are recommended, ideally during peak brain development at ages 2-4. Sleep problems are common in autistic children and may appear before diagnosis. This narrative review, informed by a systematic literature search, examines how sleep disturbances affect neurodevelopment in young children with ASD and whether treatment of sleep problems may enhance response to developmental intervention. We conducted a systematic literature search on developmental trajectories AND autism AND/OR intervention AND/OR sleep (Scopus, PubMed, Scholar, Jan 2015-Jan 2026) with focus on early development and intervention (age 2-5 years) in children with ASD. Sleep is essential for brain development, learning, memory, and emotional regulation. Insufficient sleep hinders intellectual growth and adaptive skills, reducing the effectiveness of speech, language, and behavioral interventions. Extending sleep-through behavioral strategies or medications like prolonged-release melatonin-can improve educational outcomes and adaptive behavior in young children with ASD. Addressing sleep issues promptly when ASD is diagnosed or suspected may improve developmental outcomes and enhance intervention effectiveness.

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3. Greenwood E, Miller C, Barbaro J, Date P, Dyson A, Cooklin A. Making visible the lived experience of Autistic children and their parents attending emergency departments in Australia: A Qualitative study. Int Emerg Nurs;2026 (Apr 2);86:101811.

BACKGROUND: Autistic children present frequently to emergency departments (ED) but often encounter distressing and exclusionary environments. Parents play a pivotal role during these encounters, yet their voices remain underrepresented in research. AIM: To explore the lived experiences of parents with Autistic children attending the emergency departments in Australia. METHODS: A hermeneutic phenomenological approach guided the study. Fourteen parents of Autistic children (under 18 years) participated in semi-structured interviews, analysed thematically using Bronfenbrenner’s Bioecological Model. FINDINGS: Five key themes were identified across ecological systems: (1) parents as experts and navigators of care; (2) parental and child interactions with health staff; (3) systems that undermine safety; (4) stigma and disclosure about perceptions of autism; and (5) time, trauma, and long-term effects. Parents reported anticipatory anxiety, institutional barriers, and repeated traumatic encounters, often compounded by stigma and inadequate support structures. CONCLUSION: Autistic children and families face substantial challenges in ED, highlighting the urgent need for trauma informed, autism specific, and family centered practices, guided by a holistic ecological framework to drive system wide change.

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4. Koegel LK, Wehman P, Claude CM, Lam MS, Bruzzese T, Derry M, Brooke A, Ham W, Ponder E, Roane TJ, Rooney B, Anderson J. Using Artificial Intelligence to Support Emotionally Responsive Verbal Communication Among Autistic Workers in a Work Internship Setting. J Autism Dev Disord;2026 (Apr 4)

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5. Krijnen LJ, Rippe RC, Begeer S, Plak RD. Assessing Social Identity in Autistic Individuals: Evaluating A Self-Report Questionnaire in the Netherlands. Autism;2026 (Apr 3):13623613261431269.

People with autism often face mental health difficulties at rates far exceeding those of the general population. How autistic individuals relate to their autism classification and the autistic community, also known as social identity, may form a protective factor for mental health. However, validated tools to assess social identity in autistic populations are lacking. This study aims to evaluate the Dutch version of the 14-item Social Identity in Autism Questionnaire (SIAQ) and examine associations between social identity and demographic, autism-related, and mental health variables. A total of 1443 autistic individuals from the Netherlands (mean age = 47 years, 54% women, 98% Dutch) completed the SIAQ and measures assessing demographics, autism characteristics, and mental health. Factor analyses revealed a four-factor structure: solidarity (three items, feelings of connection to people with autism), satisfaction (four items, positive feelings about being autistic), centrality (three items, the importance of autism to one’s sense of self), and self-definition (four items, perceived similarity to other autistic people and within the autistic community). Internal consistency was acceptable to excellent. Measurement invariance (scalar level) was found across age, gender, education level, ethnicity, and autism traits. Furthermore, the four factors of social identity were differentially related to age, gender, language preference, time since diagnosis, and autism traits. Higher satisfaction and lower centrality were related to better mental health. To conclude, the SIAQ forms a robust tool to assess social identity in autistic individuals in the Netherlands.Lay AbstractPeople with autism experience mental health challenges much more often than people in the general population. Understanding how autistic people relate to their autism and the autistic community – called autistic social identity – may form an important factor for mental health. However, the lack of reliable tools to measure social identity in autistic people led to this study evaluating the Dutch version of the Social Identity in Autism Questionnaire (SIAQ). Associations between social identity and demographics, autism traits, and mental health were studied. Autistic individuals from the Netherlands (n = 1443, average age = 47 years; 54% women; 98% Dutch) completed the SIAQ. The results showed that the questionnaire captures four key aspects of social identity: solidarity (feeling connected to other autistic people), satisfaction (positive feelings about being autistic), centrality (how central autism is to one’s identity), and self-definition (seeing oneself as similar to other autistic people and perceiving the autistic community as relatively similar). The questionnaire was reliable as well as suitable to use across diverse groups, including variations in age, gender, education level, ethnicity, and autism traits. Several aspects of social identity were related to gender, age, language preference, time since diagnosis, and autism traits. Importantly, higher satisfaction and lower centrality were associated with better mental health. These findings suggest that in the Netherlands, the SIAQ is a useful tool for understanding how autistic people relate to their autism and the autistic community, and how this relates to wellbeing.

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6. Lu H, Li S, Peng S, Zhang Y, Li N, Hu Z. Stepped-Care Digital Gaming Intervention Enhanced Emotion Recognition in Autistic Children: A Randomized Controlled Trial. J Autism Dev Disord;2026 (Apr 4)

PURPOSE: This randomized controlled trial (RCT) evaluated the efficacy of a novel stepped-care digital game intervention for improving emotion recognition in autistic children. METHODS: Thirty-six autistic children (aged 3-10 years) were randomly assigned to an experimental group (N = 18) or a control group (N = 18). The intervention, grounded in the Theory of Mind framework, comprised three hierarchically structured games designed to progressively train emotion recognition. Pretest and posttest including questionnaires and emotion recognition tests were administered before and after the intervention. RESULTS: Results indicated that the experimental group showed significant improvements in accuracy on the emotion recognition tests, whereas the control group did not. A significant interaction was found for scores on the autism treatment evaluation checklist (ATEC), suggesting differential change patterns across groups. Parenting stress increased significantly in the control group but remained stable in the experimental group. CONCLUSION: These findings demonstrated that this stepped-care digital game intervention can effectively enhance emotion recognition in autistic children and may bring benefits for their core traits and parenting stress.

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7. Margaux E, Elise T, Muriel D, Matthijs M, Jellina P, Arnau VV, Jean S, Nicky D, Bart B, Jeroen R, Kaat A. A pilot study on the role of the oxytocinergic system in gut microbiome composition in children with autism: baseline associations and effects of intranasal oxytocin. Brain Behav Immun;2026 (Apr 4);136:106579.

Autistic children often experience behavioral difficulties alongside nutritional and gastro-intestinal (GI) problems, including gut dysbiosis. Recent research has highlighted important interactions between the oxytocinergic system and gut microbiome compositions, however, insights into how exogenous administration of oxytocin may influence GI health remain largely unexplored. Here, we first examined whether nutrition, GI symptoms and microbiome compositions vary in autistic versus non-autistic children, and how alterations link to clinical-behavioral difficulties and oxytocinergic signaling. Next, we examined the effect of a four-week intranasal oxytocin administration regimen on GI health/dysbiosis in autistic children enrolled in a randomized placebo-controlled trial. Compared to non-autistic children, autistic children consumed more soft drinks, and fewer vegetables and experienced abdominal pain more frequently over the past three months. Notably, epigenetic variations in the oxytocin receptor gene (OXTR) were associated with stool consistency, indicating that children with looser stools exhibited lower OXTR methylation levels, indicative of increased receptor expression. Additionally, a higher abundance of Romboutsia was associated with OXTR hypo-methylation and more anxiety-like behavior. In autistic children, the four-week oxytocin regimen had no effect on bacterial diversity but did modify stool consistency, leading to less dense stools with an overall more normal stool consistency, and an increased abundance of the potentially anti-inflammatory genus Fusicatenibacter. To conclude, this study provides novel insights into the role of the oxytocinergic system in GI symptoms and gut microbiome compositions in autistic children, and preliminary evidence suggesting a modulatory effect of exogenously administered oxytocin on these parameters.

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8. Rasool A, Ahmad F, Bunterngchit C, Aslam S. Challenges in translating AI-driven ASD/ADHD diagnosis: A methodological systematic review. Int J Med Inform;2026 (Apr 4);214:106417.

BACKGROUND: Early and accurate diagnosis of neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), remains a critical challenge in pediatric care. Traditional methods rely on subjective behavioral assessments that are time-intensive and prone to bias. OBJECTIVE: This systematic review synthesizes biomedical informatics methodologies using deep learning-driven computer vision to enable objective, data-driven diagnostic decision support for pediatric NDDs. METHODS: Following PRISMA guidelines, we searched Web of Science and Scopus (2020-2024), identifying 43 Q1/Q2 studies. Four informatics-focused research questions were addressed: multimodal feature extraction, deep learning architectures, high-performing strategies, and robust data integration challenges. Methodological quality and bias were assessed using the APPRAISE-AI framework. RESULTS: Multimodal fusion and hybrid informatics pipelines dominated (38% of studies), outperforming unimodal approaches by integrating complementary streams-facial imaging (high specificity), EEG/fMRI (superior sensitivity). Transfer learning and fusion techniques were prevalent, but federated learning and explainable AI were underutilized. APPRAISE-AI revealed strong clinical relevance (72.8%) and reporting quality (66.1%), yet substantial gaps in reproducibility (41.0%) and result robustness (45.1%). CONCLUSIONS: AI-driven biomedical informatics holds significant potential to reduce diagnostic delays and costs in NDDs. However, reproducibility, interpretability, and ethical data integration must be improved through standardized, privacy-preserving, and auditable frameworks to enable scalable clinical deployment.

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9. Sato M, Yamaki H, Kawano G, Tanaka Y, Isooka A, Yamashita D, Akita Y, Eshima N, Takahashi T, Matsuishi T. Utility of the Rett syndrome behavior questionnaire (RSBQ) for Japanese patients with Rett syndrome: A pilot study. Brain Dev;2026 (Apr 4);48(3):104531.

BACKGROUND: Rett syndrome (RTT) is a neurodevelopmental disorder caused by MECP2 gene mutations. It mainly affects females and is characterized by age-dependent neurological and behavioral abnormalities. The Rett Syndrome Behavior Questionnaire (RSBQ) is a caregiver-completed tool accepted by the US Food and Drug Administration as a primary outcome measure in RTT clinical trials. However, its reliability remains uncertain, and few Japanese studies have used it. METHODS: In this study, 18 female RTT patients aged 4-44 years who regularly visited our hospital were assessed using the 45-item RSBQ through physician-guided, face-to-face caregiver interviews to ensure accurate understanding of each question. RSBQ scores were analyzed across nine behavioral domains and compared between patients aged <15 years (n = 8) and those aged ≥15 years (n = 10). Correlations between age and domain scores were examined using Spearman's rank test. Multiple regression was conducted to identify independent predictors of RTT-characteristic domains, which we defined as Domain 2 (breathing abnormalities) and Domain 3 (hand stereotypies) total scores. RESULT: Among patients aged ≥15 years, Domain 2 scores showed a strong negative correlation with age (r = -0.936, p < 0.001). Multiple regression showed that age was an independent factor associated with lower total scores on Domains 2 and 3. CONCLUSION: Breathing abnormalities and hand stereotypies tended to decrease with age. The RSBQ appears useful for evaluating symptom profiles in Japanese RTT patients. Future comparative and multicenter validation studies including female patients with intellectual disabilities are warranted. (242 words).

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10. Tian M, Au RHY, Cao S, Shi H, Xin C, Xia W. Mandarin translation and validation of the Theory of Mind Inventory-2 and the Theory of Mind Task Battery for autistic children in Mainland China. Br J Dev Psychol;2026 (Apr 3)

The objective of the study was to translate and culturally adapt two important measures of theory of mind (ToM)-the Theory of Mind Inventory-2 (ToMI-2) and the Theory of Mind Task Battery (ToMTB)-into a Mandarin version (the ToMI-2-M and the ToMTB-M). The ToMI-2-M and the ToMTB-M were first developed through translation, expert validation, and a pilot study. Ninety-four autistic children and 43 verbal ability-matched non-autistic children (aged 2.5-8 years) were then tested to evaluate the psychometric properties of the two assessment tools. Both the ToMI-2-M and the ToMTB-M showed good internal consistency and test-retest reliability. Content validity was supported by an expert panel. Concurrent validity was supported by the two assessment tools’ correlations with other ToM tasks, visual perspective taking, inhibitory control, and autistic characteristics. The discriminative validity was demonstrated by significantly higher scores of non-autistic children than autistic children on these assessment tasks. Age-related changes and the receiver operating characteristic curve analysis also provided support. The ToMI-2-M and the ToMTB-M showed good psychometric properties and represent useful tools for assessing ToM abilities of autistic children and non-autistic children.

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11. Wilkinson E, Yu YY, Bal VH, Clarke EB. Examining the Utility of the W-ADL to Assess Daily Living Skills in Non- or Minimally Speaking Autistic Adults. J Autism Dev Disord;2026 (Apr 4)

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12. Xiao R, Liang D, Ren Z, Jia Z, Qi H. Comprehension of Spatial Demonstratives in 4- to 6-Year-Old Chinese-Speaking Children with Autism Spectrum Disorder. J Psycholinguist Res;2026 (Apr 4);55(3)

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13. Zhong Y, Dimitriou D. Unlocking the Potential of Habitual Napping to Moderate the Association Between Sleep Disturbances and Behavioral Problems Among Autistic and Typically Developing Children. Autism Res;2026 (Apr 3):e70245.

Sleep disturbances are highly prevalent in autistic children and closely linked to behavioral difficulties, yet the role of napping in this relationship remains poorly understood, particularly in cultural contexts where naps are normative. This pilot study examined sleep-behavior associations and the potential protective role of napping in 53 school-aged children in China (26 autistic, 27 neurotypical, aged 6-12). Sleep was assessed both objectively (1-week actigraphy and sleep diaries) and subjectively (Children’s Sleep Habits Questionnaire), and behavioral outcomes were measured via the Child Behavior Checklist. Autistic children showed significantly more sleep disturbances than neurotypical peers, including greater bedtime resistance, longer sleep onset delay, more frequent night waking, and shorter total sleep. Night waking was a key correlate of behavioral problems in both groups. Importantly, longer nap durations were associated with weaker associations between sleep disturbances and behavioral outcomes. Temporal analyses further indicated that shorter nocturnal sleep was associated with longer next-day naps, while nap duration was not significantly associated with same-day night sleep. These findings highlight the potential relevance of culturally embedded nap routines in relation to behavioral difficulties and may inform context-sensitive sleep support strategies in neurodevelopmental populations. Autistic children showed more severe sleep disturbances than their typically developing peers, with night waking emerging as the strongest correlate of behavioral problems in both groups. Longer nap durations were associated with weaker associations between sleep disturbances and behavioral difficulties, reducing aggression in autistic children and internalizing symptoms in typically developing children. Temporal analyses revealed that naps compensated for shorter night sleep without disrupting same‐day nocturnal sleep. These findings suggest that culturally embedded nap routines may serve as a low‐cost, context‐sensitive strategy to support behavioral functioning in neurodivergent populations. eng

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