1. Aktu Y, Toğluk S, Vural B. Correction: The Links Between Parents’ Self-Stigma, Parental Burnout, Parental Competence, and Socio-Emotional Adjustment Among Parents of Children With Autism Spectrum Disorder. J Autism Dev Disord. 2026.

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2. Beccaria F, Leenen L, Kolenberg M, Vertongen K, Demurie E, Weyland M, Warreyn P, Roeyers H, Noens I, Zink I, Kissine M. Defining Language Profiles in Young Autistic Children Across Verbal, Speaking, and Generative Dimensions. Autism Res. 2026: e70324.

Language trajectories in autism are highly heterogeneous and cannot be captured by unidimensional classifications. Research and clinical practice often rely on verbal/non-verbal or speaking/non-speaking labels, but these categories, when used in isolation, obscure distinct linguistic profiles. Spoken language is also frequently used as a proxy for structural language skills, despite evidence that speech may not be generative or productive. A multidimensional perspective is therefore needed to determine whether verbal skills, spoken output, and linguistic generativity reflect dissociable aspects of language in autism, and whether variation across these dimensions can be explained by non-verbal cognition or autism characteristics. Participants were 167 autistic children aged 2-6 years from the Dutch- and French-speaking regions of Belgium. Verbal skills were assessed using standardized tests. Speaking status was quantified as the proportion of linguistic segments in spontaneous productions recorded at home. Generativity was measured using a similarity index derived from semantic embeddings. Associations with non-verbal Intelligence Quotient (IQ) and autism characteristics were examined using age-controlled linear models. Overlap between the three dimensions, Verbal, Speaking, and Generativity, was only partial. Some children with little or no speech showed relatively strong structural language abilities, whereas others produced abundant but non-generative speech and had limited structural skills. Both non-verbal IQ and autism characteristics were related to all three dimensions, with IQ explaining a larger proportion of variance. Overall, one-dimensional labels fail to capture language variability in autism; assessing Verbal, Speaking, and Generativity as complementary dimensions may better identify uneven linguistic profiles in autistic children. Autistic children are often described as ‘verbal’, or ‘non‐’ or ‘minimally verbal.’ Some have advocated that all references to verbal levels should be replaced with ‘speaking’ or ‘non‐speaking’ labels. However, when used in isolation, both verbal and speaking dimensions may not fully capture autistic children’s language abilities. In this study, we describe autistic children’s language using three dimensions: their mastery of language structure, how much spoken language they produce, and the extent to which the language they produce contains new sentences or is mostly repetitive. This approach identifies language profiles that are missed by unidimensional approaches, and can therefore support more precise assessment and more individualized interventions for autistic children. eng.

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3. Berni M, Cagiano R, Viglione V, Pecini C, Calderoni S, Mancini A, Masi G, Tancredi R, Igliozzi R. Inter-Individual Variability of Executive Functioning: a Possible Key to Understand Adaptive Behavior Across ASD and ADHD. Child Psychiatry Hum Dev. 2026.

Executive functions (EF) are neurocognitive processes frequently impaired in children with neurodevelopmental disorders, and that significantly impact on their adaptive functioning. This study investigated the relationship between executive functions and adaptive behaviors in 98 Italian preschoolers diagnosed with Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), or co-occurring ASD + ADHD. Utilizing both performance-based tasks and parent-reported questionnaires, the research aimed to: 1) examine associations between EF and adaptive behavior across the sample, 2) delineate distinct EF and adaptive functioning profiles within each diagnostic group, and 3) assess the mediating role of EF in the link between diagnosis and adaptive outcomes. Results indicated significant correlations between parent-reported executive behaviors and adaptive skills, highlighting a strong link between lower executive functioning and poorer adaptive outcomes. Diagnostic group comparisons revealed that children with ADHD and ASD + ADHD exhibited greater impairments in executive behaviors, particularly in inhibition and working memory, compared to those with ASD alone. The ASD + ADHD group consistently demonstrated the most severe difficulties across nearly all adaptive behavior domains compared to either single-diagnosis group. Mediation analyses indicated that global executive behaviors significantly mediated the relationship between diagnostic group and adaptive functioning. Findings highlight the critical role of EF in adaptive skills and support EF-focused interventions, to enhance adaptive skills in young children with these neurodevelopmental disorders.

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4. Bertuccioli A, Belli A, Palazzi CM, Di Pierro F, Cavecchia I, Matera M. Asperger Traits as a Conditionally Adaptive Neurocognitive Phenotype: An Evolutionary Narrative Review. Cureus. 2026; 18(7): e112205.

Traits historically associated with Asperger syndrome, currently included within autism spectrum disorders (ASD), include high systemizing ability, sustained attention to detail, reduced reliance on social cues, and strong cognitive perseverance. Although these characteristics are often interpreted as impairments within contemporary social environments, an increasing body of literature suggests that they may also reflect variants of human cognitive diversity with potential evolutionary relevance. This narrative review explores whether the cognitive profile commonly associated with Asperger traits can be interpreted within an evolutionary framework, integrating perspectives from evolutionary genetics, cognitive neuroscience, and developmental biology. A targeted selection of theoretical and experimental contributions was examined through full-text analysis, including models related to epistatic genetic architecture, neurocognitive network organization (including the default mode network), evolutionary behavioral strategies such as the « solitary forager » hypothesis, the extreme male brain theory, genomic imprinting models of cognition, and recent approaches investigating epistatic interactions in autism-related genetic pathways. Findings were synthesized through conceptual triangulation within a narrative review framework. Across these models, several convergent themes emerge. Traits associated with the Asperger phenotype, such as enhanced systemizing, cognitive autonomy, persistence, and technical imagination, may represent extreme expressions of cognitive strategies that could have been advantageous in certain ancestral ecological contexts. In small and variable environments, such traits may have supported technological innovation, environmental exploration, and resilience under conditions requiring independent problem-solving. Genetic evidence suggests that autism-related phenotypes arise from complex polygenic and epistatic networks rather than single-gene alterations, supporting the possibility that these traits reflect stable variants within human neurocognitive diversity. Emerging research also indicates a potential modulatory role of intergenerational epigenetic mechanisms in shaping neurodevelopmental trajectories, although these interpretations remain theoretical and should be considered with caution. Overall, the Asperger phenotype may be interpreted not solely as a neurodevelopmental deficit but as a context-dependent cognitive configuration whose functional impact varies according to environmental demands. In modern societies characterized by high social communication load, rapid relational dynamics, and sensory overstimulation, these traits may contribute to an evolutionary mismatch. However, the interaction between polygenic architecture, epistatic regulation, and potential epigenetic modulation suggests that the persistence of such cognitive phenotypes may reflect broader mechanisms maintaining neurocognitive diversity within the human population.

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5. Denisova K, Jones CRG. Autism in adolescence and adulthood. Sci Rep. 2026; 16(1).

Landmark descriptions of autism in the 1940s were based on clinical work with children. Research over the subsequent 80 years has largely focused on the experiences and needs of autistic children, with recent neuroimaging and genetic studies contributing significant insights into the developmentally driven neurobiological underpinnings of this condition. However, autism is a lifelong neurodevelopmental condition and adolescence and adulthood introduces new developmental transitions and life experiences that require specific consideration. Together, the articles in this Collection-Autism in Adolescence and Adulthood-highlight the need to understand autistic experiences and neurobiology in adolescence and adulthood through a context-sensitive lens that considers developmentally relevant experiences. Across diverse methodologies, including behavioural, physiological, qualitative, and computational (machine learning), a particular focus is on understanding and supporting emotion regulation, wellbeing and mental health. Collectively, the papers highlight that adolescence and adulthood are periods of autistic development that warrant focussed scientific attention. They also underscore that autistic flourishing in adolescence and adulthood depends on a society that embraces neurodiversity and is committed to meaningful change.

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6. Herman WX, Miller GN, Sahin M, Peters JM, Warfield SK, Krueger DA, Bebin EM, Northrup H, Wu JY, Fox MD, Cohen AL. Lesions Associated With Autism Symptoms Map to a Cerebellar Brain Network in Tuberous Sclerosis Complex. Ann Child Neurol Soc. 2026; 4(1): 64-73.

OBJECTIVE: Autism spectrum disorder (ASD) affects 1 in 36 individuals in the United States and is characterized by impaired social communication and restrictive/repetitive behaviors. Individuals with tuberous sclerosis complex (TSC) have a high incidence of ASD (40%) and exhibit congenital brain lesions (tubers), offering a unique lesion-based model to investigate the neural circuits underlying ASD symptoms. We tested whether tuber connectivity is associated with specific ASD symptom profiles in TSC patients. METHODS: Brain tuber locations were analyzed in 115 children with TSC from the TSC Autism Centers of Excellence Research Network. Lesion network mapping was performed using normative resting-state functional magnetic resonance imaging data from 1000 typically developing 9-year-olds to identify brain networks functionally connected to tuber locations. Multivariable linear regression analyses assessed associations between these networks and specific domain subscores on the Autism Diagnostic Observation Schedule (ADOS). RESULTS: Greater severity of social affect symptoms was associated with tubers connected to bilateral deep cerebellar nuclei, particularly the right side, localizing to Crus V despite no cerebellar tubers being included in this analysis. No significant associations were found for total ADOS scores or repetitive/restrictive behavior subscores. These effects were independent of age, sex, lesion burden, epilepsy severity, and language ability. INTERPRETATION: Social affect impairments in TSC patients with ASD are associated with to functional connectivity between tubers and cerebellar crus V. This symptom-specific neuroanatomical association supports the concept that different ASD features map to distinct brain circuits and highlights the role of cortico-cerebellar pathways in early social development.

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7. Jacobs GR, Cetin-Karayumak S, Coutts F, Penzel N, Seitz-Holland J, Oliver LD, Nakua H, Husain MO, Makris N, Pieper S, Zhang F, Pasternak O, O’Donnell LJ, Rathi Y, Shenton ME, Ameis SH. Adolescent trajectories of psychotic-like experiences and autistic traits and their association with cognition, environmental adversity, and white matter microstructure in the ABCD Study. Biol Psychiatry Cogn Neurosci Neuroimaging. 2026.

BACKGROUND: Psychotic-like experiences (PLEs) and autistic traits across development are associated with poor mental health outcomes. However, the relationship between PLEs and autistic traits, and their links with clinical and biological predictors of longitudinal outcomes, remain poorly understood. METHODS: PLEs and autistic traits were measured across a three year period using the Prodromal Questionnaire Brief and Child Behavior Checklist in 9,963 adolescents from the Adolescent Brain Cognitive Development Study®. Separate Growth Mixture Models identified trajectories for PLEs and autistic traits. Associations between trajectories with longitudinal internalizing and externalizing symptoms, cognition, environmental adversity, and harmonized diffusion measures of baseline fractional anisotropy (FA), were examined. RESULTS: Four trajectories were found for both PLEs and autistic traits: persistently low, persistently elevated, increasing, and decreasing. Persistently low trajectories were associated with favorable profiles across measures. Increasing or persistently elevated PLEs were associated with lower baseline FA, cognition, and socioeconomic disadvantage and linked to worsening internalizing symptoms and environmental adversity. Persistently elevated autistic traits were associated with lower cognition, more environmental adversity, and reduced FA. Overlapping trajectories of co-elevated or increasing PLEs and autistic traits conferred the highest risk, with impairments across measures. Compared to only-elevated autistic traits, only-elevated PLEs were associated with lower psychopathology, higher family conflict and life events, lower cognition, and specific white matter alterations. CONCLUSIONS: Adolescents with distinct longitudinal PLEs and autistic traits trajectories differed on psychopathology, cognitive performance, environmental adversity, and white matter microstructure. Examining trajectory-specific differences highlights heterogeneity in early adolescent neurodevelopment and may support the advancement of early-detection strategies for at-risk youth.

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8. Knudsen LV, Vafaee MS, Sheldrick-Michel AJ, Michel TM. Reduced glymphatic function in autism revealed by the diffusion tensor analysis along the perivascular space index. J Neural Transm (Vienna). 2026.

The glymphatic system supports brain homeostasis by clearing interstitial solutes via perivascular pathways. Alterations in glymphatic function have been linked to neurodevelopmental and neurodegenerative disorders, but its role in autism spectrum disorder (ASD) remains unclear. We analyzed diffusion tensor imaging (DTI) magnetic resonance imaging data from five cohorts in the Autism Brain Imaging Data Exchange (ABIDE) project. Glymphatic function was estimated using the DTI analysis along the perivascular space (ALPS) index. ASD diagnoses were confirmed according to DSM-IV-TR or DSM-5 criteria, and neurotypical (NT) participants had no history of neurological, psychiatric, or developmental disorders. The final sample comprised 250 participants (128 ASD, mean age = 18.57 ± 13.81; 122 NT, mean age = 21.32 ± 14.37). Two-way analysis of variance (ANOVA) revealed a significant main effect of diagnosis, F(1, 246) = 10.44, p = 0.0014, with lower ALPS-indices in ASD. A diagnosis-by-age interaction was also observed, F(1, 246) = 4.71, p = 0.031. Post hoc tests demonstrated that autistic adults (≥ 18 years) had significantly lower ALPS-indices than NT adults (p = 0.0004), whereas no group differences were demonstrated between younger ASD and NT (< 18 years). In ASD adults, the ALPS-index correlated negatively with depressive symptoms (r = - 0.489, p = 0.013), but not with IQ or autistic traits. These findings suggest that glymphatic dysfunction in ASD may follow a developmental trajectory, with alterations becoming most evident in adulthood, potentially contributing to an increased risk of developing neurodegenerative disorder in autistic individuals.

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9. Lledo-Graell E, Chaudhary P, Do A, Gomez K, Juste S, Evans M, Okotie-Eboh TJ, Knobles M, Soutullo CA. Amantadine-Responsive, Benzodiazepine-Resistant Catatonia in an Adolescent With Autism Spectrum Disorder. J Child Adolesc Psychopharmacol. 2026: 10445463261477342.

BACKGROUND: Catatonia is a severe neuropsychiatric syndrome increasingly recognized in autism spectrum disorder (ASD), where symptom overlap can delay diagnosis. In pediatric populations, it is associated with significant morbidity and requires prompt intervention. Benzodiazepines and electroconvulsive therapy (ECT) are first-line treatments; however, access to ECT may be limited due to legal or institutional constraints. Alternative pharmacological strategies, including N-methyl-D-aspartate (NMDA) receptor antagonists such as amantadine, have been proposed, although evidence remains limited. CASE PRESENTATION: We report a 15-year-old male with ASD who developed progressive catatonia over 1 year, with psychomotor slowing, speech latency, staring, and functional decline requiring hospitalization. Symptoms emerged after using over-the-counter supplements and partially improved after discontinuation. Medical and neurological workup was unremarkable. A lorazepam challenge produced partial improvement, but high-dose benzodiazepines were insufficient. Due to lack of access to ECT, amantadine was initiated and titrated to 200 mg twice daily. Within days, the patient showed marked improvement, including increased speech output, improved psychomotor activity, and enhanced social engagement. Improvement was supported by clinical observations and caregiver reports. DISCUSSION: Catatonia involves dysfunction in dopaminergic (DA), GABAergic, and glutamatergic systems within cortico-striato-thalamo-cortical circuits. In ASD, similar abnormalities in excitatory-inhibitory balance and connectivity have been reported, which may partly explain the overlap in presentation and the potential vulnerability to catatonia. Amantadine may help restore this imbalance through NMDA receptor antagonism and DA modulation. CONCLUSION: Amantadine may be a viable adjunctive treatment for benzodiazepine-insufficient catatonia in adolescents with ASD when lorazepam is insufficient or poorly tolerated and ECT is unavailable. Further research is needed.

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10. Longhurst P, Modica C, Swami V. Prospective associations between body appreciation and indices of psychological well-being in autistic adults from the United Kingdom. Body Image. 2026; 58: 102160.

Body appreciation is a central facet of positive body image that has been associated with stronger psychological well-being in the autistic population. While longitudinal evidence suggests a bidirectional relationship between body appreciation and well-being over time in neurotypical populations, existing research in autistic people is limited to cross-sectional study designs. For the first time, therefore, this study examines prospective associations between body appreciation and psychological well-being (operationalised here as self-esteem, life satisfaction, and flourishing, respectively) in 262 autistic adults (aged 19-73 years; M = 38.43) from the United Kingdom. Participants completed two online surveys containing study measures at baseline and at 3-month follow-up. Cross-lagged panel modelling revealed unidirectional and positive associations between body appreciation and subsequent self-esteem and flourishing, but not with life satisfaction. Higher body appreciation at baseline predicted increases in self-esteem and flourishing over time, whereas no reciprocal effects were observed, and no longitudinal associations emerged for life satisfaction. These findings highlight the possible protective role of body appreciation in autistic people, strengthening claims that body appreciation could serve as a viable target of intervention aimed at promoting psychological well-being in autistic populations.

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11. Mirzaian CB, Smith R, Betz CL. Parents of youth and young adults with intellectual and developmental disabilities: Barriers experienced during transition. J Pediatr Rehabil Med. 2026: 18758894261476176.

PurposeThe purpose of this study was to explore the experiences of parents of youth and young adults with intellectual and developmental disabilities who have undergone the transition from pediatric to adult healthcare as well as community-based transition and adult-focused services to better understand the barriers faced when individuals transition.MethodsEleven parents were recruited via email flyers and research information sheets, which were distributed to parent support/disability advocacy groups that are community partners of the Children’s Hospital Los Angeles University Center for Excellence in Developmental Disabilities. The study interview guide consisted of 11 open-ended questions. The questions were designed to explore experiences with their youth and young adults’ health care transition experience. Question items pertaining to barriers (five questions) with community-based services identified during the transition process are reported in this paper. All interviews were conducted via phone, audio-recorded, and transcribed.ResultsAnalysis of the data generated four major themes with subthemes. The day programs theme consisted of four subthemes: a) do not know what programs are available; b) lack of staffing; c) day program not appropriate; and d) waitlist. The education theme included four subthemes: a) no transition support provided; b) transition support not adequate; c) vocational training inadequate or not available; and d) need for adult supervision. The employment barrier theme contained three subthemes: a) loss of benefits; b) transition support not provided; and c) lack of accommodations or lack of options. The independent living barrier was composed of six subthemes: a) lack of resources; b) public benefits take a long time; c) self-determination services still inadequate; d) no transportation available; e) need to know to ask for services; and f) challenges pertaining to conservatorship.ConclusionThe findings revealed parents encountered numerous barriers to assisting their youth and young adults in assessing educational, employment, and community living services. The analysis supports the findings from previous studies and provides new insights and understanding.

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12. Naderi Malek A, Rasoli Jokar AH, Prelock P. Gene Therapy for Autism Spectrum Disorder: Preclinical Advances, Translational Barriers, and Ethical Dimensions – A Scoping Review. Neuropsychobiology. 2026: 1-22.

BACKGROUND: Autism spectrum disorder (ASD) lacks disease-modifying therapies. Gene therapy offers a promising avenue to target the underlying molecular causes of ASD, particularly in monogenic or syndromic forms where single-gene mutations play a central role. METHODS: A scoping review was conducted following the PRISMA-ScR framework. We searched PubMed, Scopus, Web of Science, PsycINFO, and the Cochrane Library (2000-July 2025), with the last search completed in July 2025. Eligible studies included preclinical or translational investigations involving gene-therapy modalities (e.g., AAV vectors, ASOs, CRISPR-based editing) targeting high-confidence ASD-linked genes; non-gene-therapy studies, unrelated conditions, reviews, and non-English papers were excluded. Data were charted using a standardized extraction form and synthesized descriptively across two evidence streams. Stream 1 evaluated preclinical studies of gene therapy, while Stream 2 examined translational advances and ethical considerations. RESULTS: Twenty-one preclinical studies were identified in Stream 1, focusing on genes such as UBE3A, MECP2, FMR1, SHANK3/2, SCN2A, and SYNGAP1. Most demonstrated molecular correction and improvements in synaptic, electrophysiological, and behavioral outcomes, with therapeutic effects observed from early developmental to adult timepoints. Stream 2 synthesized 12 studies highlighting translational challenges, including delivery innovations (e.g., engineered viral capsids, nanoparticles), safety concerns (immune responses, dose-dependent toxicities), and ethical considerations (pediatric consent, neurodiversity perspectives, equity in access). Limitations include heterogeneity across models, reliance on rodent studies, and absence of completed human clinical trials. CONCLUSIONS: Gene therapy for ASD shows considerable promise but faces significant translational and ethical hurdles. Standardized study designs, comprehensive safety evaluation, and transparent stakeholder engagement will be critical for developing responsible and effective clinical applications.

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13. Omelchenko MA, Larionov GV, Klyushnik TP, Obodzinskaya TE, Generalov VO. [Quality of life of parents of children with autism spectrum disorders]. Zh Nevrol Psikhiatr Im S S Korsakova. 2026; 126(7): 115-22.

OBJECTIVE: To establish a correlation between the severity of clinical symptoms in children diagnosed with autism spectrum disorders (ASDs) and the quality of life experienced by their parents, and identify potential targets for effective interventions in care. MATERIAL AND METHODS: The study included a sample of 40 parents of children diagnosed with ASD and 37 parents of neurotypical children. The clinical and psychometric evaluation of the children with ASD was conducted using the Childhood Autism Rating Scale (CARS). Additionally, the Quality of Life in Autism Questionnaire (QoLA) was used to assess parents’ quality of life. Statistical analyses were performed using MS Excel and STATISTICA software, employing nonparametric methods. RESULTS: The psychometric assessment using the CARS scale yielded an average score of 22.6±5.8 for the examined children, indicating a mild autism classification. The total QoLA score for parents of children with ASD was 132.6±25.8 points, compared with 171.8±23.6 points for parents of neurotypical children (p<0.001). The quality of life of parents, as assessed by Part B of the QoLA scale, was found to be correlated with the severity of ASD as measured by the CARS scale (p<0.05). The primary symptoms identified that negatively impacted the quality of life of parents included the social impairments associated with autism, challenges in collaborative engagement, a lack of comprehension regarding social rules and roles, alongside communication disorders (p<0.05). CONCLUSIONS: The findings highlight potential targets for social and therapeutic interventions with families, which may alleviate parental distress and enhance the quality of life for parents of children diagnosed with ASD.

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14. Poiencot LM, Vogtle LK, Franc I. Autism Stigma and Employment: A Scoping Review. J Autism Dev Disord. 2026.

PURPOSE: Despite the growing awareness of neurodivergence, autistic adults continue to face disproportionately low employment rates worldwide compared to the neurotypical population. This scoping review investigates the impact of social stigma on the employment outcomes of autistic individuals, aiming to understand the experiences of autistic adults in the workplace with the research question: How does the stigma surrounding autism affect the employment outcomes of autistic individuals? METHODS: This scoping review examined 14 qualitative studies published over the last 10 years and synthesized the perspectives of both employers and autistic employees to identify key themes shaping their workplace experiences. RESULTS: The findings suggest that stigma, evident through misconceptions and a lack of inclusive workplace cultures, often results in discriminatory practices and limits employment opportunities while negatively affecting the well-being of autistic individuals. Four consolidated themes emerged from the autistic perspective: inclusive practices, the importance of fitting in, generalizations about autism, and masking or social camouflaging. From the employer’s perspective, three consolidated themes were identified: inclusive versus non-inclusive practices, understanding of autism, and attitudes towards discrimination and disclosure. CONCLUSION: These results highlight the need for a societal shift in perceptions toward more inclusive workplace practices, including community-level anti-stigmatization education and workplace accommodations that support all employees.

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15. Prange EO, Beisang A, Pehlivan D, Suter B, Schleifer P. Expert Consensus on Real-World Use of Trofinetide for Rett Syndrome Using a Modified Delphi Method. Ann Child Neurol Soc. 2026; 4(1): 38-51.

OBJECTIVE: Trofinetide is the first approved treatment for Rett syndrome (RTT) in the United States and Canada. Trofinetide improved the core symptoms of RTT in clinical trials, and real-world evidence supports the findings of clinical trials. As RTT experts in the United States have now gained nearly 3 years of real-world experience with trofinetide, a modified Delphi process was conducted in the United States to establish consensus recommendations for the practical use of trofinetide in the treatment of RTT. METHODS: A multidisciplinary steering group of five trofinetide-experienced RTT experts practicing at an International Rett Syndrome Foundation (IRSF)-designated center of excellence convened and developed 72 consensus statements across six domains: first-line use, pre-treatment assessment, initiation, benefit evaluation, tolerability management, and discontinuation strategies. The statements were then assigned a 4-point Likert scale for testing via email by the Delphi panel identified by the steering group. Consensus was reached for individual statements if they met the pre-specified consensus threshold of ≥ 75% agreement. RESULTS: Two rounds of assessments were completed by 25 respondents in each round, resulting in agreement ≥ 75% being reached across the final statement set. The consensus supports trofinetide as the standard of care for eligible patients with early initiation and an individualized approach to titration to maximize efficacy and tolerability. The panel reflected the steering group’s view that trofinetide is efficacious. While side effects can emerge with trofinetide, they are manageable in most cases. CONCLUSIONS: Recommendations highlight a flexible, patient-centered approach to trofinetide use to optimize efficacy while addressing tolerability challenges and supporting adherence.

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16. Rajagopalan P, Kim GS, Overholtzer LN, Laltoo E, Gleave E, Benavidez SM, Retika C, Thompson P, Lawrence KE. Structural brain alterations in autism: A voxel-based morphometry mega-analysis in 3,051 participants across 51 sites. bioRxiv. 2026.

BACKGROUND: Previous large-scale structural MRI analyses of the brain in autism have identified gray matter (GM) differences when using region-of-interest analyses based on gross anatomical regions. However, such analyses have limited spatial specificity and may obscure subtle focal differences. Whole brain voxel-based morphometry (VBM) analyses enable greater spatial precision to identify and localize previously undetected neuroanatomical alterations. PURPOSE: To rigorously identify voxel-wise GM and white matter (WM) volume differences in autism in the largest VBM mega-analysis to date. MATERIALS AND METHODS: This retrospective mega-analysis included structural 3D volumetric T1-weighted MRI brain scans from 3,051 participants (15.0 ± 8.2 yrs; 76.8% male; 1,519 autism; 1,532 neurotypicals) collected across 51 sites/scanners. Voxel-wise GM and WM volumes were quantified using the ENIGMA CAT12 VBM pipeline. Linear mixed-effects regression was performed at each voxel to evaluate the association between diagnostic group and voxel-wise volume while adjusting for standard nuisance covariates. RESULTS: Autism was associated with widespread lower GM volume involving cortical, subcortical, and cerebellar regions (peak t=7.39, peak β=0.13); such GM differences were most notably detected in the bilateral orbitofrontal cortex, amygdala, thalamus, and posterior lobes of the cerebellum. WM volume was lower in autism across major projection, commissural, association, and cerebellar/brainstem tracts (peak t=6.74, peak β=0.08), including the corona radiata, internal capsule, corpus callosum, and cerebellar peduncles. These findings remained consistent in sensitivity analyses, including covarying for full-scale IQ and the application of increasingly strict motion exclusion criteria. CONCLUSION: Autism is associated with smaller voxel-wise GM and WM volume involving widespread cortical, subcortical, and cerebellar regions. This high-resolution identification and localization of structural brain differences support the involvement of distributed neural systems in autism that underlie reward processing, sensory integration, and motor functioning in autism.

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17. Reuben K, Kate MA, Hegarty DL, Buchanan B. Clinical Evidence for Increased Dissociative Experiences in Adults with High Levels of Autistic Traits: A Comparative Study. J Trauma Dissociation. 2026: 1-23.

Autism spectrum disorder (ASD) is associated with a variety of mental health conditions, including dissociation. In addition to high rates of trauma exposure, vulnerability for dissociation in autism may be heightened by social differences, cognitive inflexibility, and sensory sensitivities. This study examined dissociative symptoms across levels of autistic traits using existing clinical data from 716 individuals receiving mental health care (« clients ») in Australia. Clients completed the Multidimensional Inventory of Dissociation-60 (MID-60), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and the Adverse Childhood Experiences Questionnaire (ACE-Q) or Life Events Checklist for DSM-5 (LEC-5). Clients were grouped according to their RAADS-R scores, measuring autistic traits. Analyses first compared those with high autistic traits (HA; ≥120; n = 338) to below-threshold autistic traits (BA; <120; n = 378). The latter group was then subdivided into those with moderate autistic traits (MA; 65-119; n = 214) and low autistic traits (LA; <65; n = 164) for more comprehensive analysis. HA clients had the highest scores on all trauma and dissociation measures and subscales, and clinically elevated dissociation was significantly more prevalent among HA clients (68%) than BA clients (33%; OR = 4.42) and LA clients (15%; OR = 12.59). MA clients also scored higher than LA clients in almost all domains. Autistic traits and dissociation severity were significantly correlated overall and for all subscales, with the strongest correlations found for the RAADS-R Sensory-Motor domain. All relationships remained significant after controlling for ACEs. This highlights the need for routine screening and tailored interventions addressing both autistic traits and dissociation.

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18. Sithole BM, Mogase K, Moeketsi TD. Exploring caregivers’ experiences when seeking mental health care services for their children with autism spectrum disorder: A qualitative study from South Africa. S Afr J Psychiatr. 2026; 32: 2661.

BACKGROUND: The increasing prevalence of autism spectrum disorder (ASD) highlights the importance of understanding caregivers’ experiences in accessing mental healthcare for their children, particularly given the demanding nature of supporting children with ASD in resource-constrained settings. AIM: This study aimed to explore the experiences of caregivers of children with ASD when accessing mental healthcare services in South Africa. SETTING: This qualitative study was conducted at the Child and Adolescent Psychiatric Unit at Weskoppies Hospital, a tertiary-level hospital in Pretoria West, Gauteng province, South Africa. METHODS: This qualitative case study purposively sampled 15 caregivers of children with ASD at a tertiary psychiatric facility in South Africa. Data were gathered through in-depth interviews and analysed using a Grounded Theory-informed thematic analysis approach. RESULTS: Five main themes emerged: (1) challenges in accessing mental health care services, (2) delays in screening and early diagnosis, (3) limited ongoing education and knowledge-sharing, (4) the need for emotional support and counselling, and (5) facilitating referrals to specialised schools and allied health care services. CONCLUSION: The study identified significant barriers to mental health service utilisation, underscoring the urgent need for improved service accessibility, caregiver support and increased public awareness. CONTRIBUTION: The findings advocate for strengthened mental healthcare access and targeted caregiver support for families of children with ASD in South Africa.

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19. Velázquez González P, Rosenthal E, Waschbusch DA, Mayes SD. Seizures are associated with cognitive disengagement syndrome, incoordination, and low IQ in child ADHD and autism samples. Appl Neuropsychol Child. 2026: 1-10.

This is the first study comparing children with and without seizures in a large clinical sample and examining differences in diagnoses, IQ, neuropsychological and achievement test scores, and psychological problems. Mothers rated 2,212 children (4-17 years) with autism and/or ADHD on the Pediatric Behavior Scale. A subgroup 6-16 years had neuropsychological and academic achievement test data (n = 820). In the autism/ADHD sample, 2.8% had mother-reported seizures with falling and loss of consciousness, whereas only 0.8% of the population-based contrast sample did. Differences between children with autism, ADHD-Combined, and ADHD-Inattentive were nonsignificant. Seizures were strongly associated with lower IQ, cognitive disengagement syndrome/CDS, and incoordination. Controlling for IQ, the remaining variables were nonsignificant, including working memory, processing speed, verbal comprehension, perceptual reasoning, graphomotor, attention, reading and math scores and maternal ratings of attention deficit, hyperactivity/impulsivity, autism, irritability/tantrums, oppositional behavior, conduct problems, anxiety, depression, insomnia, and social impairment. Findings have implications for understanding associations between seizures and psychological functioning, future studies (e.g., the importance of controlling for IQ), and clinical practice (e.g., assessing for CDS, motor incoordination, and low IQ in children with seizures and providing targeted intervention if these problems are present).

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20. Wang Y, Ma Z, Wang Z, Xu X, Xia Z, Zhang H, Zhang J, Zong Y, Ke X, Li Y. Group-wise sparse coding for the discovery of functional connectivity-based biomarkers in children and adolescents with autism spectrum disorder. Front Psychiatry. 2026; 17: 1743755.

BACKGROUND: Autism spectrum disorder (ASD) is currently diagnosed through behavioral observations and evaluations, but there is still a lack of objective and consistent biomarkers. Children and adolescents with ASD exhibit impairments in advanced social, emotional, and cognitive functions, such as a lack of empathy. In general, the concept of empathy encompasses several socio-emotional and cognitive components based on interacting brain circuits. Identification of disease-related biomarkers at the brain network level could provide a crucial avenue for advancing ASD imaging research and improving diagnostic accuracy. METHODS: This study examined 80 individuals with ASD aged 6-16 years old and 50 matched control subjects, using resting-state functional magnetic resonance imaging and clinical psychological assessment datasets. Specifically, a set of functional brain networks was constructed using dictionary learning and sparse coding (DLSC) in a group-wise manner. Then, the localized common functional brain networks from both the ASD and matched control groups were automatically decomposed into a set of regions of interest (ROIs) for further functional connectivity analyses. RESULTS: Using the derived functional connectivity matrix, we investigated three parameters, namely, correlation, partial correlation, and tangent embedding, to differentiate participants with ASD from control subjects. We achieved classification accuracies of 95%, 100%, and 100%, respectively, indicating that the proposed DLSC method could extract representative and characteristic brain ROI atlases for both ASD and control participants. Further analysis of functional connectivity results showed that ASD participants had multiple atypical connections, especially those connecting the left inferior temporal and left inferior parietal regions, which belonged to the temporoparietal junction (TPJ), and connections related to the right insula and anterior cingulum, which belonged to the salience network (SN). Together, our results suggest that individuals with ASD exhibited a lower empathy capability than control subjects. CONCLUSION: Our results suggest that DLSC can effectively extract robust brain ROI atlases. Functional connectomes with high differentiation powers were mainly distributed within the brain networks of SN, social brain networks (SBNs), and the theory of mind (ToM) network (including the TPJ hub). Children and adolescents with ASD exhibited lower empathy capabilities than control subjects, which may be attributed to dysfunctions in the salience and social brain networks. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn, identifier ChiCTR-ROC-17012877.

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21. Zeng W, Suarez-Balcazar Y, Mirza M, Yu AP, Parra-Medina D, Errisuriz VL, Heydarian N, Magaña S. Understanding Maternal Health Outcomes Among Latina Mothers of Children With Intellectual and Developmental Disabilities: The Roles of Social Determinants and Sociocultural Contexts. Am J Intellect Dev Disabil. 2026: 1-16.

Latinx families of children with disabilities are at disproportionally high risk of adverse health outcomes, including overweight, obesity, and depression. Research on specific social determinants and sociocultural factors that impact their health remains limited. In this study, we examined how social determinants of health (SDOH) and sociocultural contexts are related to maternal health outcomes in a sample of 105 Latina mothers of children with intellectual and developmental disabilities (IDD) in the United States. Mothers were interviewed by phone or video conference call and were asked about maternal and child demographics, maternal chronic health conditions, SDOH indicators, and sociocultural factors (family cohesion and social support). Conditional process models were conducted for the maternal health outcomes measured by body mass index (BMI) and depressive symptoms. High levels of overweight, obesity, and depressive symptoms were observed among these mothers. SDOH related to BMI and/or depressive symptoms included annual household income, home ownership, neighborhood safety, and perceived discrimination. Family cohesion and social support were related to lower depressive symptoms but were not associated with BMI. The study findings emphasize the importance of considering SDOH when developing support programs for Latina mothers of children with IDD.

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