1. Adegbola A, Dhir N, Ogunjobi O. Pharmacogenetic Considerations in Sertraline Augmentation With Quetiapine in an Adolescent Woman With Obsessive-Compulsive Disorder, Autism Spectrum Disorder, and Attention-Deficit Hyperactivity Disorder: A Case Report. Cureus. 2026; 18(2): e102813.

Obsessive compulsive disorder (OCD) in children and young people commonly presents alongside neurodevelopmental comorbidities such as autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). These presentations are often associated with greater functional impairment and pose significant diagnostic and treatment challenges. We describe the case of an adolescent woman with OCD, ASD, and ADHD who presented with a deterioration in her mental state, characterised by symmetry-related grooming and self-care rituals lasting up to four hours daily, low mood, poor sleep, social withdrawal, suicidal ideation, and marked impairment in daily functioning. She had previously been stabilised on sertraline (200 mg) and lisdexamfetamine (60 mg). Worsening symptoms and functional decline raised the possibility of benefit from antipsychotic augmentation, and quetiapine was initiated. This was guided by pharmacogenetic testing following a poor initial response to ADHD medication and adverse effects when sertraline was first commenced. After three months of treatment with quetiapine, she demonstrated functional improvement, including a reduction in symmetry rituals and improved social engagement. This case highlights the complexities of psychological and pharmacological management of OCD in the context of neurodevelopmental comorbidity. Improved understanding of precision psychiatry in OCD with ASD comorbidity may facilitate the development of more tailored treatment approaches, including neurodevelopmentally adapted psychological interventions and targeted pharmacological strategies.

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2. Akgun Z, Ozkan F, Akkas O, Kose S, Demirkilinc Biler E. Assessment of Stereoacuity and Fusional Vergence Amplitudes in Children With Autism Spectrum Disorder: A Comparative Study. J Pediatr Ophthalmol Strabismus. 2026: 1-6.

PURPOSE: To evaluate the binocular vision and fusion potentials in children diagnosed as having autism spectrum disorder (ASD), while also assessing visual acuity, refractive errors, and the prevalence of strabismus, in comparison with typically developing peers. METHODS: This study included 57 children diagnosed as having ASD and 45 age-matched typically developing children as controls (control group). Comprehensive ophthalmologic examinations were performed in both groups, including best corrected visual acuity (BCVA), biomicroscopic evaluation of anterior and posterior segments, presence of strabismus, measurement of stereoacuity, fusional vergence amplitudes, near point of convergence, and refractive errors. Data and findings were comparatively evaluated between the two groups. RESULTS: The mean age was 12.10 ± 3.29 years (range: 7 to 18 years) in the ASD group and 10.91 ± 3.08 years (range: 7 to 18 years) in the control group, with no statistically significant difference between the groups (P = .080). A significantly higher prevalence of female participants was observed in the ASD group (P = .003). There was no significant difference in BCVA between the groups (P = .398). Strabismus was detected in 24.56% of the ASD group and 13.33% of the control group. Stereopsis of 480 sec/arc seconds and worse was observed in 47 (82.46%) patients in the ASD group and 4 (8.89%) patients in the control group, with a statistically significant reduction in stereopsis in the ASD group (P = .035). Emmetropia was present in 63.15% of the patients in the ASD group and 40% of the control group, whereas myopia was the most prevalent refractive error for both groups. Fusional amplitudes for convergence and divergence at near distance were found to be lower in the ASD group; however, no statistically significant differences were observed at distance fixation or in near point of convergence measurements. CONCLUSIONS: In children with ASD, stereoacuity and near fusion amplitudes were reduced and the near point of convergence increased. These findings are likely associated with cognitive impairments and attentional deficits characteristic of ASD, potentially rendering near vision tasks particularly challenging. Recognizing and addressing these visual function impairments may facilitate both visual and cognitive development in this patient population.

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3. Alhwaiti M. Working memory and processing speed as predictors of general fluid intelligence in adults with high functioning autism: A structural equation modeling approach. Appl Neuropsychol Adult. 2026: 1-7.

This study aimed to evaluate the predictive power of working memory and processing speed on general fluid intelligence (Gf) in adults with high functioning autism. One-hundred-seven participants were included in the study. They were adults diagnosed with autism spectrum disorder (ASD) according to Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) criteria. Pearson correlation and moderated hierarchical multiple regression analyses were conducted. The scanning electron microscope (SEM) was evaluated. The two independent variables (working memory capacity, processing speed) when put together yielded a coefficient of multiple regression (R) of 0.667 and a multiple correlation square of 0.641. This shows that 64.1% of the total variance in general Gf of those who participated in the study is accounted for by the combination of working memory capacity and processing speed.

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4. Antezana L, Conner CM, Feldman J, Manna LL, Ionadi A, Su DJ, Eldeeb S, Gastgeb H, Sivathasan S, Northrup JB, Beck KB, Scott LN, Mazefsky CA. Defining Nonsuicidal Self-Injury in Autistic People: A Framework for Assessment Using Key Elements to Aid in Characterization. Autism Adulthood. 2026.

Nonsuicidal self-injury (NSSI) is the intentional destruction of one’s own body tissue without suicidal intent and for purposes that are not socially or culturally accepted or practiced (e.g., intentional self-cutting, self-biting). Research on NSSI in autistic people is limited but increasing. NSSI is strongly associated with suicide, and it is an important behavior to better understand given the high rates of NSSI and suicide in autistic people. To date, research focused on autistic people has mostly used self-report questionnaires to assess NSSI, with a more limited application of clinical interviews of NSSI. However, researchers and clinicians may find it challenging to determine whether a behavior is categorized as NSSI in autistic people, especially since autistic people may present with other behaviors that cause self-injury. We set forth key elements in defining NSSI to support better reliability of NSSI assessment across studies. We emphasize that when assessing for NSSI the behavior must meet these key elements: (1) not intended to cause death, (2) the self-injury/harm is intentional, (3) there is immediate physical injury following the behavior, (4) the injury is to the external body, not internal body, (5) the injury is self-imposed and not done by another being, and (6) it is not a part of social or cultural practices. It will be important for future work to develop measures that can accurately assess NSSI in autistic people and advance mechanistic and intervention research related to NSSI.

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5. Arredondo-Nontol M, Arredondo-Nontol R, Reto N, Murillo Carrasco AG. Association between obesity and neurodevelopmental delay risk in children under five years: A study from Tumbes, Peru. PLoS One. 2026; 21(3): e0343815.

BACKGROUND: Childhood obesity is an emerging public health concern in low- and middle-income countries and may be associated with early neurodevelopmental vulnerability. Evidence on this association during early childhood remains limited, particularly in Latin American settings. OBJECTIVE: To evaluate the association between childhood obesity and neurodevelopmental delay risk in children under five years of age attending public healthcare facilities in Tumbes, Peru, and to develop a multivariable nomogram for probabilistic risk estimation. METHODS: An analytical cross-sectional study was conducted between 2022 and 2024 among children aged 0-59 months receiving care at two EsSalud healthcare facilities in Tumbes. Neurodevelopment was assessed using the Evaluación del Desarrollo Infantil (EDI), classifying children as having normal development, developmental lag, or being at risk of developmental delay. Childhood obesity was defined using WHO weight-for-height standards. Sociodemographic, clinical, and behavioral variables were collected. Associations were evaluated using proportional odds ordinal logistic regression guided by a directed acyclic graph. A nomogram was developed based on the final model and internally validated using bootstrap resampling (1,000 iterations). RESULTS: The final analytical sample included 431 children; 27% were classified as obese and 19% had anemia. According to the EDI, 58% had normal development, 36% developmental lag, and 6% were at risk of developmental delay. Childhood obesity was independently associated with higher cumulative odds of neurodevelopmental delay risk (OR = 2.73; 95% CI: 1.66-4.51). Male sex and older age group were also associated with increased risk, while higher caregiver knowledge of complementary feeding showed a protective association. Physical activity compliance and anemia were not independently associated in the multivariable model. The nomogram demonstrated acceptable internal discrimination (AUC > 0.7). CONCLUSIONS: Childhood obesity was associated with increased neurodevelopmental delay risk in children under five years of age. An explanation-informed nomogram using routinely available variables may support early risk stratification in primary care, although external validation is required before broader implementation.

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6. Barger B, Pigott TD, Sheldrick RC, Campbell J, Gonzalez Laca A, Starnes J, Davis B, Waford R, Olmstead J. Estimating the impact of missed cases on the accuracy of autism screening tools. Psychol Assess. 2026.

A common problem for assessing psychiatric screening tools is that initial diagnostic accuracy estimates are conducted on cross-sectional data and later found to be lower than expected when longitudinal analyses are conducted. This article uses prevalence estimates to identify potentially missed cases and adjust diagnostic accuracy metrics. To display this approach, we meta-analyze and assess 27 population-level autism screening studies identified via an umbrella review and contrast four population adjustments (none, national, U.S.-centric, and world prevalence). Studies with no positive screen adjustments displayed adequate sensitivity (.75), but poor sensitivity resulted when applying national (.52), world (.50), and U.S.-centric (.33) population adjustments. We also address missing positive screen cases due to the common problem of attrition (Sheldrick et al., 2023). Positive screen adjustments suggested a range of sensitivity impacts ranging from very poor (.32) to good (.89). Across analyses, positive predictive value estimates also ranged from .20 to .73 depending on population and missed case assumptions. The strengths and benefits of blending epidemiology and psychometric perspectives to identify screening tools that are weaker than expected are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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7. Bilaç Ö, Sobay NS, Yalçin AH, Baran DI, Özyurt BC, Sapmaz Ş Y, Kandemir H. Examination of Prenatal, Perinatal, Postnatal and Parental Psychosocial Characteristics Associated With Autism Spectrum Disorder: A Cross-Sectional Case-Control Study. Int J Dev Neurosci. 2026; 86(2): e70110.

PURPOSE: The purpose of this study was to identify biological and psychosocial factors associated with autism spectrum disorder (ASD) by comparing the prenatal, perinatal and postnatal characteristics of children with ASD and nonautistic controls. Furthermore, the relationships between parental stress, perceived parenting effectiveness and children’s behavioural and emotional adjustment were examined to emphasize the importance of supportive interventions for families of children with autism. METHODS: The sample consisted of 43 children aged 2-6 years diagnosed with ASD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and 35 nonautistic controls matched for age and sex. Prenatal, perinatal and postnatal variables were obtained using a structured sociodemographic form. Parental stress was measured with the Parenting Stress Index, while parenting effectiveness and child adjustment were assessed with the Child Adjustment and Parental Effectiveness Scale. Group comparisons were performed using t-tests and chi-square tests, and multivariate logistic regression identified independent predictors of ASD. RESULTS: Older parental age, lack of folic acid use, shorter duration of breastfeeding, delayed speech and walking, as well as higher parental stress were more common in the ASD group. Regression analysis showed that walking delay (OR = 4.47, 95% CI [1.46-13.73], p = 0.009) and higher parental stress (OR = 1.04, 95% CI [1.01-1.07], p = 0.003) independently predicted ASD after controlling for other potential confounders. CONCLUSION: Each month of delay in walking may increase the likelihood of an autism diagnosis, while higher parental stress reflects postdiagnostic care needs. Findings highlight the importance of early monitoring and psychosocial support.

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8. Block AR, Skaletski EC, Sheedy CM, Vanderpool EA, Travers BG. Motor Performance in Autistic Youth From Childhood Through Adolescence: Evidence for Both Sustained and Widening Group Differences. Autism Res. 2026: e70211.

Although motor-skill differences in autistic individuals are well established, there is diverging evidence regarding what happens to motor skills in autistic children as they become adolescents. Using both cross-sectional and longitudinal data, we examined fine and gross motor skills and grip strength of 187 autistic participants and 136 non-autistic participants (i.e., with no known diagnoses), aged 6-18 years-old. Participants completed the Bruininks-Oseretsky Test of Motor Proficiency-Short Form, Second Edition (BOT-2 SF), and maximal grip strength testing. Linear mixed-effects regression analyses indicated motor-skill differences between autistic and non-autistic participants across this age range; however, the nature of these differences depended on the specific motor domain (i.e., strength) and measure. Specifically, grip strength and BOT-2 SF strength subtest scores showed widening group differences with increasing age, whereas overall BOT-2 SF scores and subtests showed sustained or narrowing group differences through adolescence. However, items on the BOT-2 SF also demonstrated substantial ceiling effects, which may obscure later group differences between autistic and non-autistic participants and highlight the need for measures that encompass a greater range of motor skills into adolescence. These findings have important implications for healthcare, education, and community supports that address age-related motor differences within the autistic population. We looked at how motor skills—like grip strength and overall motor ability—vary with age in autistic and non‐autistic children and teenagers (6–18 years old). We found that autistic youth had weaker grip strength and more difficulty with motor skills compared to non‐autistic peers, with the gap in strength widening in adolescence and the gap in overall motor ability remaining the same or narrowing. Our findings show that motor differences in autism persist through adolescence and that we should carefully consider how we measure motor skills in this age range, which could inform better support for autistic people with motor differences in healthcare, education, and community settings. eng.

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9. Bourque K, Buzhardt J, Kamps D, Heitzman-Powell L, Zhang A. Interventions Benefitting Young Autistic Children. Educ Treat Children. 2025; 48(3): 245-58.

The education and treatment of autistic children present numerous challenges. Researchers at Juniper Gardens Children’s Project (JGCP) have contributed several important interventions. The beginning of this article in the special issue focuses on interventions promoting communication and social interactions of young autistic children. This line of research greatly expanded knowledge on evidence-based school intervention strategies that include neurotypical peers. In small group settings, peers are taught to be responsive communication partners. Recent work includes interventions to maximize communication outcomes and peer interactions for minimally-verbal or non-verbal autistic children learning to use augmentative and alternative communication. The next section of the article summarizes a telehealth training program called The Online and Applied System of Intervention Skills (OASIS) that helps caregivers learn behavioral procedures to promote independence and reduce challenging behavior. In OASIS, parents learn behavioral strategies through a sequence of online tutorials and assessments, each of which is followed by telehealth coaching sessions. Parents practice strategies in the home with their child while receiving guidance from a trained coach. OASIS has been adopted by programs around the country, especially for families on waiting lists to receive home-based treatment or services.

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10. Cermak CA, Rapley J, Fournier S, Penner M. Barriers and Innovations Towards Accessing an Autism Diagnosis in Rural Northern Ontario: A Qualitative Study. Child Care Health Dev. 2026; 52(2): e70250.

BACKGROUND: Early identification and diagnosis of autism are essential steps in supporting children and families. In rural communities, families can experience significant challenges in accessing an autism diagnosis. METHODS: We conducted semistructured interviews with four groups of participants: managers (n = 11), diagnosticians (n = 7), clinicians (n = 14) and parents/caregivers (n = 20) across six regions in Northern Ontario to learn of barriers and facilitators in accessing an autism diagnosis. Two independent coders coded each transcript and used inductive thematic analysis to identify themes across participants and regions. RESULTS: Five themes were generated from participants: (1) Gaps in autism knowledge delay early identification for children requiring an autism assessment; (2) complex systems create navigation barriers for families in knowing where to seek help; (3) families with limited access to resources face delays in the early identification process; (4) staffing challenges exacerbate barriers within the autism diagnostic process; and (5) collaboration among health disciplines while using a culturally responsive approach to care facilitates the autism assessment process. DISCUSSION: Hopes about the future of accessing an autism diagnosis were shared by families and professionals; although some challenges are fixed (e.g., vast geography), others are amenable to interventions such as building community knowledge and streamlining service navigation.

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11. Cohenour T, Gulsrud A, Kasari C. Receptive-Expressive Language Phenotypes in Infants and Toddlers With Autism Features. Autism Res. 2026: e70214.

Children diagnosed with autism often present with an atypical discrepancy between their receptive and expressive language levels, or an atypical receptive-expressive language phenotype. Children with an atypical receptive-expressive phenotype present with a relative receptive language advantage (expressive level < receptive level) or a relative expressive language advantage (expressive level > receptive level), whereas those with a typical phenotype have balanced receptive and expressive language levels. It remains unclear whether atypical receptive-expressive language phenotypes are evident before 24 months in children with autism features or whether they are associated with concurrent child developmental functioning or later language growth. Participants (N = 80) were drawn from a randomized comparative efficacy intervention study for 12-23-month-olds with autism features and elevated scores on an autism diagnostic instrument. Baseline receptive and expressive language age equivalent (AE) scores were used to describe continuous variation in receptive-expressive language phenotypes by quantifying the gap between each child’s receptive and expressive language levels. These continuous metrics were then used to classify children into discrete language profile groups: expressive advantage (EA), receptive advantage (RA), and balanced. On average, children had a gap of three AE « months » between their receptive and expressive language levels. Over 75% of children presented with an atypical receptive-expressive phenotype (40% EA profile, 36% RA profile), whereas only 24% of children had a typical receptive-expressive phenotype (balanced profile). Language profiles were not concurrently associated with age, autism features, joint attention skills, motor or cognitive functioning. However, children with the EA profile at baseline showed significantly slower expressive language growth over 12 months than those with RA or balanced language profiles, suggesting that receptive-expressive language profiles may hold promise as early prognostic markers of expressive language growth in emerging autism. This study examined the discrepancy between receptive and expressive language abilities among children with autism symptoms. Over 75% of children had an atypical discrepancy between their receptive and expressive language levels (an atypical receptive–expressive language profile). Although receptive–expressive language profiles were not associated with developmental factors like age or cognitive ability, we found preliminary evidence that children with a higher expressive than receptive language level (an expressive advantage profile) show slower expressive language growth. eng.

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12. Frankenstein NV, Taylor JL, Zheng S, Bishop SL, Libster N, Froehlich TE, Adams RE. Autistic Youth Being Ignored by Peers: An Early-Stage Study. Autism Res. 2026: e70213.

Autistic youth have been shown to be at risk for negative peer experiences, but experiences of being ignored are rarely examined in this group. This study is an early-stage examination of the experience of being ignored in autistic youth. Objectives are to test psychometric properties of a measure of being ignored; describe rates of being ignored; identify who is most at risk for being ignored; and test the association of being ignored with other social experiences and psychological health. One hundred and forty-nine autistic high school students with full scale IQs of 70 or above (M = 99.86, SD = 16.5) and aged 15-23 years completed self-reported, online surveys regarding day-to-day experiences, well-being, and psychological health. Parents completed additional measures assessing ASD symptomology and other demographic and clinical characteristics. A confirmatory factor analysis and Cronbach’s alpha indicated good psychometric properties for the Ignore factor. While the average score on the Ignore scale was relatively low, ~40% reported often having at least one type of experience of being ignored. Being ignored was associated with having more SRS-2 Restricted Interests/Repetitive Behaviors and Social Communication and Interaction Problems. Peer victimization was associated with higher rates on the ignore scale and social inclusion scale was associated with lower rates of being ignored. Multiple regressions controlling for peer victimization and inclusion found being ignored to be associated with higher rates of depression and anxiety. The findings suggest that being ignored may be an especially impactful experience for autistic youth. This study examined the experience of being ignored in a group of 149 high schoolers with autism. It was found that those who reported high rates of being ignored also reported high rates of being targeted for peer victimization and were less likely to be included by the peer group, as well as reporting higher rates of depression and anxiety. The findings suggest that being ignored may be an especially impactful experience for autistic youth. eng.

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13. Gipson TT, Bene ER, Yang CC, Perry LK, Messinger DM, Sahin M, Krueger DA, Bebin EM, Northrup H, Wu JY, Oller DK. Early Vocal Development in Tuberous Sclerosis Complex Predicts Language but Not Autism Outcomes. Pediatr Neurol. 2026; 178: 57-68.

BACKGROUND: Language impairments impact 72% of individuals with tuberous sclerosis complex (TSC). Nevertheless, evaluations are often delayed until children are 7 years old or older. Earlier prediction of language impairment is needed. Infant vocal behavior is a predictor of language development in typically developing children, but early vocal development had not been studied in TSC until recent research on 38 infants. In this study, the canonical babbling ratio (CBR) and volubility, key indicators of infant vocal behavior, were low. CBR reflects the proportion of syllables that are canonical and volubility reflects either production of utterances or syllables per minute. The present study has the following three goals: (1) To expand CBR and volubility characterization, (2) To evaluate predictiveness of CBR and volubility for autism spectrum disorder (ASD) and language outcomes, and (3) To determine if the contribution of CBR to prediction is independent of other known predictors. METHODS: We analyzed 202 recordings at 12 months for infants with TSC. Linear regression predicted language outcomes from vocal measures. Then, stepwise multiple regression compared the relative predictiveness for language outcomes of CBR and other measures known to predict language outcomes. Finally, logistic regression tested for ASD prediction. RESULTS: CBR and volubility were lower in TSC than in prior typically developing data. CBR was predictive of language outcomes at 24 months for infants with TSC even when competing against other known predictors, but neither CBR nor volubility predicted ASD. CONCLUSIONS: CBR may have utility for early identification of language impairments in TSC.

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14. Goetz J, Onwuka O, Moon JY, Shrivastava A, Park S. A Systematic Analysis of Amblyopia and Strabismus in Children With Autism Spectrum Disorder Across Tertiary Referral Centers in the United States. J Pediatr Ophthalmol Strabismus. 2026: 1-6.

PURPOSE: To evaluate the prevalence of amblyopia and/or strabismus in children with autism spectrum disorder (ASD) in tertiary referral centers across the United States and rates of surgical management of strabismus. METHODS: A systematic analysis of pediatric patients diagnosed as having ASD was performed using the Sight Outcomes Research Collaborative (SOURCE) database. Prevalence, odds ratios, and the rate of surgical management for strabismus were determined compared to age-matched controls. RESULTS: Strabismus and/or amblyopia was present in 35% of patients with ASD and 29% of age-matched controls (odds ratio = 1.33, 95% CI = 1.254 to 1.415, P < .001). Exotropia was more common than esotropia in both the ASD and control groups. The mean age at first ophthalmologic evaluation was 5.2 years for both controls and patients with ASD and strabismus/amblyopia. However, among those without strabismus/amblyopia, patients with ASD were evaluated earlier (mean ± standard deviation [SD] = 6.7 ± 4.8 years) compared to controls (mean ± SD = 7.4 ± 5.8 years). Although the ASD population had a male predominance, females had higher rates of amblyopia and/or strabismus at 39% compared to males with ASD at 34%. In all age groups, children with ASD had significantly (P < .001) higher rates of amblyopia and/or strabismus when compared to controls. The analysis found children with ASD have a higher prevalence of strabismus and/or amblyopia, with an increasing rate of diagnosis over the past two decades. CONCLUSIONS: Findings support further research into both the underlying mechanisms of strabismus in neurodivergent children and overall trends in the diagnosis of ASD and concomitant ophthalmic disease.

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15. Klein J, Krahn RL, Howe SJ, Cormier A, Rush J, Ames M, McMorris CA, Macoun S. Examining social camouflaging and its cognitive, mental health and neurophysiological correlates in autistic adolescents through triangulation-based assessment using self, parent and daily diary reports: a study protocol. BMJ Open. 2026; 16(3): e111221.

INTRODUCTION: Social camouflaging (SC; ie, the concealing of autistic traits to socially assimilate) is associated with poor mental health, self-identity and quality of life outcomes, yet its typology, consequences and contextual triggers remain unexplored in autistic adolescents. Further study is necessary to identify protective factors against the potentially negative outcomes associated with SC to promote long-term well-being. METHODS: The current project will investigate SC in youth and its mental health, cognitive and neurophysiological correlates. Camouflaging will be captured by triangulating self-reported and caregiver-reported SC behaviours, as well as SC behaviours in day-to-day contexts using intensive longitudinal methods (ie, daily diaries). Non-autistic, self-identifying autistic and formally diagnosed autistic adolescents aged 15-18 years (N=150) will be recruited. Adolescents and caregivers will complete rating scales to assess mental health, and adolescents will complete in-lab cognitive assessments of attention, executive function, intellectual ability and theory of mind. Brain neurophysiological function and cortisol concentration over time will be measured during the same visit using electroencephalography and hair samples, respectively. Over the following 7 days, adolescents will complete daily diaries using their smartphones. The daily diaries pose survey questions about the type and degree of SC behaviour used within their daily environment, including the social context, individuals who are present and current well-being. Adolescents will also complete brief performance-based cognitive assessments of attention and executive function integrated within the daily diary surveys. Finally, adolescents and their parents will complete a follow-up of SC behaviours and mental health at 3 months. Correlations and regression analyses will be conducted to explore the associations between SC and mental health/cognitive outcomes and how baseline measures of cognition, mental health and SC predict patterns seen on the daily diaries. Multilevel modelling will be used, nesting daily data to capture within-person and between-group differences in contextual predictors of camouflaging behaviour. Results will contribute to current understanding of the typology of camouflaging, as well as inform intervention to mitigate mental health challenges for autistic youth. ETHICS AND DISSEMINATION: This project is approved by the University of Victoria Human Research Ethics Board (#23-0013) and the University of Calgary Conjoint Faculties Research Ethics Board (#23-0641). Informed consent will be obtained from caregivers and adolescent participants, and safety procedures will be put in place to support the adolescent should mental health concerns arise. Results will be disseminated through academic publications and conferences, as well as summarised and communicated to interested participants and relevant stakeholders.

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16. Machado S, Paes F, Lima JL. Rethinking Autism as an Affective-Empathy Disorder. Alpha Psychiatry. 2026; 27(1): 45867.

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17. Ogunesan O, Newsom C, O’Kelley SE, Guest K, Wickliffe JK. Environmental metal exposure and autism spectrum disorder: spatial analysis of exposure patterns and associated risk among children in Alabama. Environ Sci Pollut Res Int. 2026.

Autism spectrum disorder (ASD) is a neurodevelopmental condition with increasing rates of diagnosis and potential links to environmental exposures. Metals are known neurotoxicants that may exacerbate ASD symptom presentation. Our study focused on children aged 3-10 years clinically diagnosed with ASD who have lived in Alabama since birth. Spatial analysis assessed metal distribution and clustering patterns, and Spearman correlation was used to evaluate associations between air toxic metals and ASD symptom presentation. Spatial analysis of airborne metals across Alabama showed considerable spatial variability and hot spots, mostly in central Alabama and surrounding counties. ASD symptom presentation showed moderate positive correlation with cadmium, chromium, and lead, weak positive correlation with manganese, and weak negative correlation with mercury. Proximity and statistical analysis showed 73% of the participants lived within 5 km of an industrial site; those living more than 10 km away had much lower ASD scores, and proximity was a strong predictor of ASD symptoms. Our findings show that children in Alabama may be exposed to multiple air toxic metals at different exposure windows, and industrial emissions and residential proximity to pollution sources are potential environmental contributors to increased ASD symptom presentation.

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18. Osama TA, Hori YS, Vanleuven J, Persad AR, Ustrzynski L, Emrich SC, Tayag A, Purger D, Park DJ, Chang SD. Neuromodulation for treatment resistant autism: systematic review. J Clin Neurosci. 2026; 148: 111970.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social-communication impairment, restricted interests, repetitive behaviors, and, in a subset of individuals, severe aggression, self-injurious behavior (SIB), and obsessive-compulsive symptoms. Traditional behavioral and pharmacological approaches often provide limited benefit. Neuromodulation and ablative neuropsychiatric procedures have emerged as potential therapeutic strategies targeting the neural circuits implicated in ASD. OBJECTIVE: To systematically review the existing clinical literature on neuromodulatory and neurosurgical interventions for ASD, including deep brain stimulation (DBS), repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS), transcranial direct current stimulation (tDCS), low-frequency electromagnetic stimulation, and stereotactic radiosurgery. METHODS: A comprehensive search of PubMed, Embase, and Cochrane Library was performed from inception through December 2025. Studies were included if they involved individuals with ASD undergoing any neuromodulation or ablative procedure and reported clinical outcomes. RESULTS: Sixteen studies met inclusion criteria. DBS targeting the nucleus accumbens, amygdala, or internal capsule produced substantial reductions in aggression, SIB, and obsessive-compulsive symptoms, with long-term improvements observed for up to several years. rTMS and iTBS targeting the pSTS, DLPFC, or medial prefrontal regions improved social responsiveness, emotion recognition, and aspects of executive function with minimal adverse effects. tDCS demonstrated benefits for social cognition, executive functioning, and behavioral regulation. Radiosurgery targeting limbic structures resulted in durable reductions in pathological aggression in highly refractory cases. Across modalities, adverse events were mild and transient. CONCLUSIONS: Neuromodulatory and ablative interventions demonstrate promising therapeutic potential for individuals with treatment-resistant ASD, particularly those with aggression, SIB, and profound social-cognitive deficits.

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19. Pérez-Bermejo M, Murillo-Llorente MT, Tudela J. Is There a Link Between Paracetamol and Autism? A Response to « Evaluation of the Evidence on Acetaminophen Use and Neurodevelopmental Disorders Using the Navigation Guide Methodology ». Linacre Q. 2026: 00243639261424843.

This commentary presents a critical appraisal and counterargument of a recent published work, which applies the Navigation Guide methodology to review the relationship between prenatal acetaminophen use and neurodevelopmental disorders (NDDs). The authors conclude that there is sufficient evidence to recommend taking immediate precautionary measures and limiting the use of acetaminophen among pregnant women. However, this conclusion exceeds the strength of the available evidence. In this commentary, we highlight important methodological limitations and inconsistencies between studies and address the risk of generating unjustified social alarm. Messages suggesting causality could lead pregnant women, especially those with limited access to reliable medical information, to stop taking a drug that is considered safe without having clear alternatives. We emphasize the importance of interpreting observational evidence cautiously and avoiding hasty extrapolations to clinical practice.

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20. Piccolo A. Between two worlds: A radiation therapist, a mother, and the lessons of autism. J Med Imaging Radiat Sci. 2026; 57(3): 102208.

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21. Roy P, Taywade M, Mohanty PK, Subba SH. Navigating challenges: a child with Apert syndrome and global developmental delay from a low-income family. BMJ Case Rep. 2026; 19(3).

Apert syndrome is a rare congenital disorder characterised by craniosynostosis, syndactyly and distinct facial dysmorphisms. We found a child with Apert syndrome from an economically disadvantaged family residing in an urban slum during a routine home visit by the All India Institute of Medical Sciences Bhubaneswar Extended Health Clinic. The child presented with global developmental delay, unvaccinated status and severe malnutrition, manifesting as underweight and stunted growth. Despite being eligible for free healthcare services under the Rashtriya Bal Swasthya Karyakram, the child remained unlinked to it. Contributing factors to this delayed intervention included the family’s low socio-economic status, profound lack of awareness of the condition, poor healthcare-seeking behaviour and insufficient engagement from healthcare workers. Moreover, complex psychosocial issues, such as maternal depression, parental substance abuse, limited social support and insufficient family involvement, further intensified the obstacles to the optimal growth and development of the child, highlighting the multifaceted factors that shape health outcomes in vulnerable populations.

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22. Wang J, He X, Cao Y, Gao J. Therapeutic effects of exercise interventions for children and adolescents with Autism: An umbrella meta-analysis. Psychol Sport Exerc. 2026; 85: 103115.

AIM: To evaluate the therapeutic effects of exercise interventions in children and adolescents with autism spectrum disorder (ASD) using an umbrella meta-analysis. METHOD: We systematically searched Embase, CINAHL, the Cochrane Library, Web of Science, PubMed, SinoMed, CNKI, Wanfang, and VIP for systematic reviews and meta-analyses of exercise-based interventions in ASD. Two reviewers independently assessed methodological quality and extracted data. We included 20 systematic reviews and meta-analyses comprising 14,245 participants. RESULTS: Exercise interventions were associated with enhanced social skills (SMD = 0.52; 95% CI 0.28-0.76; P < 0.001), improvements in repetitive stereotyped behaviors (SMD = 0.49; 95% CI 0.29-0.69; P < 0.001), and improved motor skills (SMD = 1.16; 95% CI 0.64-1.68; P < 0.001) in individuals with ASD. CONCLUSIONS: Exercise interventions are associated with improvements in social skills, repetitive stereotyped behaviors, and motor skills in children and adolescents with ASD. However, the overall certainty of evidence is low, and substantial heterogeneity and moderate-to-high overlap across meta-analyses warrant cautious interpretation. Exercise may represent a scalable, low-cost neuromodulatory adjunct within neurodevelopmental rehabilitation; future high-quality trials with long-term follow-up and clearly defined intensity and dose-response relationships are needed.

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23. Wang Y, Wang S, Zheng M. ‘A thorn in my heart’: Narratives of systemic burdens and gendered suffering in Chinese autism parenting discourse. Soc Sci Med. 2026; 397: 119156.

Autism parenting in China is shaped by a distinct sociocultural landscape where evolving awareness intersects with entrenched Confucian familism. While the parenting experience is multifaceted, this study conducts a targeted analysis of narratives of burden and suffering as they appear in autism parenting discourse on Xiaohongshu, a popular Chinese social media platform. Through a qualitative, metaphor-led discourse analysis of 55 posts, we identify and analyze three key themes within the register of hardships: (1) Battlefront, where war and economic metaphors convey profound distrust of a privatized intervention industry perceived as profit-oriented; (2) Care Crisis, where spatial and gendered metaphors articulate maternal despair, financial ruin, and self-erasure; and (3) Familial Disruption, where dehumanizing and Buddhist metaphors frame autism as a generational catastrophe. Metaphors like « a thorn in my heart » and « three-generation butterfly effect » are not merely linguistic flourishes; they function as culturally resonant narratives of parental distress and resistance. Furthermore, the analysis reveals a critical elision in parental discourse, where metaphors of the child as a burden coexist with social critique, illustrating how the child’s condition becomes the locus how the child’s condition becomes the locus for experiencing structural constraints. By centering these expressions of systemic and gendered suffering, our findings highlight an urgent need for multi-tiered reforms, including expanded state support and culturally tailored anti-stigma initiatives, to address the profound burdens faced by these families.

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24. Wang Y, Zhao Y, Nik W, Tan C, Lu F, Xing Q. Hot spots and frontiers in autistic traits in the general population from 2008 to 2023: A bibliometric analysis. Medicine (Baltimore). 2026; 105(10): e47887.

BACKGROUND: Autistic traits are increasingly conceptualized as continuously distributed characteristics present across the general population rather than being confined to clinically diagnosed autism spectrum disorder. Over the past 2 decades, research on autistic traits has expanded rapidly, yet a comprehensive overview of its knowledge structure, developmental trajectory, and emerging frontiers remains lacking. This study aims to systematically map the research landscape on autistic traits in the general population and to identify key themes, evolutionary patterns, and research frontiers. METHODS: A bibliometric analysis was conducted using publications indexed in the Web of Science Core Collection from 2008 to 2023. CiteSpace and VOSviewer were employed to analyze co-authorship, co-citation, keyword co-occurrence, and burst terms. Standard parameter settings were applied to ensure analytical robustness, and exploratory adjustments confirmed the stability of the overall network structure. Thematic clusters and temporal evolution were examined to reveal the conceptual organization and dynamic development of the field. RESULTS: The results indicate a steady growth in publications on autistic traits in the general population since 2008. Four major thematic domains were identified: measurement of autistic traits and individual differences, autistic traits and comorbidity, biological and genetic mechanisms, and cognitive and behavioral characteristics. Burst term analysis revealed a shift in recent years toward outcome-oriented and socially relevant topics, with sex differences and quality of life emerging as prominent research frontiers. These trends reflect increasing attention to sex-sensitive measurement, psychosocial functioning, and lived experience beyond categorical diagnosis. CONCLUSIONS: This bibliometric study provides a comprehensive overview of the intellectual structure and evolving frontiers of research on autistic traits in the general population. The findings highlight a conceptual transition from trait measurement and mechanistic exploration toward functional outcomes, well-being, and sex-sensitive perspectives. These insights may inform future research directions, measurement refinement, and the development of more inclusive frameworks for understanding autistic traits across diverse populations.

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25. Xu D, Chen J, Chen H, Wu C, Xiong Z. Self-compassion and self-efficacy among parents of children with autism: the mediating role of trust and the moderating role of social support. BMC Psychol. 2026.

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26. Zhang LB, Wu YY, Qiu DJ, Li WB, Ye ZL. Child Neurology: Multiple Genetic Etiologies Causing Dandy-Walker Variant With Microcephaly, Epilepsy, and Global Developmental Delay. Neurology. 2026; 106(7): e214793.

Dandy-Walker syndrome is typically characterized by near-complete cerebellar vermis agenesis, enlarged posterior fossa, and dilated fourth ventricle. By contrast, Dandy-Walker variant (DWv) shows milder features, typically characterized by partial agenesis of the cerebellar vermis, mild enlargement of the posterior fossa, and variable dilation of the fourth ventricle. Both conditions are usually associated with normal or enlarged head circumference. We report a 16-month-old girl presenting with congenital microcephaly, frequent seizures, and severe global developmental delay. Brain MRI revealed findings consistent with DWv, which did not explain the severity of her clinical symptoms or her microcephaly. Chromosomal microarray analysis revealed multiple regions of homozygosity on chromosome 11, indicating potential recessive inheritance; karyotype analysis and mitochondrial testing showed no clear etiology. Trio-based whole-exome sequencing identified a heterozygous variant (NM_021096.4:c.4891T>A/p.Phe1631Ile) in CACNA1I and a homozygous variant (NM_002335.4:c.1310C>T/p.Thr437Met) in LRP5. Variants in CACNA1I are associated with neurodevelopmental disorders, including epilepsy and developmental delay, while variants in LRP5 are linked to osteoporosis and microcephaly. Based on the clinical presentation and molecular findings, we hypothesize that both variants contributed to the patient’s complex phenotype. This case highlights that in patients with unusually severe or atypical manifestations, the possibility of multiple genetic pathogenic contributions should be considered, and comprehensive genomic evaluation is essential for accurate diagnosis and management.

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27. Zhou M, Zhang H. Exploring autism spectrum profiles via network analysis of parent-reported ASSQ patterns. BMC Psychiatry. 2026.

BACKGROUND: The behavioral profile of autism spectrum disorder (ASD) is highly heterogeneous. Analyses relying on total scores often fail to capture the associative patterns among individual behavioral items. This study applied network analysis to parent-reported Autism Spectrum Screening Questionnaire (ASSQ) data to explore the internal associative structure among core ASD behavioral domains and to identify key items within the network. METHODS: This retrospective study included 995 children and adolescents aged 7-16 years diagnosed with ASD according to ICD-10 criteria at Xiamen Xianyue Hospital between 2019 and 2025, whose parents completed the ASSQ. Given the 3-point Likert scale of the ASSQ, two parallel network modeling strategies were employed to enhance robustness: a dichotomized (Ising model) and an ordinal (Gaussian Graphical Model, GGM) approach to explore associations among ASSQ items. Comorbidities and psychiatric medication history were included as covariates. Central and bridge nodes were identified using expected influence and bridge expected influence, respectively, and the optimal model was selected. Network Comparison Tests were conducted to examine differences in global strength and structure between sex (male/female) and age groups (7-11/12-16 years). RESULTS: (1) The ordinal network model (ASSQ-GGM network) demonstrated better centrality stability and was therefore selected for reporting. (2) The ASSQ-GGM network identified the following central nodes: Q11 (inability to adjust, EI = 1.238), Q27 (unusual posture, EI = 1.154), and Q15 (fails to make relationships with peers, EI =  1.047). Bridge nodes were: Q26 (unusual facial expression, bEI = 0.806), Q11 (inability to adjust, bEI = 0.719) and Q12 (lacks empathy, bEI=0.710). (3) Network Comparison Tests found no significant differences in network structure by sex or age, which may be due to insufficient or imbalanced subsample sizes. The possibility of sex- or age-specific network patterns cannot be ruled out. CONCLUSIONS: This study presents a network of interrelated parent-reported ASD-related behavioral features based on ASSQ items. No significant sex or age differences in network structure were found. These findings provide insights into the associative patterns among ASSQ items. As this study is based on cross-sectional, guardian-reported data, the findings are hypothesis-generating and do not support causal inferences. Any implications for intervention require validation through longitudinal or experimental studies. CLINICAL TRIAL NUMBER: Not applicable.

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28. Zhu L, Yao D. Integrated Interventions for Executive Function Deficits in Children with Autism Spectrum Disorder: From Cognitive Training to Neuroregulation. Alpha Psychiatry. 2026; 27(1): 40062.

Autism Spectrum Disorder (ASD) is classified as a neurodevelopmental disorder primarily characterized by difficulties in social interaction, restricted interests, and repetitive behaviors. Advances in neuropsychological research have highlighted the crucial role of executive function (EF) deficits in children with ASD and their impact on the core symptoms of the disorder. EF encompasses higher-order cognitive processes, including working memory, cognitive flexibility, and inhibitory control. Given that EF deficits represent a significant cognitive impairment in this population, the variability in clinical intervention outcomes underscores the need for targeted strategies informed by underlying neural mechanisms. This narrative review explores the current research landscape on EF deficits in children with ASD. It synthesizes empirical findings related to cognitive and motor training, neuromodulation techniques, and collaborative interventions involving families and schools. The aim is to provide theoretical and practical guidance for enhancing EF and improving the quality of life of children with ASD.

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