1. Adamou M, Kehagias A, Antoniou G. A multi-scale mathematical framework for modelling the dynamic nature of autism spectrum disorder symptoms: integrating predictive coding, information theory, and network principles. Front Psychiatry;2026;17:1787120.

BACKGROUND: Autism Spectrum Disorder (ASD) is characterised by persistent deficits in social communication and interaction alongside restricted, repetitive patterns of behaviour, interests, or activities. Standard diagnostic criteria provide static descriptions, failing to capture the dynamic variability of these symptoms across contexts and developmental trajectories. Furthermore, current descriptions often lack mechanistic explanations for why these symptom fluctuations occur. There is a need for dynamic, theory-driven models that bridge neurobiological mechanisms with observable clinical phenomena. OBJECTIVE: This study aimed to develop and present a set of interpretable mathematical models representing the dynamic, context-dependent nature of the core symptoms of ASD, explicitly grounded in established neuropsychological theories including Predictive Coding, Information Theory, and Network Neuroscience principles. METHODS: Mathematical models were theoretically derived using algebraic and differential equations to represent hypothetical symptom dynamics across both diagnostic domains. Social reciprocity was modelled using modulated exponential decay functions derived from executive function and predictive processing theories. Nonverbal communication was represented by weighted summation reflecting multi-channel integration demands. Relationship development was modelled using sigmoid growth functions incorporating social motivation theory. Stereotyped movements were represented by sinusoidal functions conceptualised as homeostatic entropy-reduction mechanisms. Insistence on sameness was modelled using sigmoid preference functions explicitly derived from Bayesian precision-weighting of prediction errors. Restricted interests were represented by exponential functions reflecting atypical reward processing. Sensory sensitivities were modelled using integral functions representing habituation failure due to excitation-inhibition imbalance. No empirical data were collected; parameter ranges were derived from theoretical considerations and existing literature. RESULTS: The study produced theoretical mathematical equations that quantify the temporal dynamics and contextual modulation for each core symptom domain. These equations provide a formalised representation grounded in mechanistic principles: how social reciprocity would decay due to executive and predictive processing load, how nonverbal communication effectiveness would depend on multi-channel integration capacity, how relationships would develop under constraints of social motivation, how repetitive behaviours would fluctuate to regulate environmental entropy, how preference for sameness would emerge from aberrant Bayesian precision, how restricted interests would persist due to heightened reward salience, and how sensory sensitivities would accumulate due to habituation failure. These models generate testable quantitative predictions about symptom patterns and intervention effects. CONCLUSION: The proposed mathematical models offer a novel, quantitative framework for understanding and representing the dynamic nature of ASD symptoms. By integrating mechanistic neurobiological theories with dynamic mathematical formulations, these interpretable models provide a potential advance over static descriptions and may facilitate improved clinical assessment, identification of intervention targets at the parameter level, personalised treatment strategies, and targeted research into the mechanisms underlying ASD. The framework respects neurodiversity by conceptualising many symptoms as adaptive responses to neurobiological differences rather than mere deficits. Empirical validation is required to test model predictions, estimate actual parameter values from clinical populations, and establish clinical utility.

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2. Anderer S. New Study Finds No Link Between Acetaminophen Use in Pregnancy and Autism. Jama;2026 (May 8)

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3. Asselt AV, Roke Y, Begeer S, Scheeren AM. Extending the Minority Stress Model of Autism: Internalized Stigma and Loneliness as Predictors of Stress and Life Satisfaction. Autism;2026 (May 8):13623613261446876.

Autistic people’s minority status makes them more vulnerable to minority stressors, such as stigmatization and victimization, which are linked to greater stress and lower life satisfaction. The Psychological Mediation Framework (PMF) proposes that cognitive, affective, and social-psychological processes help explain the relationships between these stressors and adverse outcomes. This cross-sectional study tested the PMF in autistic adults by examining how two of its key processes, internalized stigma and loneliness, are associated with stress and life satisfaction. Using self-report survey data from 831 autistic participants enrolled in the Netherlands Autism Register (NAR), aged 18-87 years (M(age) = 47.5; SD = 12.5; 408 women, 309 men, and 114 gender-diverse individuals), multiple regression analyses showed that internalized autism-related stigma, emotional loneliness, and social loneliness were each positively associated with stress and negatively associated with life satisfaction. Mediation analyses indicated that both types of loneliness partially mediated the relationship between internalized autism-related stigma and these outcomes. Supporting the PMF, the findings suggest that autism-related stigmas may become internalized and be associated with loneliness, which is linked to greater stress and lower life satisfaction. Future studies should build upon the PMF and explore strategies to mitigate underlying minority stressors.Lay AbstractUnderstanding stress and life satisfaction in autistic adults with the psychological mediation frameworkWhy was this study done?Autistic adults often experience higher levels of stress and lower life satisfaction than non-autistic adults. Recently, research has suggested that these experiences are linked to them being part of a minority group-autistic people. Minorities often experience extra stress from experiences like stigma, sometimes called minority stressors. A theoretical model, the Psychological Mediation Framework (PMF), describes how minority stressors are linked to differences in people’s thoughts, emotions, and feelings. This study examined whether the PMF can also help explain the stress and life satisfaction of autistic adults. We did this by testing whether two important parts of the PMF, internalized autism-related stigma (negative beliefs about being autistic) and loneliness, were linked to their stress and life satisfaction (how content people feel with their lives overall).What did we do?We analyzed data from 831 autistic adults who filled out a survey. In our statistical models (mathematical analyses that test how variables are related), we took into account other factors that are more commonly used to examine which factors were statistically associated with stress and life satisfaction in autistic adults, such as the level of characteristics related to autism and education level. By doing this, we increased the chance that any relationships we found could be attributed to minority stressors.What did we find?Autistic adults who experienced more internalized autism-related stigma, emotional loneliness (feeling disconnected from close relationships), and social loneliness (lacking a broader social network) reported higher stress levels and lower life satisfaction. We also found that autistic adults with more internalized stigma felt lonelier, and this loneliness was linked to higher stress and lower life satisfaction.What do the findings mean?The results suggest that autistic adults may internalize autism-related stigmas, which are linked to greater loneliness, higher stress, and lower life satisfaction. As these findings align with the PMF, we believe future studies should continue using this model. Also, we recommend that researchers should study ways to reduce minority stressors and improve the mental health of autistic adults.

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4. Benfica TR, Franco FN, Siquara GM, Pondé M, Souza APR. The use of the Labyrinth Scale in the differential diagnosis of children aged 2 to 4 with a history of psychological distress, autism and different language outcomes. Codas;2026;38(2):e20250152.

PURPOSE: To analyze the diagnostic utility of the Autism Diagnostic Labyrinth Scale to differentiate children with Autism Spectrum Disorder (ASD) from children with language disorders or delay and those with typical development in the 2 to 4 age range. METHODS: 29 children aged 2 to 4 years were evaluated using the Labyrinth Scale, with and without a history of psychological distress, identified as having Typical Development (TD), Delayed Language Acquisition (DLA), Developmental Language Disorder (DLD), or ASD. Totals and subscale scores for social interaction, verbal and nonverbal communication, restricted and repetitive behaviors, and gestures were statistically compared to differentiate between groups. RESULTS: there were statistically significant differences in total scores and across all four subscales of the Labyrinth Scale between the ASD group and the other clinical groups evaluated (TD, DLA, and DLD) (p < 0.001). The Verbal Communication subscale also demonstrated specific ability to significantly distinguish the LAD group from the DLD group (p<0.001). CONCLUSION: The Labyrinth Scale proved to be useful in clearly differentiating children with ASD from those with DLD, LAD, and typical development, suggesting strong clinical potential of the instrument for early differential diagnosis among these clinical conditions.

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5. Charlton RA, Fahey N, Mandy W, Happé F, Stewart GR. Understanding the impact of prior depressive and anxiety symptoms and autism diagnosis on menopause symptoms. Womens Health (Lond);2026 (Jan-Dec);22:17455057261446945.

BackgroundThere is growing awareness from qualitative research studies that menopause may be particularly challenging for autistic people. Research in the general population suggests that preexisting conditions may be a risk factor for negative experiences during menopause. However, there are limited studies examining variables associated with experiences of menopause symptoms for autistic people.ObjectivesTo explore whether pre-existing depression and anxiety symptoms impact menopause symptoms for autistic and non-autistic people.DesignThe study design is classified as STROBE.MethodsAutistic (n=52) and non-autistic (n=28) people assigned female at birth participated in the longitudinal AgeWellAutism (AWA) study. They reported self-report depression and anxiety symptoms at baseline and menopause symptoms (Greene Climacteric Scale) at follow-up after 4.5 years. Age, autism diagnosis and autism characteristics of mentalising difficulties, sensory reactivity, and social anxiety (subscales from the self-reported Ritvo Autism and Asperger Diagnostic Scale, RAADS) were recorded.ResultsRegression analyses were conducted with menopause symptoms as the dependent variable and as independent variables: Step 1, age; Step 2, baseline depression and anxiety symptoms, Step 3, autism diagnosis (alternative step 3, RAADS subscales). In the final regression model, younger age, higher baseline depression and autism diagnosis contributed significantly to explaining menopause symptom severity. In the alternative model (including subscales of the RAADS), younger age, higher baseline depression, mentalising difficulties and sensory reactivity contributed significantly to explaining menopause symptom severity.ConclusionsResults align with research from the general population suggesting that a history of depression symptoms increases risk of negative experiences during menopause, furthermore, being autistic confers additional risk. Further studies examining the influence of lifetime experiences on menopause symptoms for neurodivergent people are required to better understand and mitigate risk during this critical time.

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6. Chen X, Xu H, Huang Y, Zhang P, Hu L, Zhu F, Liu J, Xu H, Gong Z, Lu L. Auditory brainstem response abnormalities in autism spectrum disorder: A deep learning approach to characterize time-frequency signatures. Hear Res;2026 (May 8);477:109654.

BACKGROUND: While Auditory Brainstem Response (ABR) provides a non-invasive window into auditory brainstem function, prior studies of ASD have primarily focused on localized waveform features (e.g., waves I, III, and V), potentially overlooking subtle but informative patterns in the full-band signal. This study introduces a deep learning framework to comprehensively characterize time-frequency signatures of auditory brainstem activity in ASD, with the goal of identifying neurophysiologically meaningful ABR features associated with ASD. METHODS: We analyzed a clinical dataset of 1209 ABR recordings (ASD: 961; Typically Developing Controls: 248). A dual-branch Time-Frequency Fusion and Transformer-Based Network (TF-TBN) was developed. The temporal branch utilizes a Transformer-enhanced 1D-CNN to analyze raw ABR waveforms, while the frequency branch employs a Vision Transformer to analyze spectrograms generated via Continuous Wavelet Transform. A fusion module integrates these features for final classification. Model interpretability was analyzed to identify critical ABR features. RESULTS: The TF-TBN model achieved a classification accuracy of 96.62%, significantly outperforming conventional deep learning baselines. Interpretability analysis revealed that the model’s decision was heavily influenced by prolonged absolute latencies of waves III and V, and interpeak latencies of I-III and I-V, which were confirmed as statistically significant in the ASD cohort. This suggests that the model successfully learned biologically plausible biomarkers of auditory pathway dysfunction. CONCLUSIONS: This study provides the first comprehensive characterization of full-band ABR abnormalities in ASD using a deep learning framework. The TF-TBN model identifies prolonged wave III- and wave V-related timing features as prominent contributors to ASD-TD discrimination, with wave III-related delay emerging as an important component of the observed ABR abnormality. By linking AI-driven feature discovery to interpretable neurophysiological biomarkers, our work advances the analytical framework for ABR and contributes to understanding the neural basis of auditory processing deficits in ASD.

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7. Cruz TKF, Netto R, Costa FRM, Cota EB, Nascimento A, Barreto SR, Souto DO. Effectiveness of the Global Integration Method (Método de Integração Global – MIG) for improving motor and functional outcomes in children with autism spectrum disorder: a randomised controlled trial protocol. Front Pediatr;2026;14:1804826.

INTRODUCTION: Motor impairments are highly prevalent in children with Autism Spectrum Disorder (ASD) and have been associated with reduced functional independence, participation, and sociocommunicative development. Despite the growing body of evidence supporting the relevance of motor functioning in ASD, motor-based interventions remain underrepresented in high-quality randomized clinical trials. The Global Integration Method (Método de Integração Global – MIG) is an intensive, interdisciplinary intervention grounded in the theories of predictive coding and embodied cognition, with emphasis on motor organization, proprioceptive stimulation, and generalization of functional skills in real-life contexts. OBJECTIVE: The aim of this study is to evaluate the effectiveness of the MIG program in improving fundamental motor skills and achieving functional goals, compared with conventional physiotherapy and psychological interventions, in children with ASD. Secondary objectives are to investigate the effects of MIG on balance, sociocommunicative skills, and motor performance. METHODS AND ANALYSIS: This is a three-arm randomized controlled trial with concealed allocation and blinded outcome assessors. Sixty-six children with ASD, aged 6 to 12 years, classified as requiring level 1 or 2 support, will be randomized into one of three groups: (I) MIG program, (II) conventional psychological intervention, and (III) conventional motor physiotherapy. Interventions will last five weeks. Assessments will be conducted at baseline, immediately post-intervention, and three months after completion. Primary outcomes include fundamental motor skills and functional goal attainment. Secondary outcomes include measures of balance, sociocommunicative skills, and motor performance. Data will be analyzed using linear mixed-effects models, following the intention-to-treat principle. ETHICS AND DISSEMINATION: The protocol was approved by the Research Ethics Committee of the Faculty of Medical Sciences of Minas Gerais, Brazil (Approval No. 7,456,658). Written informed consent will be obtained from parents or legal guardians, and assent will be sought from participating children when developmentally appropriate. Study findings will be disseminated through peer-reviewed publications, conference presentations, and reports to participating families and institutions. CLINICAL TRIAL REGISTRATION: This protocol was prospectively registered in the Brazilian Registry of Clinical Trials https://ensaiosclinicos.gov.br/rg/RBR-7r6n8zd, identifier U1111-1326-2272.

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8. De Stefano LA, Kim H, Erickson CA, Schmitt LM, Dominick KC, Pedapati EV, Huckle R, Wilson R, McKinney WS, Reisinger DL, Nelson MN, Dapore AE, Horn PS, Miyakoshi M. Gaboxadol increases resting theta and alpha power without affecting evoked responses in fragile X syndrome in a home-based setting. J Neurodev Disord;2026 (May 8)

BACKGROUND: Fragile X syndrome (FXS) lacks FDA-approved treatments despite various small molecules contributing to phenotypic rescue in the FMR1 knockout (KO) mouse model. Translation from the mouse model has been hampered by phenotypic heterogeneity that contributes to participation barriers among participants who are most affected and may be unable to regularly visit the research laboratory. The current study utilized a crossover design to test the acute neural and behavioral effects of a single 10 mg dose of gaboxadol and the reliability of electroencephalography (EEG) and behavioral data collected in participant homes compared to the clinic. METHODS: Ten adult males with full mutation FXS completed four blinded dosing visits (two placebo, two gaboxadol), with two occurring in-home and two in-lab. Pre- and post-dose assessments included resting high-density EEG, an auditory chirp paradigm, RBANS List Learning, and NIH Toolbox Cognition Battery subtests. RESULTS: No serious adverse events were reported. Compared with placebo, gaboxadol increased theta and alpha band power, with no interaction between collection environment (home vs. lab). Additionally, gaboxadol increased the proportion of electrodes with detectable low-frequency peaks and slowed the peak frequency. There were no effects on auditory-evoked measures or NIH Toolbox, with only a marginal effect on RBANS List Learning. An analysis of pre-dose EEG found reliability estimates across testing locations for all tested resting power and behavioral measures that were similar to in-lab reliability estimates found in the literature. CONCLUSIONS: Single-dose gaboxadol augmented theta and alpha power in FXS during resting EEG, similar to previous findings in the typically developing population and in the FMR1 KO, without normalizing gamma abnormalities, altering auditory-evoked responses, or contributing to behavioral change. These results did not significantly differ between the home and lab settings, supporting the feasibility of in-home data collection for clinical trials in FXS, including those that use complex measures such as EEG as endpoints. TRIAL REGISTRATION: clinicaltrials.gov, NCT06334419, Registration Date: March 8, 2024.

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9. Dominguez Ortega L, Sturm A, Krushena MM, Gulsrud AC. Emotion regulation and self-inhibition’s association with mental health outcomes, caregiver strain, and well-being in parents of autistic children: a dyadic analysis. J Neurodev Disord;2026 (May 8)

BACKGROUND: Parents of autistic children report more depression, anxiety, and caregiver strain, and poorer well-being than parents of non-autistic children. Though more research has begun to investigate how parent-specific factors may influence these outcomes, few consider cognitive factors like emotion regulation or self-inhibition. These skills may be particularly relevant given their documented benefits and associations with mental health and well-being in the general population. An important consideration when investigating the needs of parents is the interconnectedness of the family unit. Thus, methodologies that consider this shared context are essential to appropriately support resilience of parents of autistic children. METHODS: Our sample consisted of 263 different-sex parent dyads with at least one child formally diagnosed with autism spectrum disorder. Using the Actor-Partner Interdependence Model, we assessed the links between parents’ emotion regulation and self-inhibition and their own and their partner’s depression and anxiety symptoms, caregiver strain, and well-being. Interdependence was established using correlations given the distinguishable nature of our dyads. RESULTS: Both mothers’ and fathers’ emotion regulation were associated with their own depression and anxiety symptoms, caregiver strain, and well-being. Stronger emotion regulation was associated with fewer mental health symptoms, less caregiver strain, and better well-being. There was only one significant association for self-inhibition: stronger self-inhibition scores in fathers were linked to better well-being. We did not observe any associations between parents’ emotion regulation or self-inhibition and partner outcomes after false discovery rate correction. CONCLUSIONS: Emotion regulation, and not self-inhibition, emerged as an important source of resilience for mental health and well-being of parents of autistic children. Previous work has looked to reduce caregiver strain in this population through interventions that directly and indirectly target emotion regulation. Our findings highlight the need for further research on interventions that both directly target parents’ emotion regulation skills and modify environmental contexts (e.g., social support, respite care) to enhance regulatory capacity and support parental resilience. As our work was cross-sectional, future work should investigate the causal relationship between emotion regulation, mental health, and well-being in parents of autistic children.

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10. El Sehrawy A, Aljumaili OI, Axmedov U, Khasawneh MAS, Alanazi MA, Smerat A, Basunduwah TS. Personalized Medicine in Autism Spectrum Disorder: Integrating Epigenomics, Microbiome Research and Early Diagnostics. Int J Dev Neurosci;2026 (May);86(3):e70128.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by persistent difficulties in social communication together with restricted, repetitive patterns of behaviour and sensory-processing differences. Growing evidence suggests that ASD is shaped by complex interactions among genetic susceptibility, epigenetic regulation, immune signalling, maternal and early-life exposures and gut microbiome-related pathways. However, many of these associations remain biologically plausible rather than definitively causal, particularly when findings from experimental models are considered alongside human clinical data. This narrative review examines recent advances across these interconnected domains, with particular emphasis on maternal immune activation, prenatal nutrition, gut microbial imbalance, epigenetic and molecular mechanisms, emerging therapeutic directions and developing biomarker platforms. We also discuss current diagnostic limitations and evaluate the potential of salivary microRNAs, perinatal metabolic and epigenetic markers, oxidative stress-related measures and microbiome-based profiles as early and biologically informative indicators of ASD risk. Special attention is given to the need for biologically informed stratification, although current subgrouping frameworks remain preliminary and not yet sufficiently validated for routine clinical use. Likewise, candidate biomarkers remain investigational and require stronger evidence for reproducibility, external validation, longitudinal performance and clinically meaningful sensitivity and specificity before they can be considered for screening or precision-guided care. Emerging therapeutic strategies targeting immune, epigenetic and microbiome-related pathways are also reviewed, but most remain preclinical or early-stage and face substantial translational barriers. The convergence of epigenomics, microbiome research and early diagnostic science may help advance a more personalized medicine framework for ASD, provided that future studies improve cross-cohort reproducibility, clarify brain relevance of peripheral signals and develop practical multiomics models that can support clinically meaningful integration.

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11. Emet A, Armet G, Luck C, Aksoy T, Mendelson S, Dede O. Pediatric Femoral Neck Fractures: Unrecognized Association With Autism Spectrum and Neurodevelopmental Disorders. J Pediatr Orthop;2026 (May 8)

BACKGROUND: This study aimed to identify all pediatric femoral neck fractures and determine the prevalence of autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDD) among these patients. In addition, it aimed to assess their impact on clinical and radiographic outcomes. METHODS: A total of 289 pediatric patients with proximal femoral fractures were initially identified, of whom 140 met the inclusion criteria for femoral neck fractures after excluding pathologic fractures, polytrauma, and incomplete records. Demographic, clinical, and radiographic data, including the presence of ASD and other NDD conditions, were collected. Intraoperative and postoperative complications were recorded. Statistical analyses were performed using (IBM SPSS Statistics; IBM Corp., Armonk, NY) with associations between variables assessed using t tests and χ 2 tests, and significance set at P <0.05. RESULTS: Among 140 pediatric patients with femoral neck fractures, 39 (28%) were diagnosed with ASD or NDD. Compared with non-ASD patients, those with ASD exhibited more frequent additional neurological and gastrointestinal/endocrinologic comorbidities, higher prevalence of low preoperative vitamin D levels, and a greater incidence of home-related injuries (all P <0.05). Intraoperative and postoperative complications, including infection and avascular necrosis, were infrequent and did not differ significantly between groups. The mean time for return to daily activities was similar between ASD and non-ASD patients. CONCLUSION: A significant association was observed between pediatric femoral neck fractures and ASD or other NDD, including intellectual disabilities. Children with ASD or NDD demonstrated higher rates of medical comorbidities, low preoperative vitamin D levels, and home‑related injuries, suggesting unique risk profiles in this population. LEVEL OF EVIDENCE: Level III.

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12. Fan G, Wang P, Zhang W, Chen X. Efficacy of dialectical behavior therapy-based interventions for individuals with autism spectrum disorder: a systematic review and meta-analysis. BMC Psychol;2026 (May 8);14(1)

BACKGROUND: Autism spectrum disorder (ASD) is characterized by social communication deficits and emotional dysregulation. Dialectical behavior therapy (DBT) has shown potential benefits in various psychiatric conditions; however, evidence regarding its effectiveness in individuals with ASD remains limited. This study aimed to evaluate the effects of DBT-based interventions on emotional regulation, suicidal ideation, and depressive symptoms in ASD. METHODS: Six English and Chinese databases were searched from inception to April 1, 2025. Randomized controlled trials (RCTs) comparing DBT-based interventions with control conditions in individuals with ASD were included. Data were pooled using standardized mean difference (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic, and subgroup analyses were conducted. RESULTS: Four RCTs involving 375 participants were included. Compared with controls, DBT-based interventions were associated with significant improvements in emotional regulation (SMD = - 0.89, 95% CI: -1.67 to - 0.10) and reductions in suicidal ideation (SMD = - 1.97, 95% CI: -3.02 to - 0.91) and depressive symptoms (SMD = - 2.23, 95% CI: -4.35 to - 0.11). Subgroup analysis indicated that shorter session duration (≤ 60 min) was associated with greater improvements in emotional regulation, whereas no significant effect was observed for longer sessions (> 60 min). No significant effects were found for anxiety. CONCLUSION: DBT-based interventions show potential benefits in improving emotional regulation, reducing suicidal ideation, and alleviating depressive symptoms in individuals with ASD. However, the findings should be interpreted with caution due to the limited number of trials and substantial heterogeneity. Further large-scale, high-quality RCTs are warranted.

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13. Feng M, Liang D, Xu J. Vocalization patterns distinguish toddlers later diagnosed with autism from TD at 18-23 months. J Commun Disord;2026 (May 1);122:106647.

In this cross-sectional study with prospective diagnostic follow-up, vocalizations of infants and toddlers later diagnosed with autism spectrum disorder (ASD) and typically developing (TD) controls (aged 6-23 months) were coded frame-by-frame during a single Still-Face paradigm into four categories: directed; nondirected; speech-like; and non-speech-like vocalizations. We examined their relationship with the Language Development Quotient (LDQ). After FDR correction for multiple comparisons, two vocal patterns showed robust differences exclusively in the 18-23-month window: (1) directed vocalization frequency was significantly higher in TD versus ASD, and (2) nondirected vocalization duration was significantly longer in ASD versus TD, both with large effect sizes. Differences in the 6-10-and 11-17-month groups did not survive correction. Conclusions: The late divergence pattern-minimal differences in directed and nondirected vocalizations before 18 months, significant amplification at 18-23 months-identifies this window as a critical period for screening and early intervention in ASD, when social-communicative vocal patterns diverge most substantially from typical development. The findings suggest that directed vocalizations may serve as a possible low-cost behavioral marker distinguishing ASD from typical development, and that speech-like vocalizations show age-dependent associations with language outcomes, defining 18-23 months as a sensitive window for screening and early intervention.

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14. Garcia-Vite TK, Pavlou A, Pari C, Foulsham T, Cooper NR. Resting-state EEG microstates across a dimensional spectrum of autistic traits: From typical development to diagnosed ASD. Behav Brain Res;2026 (May 8);505:116105.

Autism spectrum disorder (ASD) has been linked to atypical large-scale brain dynamics, but it is unclear how these alterations extend across the broader autism phenotype. We applied a seven-class resting-state EEG microstate model (A-G) to adults with clinical ASD and to typically developing adults with high (TD-High) and low (TD-Low) autistic traits, quantified with the Autism-Spectrum Quotient. We compared temporal parameters, spatial coverage, explained variance, and both observed and chance-corrected transition probabilities. Across all microstates, the ASD group showed a globally more fragmented regime than both TD groups, with markedly shorter but more frequent microstate episodes and reduced duration variability. By contrast, TD-High and TD-Low were similar on these global indices. At the network level, Microstate C showed reduced explained variance and coverage in ASD relative to both TD groups. In Microstates E and G, explained variance and coverage increased from TD-Low to TD-High to ASD, with TD-High consistently occupying an intermediate position. Mean GFP and GFP variability for Microstate E were also elevated in ASD relative to both TD groups. Transition analyses revealed reduced short-range transitions within an early A-C ensemble and increased transitions from these states into other microstates in ASD, with TD-High again showing an attenuated, intermediate pattern. Chance-corrected transitions confirmed that sensory/self-related routes occurred less often than expected, whereas routes from these states into other microstates were over-expressed. These findings support a dimensional account in which EEG microstates index autism-related network organisation across clinical and subclinical ranges.

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15. Javitt DC, Martinez A, Sehatpour P, Butler PD, Dias E, Micceri K, Breland M, Tobe RH. Opposite sides of different coins: near-diametrical opposition of physiological indices of reduced accuracy of face emotion recognition in schizophrenia and autism spectrum disorders. Front Neuroimaging;2026;5:1771087.

BACKGROUND: Schizophrenia (Sz) and autism spectrum disorder (ASD) are associated with reduced accuracy offace emotion recognition (FER). Nevertheless, the underlying pathophysiological mechanisms may diverge, potentially related to differential processing patterns within the early visual system. Here, we investigated physiological-level responses to emotional faces. We hypothesized that Sz and ASD would be associated with convergent behavioral performance, but divergent pathophysiological mechanisms. STUDY DESIGN: Simultaneous eye-tracking and continuous EEG data were obtained from 23 adults diagnosed with schizophrenia (Sz), 21 autistic adults, and 24 neurotypical controls (NC) in response to intact and chimeric emotion faces. Event-related potentials (ERP) were calculated from the ongoing EEG data using time- and time-frequency (TF) domain approaches. Symptoms were rated using the Positive and Negative Symptom Scale (PANSS) and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in Sz and ASD, respectively. STUDY RESULTS: As predicted, Sz and ASD were associated with similar levels of reduced FER accuracy relative to NC, but differential patterns of eye tracking and EEG-related activity. Rates of eye- vs. mouth-fixations were reduced across groups but did not correlate with FER. Nevertheless, the ability to utilize eye-information diverged across groups. Thus, when viewing chimeric faces, Sz was associated with reduced tendency to utilize eye information and increased tendency to utilize mouth information even when fixation location was considered. In TF analyses, reduced FER accuracy was associated with reduced initial sensory responses in Sz, as reflected in the theta-band time-frequency response. In contrast, in ASD, reduced FER accuracy was associated with increased alpha-frequency event-related desynchronization (alpha-ERD) consistent with hyper-engagement of secondary visual regions (V2). A combination of physiological and eye-tracking measures differentiated schizophrenia and ASD with >90% accuracy. V2 hyper-engagement in ASD correlated with both reduced FER accuracy and ADOS Social Interaction domain scores. CONCLUSION: Schizophrenia and ASD are associated with divergent physiological-level alterations within the early visual system during emotional face processing, supporting models of magnocellular visual hypoactivity in schizophrenia but retinotectal visual hyperactivity leading to hyper-engagement of non-face regions (V2) by face stimuli in ASD. These alterations, in turn, may serve as targets for future intervention studies related to social cognition.

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16. Kaur T, Dushyant, Yadav N, Saini V, Devi R, Dhingra AK. Neuroinflammatory and Synaptic Roles of Glial Cells in Autism Spectrum Disorder. CNS Neurol Disord Drug Targets;2026 (May 8)

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social communication and repetitive behavior. Early indicators are that glial cells-astrocytes, microglia, and oligodendrocytes-are at the center of the etiology and pathogenesis of ASD. A systematic review of literature studies examining glial cell pathology in ASD was conducted. Peer-reviewed literature on astrocyte function, microglial phenotypes, oligodendrocyte-mediated connectivity, and molecular pathways of neurotransmission and neuroinflammation was searched in databases. Astrocytes, playing a crucial role in synaptogenesis and neurotransmitter modulation, exhibit disrupted calcium signaling and increased IL-6 expression in ASD, potentially leading to neuroinflammation and synaptic injury. Microglia, maintaining synaptic homeostasis, become pro-inflammatory (M1) in ASD, which produces cytokines that destroy neurons. Disrupted oligodendrocyte function is linked to aberrant myelination and disrupted neural connectivity. Molecular mechanisms underlie dysregulated activation of toll-like receptors, cytokine signaling, oxidative stress, and dysregulation of glutamate/GABA metabolism. Environmental toxins like chlorpyrifos aggravate excitatory signaling and glial dysfunction. Most of the features of ASD are caused by these glial disorders. Interventions to correct glial dysfunction-e.g., anti-inflammatory medication (e.g., minocycline, ibudilast), gene therapy, and stem cell therapy-are investigated for their potential to restore glia to normal and diminish ASD symptoms. Understanding glial-neuronal communication mechanisms and their role in neuroinflammation offers a hopeful future for accurate, target-specific treatment. Advances in the elucidation of these processes will foretell an enormous increase in therapeutic efficacy and quality of life for individuals with ASD.

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17. Landau E, Brooks SE, Guilfoyle J, Nayar K, Crawford S, Xing J, Lau JCY, Martin GE, Voigt R, Valluripalli Soorya L, Losh M. A multi-method phenotypic study of sex differences in pragmatic language in autism. Front Psychiatry;2026;17:1759436.

INTRODUCTION: Autism spectrum disorder (ASD) is characterized in part by differences in pragmatic (i.e., social) language use. However, few studies on pragmatic language have included a meaningful number of autistic females, and even fewer have evaluated pragmatic language profiles for sex-specific differences. The existing literature on pragmatic language in autistic individuals without intellectual disability suggests that females may have stronger social communication skills compared to males, but findings are mixed, and there is not a clear profile of specific pragmatic skills that are liable to sex differences. It is also important to develop novel methodologies, such as computational methods, to characterize pragmatic language in ways less labor-intensive than gold-standard hand-coding methods, which are extremely time consuming and typically not feasible in clinical settings. METHODS: The present study examined hand coding of pragmatic language data samples alongside multiple computational linguistic methodological approaches to characterize sex differences in pragmatic language in autistic males and females across narrative and semi-structured conversational tasks that might reveal context-specific patterns across sex and diagnostic groups. RESULTS: Results indicated that most pragmatic domains differed between autistic and non-autistic groups, with autistic males showing the most obvious pragmatic differences, and that differences between diagnostic groups were more pronounced in the semi-structured conversational context. The alignment between computational and hand-coded findings was strongest in domains with clear theoretical overlap (e.g., frequency of emotional words) but was less consistent in areas that were less theoretically aligned (e.g., conversational dynamics and single word function). DISCUSSION: These findings support the promise of computational methods for characterizing narrative abilities, though further study including validation against hand-coded approaches is warranted.

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18. Li C, Butterfield J, Wilkinson C. TCF12-related bicoronal craniosynostosis complicated by a large middle fossa arachnoid cyst and developmental regression: a case report. Childs Nerv Syst;2026 (May 8);42(1)

Pathogenic variants in Transcription Factor 12 (TCF12) have been identified as genetic causes of craniosynostosis. The phenotypic spectrum of TCF12-related craniosynostosis is broad and remains incompletely understood. Herein, we report a case of a 2-month old male with a heterozygous pathogenic variant of TCF12 (c.1267C > T; pArg423*) and bicoronal craniosynostosis. He underwent bicoronal suturectomy at 4 months of age, followed by post-operative molding helmet therapy. He returned at 2 years of age with developmental regression including loss of expressive language and fine motor skills. Shortly after he developed clinical findings of elevated intracranial pressure (ICP) and was found to have synostosis of the sagittal and bilateral lambdoid sutures, and a Galassi III left middle fossa arachnoid cyst with significant midline shift, requiring surgical fenestration. Post-operatively, the cyst decreased in size with resolution of midline shift. The patient did not regain any developmental milestones and continued to demonstrate deficits in language, social communication, and fine motor function despite resolution of other preoperative signs and symptoms of elevated ICP. To our knowledge, this is the first reported case of TCF12-associated craniosynostosis with a co-occurring arachnoid cyst. Furthermore, there is limited literature describing the long-term neurodevelopmental outcomes of children with TCF12 pathogenic variants. Thus, this case offers expanded insight into the broad phenotypic spectrum of TCF-12 related craniosynostosis and its potential clinical sequelae.

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19. Luo B, Wanpen S, Eungpinichpong W, Konharn K, Rattanathongkom A. Trampoline exercise reduces anxiety and improves motor skills in children with autism spectrum disorder: A randomized controlled trial. Medicine (Baltimore);2026 (May 8);105(19):e48616.

BACKGROUND: Anxiety affects approximately 40% to 50% of children with autism spectrum disorder (ASD), yet evidence-based nonpharmacological interventions remain limited. Trampoline exercise, which combines vestibular stimulation and aerobic activity, may offer dual benefits by reducing anxiety and improving motor skills in this population. To examine the effects of an 8-week trampoline exercise program on anxiety, motor performance, and physiological outcomes (heart rate variability, HRV) in children with mild-to-moderate ASD. METHODS: This assessor-blinded, randomized controlled trial (Registered at Chinese Clinical Trial Registry: ChiCTR2500104402; Date: June 17, 2025) enrolled 50 children with mild-to-moderate ASD (aged 9-14 years) from Shandong Special Education Rehabilitation Center, China. Participants were allocated 1:1 to an 8-week trampoline intervention group (IG, n = 25; 3 sessions/wk, 30 min/session) or a resistance training control group (CG, n = 25). Primary outcomes: anxiety (screen for child anxiety related disorders [SCARED] questionnaire) and HRV root mean square of successive differences (RMSSD). Secondary outcomes: standing long jump (SLJ), one-leg stance with eyes closed (OLS), and BMI (body mass index). Between-group differences were analyzed via Mann-Whitney U tests; effect sizes were reported as Cliff δ (thresholds: small = 0.11, medium = 0.28, large = 0.43). RESULTS: All 50 participants completed the intervention and assessments. Compared with CG, IG showed significantly greater reductions in SCARED scores (Δ = -9.4 vs Δ = 0, false discovery rate-corrected P < .001, δ = -0.92) and improvements in HRV (RMSSD: Δ = +8.51 ms vs Δ = +1.45 ms, false discovery rate-corrected P = .003, δ = -0.66). Standing long jump (SLJ) improved markedly in IG (Δ = +15.0 cm vs CG Δ = +4.0 cm, false discovery rate-corrected P < .001, δ = -0.68). However, one-leg stance with eyes closed (OLS) showed no significant between-group difference after false discovery rate correction (Δ = +0.65 seconds vs Δ = +1.14 seconds, false discovery rate-corrected P = .076, δ = -0.37). BMI remained stable in both groups (false discovery rate-corrected P = .348). CONCLUSION: Trampoline exercise significantly reduces anxiety and enhances lower limb explosive power in children with mild-to-moderate ASD, with effect sizes exceeding clinical thresholds. Its low cost (<$100) and high adherence (85%) support integration into school-based interventions. Future studies should explore long-term effects (3-6 months) and neural mechanisms via functional magnetic resonance imaging.

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20. Mutlu M, Aydoğan Avşar P, Akkuş M, Kara T. Associations of Mothers’ Childhood Trauma and Autistic Traits with Their Adolescent Child’s Attachment Style, Depression and Anxiety. Psychiatry;2026 (May 8):1-15.

OBJECTIVE: Caregivers’ childhood trauma (CT) and autistic traits (AT) are thought to impair the social and emotional competencies essential for proficient parenting. The intergenerational associations through which these caregiver factors affect adolescents’ attachment relationships to with both mothers and peers, as well as their internalizing symptoms, remain unexamined. This study examined the correlation between maternal CT/AT and adolescents’ attachment styles, anxiety, and depression to address this notable gap. METHODS: This cross-sectional study comprised 115 adolescent-mother dyads (aged 12-18, 38.3% male) who sought outpatient clinic services solely for counseling related to adolescent concerns and were without any psychiatric diagnoses. Mothers were evaluated for AT and CT, while adolescents were assessed for parental and peer attachment styles, as well as depressive and anxiety symptoms using standardized instruments. Correlational and serial mediation analyses were conducted. RESULTS: Serial mediation analysis showed that maternal childhood trauma was directly associated with lower parental attachment (β = -0.281, p = .001) and indirectly through depression (β = -0.065, p = .025) and the sequential pathway via anxiety and depression (β = -0.030, p = .042), whereas anxiety alone was not significant. For peer attachment, neither direct nor indirect effects were significant. Maternal AT scores were not significantly associated with adolescent outcomes (all p > .05). CONCLUSIONS: Maternal CT was linked to adolescents’ internalizing symptoms and parental attachment security, with depression mediating these associations. These findings underscore the potential relevance of trauma-informed and attachment-focused interventions, although longitudinal research is needed to clarify causal processes.

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21. Shi M, He JL, Powell H, Lack O, Oeltzschner G, Deronda A, Crocetti D, Wodka EL, Edden RA, O’Muircheartaigh J, Mostofsky SH, Puts NAJ. Distinct sensory atypicalities bridge the gap between brain chemistry and motor dysfunction in autism. Transl Psychiatry;2026 (May 8)

Sensory and motor difficulties are common in autism. Altered excitation-inhibition (E-I) balance is a putative framework for understanding atypical sensory and motor function. We investigated whether sensory differences of autism mediate motor difficulties of autism via differences in E-I balance. 106 children were included in the study (Autism n = 44, Typical development children (TDC) n = 62, age 10.32 ± 1.49). E-I balance was assessed through magnetic resonance spectroscopy (MRS), quantifying Glutamate and Glutamine (Glx) and Gamma-Aminobutyric Acid (GABA) in primary sensorimotor cortex (SM1) and thalamus (Thal). Sensory function was evaluated using both objective vibrotactile perceptual sensitivity assessments and subjective parent ratings via the Sensory Experience Questionnaire (SEQ). Motor ability was assessed objectively through the Movement Assessment Battery for Children-second edition (MABC-2) and the Physical and Neurological Examination for Subtle Signs (PANESS). Our findings reveal that lower sensory reactivity and lower tactile thresholds are both predictive of better motor ability (R(sig) range between 0.32 and 0.57) with higher sensory scores reflecting poorer sensory filtering predicting worse motor function (R(sig) range -0.22 and -0.63). We identified significant associations between MRS-measured Glx and GABA+ levels and sensory reactivity (p < 0.001). Importantly, sensory reactivity sub-scores were found to fully mediate E-I balance to motor associations in domain-specific patterns: Hyper-reactivity mediated the impact of SM1 Glx levels, while hypo-reactivity mediated the impact of SM1 GABA levels. Additionally, sensory seeking mediated the impact of Thalamic GABA levels with all indirect paths ab p < 0.01. These results propose a model where regional metabolite-specific markers of E-I balance explain patterns of autism-associated sensory and motor difficulties, and where subsequently, distinct sensory phenotypes differentially mediate metabolite-motor associations (see Graphical Abstract for detail).

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22. Shih A. Family reflections: bridging the gap between pediatric and adult care in autism. Pediatr Res;2026 (May 8)

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23. Shoaran M, Golshaniniya P, Dadashzadeh Asl A, Sadeghvand S, Valizadeh M, Akbari A. The Effect of Gluten-Free Diet on Gastrointestinal Symptoms and Disease Severity of Autistic Children: A Randomized Controlled Trial. Iran J Child Neurol;2026;20(2):29-38.

OBJECTIVES: Autism Sspectrum Disorder (ASD) is a kind of neurodevelopmental disease characterized by difficulties in social interactions, verbal and non-verbal communication, movement limitations, and repetitive movement patterns. The goal of this study is to investigate the effects of a Gluten-Free Diet (GFD) on gastrointestinal (GI) and neurological symptoms in patients diagnosed with autism. MATERIALS & METHODS: In this study, 120 patients with autism from Tabriz Children’s Hospital and Sheikh Al-Rais Clinic were included. Neurologists and psychologists confirmed the diagnosis of autism using the M-CHAT-R/F questionnaire. Based on the patients’ clinical history and Rome 3 criteria, GI symptoms such as diarrhea, constipation, vomiting, and abdominal discomfort were detected. A Gluten Free Diet was advised, and the parents received nutrition education and ongoing autism therapies. The control group consisted of children who received specialized medications for autism while maintaining a regular diet. These children were monitored closely. RESULTS: The average age of the patients was 9.27 ± 3.25 years with a median of nine years. Fifty-two patients (47.3%) were boys, and fifty-eight patients (52.7%) were girls. The severity of ASD, as measured by the M-CHAT-R/F scale, was significantly reduced at the 12th month in the intervention group. Furthermore, significant improvements in speech, cognition, and behavior have been observed in patients in the intervention group after using a GFD. Moreover, GI symptoms, including nausea and vomiting, constipation, abdominal pain, and discomfort, were significantly decreased in the intervention group. However, the GI symptoms in the control group did not show any statistically significant difference compared to the 12th month. CONCLUSION: According to the results obtained in this study, the administration of GFD in children with ASD can significantly lead to the improvement of GI disorders and neurological symptoms regarding the severity of autism in speech, cognition, and behavior.

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24. Spinazzi NA, Rea H, Santoro JD, Pawlowski K, Baumer N, Patel L, Olsen D, Sargado S, Channell MM. Practice Patterns and Barriers in the Assessment and Treatment of Autism Spectrum Disorder in Children With Down Syndrome. J Intellect Disabil Res;2026 (May 8)

BACKGROUND: Autism spectrum disorder (ASD) is common in individuals with Down syndrome (DS), with an estimated prevalence of 16%-18%. However, receiving a dual diagnosis of Down syndrome and ASD (DS + ASD) is often delayed. Little evidence exists on the path to ASD diagnosis nor interventions to support individuals with DS + ASD. Barriers to diagnosis and treatment for this unique patient population have yet to be described. This study explores clinicians’ practices and perceptions regarding the diagnosis and treatment DS + ASD, and the barriers their patients face in connecting to recommended evaluations and services. METHODS: The study used an anonymous web-based survey developed by a group of physicians, psychologists and researchers who work with individuals with DS, ASD and DS + ASD. The survey queried clinicians from various specialties about their practice patterns regarding assessment of suspected ASD in individuals with DS. The survey inquired about treatment recommendations for DS + ASD and perceived barriers to connecting families with evaluations and services. Data analysis involved descriptive statistics and Mann-Whitney U tests. RESULTS: Most respondents believe diagnosing ASD in individuals with DS significantly impacts management. Challenges were reported in accessing diagnostic evaluations, with heavy reliance on highly specialised DS and ASD clinics. Communication impairment (n = 64, 65%), aggressive behaviours (n = 38, 39%), self-injurious behaviours (n = 33, 34%) and adaptive skills (n = 27, 28%) are priority targets for intervention, and applied behavioural analysis (ABA) (n = 80, 82%), speech therapy through insurance (n = 60, 61%), augmentative and alternative communication evaluation through insurance (n = 59, 60%), and occupational therapy through insurance (n = 57, 58%) are the most frequent referrals following a diagnosis of DS + ASD. All respondents identified multiple barriers to care for individuals with DS + ASD, including waitlists, insurance networks and requirements, lack of experienced providers and high turnover. CONCLUSION: This study highlighted the complexity of caring for individuals with DS + ASD, revealed the heterogeneity of practice patterns among providers, and reported multiple barriers to care for this underserved patient population. Results should prompt work aimed at redressing barriers to care and additional research in the field of effective interventions for individuals with DS + ASD.

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25. Srinivasan H. Silent signals: Autism, disability, and heat vulnerability in a warming world. Glob Public Health;2026 (Dec 31);21(1):2671510.

Extreme heat is among the most severe climate hazards, driving substantial preventable morbidity and mortality worldwide, yet autistic and disabled people remain largely invisible within adaptation and health policy. Differences in thermoregulation, interoception, and sensory processing can mute awareness of heat stress, while poverty, inaccessible housing, and exclusion from emergency planning amplify danger. Historical heatwaves reveal how disability invisibility turns preventable stress into tragedy, and these inequities are even sharper in low-resource settings where cooling infrastructure is scarce. This commentary argues that climate resilience must include disabled embodiment as a dimension of global justice. Disability-inclusive heat adaptation-co-designed with autistic and disabled communities and grounded in universal design and human rights-offers a feasible path toward equitable survival in a warming world.

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26. Tateno Y, Monden R, Kumagai K, Tateno M. Effectiveness of the Early Start Denver Model (ESDM) as an early intervention for young children with autism spectrum disorder in clinical settings in Japan: A non-randomized controlled trial. PCN Rep;2026 (Jun);5:e70340.

AIM: The Early Start Denver Model (ESDM), a core Naturalistic Developmental Behavioral Intervention (NDBI), promotes developmental gains in young children with autism spectrum disorder (ASD) through socially embedded learning. Because high-intensity ESDM programs (approximately 20 h/week) are difficult to implement in many Japanese clinical settings, this study evaluated the effectiveness of a low-intensity ESDM program using standardized assessments. METHODS: A non-randomized controlled design was employed with 47 toddlers aged 18-36 months with a confirmed ASD diagnosis. Thirty participants were allocated to the intervention group, while 17 participants were assigned to the control group and received treatment as usual. Unlike the original ESDM randomized controlled trial implementing approximately 20 h/week, the intervention group (ESDM group, n = 30) received 60-min ESDM sessions once weekly for 24 weeks, with parents present during sessions. Outcomes were assessed before and after intervention using the Autism Diagnostic Observation Schedule-2 (ADOS-2), Kyoto Scale of Psychological Development 2020 (KSPD-2020), and Vineland Adaptive Behavior Scales-II (Vineland-II). RESULTS: Analysis of covariance (ancova) controlling for baseline scores revealed a significant group difference in the KSPD-2020 all domains developmental quotient (DQ) (p = 0.0416). Trend-level differences were observed in the postural-motor domain (p = 0.0811) and the cognition-adaptation domain (p = 0.0555). No significant between-group differences were found in the other outcome measures. Adaptive behavior showed modest increases in communication and socialization, although between-group differences were not statistically significant. CONCLUSION: Although the original ESDM recommends intensive delivery exceeding 15 h per week for 2 years, the present findings provide preliminary evidence that a low-intensity ESDM program-delivered once weekly for 24 sessions-can support meaningful developmental progress, even when changes in core autism symptoms are not detected after statistical adjustment in toddlers with ASD in Japanese clinical settings. These results highlight the feasibility of adapting ESDM principles to low-intensity service environments and underscore their potential applicability within Japanese cultural and systemic contexts.

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27. Tuo X, Zhou HY, Wang Y. Social Priors and Mentalizing Connectivity Across Autistic and Schizotypal Traits. Soc Cogn Affect Neurosci;2026 (May 8)

Autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) both involve social-cognitive difficulties but may rely on opposite predictive mechanisms. Predictive-coding and diametrical accounts propose weak priors in ASD versus strong priors in SSD. We tested whether autistic and positive schizotypal traits differentially shape the use of social priors when interpreting ambiguous social cues. Two studies with non-clinical adults employed an adapted Animated Triangles Task (ATT) with three cueing conditions: Random-Uncued, Random-Cued, and ToM-Cued. Study 1 (n = 71) assessed behavior; Study 2 (n = 45) combined behavioral data with task-based functional magnetic resonance imaging (fMRI), including region-of-interest (ROI) and psychophysiological interaction (PPI) analyses of the temporoparietal junction (TPJ), medial prefrontal cortex (mPFC), and cerebellar Crus II. Social-attribution ratings increased across conditions, confirming the cueing manipulation. At the uncorrected level, higher positive schizotypal traits were associated with greater social attribution without cues, whereas higher autistic traits were associated with lower intention ratings despite strong cues. ToM-Cued trials activated the mentalizing network. Both trait dimensions showed exploratory associations with reduced mentalizing-network connectivity. These preliminary findings suggest potentially shared neural patterns coupled with divergent behavioral responses across the autism-psychosis trait continuum, pending further validation with larger sample sizes and adjusted statistical analyses.

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28. Udeshi A, Smout S, Caballero M, Rapp A, Kolevzon A, Mahjani B, Jung S. SHANK3-anchored reverse phenotyping identifies a rare-variant-enriched cognitive-motor subgroup of autism. medRxiv;2026 (May 8)

Rare deleterious variants in SHANK3 are established causes of autism spectrum disorder (ASD), but the extent to which they define a phenotypically and genetically coherent ASD subgroup remains unclear. Using the SPARK cohort, we identified 132 SHANK3 variant carriers; 108 had phenotype data and were compared with 47,555 non-carrier ASD cases. SHANK3 damaging variant carriers showed lower cognitive ability, poorer motor coordination, and delayed developmental milestones. Protein-truncating variant and deletion carriers showed similarly severe phenotypic profiles, whereas duplication carriers did not differ from non-carriers. A combined threshold of intelligence quotient (IQ) < 70 and impaired motor coordination (DCDQ total score) < 35 defined a discriminative cognitive-motor phenotype among cases meeting this cognitive-motor phenotype. Beyond SHANK3 , SLC6A1 was the only additional gene reaching false discovery rate significance, while pathway analyses implicated synaptic and chromatin-related processes. Phenotype-meeting cases did not show elevated ASD polygenic risk, supporting a rare-variant-enriched cognitive-motor subgroup within ASD.

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29. Umehara H, Takeda T, Matsuura K, Irizawa K, Abe Y, Masuda T, Kamiyama Y, Yamada N, Numata S. Group CBT targeting hostile attribution bias in adolescents and young adults with ASD traits. Front Psychiatry;2026;17:1796850.

BACKGROUND: Adolescence is characterized by heightened self-consciousness and sensitivity to social evaluations. During this period, hostile attribution bias-interpreting ambiguous social cues as hostile-can lower quality of life (QOL) and contribute to future mental health problems. Adolescents with autism spectrum disorder (ASD) show similar difficulties, often more pronounced due to their cognitive style and interpersonal vulnerabilities. Group cognitive behavioral therapy (CBT) aims to correct such biases through structured cognitive and social experiences. This study evaluated the psychological effects of group CBT on hostile attribution bias, social functioning, and QOL in adolescents and young adults with ASD traits. METHODS: We conducted an 8-session group CBT program focusing on hostile attribution bias and suspiciousness in 21 adolescents and young adults with ASD traits attending a hospital psychiatric outpatient department. The 15 participants who completed the program were included in analyzes. Psychological indices included hostile attribution bias (Ambiguous Intentions Hostility Questionnaire), social functioning (Social Responsiveness Scale, Second Edition [SRS-2]), and subjective QOL. Pre-post changes were quantified as change rates ((post – pre)/pre × 100). Group-level changes were tested with paired analyzes; exploratory associations among change rates were examined using Spearman correlations. RESULTS: Group CBT significantly improved hostile attribution bias (effect size [ES] = 0.698, p = 0.017), social communication and interaction (SRS-2; ES = 0.780, p = 0.012), and subjective QOL (ES = 0.752, p = 0.011). Exploratory individual-level analyzes showed a discordant pattern: smaller reductions in hostile attribution bias (less negative change rates) were associated with greater increases in subjective QOL (ρ = 0.597, p = 0.019). CONCLUSIONS: This pilot study suggests that group CBT may reduce hostile attribution bias and improve QOL and social functioning in adolescents and young adults with ASD traits. Notably, the positive correlation between hostile attribution bias change rates and QOL change rates suggests that greater QOL gains were not necessarily accompanied by larger reductions in hostile attribution bias, indicating that improvements in cognitive bias and perceived well-being may arise through partly distinct or non-linear pathways rather than a simple one-to-one relationship. CLINICAL TRIAL REGISTRY: University Hospital Medical Information Network (UMIN000030140).

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30. Vanneau T, Brittenham C, Darrell M, Foxe JJ, Molholm S. Neural oscillatory dynamics reveal altered top-down and integrative mechanisms during face processing in autistic children and unaffected siblings of autistic children. J Neurodev Disord;2026 (May 8)

Face processing is fundamental to social communication and has been a major focus of autism research. While event-related potential (ERPs) studies of face processing have produced mixed results, little work has examined neuro-oscillatory dynamics, which may better capture the integrity of underlying networks. To address this gap, EEG was recorded from children aged 8-13 across three groups: autistic (n = 50), non-autistic (n = 38) and siblings of autistic children (n = 26), during a visual oddball task. In a blocked design, participants viewed faces and objects, presented upright and inverted (non-targets), to assess the face inversion effect (the FIE; a larger or delayed N170 to inverted than upright faces), and responded to infrequent shadow versions (targets). Analyses using permutation statistics and linear mixed models focused on non-target stimuli, quantifying face-related ERPs (P1, N170) and oscillatory activity associated with sensory and attentional processing (theta, alpha, gamma). Across groups, faces elicited earlier P1 and larger N170 amplitudes than objects, and showed a FIE. Furthermore, the rightward lateralization of the FIE was reduced for autistic participants. Analyses in the frequency domain revealed greater induced theta for inverted versus upright stimuli and for faces versus objects, revealing face specific effects, and stronger theta for inverted faces for the autistic and sibling groups, suggesting greater cognitive effort in processing these social stimuli. Gamma-band inter-trial phase coherence exhibited face selectivity only in the non-autistic group, pointing to differences in early network synchronization in autistic children relative to their non-autistic peers, whereas alpha event-related desynchronization did not vary by group or category. Altogether, these findings support altered neural synchronization/efficiency for autistic participants and siblings of autistic children, that is specific to face stimuli and seen despite largely typical sensory driven encoding. These data suggest that neural oscillatory assays are more sensitive to face processing differences in autism than broadband ERPs and that these oscillatory assays may be endophenotypic.

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31. Wu T, He J, Xu CJ, Li CY, Zhang P, Wang Y, Zhu S, Zhang L, Zhu J, Zhang J, Li JD, Liu H. Reciprocal regulation between autism risk gene POGZ and circadian clock. JCI Insight;2026 (May 8);11(9)

Sleep disturbance is a prevalent yet poorly understood comorbidity in autism spectrum disorders (ASD). Here, we uncover a bidirectional regulatory axis connecting the ASD risk gene POGZ to core circadian mechanisms. We demonstrate that Pogz is widely expressed in the suprachiasmatic nucleus (SCN), the central pacemaker of the circadian rhythms, and exhibits circadian oscillations in both the hypothalamus and liver, with its transcription directly regulated by the circadian molecule DBP through a D-box element in its proximal enhancer. Pogz-deficient mice exhibited prolonged circadian periodicity, impaired light-induced phase shift, delayed adaption to an 8-hour advance jet-lag, and reduced SCN c-Fos activation in response to light pulses. Mechanistically, POGZ interacts with and enhances the transcription activity of CREB, a key regulator of light-induced phase resetting. Notably, Pogz deletion leads to ASD-related deficits in social novelty and cognition, with cognitive impairments influenced by both photoperiod and behavioral paradigm. Our findings, thus, reveal a critical, previously unrecognized intersection between an ASD risk gene and circadian clock, offering insights into the pathogenesis of core ASD symptoms and comorbid sleep disturbances.

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