1. Adams KL, Catmur C, Bird G. Associations Between Autism and Self-Reported Dimensions of Interoception. Autism;2026 (Apr 6):13623613261434431.

Despite a wealth of research on autism and interoception, there is not a clear consensus about which dimensions of interoception (if any) are related to autism. This study explored whether self-reported interoceptive accuracy, attention and evaluation are related to autism diagnosis and autistic traits. We analysed questionnaire responses from 519 participants, including 232 autistic participants. We found that people with an autism diagnosis had more negative interpretations of their bodily signals than people without an autism diagnosis, and increasing autistic traits in a general population sample were associated with higher interoceptive attention, lower interoceptive accuracy and higher negative interoceptive evaluation. Our findings suggest that interoceptive evaluation should be a priority for future research.Lay AbstractAutism is thought to be linked to differences in the way people notice, process and understand signals coming from inside of their bodies. This study explored how both autistic traits and autism diagnoses are associated with the processing of bodily signals. We found that among 519 participants, having more autistic traits meant that people paid more attention to body signals, reported lower accuracy at detecting them and had more negative interpretations of those signals. Autism diagnoses were associated with more negative interpretations of bodily signals.

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2. Al-Ghabban H, Bashiri FA, Alenezi S, El-Ansary A, Sabr A, Alayadhi L. Therapeutic potential of low-frequency transcranial magnetic stimulation in children with autism spectrum disorder: sensory and behavioral outcomes-a randomized trial. Front Psychiatry;2026;17:1725598.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects individuals across multiple life domains. Despite this, therapeutic options remain scarce, with none officially approved for its treatment. One recently explored treatment modality is repetitive transcranial magnetic stimulation (rTMS), a noninvasive neurostimulation intervention. This study examines the effectiveness of low-frequency rTMS in improving social, cognitive, and sensory function in individuals with ASD. METHOD: The study included 35 children aged 5 to 10 years who had been diagnosed with ASD. Participants were randomly assigned to two groups: 17 children received rTMS treatment twice weekly (active group), while the remaining 18 served as a waitlist (WTL) control group. Outcome measures were collected at baseline (preintervention) and 3 weeks after the completion of the 9-week rTMS intervention (postintervention). RESULTS: Significant (p < 0.05) improvements in cognitive, social, and sensory functions were observed in the active group measures 3 weeks after the 9-week rTMS intervention (postintervention). This was evidenced by their Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Short Sensory Profile (SSP) scores (27.47 ± 7.95, 71.59 ± 11.55, and 156.47 ± 20.17, respectively), with a highly significant reduction in sensory hypersensitivity (p = 0.001) compared to the WLT group, which presented more severe scores on CARS (35.89 ± 8.96), SRS (81.72 ± 7.68), and SSP (133.67 ± 11.65). Additionally, receiver operating characteristic (ROC) curves were analyzed. CARS, SRS, and SSP recorded poor areas under the curve (AUCs) in the active pre-rTMS group (0.557, 0.565, and 0.574, respectively), while all ROC curves showed significantly higher AUCs in post-rTMS (0.775, 0.753, and 0.825, respectively). CONCLUSION: The findings of this study suggest that low-frequency rTMS may have potential as an adjunctive intervention for specific ASD-related symptoms in social, cognitive, and sensory domains. However, further research is warranted to validate and expand these preliminary observations. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT06524310, identifier NCT06524310.

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3. Bourgeois JA, Schneider A, Klusek J, Christensen TR, Levin E, Gardner K, Jacobi AA, Hagerman RJ. Comprehensive, multidisciplinary care for fragile X-associated tremor/ataxia syndrome. Front Neurol;2026;17:1746002.

OBJECTIVE: The authors reviewed the pathophysiology, clinical genetics, phenotype, and comprehensive clinical management of Fragile X-associated Tremor/Ataxia Syndrome (FXTAS), a neurodegenerative disorder affecting FMR1 premutation carriers (55-200 CCG repeats). PARTICIPANTS: A multispecialty and multidisciplinary team of authors with backgrounds in psychiatry, pediatrics, clinical psychology, speech and language pathology, and neurosciences. EVIDENCE: Review of English language sources on the clinical phenomenology, genetics, pathophysiology, and clinical management of FXTAS from 2001 (the original report) through 2025, with emphasis on the general medical, psychiatric, and neurological features of FXTAS and its multispecialty and multidisciplinary clinical management. CONSENSUS PROCESS: All authors contributed to the review of the literature. Major components of the manuscript were drafted by clinicians with clinical experience in the specific areas of management. CONCLUSION: Fragile X-associated Tremor/Ataxia Syndrome (FXTAS) is a neurodegenerative disorder affecting FMR1 premutation carriers (55-200 CCG repeats) that is an illustrative model for a genetically-determined neuropsychiatric illness. It is characterized by intention tremor, gait ataxia, neurocognitive disorder, and other psychiatric symptoms. FXTAS occurs in patients with a family history of Fragile X-associated conditions, including Fragile X syndrome. Patients often develop fronto-subcortical dementia/major neurocognitive disorder (MNCD), leading to significant functional decline (particularly in males). A holistic, person-centered approach coordinated by the primary care clinician with multispecialty and multidisciplinary collaboration is recommended to address the complex needs of FXTAS patients and their support networks. This highlights the importance of integrated support for patients and caregivers, including addressing end-of-life/palliative care considerations.

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4. Brouche S, Rigal N, Paroissin C, Bouaziz N, Baleyte JM, Cazalis-Judet de la Combe F. Atypical modulation of electrodermal reactivity during exposure to graded unisensory and multisensory stimuli in autistic children and adolescents. Front Psychiatry;2026;17:1783075.

BACKGROUND: Despite the substantial increase in research on sensory processing in autism, the standardization of their assessment remains non-consensual. Physiological measures such as electrodermal reactivity (EDR) are still rarely used in clinical practice, although previous studies have reported differences in reactivity between autistic individuals and the general population. This experimental study aimed to test electrodermal reactivity (EDR) as an objective and measurable marker of sensory perception in children and adolescents with autism. METHODS: Data were collected from 37 participants, including 21 typically developing children (11 girls and 10 boys, M = 9.86 years) and 16 autistic children (all boys, M = 11.37 years). EDR was assessed both in its tonic (SCL) and phasic (SCR) components. Participants were exposed to three types of stimuli: unisensory (visual or auditory) and multisensory (audiovisual). Each stimulus was presented at increasing intensity from the first to the third exposure (nine conditions in total). RESULTS: SCL was consistently lower in autistic participants as compared to typically developing peers. SCR was lower in autistic participants for 4 exposure conditions out of 9. In contrast, no between group differences were found in relation to stimulus intensity or between unisensory and multisensory modalities. Within-group comparisons revealed significant increases in SCR during stimulus conditions only in the control group. Additionally, no significant age-related effects were observed. CONCLUSIONS: These findings highlight a specific EDR pattern in autistic children and adolescents during sensory stimulus processing characterized by hypoactivity in both tonic and phasic components of the signal. Future research should aim to better characterize this profile using a broader range of stimuli, across varied exposure contexts, and by integrating these physiological measures with cognitive assessments.

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5. Coloma P, Coury D, Wernette S, Beevers V, Dubois C, Di Marco T, Dursun OT, Bruni O. Daridorexant in children and adolescents with insomnia disorder: study protocol for a multicentre randomised controlled trial. BMJ Open;2026 (Apr 6);16(4):e099888.

INTRODUCTION: Insomnia disorder imposes a significant burden on children and adolescents; however, treatment options are limited. This paper describes the first controlled study to investigate the efficacy and safety of daridorexant, a dual orexin receptor antagonist, in children and adolescents with or without comorbid neurodevelopmental disorders, allowing its evaluation in a broad paediatric population. METHODS AND ANALYSIS: This multicentre, double-blind, randomised, placebo-controlled, parallel-group, dose-finding Phase 2 trial includes male and female participants aged ≥10 to <18 years meeting the diagnosis of insomnia disorder as per Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or International Classification of Sleep Disorders, Third Edition (ICSD-3) criteria. The study population is stratified into three groups: those with a known diagnosis of autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD); those without a diagnosis of ASD/ADHD but who meet the definition of 'subthreshold ASD' or 'subthreshold ADHD'; those with neither diagnosed ASD/ADHD nor 'subthreshold' ASD/ADHD. Study participants are randomised 1:1:1:1 to daridorexant 10 mg, 25 mg, 50 mg or placebo for at least 14 days. The change from baseline to Day 1 in total sleep time, measured by polysomnography, is the primary endpoint used to characterise the dose-response relationship of daridorexant in paediatric subjects with insomnia disorder. The study also assesses the safety, tolerability, pharmacokinetics, palatability and acceptability of daridorexant. ETHICS AND DISSEMINATION: This study has been approved by the respective health authorities and institutional review boards/independent ethics committees for each participating site and country and is conducted in accordance with the Declaration of Helsinki. Ethics approval has been obtained for each participating country/site. Regardless of the outcomes, the results will be published in an international peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: NCT05423717.

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6. Deniz E, Noret N, Chow ARW, Baldwin JR, Toseeb U. Bullying Trajectories From Childhood to Adolescence: The Relationship With Mental Health Outcomes for Autistic and Neurotypical Youth. Autism Res;2026 (Apr 6):e70227.

Autistic youth are more likely to be involved in bullying, have poorer mental health, and experience friendships and social support differently compared to neurotypical youth. What remains unclear is whether the relationship between bullying and mental health is different for autistic and neurotypical youth and whether friendships and social support moderate this relationship. In this United Kingdom-based population-based study, we investigated the relationship between bullying involvement, victimization, and perpetration, from early childhood (age 5 years) through to mid-adolescence (age 14 years) with mental health outcomes in later adolescence (age 17 years) for autistic (n = 576) and neurotypical youth (n = 14,963). We used parent-, teacher-, and self-reports of bullying at ages 5, 7, 11, and 14 years to identify five bullying trajectory groups (uninvolved, adolescent victim, early childhood victim, early childhood bully, and bully-victims). Autistic youth were more likely than their neurotypical peers to be in one of the bullying trajectory groups compared to being in the uninvolved group. Specifically, 74% of autistic youth experienced bullying either as victims, bullies, or bully-victims between early childhood and adolescence compared to 38% of neurotypical youth. Both autistic and neurotypical youth who were involved in bullying, whether as a perpetrator or victim, experienced poorer subsequent mental health later in adolescence. Higher perceived social support buffered the effects of bullying involvement for neurotypical and, to a lesser extent, autistic youth. These findings highlight the need for further research focusing on possible targets for intervention to mitigate the possible impacts of bullying on subsequent mental health for autistic youth. Autistic youth are more likely to be involved in bullying, both as a victim and perpetrator, compared to neurotypical youth. Being involved in bullying from childhood to adolescence is associated with poorer mental health later in adolescence. Perceived social support buffers some of the impacts of bullying on mental health for neurotypical youth and to a lesser extent autistic youth. eng

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7. Doijad S, Sakthivel D, Gowda NKC. Integrated genetic analysis reveals synaptic m(6)A enrichment in high-risk autism genes. Front Mol Neurosci;2026;19:1767983.

Autism Spectrum Disorder (ASD), a complex neurodevelopmental condition, is characterised by reduced social and emotional expression and repetitive patterns of behaviour. The clinical observations of defects in brain development and disrupted connectivity in ASD correlate with the perturbations at the neuronal and molecular levels. While the underlying genetic basis has been extensively studied, understanding the epigenetic and epitranscriptomic regulation has only begun to unravel in the past two decades. This work aims to link the ASD clinical phenotypes to the molecular dysfunction, specifically highlighting one of the crucial mRNA modifications, N6-methyladenosine (m(6)A). During neuronal development, m(6)A, a key post-transcriptional regulator, dynamically modulates mRNA translation at synapses and is essential for maintaining synaptic plasticity. However, the mechanisms by which m(6)A operates at synapses in the context of ASD are poorly understood. Our work establishes connections across neuronal developmental timelines to m(6)A regulation and discusses the possibility of how this dysregulation may underlie the development of synaptopathies observed in ASD. By integrating previously published m(6)A-seq and CLIP-seq data with the SFARI gene database, we found that 41.59% (515 of 1,238 genes) of ASD risk genes are m(6)A-enriched. Specifically, we found 28 syndromic genes overlapping with the Synaptic m(6)A Epitranscriptome (SME). Here, we also shed light on the importance of m(6)A readers, with a focus on FMRP and YTHDF1 and their regulation at the synapse. Altogether, we suggest a model in which m(6)A-mediated post-transcriptional regulation influences ASD-related synaptic dysfunction.

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8. Kemp F, Hudson M, Schröder T, Gale C. Adapting compassionate mind training into guided self-help for parents of autistic children. Psychol Psychother;2026 (Apr 6)

OBJECTIVES: Parents of autistic children (PAC) are at increased risk of psychological distress, including shame and self-criticism. Compassion-focused therapy (CFT) is a recommended transdiagnostic intervention for such difficulties, but to date, there is limited research around the use of CFT with PAC. The present study aimed to explore the adaptations needed for a guided self-help CFT intervention for wellbeing, and the potential factors influencing future implementation during feasibility testing, through engagement with relevant stakeholders. DESIGN: A two-stage qualitative research design aimed to (1) extract and configure stakeholder feedback for adaptations and (2) understand stakeholder views regarding the anticipated factors influencing implementation of the CFT resource during future feasibility testing. METHODS: Five iterative rounds of stakeholder feedback and intervention refinement were facilitated, using focus groups and written commentary with PAC (n = 7), clinical psychologists working within children’s autism services (n = 4) and a CFT expert (n = 1). Directed content analysis supported extraction of adaptation suggestions during each feedback round. Framework analysis was employed to all focus group data to meet the second research aim. RESULTS: Compassionate Mind Training for Parents of Autistic Children (CMT-PAC) guided self-help intervention was developed. Two key concepts from the framework analysis were recognised across focus groups: ‘personal and social context of parents’ and ‘barriers and facilitators to engagement’. CONCLUSIONS: Stakeholders appeared optimistic about the use of CMT-PAC within a future feasibility study. However, some potential issues were raised relating to how CMT-PAC could be implemented amongst the target population. Implications for research and clinical practice are discussed.

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9. Kumar J, Hartzell C, Abelson E, Mano KJ, Chidambaran V. Prevalence, Expression, Assessment, Mechanisms, and Management of Pain in Autistic Children: A Scoping Review. A A Pract;2026 (Apr 1);20(4):e02178.

Autism spectrum disorder is a neurodivergent condition affecting communication, social interaction, and behavior, and is characterized by sensory-processing abnormalities. There is a high incidence of chronic pain in autistic children, and pain can also be a presenting symptom of autism. With improved identification of autism in children, it is increasingly important to understand the implications for pain management. This scoping review describes and summarizes existing literature on pain prevalence, mechanisms, expression, and assessment challenges, as well as acute and chronic pain management in autistic children. A systematic search strategy of MEDLINE, PsycINFO, SCOPUS, and Web of Science was utilized to identify major findings of qualitative, quantitative, observational studies, and reviews reporting on pain in pediatric patients (3-18 years) with concomitant autistic symptomatology. We identified 260 eligible articles, of which 85 were included for review. Our findings challenge earlier assumptions that autistic children are not sensitive to pain. Rather, they react differently to pain than nonautistic peers, have comorbidities that increase pain risk, and are hypersensitive to painful stimuli. Altered sensory-processing, genetic mechanisms, and brain-gut microbiome interactions have been suggested as mechanisms for higher pain sensitivity. The combination of altered pain expression and lack of proper pain assessment tools in this population can lead to unnecessary testing or delays in diagnosis and management. Management of pain requires parental engagement, multidisciplinary coordination, and tailored interventions unique to the individual’s responses.

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10. Kusunoki M, Kawabe K, Matsumoto Y, Inoue S, Soga J, Horiuchi F, Ueno SI. Caregivers’ Attitudes for Pharmacotherapy in Child Psychiatry: A Regional Survey in Japan. Int J Dev Neurosci;2026 (Apr);86(2):e70121.

BACKGROUND: Pharmacotherapy plays an essential role in managing neurodevelopmental and psychiatric disorders in children, although most psychotropic medications are prescribed off-label. Caregivers’ hesitation toward medication remains an important issue in child psychiatry practice. This study aimed to investigate caregivers’ concerns and expectations regarding pharmacotherapy for their children and identify factors associated with their willingness to medicate. METHODS: This cross-sectional study was conducted between August and December 2023 at the Center for Child Health, Behavior, and Department, University Hospital, Japan. Primary caregivers of children aged 2-15 years attending follow-up outpatient visits completed structured questionnaires assessing their concerns, expectations, and perceived treatment purposes. Descriptive statistics and multivariate logistic regression analyses were performed to identify predictors of caregivers’ willingness to medicate. RESULTS: A total of 212 caregivers (92.5% mothers) participated. The most frequent diagnosis reported was autism spectrum disorder (47.6%), followed by attention deficit/hyperactivity disorder (25.5%). The leading concerns regarding pharmacotherapy were long-term medication use (56.1%), side effects (43.4%) and dependence (41.0%). Over 90% of caregivers expected child psychiatrists to provide supportive opportunities for both children and caregivers. Logistic regression analysis revealed that concern about long-term medication use was significantly associated with a positive attitude toward pharmacotherapy (p < 0.001). Caregivers' perceived distress regarding their children's problems, measured using a visual analogue scale, significantly decreased from 7.9 ± 2.0 at the initial visit to 5.3 ± 2.2 at present under medical care (paired t-test, p < 0.001). CONCLUSIONS: Long-term pharmacotherapy remains a major concern among caregivers in child psychiatry, indicating the need for clinicians to address it earnestly.

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11. Loughnane G, Mothersill D, Gonzalez-Velez H, Mulbah M, Ebuenyi I, Dossen B, Hargreaves A. Knowledge, attitudes, and behaviours towards schizophrenia, bipolar disorder, autism, and epilepsy in Ireland: a national survey. Ir J Psychol Med;2026 (Apr 6):1-9.

OBJECTIVES: Stigma towards individuals with mental, neurodevelopmental, and neurological conditions is associated with problems accessing healthcare (e.g. schizophrenia) and gaining employment (e.g. epilepsy). In Ireland, stigma differs towards different conditions, with previous research showing that schizophrenia is viewed more negatively than bipolar disorder or autism. More detailed understanding of stigma in Ireland requires replication of these findings in a larger, population-representative sample. METHODS: 1,232 participants around Ireland completed a survey examining knowledge, attitudes, and behaviours towards schizophrenia, bipolar disorder, autism, and epilepsy as a comparator. Knowledge, attitudes, and behaviours towards these groups were compared using cumulative link mixed models. RESULTS: Perception of others’ stigma and participants’ own self-reported behaviour were more negative towards schizophrenia compared to any of the other groups. Familiarity with mental health issues was associated with more positive self-reported behaviour towards those with schizophrenia. This improvement in behaviour was mediated by reduced perception of danger of this group. In contrast, greater mental health knowledge had no such impact on behaviour. Bipolar disorder was the second-most negatively perceived condition, followed by autism and epilepsy. CONCLUSIONS: These findings support our recent pilot study and provide further evidence that stigma differs towards different conditions in Ireland, with Irish people perceiving more negative societal attitudes, and self-reporting more negative behaviour, towards schizophrenia. The finding that familiarity with schizophrenia predicted more positive behaviour and that this was mediated by reduced perception of danger suggests targets for future anti-stigma interventions.

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12. Mathur M, Tang J, Markham C, McKay S, Li R, Ernest D, Marshall A, Sharma S. A Qualitative Analysis of Pediatricians’ Perspectives Regarding Barriers, Facilitators, and Strategies for Providing Timely Autism Spectrum Disorder Screening and Diagnosis. Clin Med Insights Pediatr;2026 (Apr 6):11795565261431178.

BACKGROUND: Autism spectrum disorder (ASD) is a developmental disorder that has increased in prevalence over the years. Diagnosis and subsequent intervention by the age of 3 is essential for development. However, recent estimates indicate that less than 50% of children receive an evaluation by age 3. Underserved populations are more likely to receive an evaluation at an older age. Several barriers in the diagnostic process have been identified; however, limited studies have aimed at understanding the specifics of these barriers among underserved populations and whether current strategies are beneficial for all children. OBJECTIVES: The aim of this study was to identify barriers and strategies, as reported by pediatricians serving underserved populations, to enhance timely screening and diagnosis of ASD. DESIGN: A qualitative study was conducted. METHODS: Semi-structured interviews were conducted with general pediatricians and subspecialists (N = 14) practicing in the Greater Houston area, Texas. Thematic analysis was conducted using inductive reasoning. RESULTS: Participants were majority White (50%), female (79%), practicing in hospital-based settings (64%), with 3 to 5 years of professional experience (64%) and a mean age of 50 years. Three themes were identified (1) barriers causing delays in ASD screening and diagnosis; (2) individualized approaches in pediatric care to address barriers, and (3) recommendations to improve timely ASD screening and diagnosis. CONCLUSION: The results of this study identified potential strategies to overcome access, availability, and knowledge barriers; however, the lack of standardization across the health system results in the continued reporting of significant barriers. Using a health equity approach is key to ensure improvements in timely screening and diagnosing by tailoring strategies to the population being served. Health systems should work on expanding and evaluating identified strategies. Additionally, improve education for providers and parents to address parental hesitancy, increase attendance with routine well-child checks, and improve ASD evaluation referrals.

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13. Moseley RL, Marsden SJ, Pelton M, Weir E, Procyshyn T, Allison CL, Parsons TA, Cassidy S, Chikaura T, Hodges H, Mosse D, Rodgers J, Hall I, Owens L, Cheyette J, Crichton D, Hedley D, Baron-Cohen S. « The best way we can stop suicides is by making lives worth living »: a mixed-methods survey in the UK of perspectives on suicide prevention from the autism community. EClinicalMedicine;2026 (Mar);93:103793.

BACKGROUND: Autistic people are at higher risk of dying by suicide than are non-autistic people, but research focused on suicide prevention in autistic individuals is lacking. We aimed to understand, from autistic people and those who support them, the pathways to suicide prevention, the balance of crisis measures vs. longer-term prevention, the importance of formal diagnosis, and the role of co-design and co-production in suicide prevention activities. METHODS: We undertook a mixed-methods, two-phase online survey focused on the priorities, views and perspectives of autistic people and their supporters/allies on approaches and strategies to prevent suicide. In Phase 1 (Jan 10-July 31, 2024), via the first survey, we collected and thematically analysed ideas for suicide prevention from almost 1200 autistic people and more than 200 people who identified as supporters and/or allies of autistic people. In Phase 2 (reported herein), a larger group of participants rated and ranked these ideas via a second online survey, during which we collected qualitative and quantitative data. Participants were UK residents aged ≥16 years who self-identified as being in one or more of the following groups: autistic; someone with experience supporting an autistic person of any age or ability; and/or someone with experience of bereavement by the suicide of an autistic person they supported. The online survey included closed-ended and open-ended (qualitative) questions. We thematically analysed free-text responses, and computed descriptive statistics for closed-ended questions. FINDINGS: Between Nov 1, 2024, and Jan 31, 2025, 2778 individuals responded to the online survey (Phase 2), comprising 2463 autistic people and 315 non-autistic people who identified as supporters/allies of autistic people, some of whom had been bereaved by the suicide of an autistic person. Although some participants reported that crisis interventions (eg, dedicated helplines) were most urgent, a greater number prioritised larger-scale preventative measures (eg, improving support in schools) to address systemic inequalities, which some participants perceived as the root of suicidal thoughts. Across their qualitative and quantitative responses, most participants recommended providing support to people awaiting autism assessment, but some were less supportive of providing dedicated autism supports to people who self-diagnose or who are questioning a possible autistic identity. The qualitative and quantitative data suggested that most participants viewed co-design and co-production of interventions and initiatives to prevent suicide as vital for ensuring these reflect the expertise and empathy that autistic people could bring to individuals struggling with similar experiences. INTERPRETATION: This qualitative work with experts by experience supports that suicide in autistic people should be viewed in the context of pervasive and systemic injustices, rather than individualistic psychopathology. Accordingly, the extent to which crisis interventions can reduce suicide rates is contingent on additional systemic, preventative, and coordinated actions to tackle the social determinants of suicide and support enduring wellbeing in this group. Support should be produced in partnership with autistic people and their advocates, and be needs-based rather than diagnosis-based. In future research, researchers, practitioners, and policymakers should develop community partnerships to facilitate co-development of strategic, multi-level action plans and initiatives for suicide prevention. FUNDING: Autism Action (previously the Autism Centre of Excellence at Cambridge).

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14. Nannen D. Hospital passports for people with learning disabilities and autistic people. Br J Nurs;2026 (Apr 2);35(7):380-381.

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15. 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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16. Sharma PP. Isolated β-Human Chorionic Gonadotropin Elevation-From Pregnancy to Fragile X-associated Premature Ovarian Insufficiency. AACE Endocrinol Diabetes;2026 (Mar-Apr);13(2):308-312.

BACKGROUND/OBJECTIVE: Elevated β-human chorionic gonadotropin (β-HCG) in a young female usually suggests pregnancy, gestational trophoblastic disease or germ cell tumor. We describe β-HCG elevation in a young female using intrauterine device (IUD), ultimately diagnosed with Fragile X-associated premature ovarian insufficiency (FXPOI). CASE REPORT: A 31-year-old woman with Hashimoto’s hypothyroidism and a levonorgesterel IUD presented to the emergency room for hematemesis. She had a positive urine and serum pregnancy test. Ultrasound showed no evidence of intrauterine gestation with a normally centered IUD. After removal of the IUD and methotrexate therapy for presumed ectopic pregnancy in an unknown location, β-HCG level remained elevated. Heterophile antibody interference was ruled out. Over the next 2 months, further testing confirmed FXPOI (follicle-stimulating hormone 174.58 mIU/mL, luteinizing hormone 70.61 mIU/mL, undetectable estradiol, undetectable progesterone, undetectable anti-mullerian hormone, and one FMR1 premutation allele). Hormone therapy with oral estradiol 2 mg daily and cyclic oral micronized progesterone 200 mg on 12 days of each month was initiated. DISCUSSION: In menopause, decreased estradiol and progesterone lead to mildly elevated β-HCG through luteinizing hormone-mediated β-HCG production in the pituitary gland. This may be confused with pregnancy and could delay diagnosis of premature menopause due to premature ovarian insufficiency (POI), especially in young females. In young patients with normal karyotype, Fragile X premutation is the most common genetic cause of POI. CONCLUSION: After pregnancy has been ruled out, less common causes of β-HCG elevations like gestational trophoblastic disease, germ cell tumors, POI associated menopause, and heterophile antibody interference, should be evaluated. FXPOI should be considered in young patients with β-HCG elevation.

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17. Tan X, Zhang L, Wang D, Wu X. Effects of physical activity on fundamental motor skills and body composition in children and adolescents with intellectual and developmental disabilities: a systematic review and meta-analysis. PeerJ;2026;14:e20946.

BACKGROUND: The development of fundamental motor skills (FMS) and changes in body composition among children and adolescents with intellectual and developmental disabilities (IDD) are an emerging public health issue. Physical activity serves as a dual protective mechanism, enhancing motor skills and optimizing body composition. Yet no systematic reviews have been published examining the effects of structured exercise programs on both FMS progression and weight management in this population. METHODS: Web of Science, PubMed, Cochrane Library, and Medline databases were searched for peer-reviewed English-language literature, from the establishment of the database to October 1, 2025. Risk of bias was assessed using a modified Cochrane Collaboration’s tool and PEDro scale. The inclusion criteria comprised randomized or controlled trial that reported on FMS or body composition in children and adolescents (4-18 years) with IDD. Subgroup analyses were performed according to the type of physical activity. RESULTS: Thirty-three studies (n = 5,245, average age ranging from 4 to 18 years) were included. Physical activity significantly improved FMS (standard mean difference (SMD) = 1.21, 95% CI [0.85-1.57], p < 0.001). Subgroup analyses showed significant improvements in locomotor skills (SMD = 1.13, 95% CI [0.83-1.42], p < 0.001) and object control skills (SMD = 0.87, 95% CI [0.57-1.17], p < 0.001). Among physical activity types, virtual reality (VR) games (SMD = 1.00, 95% CI [0.60-1.40], p < 0.001), motor skills (SMD = 1.79, 95% CI [1.11-2.47], p < 0.001), and sport-specific programs (SMD = 1.13, 95% CI [0.57-1.70], p < 0.001) improved the FMS. In terms of body composition, moderate intensity continuous training (MICT) significantly reduced body mass index (SMD = -0.29, 95% CI [-0.50 to -0.08], p = 0.006) and body fat percentage (SMD = -0.55, 95% CI [-1.01 to -0.09], p = 0.020). In contrast, the reduction in waist circumference was not significant (SMD = -0.32, 95% CI [-0.69 to 0.04], p = 0.080). CONCLUSION: Our findings identify interventions focused on motor skills and MICT as effective strategies for improving FMS and body composition in this population, which may lay a foundation for their long-term health. In contrast, VR games have limited empirical support based on our assessment of the evidence quality.

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18. Tseng A, Yang A, Van Hecke AV, Hudock RL, Laugeson EA, Lee HK, Biagianti B, Jacob S. Neuroplasticity-Based Targeted Cognitive Training as Enhancement to Social Skills Program: A Randomized Controlled Trial Investigating a Novel Digital Application for Autistic Adolescents. JAACAP Open;2026 (Apr);4(2):281-297.

OBJECTIVE: Few evidence-based social cognitive interventions are available to autistic youth as they navigate their complex, socially demanding teenage years. Building from pilot research using neuroplasticity-based targeted cognitive training, CICADAS (Care Improving Cognition for ADolescents on the Autism Spectrum), a digital application (app) designed to prime the brain for socio-affective learning, was developed. In a randomized active-controlled trial with 3 comparison arms, CICADAS was evaluated as a stand-alone program and as an augmentation to evidence-based PEERS (Program for the Education and Enrichment of Relationship Skills). METHOD: Recruiting from clinics providing PEERS, 62 adolescents (11-18 years old) with confirmed autism were enrolled. Adolescents scheduled to start PEERS were assigned using block randomization to PEERS + CICADAS (n = 22) and PEERS + Active Control (n = 21) groups. A third comparison group (n = 19) comprised adolescents who used the app as a stand-alone intervention (CICADAS only). In addition to in-app performance metrics, data were collected from social, behavioral, and cognitive assessments (self-report/parent-report measures) at preintervention (baseline), postintervention (16 weeks), and follow-up (32 weeks) sessions. RESULTS: Significant effects of group, time, and group × time interaction were found on multiple measures collected longitudinally. For example, on the Pediatric Quality of Life Inventory, PEERS + CICADAS participants showed significant psychosocial health improvements (F = 6.862, p = .002) over the study timeline compared with trend level gains in the CICADAS only (F = 2.150, p = .122) and PEERS + Active Control (F = 1.917, p = .153) groups. Whereas all participants improved from baseline on the Social Responsiveness Scale, 2nd Edition (F = 11.038, p < .001), only the PEERS + CICADAS group gained significantly (F = 3.786, p = .026) on the social cognition subscale across all 3 time points. CONCLUSION: Our data demonstrate the potential of CICADAS as a stand-alone intervention and suggest that engaging with the adaptive app (vs static active control) conferred an additional advantage to autistic teens participating in PEERS. CLINICAL TRIAL REGISTRATION INFORMATION: Care Improving Cognition for ADolescents on the Autism Spectrum (CICADAS); https://www.clinicaltrials.gov/study/NCT04562688. Youth with autism have few options for social cognitive support. To address this gap, researchers developed Care Improving Cognition for ADolescents on the Autism Spectrum (CICADAS), an adaptive cognitive training app designed to prime the brain for social cognitive learning. This study tested CICADAS by pairing the digital app with the Program for the Education and Enrichment of Relationship Skills (PEERS), one of the few well-established group-based social skills programs. This study of 62 adolescents (11-18 years) with autism compared groups using CICADAS alone, PEERS alone, or the combination. Data collected pre-/post-intervention showed gains from CICADAS used alone, but particularly as an enhancement to PEERS. Results suggest the digital tool may be a useful stand-alone or augmenting program for improving social cognition in youth with autism. eng

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19. Underwood Carrasco VI, Asantewaa SM, Zuckerman KE, Lindly OJ. Socioecological factors captured in autism service disparities research on Medicaid-enrolled patients: a rapid evidence review. Front Psychiatry;2026;17:1767829.

There continue to be disparities in access to quality services that vary from the individual to the policy level. Medicaid is particularly relevant to accessing autism services, since obtaining a diagnosis often confers eligibility, regardless of income requirements, making it a major insurer in this population. Therefore, studies using Medicaid claims data to examine autism service access and utilization may provide unique insights into the demographics being studied and the factors influencing service equity. This rapid evidence review followed the Cochrane Rapid Review Methods Group recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to conduct a literature search across five databases (i.e., ERIC, SCOPUS, PubMed, CINAHL Plus, PsycINFO) to locate articles describing studies of autism services utilization conducted in the United States using Medicaid claims data. Studies had to use Medicaid claims, include an autistic population, be peer-reviewed, original empirical research, and examine variances or disparities in autism services. Case studies or series were excluded. Inclusion criteria were assessed using the Covidence review management tool; 60 articles met all criteria and were included. Information was extracted regarding each study, including characteristics of the study and the included participants, including factors analyzed for variation in service utilization. Results show that existing autism disparities research primarily represents the experiences of school-aged children and young adults (ages 6-21 years), pharmacological and therapeutic services, and individual-level factors, limiting the generalizability of existing research on autism service use.

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20. Win TT, Prasopkittikun T, Phetrasuwan S, Lenwari C. Mindfulness and communication intervention for mothers of children with developmental disabilities in Yangon: A randomized controlled trial on parental stress and problem-solving communication. Int J Nurs Sci;2026 (Mar);13(2):105-112.

OBJECTIVE: This study aimed to examine the effects of the Mindfulness and Effective Communication Enhancement (MECE) program on parental stress and problem-solving communication among mothers of children with developmental disabilities in Yangon, Myanmar. METHODS: A randomized controlled trial was conducted with 60 mothers of school-aged children with developmental disabilities from a specialized daycare center in Yangon. Participants were randomly assigned to either an intervention group (n = 30) or a control group (n = 30). The intervention group received the MECE program in addition to routine services, which included four weekly in-class sessions (Weeks 1-4) and two follow-up sessions (Weeks 6 and 10). At the same time, the control group received routine services. The outcomes were collected at baseline (Week 1), post-intervention (Week 4), and follow-ups at Week 8 and Week 12 using the Parental Stress Scale, the Family Problem Solving Communication Index, and a program satisfaction survey. RESULTS: All 60 mothers completed the study. The stress scores of mothers in the intervention group were lower than those in the control group at Week 4 (44.93 ± 8.00 vs. 52.47 ± 7.41), Week 8 (40.33 ± 7.00 vs. 55.37 ± 7.97), and Week 12 (43.07 ± 7.61 vs. 52.63 ± 7.97) after the intervention (P < 0.001). The mothers in the intervention group scored higher in family problem-solving communication at Week 8 (21.70 ± 4.35 vs. 18.93 ± 5.11) and Week 12 (21.90 ± 4.38 vs.17.93 ± 4.91) than the control group after the intervention (P < 0.05). The mean program satisfaction score of mothers in the intervention group was high (42.77 ± 2.97). CONCLUSION: The MECE program, integrating mindfulness practices with communication skill training, effectively reduced parental stress and improved problem-solving communication among mothers of children with developmental disabilities. These findings offer a theoretical foundation for nurses to implement targeted psychosocial interventions in similar situations.

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