1. [Clinical practice consensus on dietary interventions for autism spectrum disorder (2025 edition)]. Zhonghua Nei Ke Za Zhi;2026 (Apr 1);65(4):314-325.

Autism spectrum disorder (ASD) is a severe neurodevelopmental condition among children in China, with a prevalence of approximately 1.8%. In addition to core features-including deficits in language and communication, stereotyped behaviors, and restricted interests-many patients present with dietary imbalance, nutritional deficiencies, gastrointestinal symptoms, and gut dysbiosis. Dietary patterns influence neurodevelopment and nervous system function through the gut-brain axis. Over recent years, dietary interventions have been increasingly incorporated into comprehensive ASD management and have demonstrated benefits in alleviating gastrointestinal disturbances and specific ASD-related symptoms. However, given the high heterogeneity of ASD, treatment responses vary considerably, and no standardized or widely accepted intervention strategy has been established. Based on available scientific evidence and clinical practice, this consensus proposes a framework and provides recommendations for dietary intervention in ASD. The core recommendations include recognizing dietary intervention as a fundamental component of ASD treatment; advocating for a balanced and healthy diet while limiting high-sugar and ultra-processed foods; and implementing specific dietary approaches in combination with individualized nutritional supplementation according to coexisting multisystem symptoms. The aim of this consensus was to provide clinical guidance for healthcare professionals, promote the application of dietary interventions, and improve clinical outcomes and prognosis for individuals with ASD.

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2. Correction to « Zinc Deficiency and Supplementation in Autism Spectrum Disorder and Phelan-McDermid Syndrome ». J Neurosci Res;2026 (Apr);104(4):e70128.

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3. Abd Elaziz M, Mahmoud N, Ewees AA, Khattap MG, Dahou A, Alghamdi SM, Nafisah I, Fares IA, Azmi Al-Betar M. Hybrid deep learning and feature selection approach for autism detection from rs-fMRI data. PLoS One;2026;21(4):e0339921.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that is primarily characterized by deficits in social communication and restricted or repetitive behavioral patterns. Although psychologists contribute significantly to the understanding of ASD, offering insights into its cognitive, emotional, and behavioral dimensions through assessments, diagnoses, therapeutic approaches, and family support, the diagnostic process remains complex. This complexity arises from the diverse manifestations of the disorder and the challenges associated with data sharing. In addition, conventional machine learning approaches for ASD detection may struggle with high-dimensional neuroimaging data and may require careful feature engineering. Consequently, this motivated us to enhance ASD diagnosis by incorporating deep learning (DL) techniques for feature extraction alongside a modified exponential-trigonometric optimization (ETO) algorithm as a feature selection (FS) technique. The modified ETO integrates the Arithmetic Optimization Algorithm (AOA) and the Guided Learning Strategy (GLS) to improve diagnostic performance. To evaluate the effectiveness of the proposed model, we utilized resting-state functional MRI (rs-fMRI) data from the Autism Brain Imaging Data Exchange (ABIDE I). Furthermore, the performance of the proposed model was compared with that of established models. The results indicate that the proposed model achieves competitive and, in most cases, superior performance compared with the benchmark methods, demonstrating superior accuracy, sensitivity, and AUC in diagnosing ASD. On average across the three atlas-based feature sets, the proposed model has an accuracy, sensitivity, and AUC of 73%, 78%, and 79%, respectively.

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4. 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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5. Akers BM, Peterson ZD. Comparing Prevalence of Multiple Types of Sexual Victimization Among Individuals with and without an Autism Spectrum Disorder Diagnosis. J Sex Res;2026 (Apr 7):1-12.

Sexual victimization (SV) disproportionately affects individuals with Autism Spectrum Disorder (ASD), yet few studies have incorporated updated, well-validated tools that capture the full range of SV experiences. This study utilized the revised Sexual Experiences Survey – Victimization (SES-V) measure to examine rates of four forms of SV (noncontact, technology-facilitated, illegal, and verbal pressure) among U.S. adults with and without self-reported ASD diagnoses. Participants (N = 663) were recruited online and categorized into ASD (N = 287); non-ASD (N = 270); and an exploratory subclinical group (N = 106), consisting of individuals who suspected they might have ASD but had never received a formal diagnosis. Logistic regressions controlling for gender, age, and sexual orientation revealed that ASD participants were significantly more likely than non-ASD participants to report noncontact and illegal SV, but not technology-facilitated or verbally pressured SV. Women were consistently at higher risk than men across all SV categories. Notably, individuals in the subclinical group reported SV prevalence rates comparable to those with formal diagnoses. Exploratory analyses using RAADS-14 scores suggested that sensory reactivity was consistently associated with SV experiences and was particularly strongly associated with noncontact SV. Together, these findings suggest that vulnerability to SV may extend beyond categorical diagnosis and be linked to specific neurodevelopmental traits, rather than diagnostic status alone. This underscores the importance of education efforts that address sensory-related vulnerabilities regardless of formal diagnostic status.

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6. Caron J, Babb S, Zimmerman TO, Anderson A. Improving Early Literacy Skills for Autistic Children who use High Tech AAC: Effects of a Parent-Delivered Intervention. Folia Phoniatr Logop;2026 (Apr 7):1-31.

INTRODUCTION: Literacy skills contribute to meaningful societal participation and maximize expressive language for AAC users; however, AAC users continue to experience pervasively low levels of literacy achievement. Many extrinsic factors related to the instructional approaches, such as reliance on oral responding and the need for extensive retrofitting of materials, create significant barriers to literacy instruction for AAC users. There is a need for innovative, evidence-informed literacy interventions that incorporate adaptations and systematic instruction to improve outcomes for this population. METHODS: A single case experimental design with a multiple baseline across participants design was used to investigate the effects of the ALL app, implemented by trained parents, on the acquisition and generalization of three phonics-based early literacy skills (i.e., sound blending, decoding, and sight words), with threefour children who had minimal or no speech and used high-tech AAC. The ALL app was implemented by parents who were virtually trained, and progress was monitored remotely by researchers. Social validity data was also collected from parents. RESULTS: All participants demonstrated progress in the three skills targeted, as well as generalization in sound blending, demonstrated by effect sizes from large to very large. The intervention was also efficient, with these gains occurring with only ten weeks of instruction. These gains are notable given that the participants each entered the intervention knowing less than ten sight words and less than five letter sounds. Perception data from the parents is also shared. CONCLUSION: Future research and practice should aim to providing simultaneous instruction in foundational and interrelated literacy skills, support motivation and participation of AAC users through use of adaptations and numerous opportunities to apply skills in the context of meaningful shared literacy experiences, and use parent-implemented, direct instruction with explicit practice of target skills.

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7. Cliffe C, Rees H, Childs H, Day R, Shade E, Simmond L, Jennison J, Allely C, Mukherjee RAS. Sex differences in mental health disorders among autistic men and women: retrospective service audit of a random cohort. BJPsych Bull;2026 (Apr 7):1-5.

AIMS AND METHOD: This study investigated mental health diagnoses in autistic adults to determine whether there were any sex differences in presentation. Autistic adults attending the neurodevelopmental service at Surrey and Borders Partnership NHS Foundation Trust were included. RESULTS: As part of a service audit, 150 random adults (75 males and females) were selected and their case notes were reviewed. Mental health diagnoses were common: 36% had current suicidal ideation, 20% had attempted suicide, 40% had a past or current diagnosis of anxiety and 62% had a past or current diagnosis of depression. There were more women diagnosed with an eating disorder (9% female, 0% male) and with a historical suicide attempt (21% female, 9% male). However, using a Holm-Bonferroni correction, there were no statistically significant sex differences between mental health diagnoses. Among both sexes, a significant number had been exposed to prenatal and early childhood trauma, nearly 10% had experienced physical trauma, abuse, neglect or assault, and nearly a third had been through parental separation. CLINICAL IMPLICATIONS: This demonstrates that autistic people presenting to a National Health Service diagnostic clinic are more at risk of experiencing trauma, which subsequently increases their risk of mental illness, alongside any neurological predisposition.

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8. 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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9. Darrell M, Vanneau T, Cregin D, Lecaj T, Foxe JJ, Molholm S. Testing the Auditory Steady-State Response (ASSR) to 40-Hz and 27-Hz Click Trains in Children With Autism Spectrum Disorder and First-Degree Biological Relatives: An Electroencephalographic (EEG) Study. Autism Res;2026 (Apr 7):e70246.

Altered auditory processing likely contributes to core social and attentional impairments in autism spectrum disorder (ASD). The auditory steady-state response (ASSR), a neural measure of auditory processing and cortical excitatory-inhibitory balance, has yielded mixed results in ASD. This study uses electroencephalography (EEG) to evaluate ASSR in ASD and unaffected siblings to clarify neural mechanisms underlying auditory deficits in autism. High-density 70-channel EEG was recorded in children (8-12 years, IQ > 80) with ASD (n = 53), typically developing (TD) peers (n = 35), and unaffected biological siblings (n = 26) during 500-ms binaural click trains (27- and 40-Hz) in an active oddball task. The ASSR was evaluated using data from frontocentral sensors, where the grand averaged response was greatest. No group differences were observed in frequency-following responses (FFR) to 27- or 40-Hz stimuli, although higher 40-Hz power and ITPC were associated with older age and better behavioral performance in ASD. The broad-band response from 180 to 250 ms was reduced in ASD for both stimulation frequencies-particularly in the low-frequency (< 8 Hz) range-and significantly correlated with IQ and age. Siblings showed intermediate broad-band responses. While FFRs appeared intact in ASD, we observed reduced broad-band response in the transition period to the steady state FFR, which was specific to low (< 8-Hz) frequencies. Intermediate responses in first-degree relatives suggest that this is related to genetic vulnerability for ASD and highlights its clinical relevance. These findings suggest intact sensory processing in ASD alongside possible top-down auditory feedback deficits, which may serve as a heritable neurophysiological marker. Children with autism may process sounds differently, which could contribute to challenges with attention and communication. Here, electroencephalography (EEG) measured how the brain responds to rapidly repeating sounds and found that, while basic sound processing was intact, children with autism showed significantly reduced low‐frequency responses. Interestingly, unaffected siblings showed an intermediate response, suggesting this may be a heritable marker of neural differences in autism. eng

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10. Herlitasari HA, Fajariani D, Miyamoto R. Exploring Vocational Training Interventions for Adults With Autism Spectrum Disorders: A Scoping Review. Occup Ther Int;2026;2026(1):e7704446.

Adults with autism spectrum disorder (ASD) continue to face substantial barriers to obtaining and sustaining employment, including challenges related to social communication, understanding workplace expectations, and navigating job interviews, which contribute to underemployment and reduced quality of life. This scoping review mapped the contemporary evidence (2015-2025) on vocational training and employment-related interventions for autistic adults, with particular attention to intervention types, strengths/limitations, professional roles, and contextual factors shaping implementation. Following the Arksey and O’Malley framework and PRISMA reporting guidance, we searched PubMed, MEDLINE and Web of Science in two stages (June 2024; updated November 2025), combining ASD terms with vocational rehabilitation/employment and training terms. Records were deduplicated and screened in Rayyan using predefined eligibility criteria (adults ≥ 18 years with ASD; English-language empirical studies of vocational training interventions). The search identified 1117 records; after removing 434 duplicates, 683 records underwent title/abstract screening, 191 full texts were assessed, and 26 studies were included. Most studies were published from 2019 to 2025 (73.1%) and conducted in the United States (53.8%), followed by Japan (15.4%) and Australia (11.5%). Primary investigators most often represented psychology/psychiatry/clinical sciences (38.5%). Interventions were commonly delivered in workplace/community settings (57.7%), with highly variable dose: Among studies reporting calendar duration, the median was 23.0 weeks (range: 0.71-312), and among those reporting contact hours, the median was 32.0 h (range: 2-900). Qualitative synthesis identified three recurring themes: (1) integrated supported employment and work-based learning pathways (e.g., internship-to-employment models, customized employment, and IPS-informed approaches), (2) targeted work-readiness and discrete skill acquisition interventions (notably job interview and workplace social communication training, including technology-mediated formats), and (3) implementation context, stakeholder perspectives, and sustainability considerations. Overall, the evidence base is expanding but remains heterogeneous in intervention reporting and outcome measurement, underscoring the need for clearer specification of intervention components, professional roles, and occupationally meaningful outcomes.

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11. Hijab MHF, Shamhan ANM, El Houki Z, Qaraqe M, Al-Thani D. A Systematic Review on Computer Vision in Play-Based Research and Interventions for Autistic Children. Autism Res;2026 (Apr 7):e70249.

Play holds a prominent role in Autism Research and practice, serving not only as a medium for assessment, providing insights into developmental progress and diagnostic indicators, but also as a foundational element in targeted interventions designed to support specific skills, education, and therapeutic outcomes. Additionally, free, unstructured play offers autistic children vital opportunities for self-expression, exploration, and emotional regulation. Recent advancements in computer vision techniques have significantly expanded the possibilities in Autism Research by capturing nuanced motor behaviors and facilitating interactive environments tailored to enhance social engagement and responsiveness. This paper investigates the application of computer vision techniques within diverse play contexts involving autistic children. A systematic literature review was conducted across six major databases, identifying 39 studies published between January 2014 and January 2026 that met the inclusion criteria. The collected data included the type of computer vision techniques used, participant demographics, and purpose of play and its environment. Most of the included studies used structured play scenarios, employing methods such as facial expression recognition, eye tracking, and pose estimation to objectively assess social communication, emotion recognition, and motor coordination in autistic children. Some studies positioned their approach as targeted interventions, while others utilized play-based tasks for early screening and diagnostic insights. The findings highlight the usefulness of computer vision in enhancing child-centered play and autism-related assessments. However, small sample sizes, methodological inconsistencies, and limited real-world applicability remain significant constraints. Future research should focus on inclusive designs, larger and more diverse participant samples, and longitudinal studies to validate the long-term effectiveness of these systems. By addressing these limitations, computer vision-enhanced play could become a crucial component of both personalized interventions and diagnostic frameworks for autistic individuals.

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12. Horien C, Mandino F, Corriveau A, Greene AS, O’Connor D, Shen X, Keller AS, Baller EB, Chun MM, Finn ES, Chawarska K, Lake EM, Scheinost D, Satterthwaite TD, Rosenberg MD, Constable RT. Feature consistency in transdiagnostic connectome-based models of sustained attention and autism symptoms. medRxiv;2026 (Apr 7)

Sustained attention is an important neurobiological process. Difficulties with attention play a key role in neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and autism. Here, we identified functional connections consistently associated with sustained attention across datasets, participant populations, and fMRI scan types. We interrogated five transdiagnostic, previously published connectome-based models predicting attention and autistic phenotypes. All models were related to sustained attention, including in samples comprising participants with autism. We found that model similarity was associated with participant characteristics, including age and clinical diagnosis, and predicted behavioral measure. As expected, models predicting attention phenotypes shared more similar features with each other than models predicting autism symptoms. Furthermore, predictive features overlapped more between datasets that included participants of similar ages (i.e., youth vs. adult) and diagnostic status (autism diagnosis vs. no diagnosis). This suggests that functional connectivity patterns predicting individual differences in behavior are phenotype-specific and may vary as a function of age and clinical diagnosis.

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13. Imbelloni L, Rivoli A, Lemos Neto SV, Santos MV, SantaRosa AA, Modolo NP. Anesthetic Strategy for 30 Radiotherapy Sessions in a Child With Autism Spectrum Disorder (ASD) and Severe Behavioral Dysregulation: A Case Report. Cureus;2026 (Apr);18(4):e106480.

Autism spectrum disorder (ASD) refers to a spectrum of neurodevelopmental conditions characterized by challenges in social interaction and communication, which coexist with repetitive behaviors and narrowly focused interests. Autistic patients, particularly children, often present with heightened sensitivity, which must be considered when anesthesia is necessary. A six-year-old child with ASD was diagnosed with rhabdomyosarcoma of the left lower limb, and after surgical treatment, was indicated for 30 radiotherapy sessions. The routine technique for radiotherapy in children involves inhalation anesthesia with sevoflurane. After the first session, there were undesirable side effects, and it was decided to use sedation with clonidine as pre-anesthesia and ketamine and dexmedetomidine intranasally in the radiotherapy room. The remaining 29 sessions were all performed with this technique, achieving ease during radiotherapy and awakening without aggression in the post-anesthesia care unit (PACU). Clonidine is used as a pre-anesthetic medication in pediatrics due to its sedative and analgesic properties, providing preoperative sedation and preventing postoperative pain and vomiting. Ketodex is a combination of ketamine and dexmedetomidine. The combined use of ketamine and dexmedetomidine offers several clinical advantages, including cardiovascular stability, preservation of spontaneous ventilation, effective postoperative analgesia, and smooth recovery.

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14. 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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15. Kim H, Han DG, Kim HS, Seo S, Lee Y, Choi H, Lee J, Kang JG, Kim TH, Ko E, Park MH. Economic Burden of Developmental Disorder Treatment in Korea and Various Overseas Policies: A Study on the Reinforcement for National Assistance. J Korean Med Sci;2026 (Mar 30);41(12):e101.

BACKGROUND: Developmental disorders are characterized by delays in motor skills, language, cognition, emotional regulation, and social abilities. The most common conditions within this category include intellectual disabilities and autism spectrum disorder, which not only impact individuals and families but also have broader effects on the socioeconomic system. Despite the necessity of early detection and intensive treatment for developmental disorders, limited coverage by the national health insurance system in South Korea imposes a significant financial burden on families. METHODS: In this study, a structured survey was conducted on 105 caregivers of infants and children younger than six with developmental disorders, 52 medical doctors (child and adolescent psychiatrists, pediatricians, and rehabilitation physicians), and 51 treatment specialists to assess the economic circumstances related to developmental disorder treatment. RESULTS: Among 105 children (68.6% male), most initiated treatment between ages 2 and 4, with speech therapy (88.4%) and sensory therapy (64.0%) being the most utilized services. Although Applied Behavior Analysis had the highest session intensity and cost, its voucher utilization was remarkably low (2.4%), contributing to a significant perceived financial burden, with 72.4% of caregivers reporting high burden (mean score 3.99/5). Consequently, specialists reported a discrepancy between recommended and accessible treatments due to costs, rating the reasonableness of current voucher fees at only 1.98 out of 5. CONCLUSION: Given the substantial financial burden, the introduction of new policies and revisions to existing policies are urgently needed to support the treatment costs for individuals with developmental disorders.

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16. 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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17. Laurén K, Järvelä M, Huotari N, Raitamaa L, Kananen J, Tuunanen J, Väyrynen T, Korhonen V, Hautamäki K, Hurtig T, Mattila ML, Jussila K, Kiviniemi V. Increased intracranial very low frequency pulsation power in central brain regions of high-functioning young adults with autism spectrum disorder. Neuroimage;2026 (Apr 7);332:121908.

Autism spectrum disorder (ASD) is an increasingly diagnosed neurodevelopmental condition characterized by persistent difficulties in social communication and restricted, repetitive patterns of behavior and sensory processing that leads to functional impairment. The diagnosis of ASD relies on behavioral and clinical assessment as there are no currently available biomarkers. Recent brain imaging studies have suggested abnormalities in the brain fluid flow in individuals with ASD. Cardiorespiratory and vasomotion-induced very low frequency (VLF ≤ 0.1 Hz) brain pulsations are now considered to facilitate the cerebrospinal- and interstitial fluid exchange in the brain, thus contributing to maintaining cerebral homeostasis and fluid clearance. In this study, we utilized ultrafast resting-state functional magnetic resonance imaging (fMRI) to capture and compare the powers of each physiological pulsation in groups of 18 young adults diagnosed with ASD and 19 neurotypical controls (NTC). We further probed the clinical significance of findings by undertaking regression analyses examining the associations of both Autism Spectrum Quotient (AQ) and Autism Diagnostic Observation Schedule (ADOS) scores with pulsation powers, and by receiver operating characteristics (ROC) analysis. Compared to the NTC group, the ASD group showed significantly higher VLF pulsation power, which was located predominantly in subcortical grey matter nuclei and the white matter, indicating increased vasomotor power in ASD. In addition, the individual VLF power enabled good accuracy (ROC area under the curve = 75%-93%) for discriminating ASD subjects from NTCs. In conclusion, present findings of increased VLF power are postulated as possible indication of altered driving force of cerebral neurofluid dynamics and could potentially serve as a useful clinical classifier.

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18. Lee JY, Collins JM, Ryan FS. The experience and understanding of learning disability and autism of orthodontic practitioners in the United Kingdom: A national survey. J Orthod;2026 (Apr 7):14653125261434036.

OBJECTIVE: To explore the experience, knowledge and confidence of orthodontic practitioners in the United Kingdom in managing patients with learning disability or autism. DESIGN: National online survey. SETTING: British Orthodontic Society membership. METHODS: A novel questionnaire was developed and distributed online to orthodontic practitioners within the British Orthodontic Society. It included questions on the participants’ prior training, experience in treating patients with learning disability or autism, knowledge levels using the Learning Disability Knowledge Questionnaire and Autism Knowledge Survey, and self-efficacy in managing these patients. RESULTS: A total of 171 responses were received with participation from various practitioner groups: orthodontic consultants, specialists, postgraduates, therapists and dentists with special interest. The median score for the Learning Disability Knowledge Questionnaire was 73% (interquartile range [IQR] = 20). The median score for the Autism Knowledge Survey was 93% (IQR = 6.7). The percentage of respondents who reported feeling confident in patient management varied across the self-efficacy domains: (1) treating patients with learning disability (51%) and autism (64%); (2) making reasonable adjustments for patients with learning disability (54%) and autism (61%); (3) recognising the signs of learning disability (38%) and autism (48%); and (4) signposting patients with learning disability (27%) and autism (30%) to the relevant local care pathways or services. The participants employed a range of techniques and resources when managing these patients. These included tailoring communication to individuals, adapting to sensory needs, involving parents/carers in treatment planning, adjusting the pace of care, and building trust through behavioural and acclimatisation strategies. CONCLUSION: Having a good knowledge of learning disability or autism does not always translate to greater confidence in patient management. Improving access to orthodontic-specific learning disability and autism training, national guidance and communication aids could enhance the confidence of orthodontic practitioners in managing these patient groups. A national survey of the experience and understanding of learning disability and autism of orthodontic practitioners in the United KingdomWhy was the study done? People with learning disabilities or autism can find it harder to access orthodontic care. This may be due to behaviour, other health needs or how confident the orthodontic clinician feels about caring for these patients. This study looked at how much the clinicians in the UK knew about learning disabilities and autism. They also asked about the clinicians’ experiences of and confidence in treating such patients. What did the researchers do? They sent an online survey to members of the British Orthodontic Society. It asked about their training, experience, knowledge and confidence in treating patients with learning disabilities or autism. A total of 171 clinicians replied. They were from orthodontic consultants, specialists, postgraduate trainees, therapists and dentists with a special interest in orthodontics.What did the researchers find? The clinicians had a good knowledge of autism and moderate knowledge of learning disabilities. Many clinicians said they did not feel confident in managing both groups. This was mainly when spotting these conditions or knowing where to refer patients for extra support. Even so, they reported using a mix of methods that were helpful. These included using clear language, supporting sensory needs and involving families. Taking treatment in smaller steps and using methods to modify behaviour also helped.What do the findings mean? The findings suggest that knowledge alone is not enough to make clinicians feel confident. More orthodontic-specific training, clear national guidance and easy-to-use communication tools could help clinicians feel more confident. These may make treatment better for people with learning disabilities or autism. eng

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19. Liu J, Xu A, Zhao Z, Li T, Dang Y, Liu M, Wang Y, Zhao H, Dai Y, Zhang J. Global Inequality and Future Burden of Autism Spectrum Disorders: A Frontier and Projection Analysis Based on GBD 2021. Brain Behav;2026 (Apr);16(4):e71365.

BACKGROUND: Autism spectrum disorder (ASD) comprises a group of persistent neurodevelopmental conditions characterized by impairments in communication, restricted behavioral patterns, and social dysfunction. In severe cases, ASD can lead to self-injury or suicide, imposing a significant burden on individuals, families, and society. This study aimed to comprehensively assess the temporal, demographic, and regional patterns of ASD burden from 1990 to 2021; project future trends; and provide insights into potential causes and public health strategies. METHODS: Data on the incidence, prevalence, and disability-adjusted life years (DALYs) of ASD were extracted from the Global Burden of Disease (GBD) Study 2021. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Bayesian age-period-cohort (BAPC) modeling. We further examined burden distribution by age, sex, region, and sociodemographic index (SDI). RESULTS: In 2021, an estimated 61.82 million individuals were living with ASD globally, with 1.16 million new cases and 11.54 million DALYs. The global age-standardized point prevalence, incidence, and DALY rates were 788.3, 18.8, and 147.6 per 100,000 population, respectively-representing increases of 2.0%, 5.2%, and 2.1% since 1990. Regionally, the highest age-standardized prevalence rate was observed in the High-income Asia Pacific region, while tropical Latin America had the lowest. At the national level, Japan recorded the highest age-standardized prevalence, whereas the Republic of Mauritius had the lowest. CONCLUSION: ASD poses a rising global public health challenge, with persistent regional disparities and underrecognized burden in adults and females. Current gaps in epidemiological surveillance, etiological understanding, and treatment capacity highlight the urgent need for greater governmental investment in ASD-related research, early detection strategies, and inclusive care systems.

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20. Liu W, Lu Y, Ng SC, Chan FK, Sung JJ, Yu J. Bacterial genomic structural variations in children with autism serve as diagnostic biomarkers. Gut;2026 (Apr 7);75(5):937-948.

BACKGROUND: Gut microbiota dysbiosis is linked to autism spectrum disorder (ASD) in children. However, the role of bacterial genomic structural variations (SVs) in ASD remains largely unexplored. OBJECTIVE: We aimed to identify bacterial SVs associated with ASD and explore their mechanistic role and clinical application. DESIGN: We collected faecal metagenomes from 452 children (261 ASD, 191 neurotypical) across an in-house and seven public datasets. Using linear mixed-effects modelling, we identified ASD-associated SVs and compositional shifts and validated candidate SVs in humanised gut microbiome mice. RESULTS: We identified 100 bacterial SVs significantly associated with ASD (p<0.05). These SVs were enriched in genes involved in critical biological processes, including ion and amino acid metabolism and bacterial growth regulation in ASD. In particular, we found important SVs in Bacteroides uniformis related to thiamine and iron metabolism. Moreover, SVs in Ruminococcus torques were associated with the MazF (endoribonuclease toxin) and MazE (antitoxin) system, a key regulator of pathobiont proliferation. Validation in humanised mouse models confirmed significant correlations between these SV signatures and ASD-like behaviours, such as reduced social interaction and increased repetitive behaviours. Both phylogeographically conserved and regionally restricted SVs showed strong associations with ASD. A diagnostic model combining nine SVs and three bacterial species achieved an area under the receiver operating characteristic curve of 81.1%, outperforming models based solely on variable SVs (79.1%), deletion SVs (75.2%) or bacterial species abundance alone (72.3%). CONCLUSION: Our findings suggest the significant role of bacterial genomic SVs in ASD and highlight their potential as diagnostic biomarkers.

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21. Liu Y, Chen W, Pan Y. Multimodal Population Graph Networks with Self-Attention Mechanisms for Autism Spectrum Disorder Identification. IEEE J Biomed Health Inform;2026 (Apr 7);Pp

Autism Spectrum Disorder (ASD) identification is challenged by data heterogeneity across sites, unclear population-level inter-subject relationship modeling, and a lack of biologically meaningful brain-region analysis. To address these issues, this paper proposes GPGATNet, a cross-site ASD identification framework that introduces learnable mechanisms at three levels-individual representation alignment, population graph construction, and stable propagation learning-to achieve robust classification while enabling biomarker discovery. A three-layer self-attention unsupervised graph pooling module, SAGNet, is designed to adaptively extract brain-feature subgraphs via node-importance scoring and hierarchical Top-k selection. This strategy alleviates cross-site scale discrepancies and simultaneously provides interpretable estimates of regional contributions. In addition, a population-graph modeling scheme based on a « phenotypic skeleton + functional-connectivity edge-weight updating » paradigm is employed to enhance the robustness of inter-subject relationship modeling. Furthermore, a graph convolutional network, MH-GCAT, is constructed by integrating multi-branch convolutions with multi-head attention fusion to strengthen population-level discriminative capability. Experiments on the ABIDE dataset demonstrate that GPGATNet outperforms existing methods. Moreover, by combining attention-based localization with analyses of BOLD signal fluctuations, we observe functional abnormalities and activity instability in key regions such as the thalamus and hippocampus in ASD, providing neuroimaging evidence for understanding impairments in emotion regulation and social behavior.

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

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

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23. Pedapati EV, Vanderklish PW, Sarraf ST, Gargosky S, Nelson M, Richter S, Westerkamp G, Erickson CA. SPG601-associated modulation of resting-state EEG and improvement in executive function in a fragile X syndrome randomized controlled crossover study. Sci Rep;2026 (Apr 7);16(1)

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability and autism spectrum disorder. Despite extensive research, no targeted treatments exist for the core symptoms of FXS. SPG601 represents the first BK channel activator to enter clinical testing for FXS, designed to restore synaptic function by correcting specific ion channel dysfunction downstream of fragile X messenger ribonucleoprotein protein (FMRP) loss. We conducted a randomized, double-blind, placebo-controlled, 2-period balanced crossover study in 10 adult men with genetically confirmed full-mutation fragile X syndrome. Participants received single doses of SPG601 800 mg and placebo separated by a 1-week washout period. Given the first in FXS nature of the study, the safety and tolerability of SPG601 were evaluated as a primary outcome. Additional endpoints included resting-state EEG power spectral density analysis across predefined frequency bands and auditory-evoked gamma oscillations combined with cognitive assessments using validated instruments and clinical global impressions scales. Among EEG measurements, excessive high frequency gamma band activity has been most extensively validated as a biomarker across species in FXS and has demonstrated correlation with severity of the human FXS phenotype and therefore served as the primary neurophysiologic endpoint. SPG601 was well tolerated with a favorable safety profile. SPG601 demonstrated significant modulation of resting-state EEG power spectral density compared to placebo. Significant treatment effects were observed for gamma power (F = 5.20, p = 0.023), alpha2 power (F = 17.43, p < 0.001), and theta power (F = 7.06, p = 0.008). SPG601 also significantly modulated aperiodic EEG slope (F = 5.28, p = 0.022), indicating alterations in the broadband 1/f component reflecting excitation-inhibition balance. Cognitive improvement was observed in the NIH Toolbox Flanker Inhibitory Control and Attention Test across multiple scoring metrics (p = 0.027). No significant effects were observed on auditory-evoked gamma measures. This study provides the first clinical evidence that SPG601 produces significant neurophysiological changes in FXS, accompanied by a cognitive enhancement in executive function.

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24. St John BM, Laufenberg H, Sommers M, Sylvester G, Ausderau KK. Feeding Self-Help Skills and Adaptive Behavior Are Related to Feeding Challenge Severity in Autistic Children. Phys Occup Ther Pediatr;2026 (Apr 7):1-17.

AIMS: This project aimed to (1) Describe feeding self-help skills in autistic children with feeding challenges and (2) Identify the relationships among feeding self-help skills, feeding challenge severity, family mealtime factors, and adaptive behavior. METHODS: This study used data from a cross-sectional national survey of 358 caregivers of autistic children (ages 2-12 years) with feeding challenges, recruited through a national research registry. Data were captured using validated caregiver-report measures. Descriptive statistics were completed to characterize feeding self-help skills and additional variables within the sample. Pearson’s R correlations were run to investigate relationships among variables. RESULTS: Feeding self-help skills, feeding challenge severity, and adaptive behavior scores were widely heterogeneous. Overall, children in the study required higher levels of support from caregivers to participate in feeding and had lower adaptive behavior than expected for their age. Significant Pearson r correlations ranging from 0.11 to 0.60 were observed between feeding self-help skills, feeding challenge severity, family mealtime factors, and adaptive behavior. CONCLUSIONS: Feeding self-help skills and adaptive behavior are essential to evaluate in autistic children with feeding challenges. Future research should explore component skills, (e.g. use of utensils) in addition to behavior and sensory components of feeding to inform child-centered evaluation and intervention.

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25. Turnage DM, Thornbury E. Supporting and Empowering Autistic Nurses in the Workplace. J Psychosoc Nurs Ment Health Serv;2026 (Apr);64(4):3-4.

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26. Vaher K, Neal SR, Cábez MB, Jiménez-Sánchez L, Corrigan A, Stoye DQ, Turner HL, Smikle R, Cruickshank H, Rudnicka M, Bastin ME, Thrippleton MJ, Reynolds RM, Boardman JP. Neonatal amygdala microstructure and structural connectivity are associated with autistic traits at 2 years of age. Dev Cogn Neurosci;2026 (Apr 7);79:101721.

Prenatal maternal stress is linked to neurodevelopmental outcomes. Maternal hair cortisol concentration in pregnancy is associated with neonatal amygdala microstructure and structural connectivity, suggesting that amygdala is sensitive to antenatal stress. We investigated whether amygdala microstructure and/or connectivity associate with neurodevelopmental outcomes. 174 participants (105 preterm) underwent brain MRI at term-equivalent age and assessment of neurodevelopment, autistic traits, temperament, and executive function at 2 years corrected age. We calculated amygdala microstructure (fractional anisotropy, mean diffusivity, neurite density index, orientation dispersion index) and structural connectivity (mean fractional anisotropy) to 6 regions (insula, putamen, thalamus, inferior temporal gyrus, medial orbitofrontal cortex, rostral anterior cingulate cortex). We used linear regression to model amygdala-outcome associations, adjusting for gestational age at birth and at scan, sex, maternal education and postnatal depression score, and network-based statistics (NBS) for whole-brain analyses. Following correction for multiple comparisons, lower amygdala mean diffusivity (left: β = -0.32, p = 0.026, right: β = -0.38, p = 0.012), higher left amygdala neurite density index (β = 0.35, p = 0.026), and increased left amygdala-putamen connectivity (β = 0.31, p = 0.026) associated with higher autistic traits across the whole sample. NBS additionally revealed amygdala-involving networks associated with cognition and surgency among preterms, and gestation-dependent associations with autistic traits. Findings indicate that neonatal amygdala microstructure may be important in the development of autistic traits.

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27. Yogarajah P, Metwally AM, Chaurasia P, Elshaarawy GA, El Khateeb SM, Ashaat EA, Elsaeid A, Elghareeb NA, ElRifay AS. Feasibility and Acceptability of AI-Powered Tools for Early Autism Screening in Egypt: Semistructured Focus Group Study. J Med Internet Res;2026 (Apr 7);28:e82564.

BACKGROUND: Autism spectrum disorder (ASD) is often underdiagnosed in low- and middle-income countries due to limited specialist access, sociocultural stigma, and fragmented screening systems. Artificial intelligence (AI)-powered screening tools may improve early detection by enabling low-cost, accessible assessments. However, adoption depends on stakeholder trust, ethical safeguards, and alignment with local health system capacities. OBJECTIVE: This study explored the feasibility, acceptability, and perceived ethical and practical enablers and barriers to implementing AI-powered tools for early ASD screening in Egypt, with attention to urban-rural disparities and integration into existing care pathways. METHODS: We used a qualitative design with semistructured focus group discussions with 49 participants (21 parents of children with ASD and 28 health care professionals) recruited from urban and rural governorates. Discussions were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s reflexive thematic analysis, supported by NVivo software (Lumivero). Methodological integrity was ensured through reflexivity, triangulation, and peer debriefing. Thematic saturation was monitored across groups, and participant diversity was prioritized across contexts. RESULTS: Five themes emerged: (1) AI as a supportive tool rather than a replacement for clinicians, emphasizing scalability and assistance for nonspecialists; (2) the need for cultural and contextual adaptation to ensure local relevance; (3) privacy, trust, and transparency concerns, including data security, consent, and algorithmic opacity; (4) reducing diagnostic inequities by addressing urban-rural disparities and strengthening community-based deployment; and (5) the preference for hybrid AI-human models, with conditions for adoption including cultural sensitivity, human oversight, and digital literacy support. Counts (n/N) of parents and health care professionals contributing to each theme were used descriptively as indicators of pattern salience rather than as statistical estimates of prevalence. Participants expressed cautious optimism, with parents emphasizing accessibility and speed, while health care professionals highlighted concerns about reliability, cultural adaptation, and data governance. CONCLUSIONS: AI-powered ASD screening has potential to advance equitable early detection in underserved areas. Adoption requires transparent data governance, integration into hybrid human-AI models, culturally adaptive design, and targeted digital literacy initiatives. These findings provide an evidence-based roadmap for policymakers, technologists, and health system leaders to implement AI screening tools that are ethically sound, contextually relevant, and equity-focused.

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28. Yu L, Xie S, Wang L, Mottron L. Autistic Children With Speech Onset Delay Show Reversed Bias in Spectral Versus Temporal Auditory Processing. Autism Res;2026 (Apr 7):e70248.

A recent « hierarchical » reinterpretation of the neurological basis of autism suggests that in autism with early language delay, perceptual processing may be favored over the integration of transmodal information. This model is largely based on neuroimaging findings relating to visual processing, but predicts a corresponding reorganization in the auditory modality. The present study provides the first direct psychophysical evidence of a reversed auditory processing bias in children with prototypical autism, characterized by impaired temporal resolution and enhanced spectral sensitivity. Using two matched psychoacoustic paradigms-temporal gap detection and low-frequency frequency modulation (FM) detection-we assessed auditory thresholds in 21 autistic and 23 typically developing (TD) children. Compared to TD peers, autistic children exhibited significantly higher temporal thresholds and significantly lower spectral thresholds, yielding a markedly elevated Auditory Bias Index (ABI) that quantifies a preference for spectral over temporal cues. In the group of autistic children investigated here, enhanced spectral resolution correlated positively with receptive language and nonverbal IQ, whereas temporal resolution was associated with age-related gains and language outcomes. These findings support the hypothesis of an atypical sensory-perceptual hierarchy in autism with speech onset delay and early behavioral atypicalities, with potential implications for alternative, nonsocial pathways to language acquisition. Children on the autism spectrum often process sounds differently, but the exact nature of these differences is not well understood. In this study, we tested how children with early language delays respond to two basic aspects of sound: timing (when a sound happens) and pitch (how high or low a sound is). Compared to typically developing children, these autistic children had more difficulty noticing tiny gaps in sounds (reflecting lower sensitivity to timing) but were better at detecting subtle changes in pitch (reflecting higher sensitivity to frequency). We combined these two measures and found that our group of autistic children shows a clear preference for pitch‐based over timing‐based cues. Interestingly, better pitch sensitivity was linked to stronger language and cognitive skills in the autism group. These different sound processing patterns may help explain why some autistic children develop language through alternative pathways. eng

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