1. Akıncı Coşgun A, Ucar Cabuk F, Sardohan Yildirim AE. Why is teaching math to my child difficult? Experiences from mothers of children with autism spectrum. Front Psychol. 2026; 17: 1918249.

INTRODUCTION: Children’s mathematics learning processes are significantly shaped by parental involvement in their home environments. In the context of children with autism, this process takes on a unique structure owing to individual characteristics and learning dynamics. However, the literature offers limited findings regarding how parents of children with autism structure mathematics instruction and the strategies they use. This study aimed to examine the perceptions of parents of children with autism regarding mathematics instruction and the teaching approaches and strategies they use at home to teach mathematics. In addition, it addresses how autism-specific characteristics affect the mathematics teaching process. METHODS: This study used a qualitative research approach to examine mothers’ experiences and perceptions of the processes of learning and teaching mathematics at home for children with autism. RESULTS: The findings indicate that parents mostly teach mathematics in the context of daily life, using natural and interaction-based approaches. Game-based practices, asking questions, and using concrete materials were the strategies most frequently employed by the participants. Moreover, mothers perceived certain autism-related characteristics as influencing the mathematics teaching process at home. CONCLUSION: It was determined that parents require professional support during the mathematics teaching process. Additionally, mothers perceive school as a more effective learning environment than home for teaching mathematics, value school-family cooperation, and believe that peer interaction plays a supportive role.

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2. Alalwan TA, Perna S. Maternal diet and offspring ASD and ADHD: A critical narrative review of dietary patterns, choline, and polyphenol-related exposures. Behav Brain Res. 2026; 517: 116512.

Maternal diet may influence fetal neurodevelopment through nutrient availability, placental function, and maternal-fetal metabolite signaling. This critical narrative review used a structured, purposive search to organize human evidence on prenatal dietary patterns, choline, and polyphenol-related exposures according to outcome directness: diagnosed autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD), related dimensional traits, and general neurodevelopment. Whole-diet studies provide the most direct human evidence, but diagnostic findings are cohort-dependent and vulnerable to residual familial and genetic confounding. Choline trials and cohorts mainly address attention-related traits or general cognition; they do not establish prevention of diagnosed ASD or ADHD. Polyphenol evidence is limited to food proxies and one trimester-specific cohort of estimated intake, without diagnostic or biomarker-based studies. Preclinical data support biological plausibility-particularly for choline in BTBR, maternal immune-activation/CHRNA7, and Ts65Dn models and for resveratrol in valproate-exposed rodents-but remain model-specific. The evidence is therefore best treated as an organizing framework rather than a confirmed causal hypothesis. Clinical translation should prioritize achieving recommended dietary adequacy and balanced dietary patterns; evidence does not support high-dose single-nutrient or concentrated-polyphenol supplementation for ASD/ADHD prevention.

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3. Amarante P, Gomes JG. From the emergence of psychiatry to neoliberal logic: the commodification of contemporary suffering. Cien Saude Colet. 2026; 31(9): e18132025.

This study discusses the concepts of normality and pathologization in contemporaneity from a historical context of the emergence and growth of psychiatry associated with the development of neoliberalism. The psychiatric knowledge begins to grown allied to an economic management of the government, transforming the suffering in commodity. Therefore, the psychiatric reform face challenges against the asylum logic, still present in society, which seeks to catalog diseases and diagnose natural issues of everyday life. Thus, we seek to understand how neoliberal logic is associated with psychiatric knowledge and consequently influences the increase in diagnoses of mental disorders in contemporary times. To achieve this goal, we analyzed journalistic articles and scientific research that address the increase in diagnoses of Autism Spectrum Disorder (ASD) and Attention Deficit with Hyperactivity Disorder (ADHD). It was concluded that it is still necessary to question the influences of psychiatric knowledge and the pharmaceutical industry on what is transmitted to society regarding this subject.

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4. Baweja R, Waschbusch DA, Malhi N, Weiss MD, Murray M, Waxmonsky JG. Treatment Patterns and Clinical Outcomes in Youth With Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder. JAACAP Open. 2026; 4(5): 809-22.

OBJECTIVE: The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) is common and associated with greater clinical complexity. This study evaluated real-world treatment patterns and outcomes among children and adolescents with ADHD, comparing those with and without comorbid ASD. METHOD: A retrospective comparative cohort study analyzed electronic health records from the TriNetX Research Network, including 869,510 children and adolescents aged 3 to 18 years with ADHD, of whom 155,543 (17.9%) had ASD. Outcomes included treatment patterns and clinical outcomes. Analyses used propensity score matching and Cox proportional hazards models adjusted for sociodemographic and psychiatric factors, estimating relative risks (RRs), hazard ratios (HRs), and 95% confidence intervals over 1 year. RESULTS: Children and adolescents with ADHD+ASD had higher psychiatric comorbidity and health care use than those without ASD. They received fewer CNS stimulant prescriptions (RR = 0.82, 95% CI = 0.81-0.83) but a higher proportion of non-stimulant prescriptions (RR = 1.52, 95% CI = 1.50-1.54) compared with those without ASD. Slightly higher ADHD prescribing occurred among Hispanic youth (RR = 1.03) and preschoolers (RR = 1.23) with ASD compared to those without ASD. Within the ADHD+ASD cohort, CNS stimulants were associated with the most favorable outcomes, including reduced hospitalization, emergency visits, suicidal behaviors, and subsequent antipsychotic/mood stabilizer initiation (adjusted HRs 0.33-0.83). Atomoxetine showed relatively favorable outcomes among non-stimulants. CONCLUSION: Comorbid ASD in children and adolescents with ADHD increases clinical burden and shifts treatment from CNS stimulants to non-stimulants and other psychotropics. Despite lower use, CNS stimulants are associated with improved outcomes, underscoring the need for prospective studies examining the risk-to-benefit ratio in this population. Youth with both attention-deficit/hyperactivity disorder (ADHD) and autism often have complex needs. This study compared real-world treatment of youth with both ADHD and autism to treatment of youth with ADHD alone. Youth with both ADHD and autism had more complex clinical presentations and were prescribed fewer stimulants and more nonstimulants compared to youth with ADHD alone. Although stimulant medications were associated with better outcomes, more research on the relative risks and benefits of stimulants is needed for youth with ADHD and autism. eng.

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5. Boscato A, Milesi L, Biagioli M, Tata A. Primary cilia as a molecular convergence hub linking neurodevelopment and autism spectrum disorder. Front Cell Neurosci. 2026; 20: 1914796.

The primary cilium, a highly conserved microtubule-based organelle, orchestrates a broad repertoire of signal transduction cascades required for embryonic development, tissue homeostasis and cellular communication. Disruption of ciliary structure or function results in a heterogeneous group of multisystem disorders known as ciliopathies. Emerging genomic and transcriptomic evidence indicates that perturbation of ciliary architecture or signaling may also contribute to neurodevelopmental conditions and specifically to autism spectrum disorder (ASD). Genes linked to ASD show a wide range of genetic and phenotypic characteristics: spanning from syndromic neurodevelopmental disorders with overlapping ciliopathy features to idiopathic ASD. Yet the mechanistic contribution of ASD risk genes to ciliary biology remains insufficiently characterized. This study aims to explore the molecular convergence between ciliopathies and ASD by systematically interrogating ciliary gene datasets (CiliaCarta and SysCilia GSv2) in cross-comparison to ASD-associated gene repositories (SFARI Gene). This integrative analysis identifies 105 high-confidence shared genes, which segregate into four mechanistic modules: (i) structural determinants of cilium assembly and maintenance, (ii) components of cilium-dependent signaling pathways, (iii) regulators of cilium-associated gene expression and (iv) cilium associated pathways. We propose that ciliary dysfunction constitutes a convergent mechanism, perturbing neurodevelopmental signaling, neuronal polarity and synaptic maturation in a subset of ASD cases. Clarifying the role of the genes shared between ciliogenesis and neurodevelopmental signaling will refine genotype-to-phenotype correlations, expand the spectrum of cilia-associated neurodevelopmental disorders and potentially uncover therapeutically actionable hubs within cilium-dependent signaling circuitry.

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6. Conrad CE, Ziegler SMT, Bilenberg N, Christiansen J, Davidsen KA, Fagerlund B, Færk E, Jakobsen H, Jakobsen RH, Jeppesen P, Kamp C, Kilburn TR, Thomsen PH, Varenne M, Vestergaard M, Jakobsen JC, Lauritsen MB. Parent-mediated interventions versus usual care in children with autism: A systematic review with meta-analysis and Trial Sequential Analysis. medRxiv. 2026.

OBJECTIVES: To evaluate the positive and adverse effects of parent-mediated interventions (PMIs) versus care as usual for children with autism. SETTING: Systematic review and meta-analysis and Trial Sequential Analyses (TSA), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS: We searched for randomised clinical trials of PMIs for children with autism in the databases CENTRAL, EMBASE, LILACS, PsycINFO, MEDLINE, and SCI-EXPANDED (up to 13 August, 2025), complemented with manual searches. 12,359 articles were screened. Data were synthesised using meta-analyses and Trial Sequential Analyses (TSA), and risks of bias and certainty of the evidence were evaluated. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was autism characteristics. Secondary outcomes were adverse effects, child adaptive functioning, child language, child and parent quality of life, and parental stress. Ten exploratory outcomes were included. RESULTS: 32 trials (N=1,625) comparing PMIs to usual care, waiting list, or no intervention were included. All trials had a high risk of bias. The multiplicity-adjusted threshold for statistical significance was p = 0.013 due to the number of outcomes. Meta-analyses and TSAs showed it could be rejected that PMIs reduced autism characteristics (MD = -0.88; 95% confidence interval -2.92 to 1.15; p = 0.05, 4 trials, N =353, low certainty), child adaptive functioning (7 trials, N =408), child language (4 trials, N =308), or parental stress (7 trials, N =385). Due to insufficient data, the remaining secondary meta-analyses could not be conducted. Meta-analyses of exploratory outcomes showed beneficial effects concerning child behaviour problems and parent sensitivity/synchronicity. CONCLUSIONS: This meta-analysis found no benefits of PMIs on child autism characteristics, child adaptive functioning, child language, or parental stress. Benefits were found in reduction of child behaviour problems and improved parent sensitivity/synchronicity. The evidence remains uncertain, and more trials including outcomes of adverse effects and quality of life are needed. TRIAL REGISTRATION: CRD42022385188 PROSPERO.

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7. Cross K, Knott F, James AI. Invisible Needs and Uneven Recognition: A National FOI Study of Autism Support Across Diagnostic Stages in U.K. Universities. Autism. 2026: 13623613261489841.

This study investigates how universities in the United Kingdom identify and support autistic students across three groups (diagnosed, seeking diagnosis, self-identifying without wishing to pursue a diagnosis). In addition, it examines communication practices and interim adjustments. Freedom of Information (FOI) request questionnaires, issued under Freedom of Information Act (FOIA) 2000 and FOI (Scotland) Act 2002, were submitted to 142 publicly funded U.K. universities, generating 125 valid responses (88%). The 77-item FOI questionnaire comprised multiple-choice and open-text items. Data were analysed descriptively and using qualitative content analysis. Results revealed 50% of institutions reported data on formally diagnosed autistic students, 16% on students seeking diagnosis and 7% on students who self-identify without wishing to pursue diagnosis. Only 2% of universities reported formal policy guiding disability staff when responding to undiagnosed autistic students. The findings suggested that institutional practices varied across universities and by diagnostic group. Staff judgement and discretion mostly determined availability of support and adjustments. Support was frequently dependent upon diagnostic evidence. Reliance on individual staff decisions may contribute to variability in support across the three groups of autistic students. Therefore, future research should focus on the experiences of autistic university students across the three groups and how they navigate university and institutional support.Lay AbstractThis study looks at how U.K. universities recognise and support autistic students. We focused on three different types of autistic students: those who enter university with a formal autism diagnosis, those currently seeking an autism diagnosis and those who consider themselves autistic but do not wish for a formal autism diagnosis. Currently, there has been little research about how universities identify these students or decide what help to offer. To gain a better understanding, we sent detailed questionnaires to every publicly funded university in the United Kingdom using Freedom of Information requests. This approach meant that publicly funded universities were legally required to provide information about their policies and practices. We received 125 valid responses out of 142 universities, an 88% response rate. Our questionnaire included multiple choice questions and areas in which universities could provide extra information if they wished. This allowed us to gather numbers and real-world examples from staff working in university disability support services. After data analysis, results showed that only half of universities kept records on students with a formal autism diagnosis. Fewer collected information about students seeking a diagnosis (16%) or who self-identify as autistic without wishing for a diagnosis (7%). Just 2% had a formal policy guiding staff on how to support students who do not have a diagnosis. In most cases, adjustments and support for undiagnosed students were left to staff judgement, and often depended on providing medical evidence, even though the law says support should be given based on need, not just diagnosis. These findings highlight large differences in how universities identify and support autistic students, especially those without a formal diagnosis. This raises important questions about fairness and consistency, and what more can be done to ensure all autistic students can access the help they need during their studies.

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8. Del Giorgio F, Driollet B, Buajitti E, Ahmed A, Hutcheon JA, Rosella L, Yang S. Disparities in Autism Spectrum Disorder and Perinatal Risk Factors. JAMA Netw Open. 2026; 9(10): e2637174.

IMPORTANCE: In universal health care settings, trends in autism spectrum disorder (ASD) diagnosis remain poorly characterized, yet are critical for identifying inequities that persist despite more equitable health care access. OBJECTIVE: To describe temporal trends in ASD diagnosis and in perinatal risk factors for ASD across maternal socioeconomic and immigration factors. DESIGN, SETTING, AND PARTICIPANTS: This is a population-based retrospective cohort study of children born in Ontario, Canada (2002-2020), linked to maternal health, immigration, and census data. Children were followed up from age 1 year until ASD diagnosis, death, out-migration, or April 2020. Data analysis was performed between August 2024 and March 2026. EXPOSURES: Maternal socioeconomic indicators (area-level deprivation, ethnic diversity, income, Ontario Drug Benefit enrollment, and rural vs urban residence) and immigration characteristics (immigration status, category, time since immigration, region of origin, and country income level). Perinatal risk factors included maternal diabetes, maternal age 35 years or older, severe maternal morbidity, and prematurity. MAIN OUTCOMES AND MEASURES: ASD was identified using a validated administrative algorithm. Incidence rates were calculated per 10 000 person-years and cumulative incidence per 1000 live births at 8 years. Temporal trends were estimated using negative binomial regression with interaction terms between birth year and covariates. RESULTS: Of 2 319 302 children (1 188 270 male [51.2%]), 29 374 (1.3%) met ASD criteria, with 80.0% (23 068 children) receiving a diagnosis by age 8 years and 78.5% of cases (23 071 cases) occurring in male children. Diagnosis increased by 10% per birth cohort (95% CI, 10%-11%). Disparities in ASD diagnosis by socioeconomic and immigration characteristics widened across birth cohorts: by the 2012 birth cohort, diagnosis was 2.2-fold (95% CI, 2.0-2.4-fold) higher in the most vs least deprived neighborhoods, 2.0-fold (95% CI, 1.8-2.2-fold) higher in the most vs least ethnically diverse areas, and lower in rural vs urban regions. Diagnosis was 1.4-fold (95% CI, 1.3-1.5-fold) higher among children of immigrant mothers, with the highest rates among mothers from low- and middle-income regions. Diabetes during pregnancy, severe maternal morbidity, and prematurity were more common in marginalized populations, with disparities in maternal diabetes widening over time. CONCLUSIONS AND RELEVANCE: In this cohort study of more than 2.3 million mother-child pairs, ASD diagnoses occurred disproportionately among children from socioeconomically disadvantaged and immigrant families, with disparities widening over time. The higher prevalence of maternal diabetes, obstetric complications, and prematurity in these populations may have contributed to these differences.

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9. Di X, Biswal BB. Sub-Additive Effects of Autism-ADHD Comorbidity on Resting-State Pupillary and Oculomotor Phenotypes. bioRxiv. 2026.

BACKGROUND: Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) share substantial clinical and physiological overlap. While naturalistic and sensory-driven paradigms increasingly capture evoked neurophysiological responses, the intrinsic baseline physiology of these conditions remains poorly defined. We characterized resting-state pupillary volatility and oculomotor stability across the ASD-ADHD spectrum using dimensional and categorical (DSM-5) frameworks. METHODS: We analyzed resting-state eye-tracking data from a large pediatric cohort (N = 2,315) from the Healthy Brain Network, extracting Pupil Relative Volatility (Coefficient of Variation [CV]) and Bivariate Contour Ellipse Area (BCEA) to index pupillary and spatial gaze stability. Data were evaluated via continuous regressions against Social Responsiveness Scale (SRS) and SWAN inventories, then 2×2 factorial ANCOVAs based on clinical diagnoses, with sensitivity analyses for extreme values, hardware heterogeneity, and psychostimulant medication. RESULTS: Dimensional models revealed no significant association between either metric and continuous ASD or ADHD trait severity, apart from a modest sub-additive SRS × SWAN interaction on pupillary CV; an apparent pooled BCEA-trait association proved attributable to hardware differences and was absent within hardware-consistent subgroups. Categorical models showed robust diagnostic differentiation for both metrics: isolated ASD was associated with elevated CV and impaired BCEA, with ADHD additionally impairing BCEA. Comorbid ASD+ADHD produced a sub-additive CV interaction robust across outlier-resistant, hardware-stratified, and medication-adjusted analyses; an analogous BCEA interaction was directionally consistent but not significant under standard estimation. CONCLUSIONS: Categorical diagnostic status was consistently associated with baseline pupillary and oculomotor physiology across the ASD-ADHD spectrum in this cohort, with a shared sub-additive comorbidity effect most robustly expressed in pupillary volatility; continuous trait severity showed little independent association with either metric. These findings, obtained using a rigorously validated, hardware-heterogeneous multi-site sample, establish a foundation for future naturalistic and sensory-evoked investigations of the shared physiological architecture underlying ASD-ADHD comorbidity.

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10. Egorova O, Domellöf E, Silfverdal SA. Maternal folate receptor alpha autoantibodies and folate levels during pregnancy in relation to autism spectrum disorder: a pilot case-control study. Front Psychiatry. 2026; 17: 1914371.

BACKGROUND: Folate receptor alpha autoantibodies (FRAA) are reported to be associated with autism spectrum disorder (ASD) and are found more frequently in mothers of children with ASD. However, the relationship between maternal FRAA during pregnancy, folate status, and ASD risk in offspring remains unclear. OBJECTIVE: In this exploratory pilot study, we compared maternal serum binding FRAA measured during pregnancy between high-folate ASD cases and childbirth-time-matched mothers of typically developing children. METHODS: FRAA were retrospectively analyzed in serum samples collected between gestational weeks 7 and 18 from women whose children were later diagnosed with ASD (case subgroup, n = 10) and mothers of neurotypical children (control subgroup, n = 10). Case samples were selected based on previously measured elevated folate levels, while controls were selected to minimize differences in biobank storage duration. RESULTS: FRAA were detected in 2 of 10 samples in each group, corresponding to a prevalence of 20%. Although based on limited statistical power, no significant difference in FRAA prevalence was observed. CONCLUSION: In this exploratory pilot study, no difference in binding FRAA prevalence was found between mothers of children with ASD, who were selected for elevated maternal folate levels, and mothers of neurotypical children. While this finding does not support a link between FRAA and elevated maternal folate levels, the small sample size and selection criteria limit interpretation. LIMITATIONS: The study was limited by the small sample size, differences in subgroup selection, uncertainty in gestational age at sampling, and the inability to assess blocking FRAA.

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11. Gabriels RL, Peters C, Pan Z, Merritt T, Widick M, Mazefsky C, Siegel M. Therapeutic Horseback Riding for Youth With Autism and Psychiatric Comorbidities: A Randomized Trial. Pediatrics. 2026.

OBJECTIVE: Autism spectrum disorder care is often complicated by co-occurring psychiatric symptoms. Equine-assisted services show promise for improving behavioral outcomes in this population. We aimed to examine benefits of equine-assisted services for youth with autism at higher risk for mental health interventions. METHODS: A total of 236 youth with autism and psychiatric comorbidity (aged 6-16 years.) were enrolled in a randomized controlled multisite clinical trial, stratified by nonverbal IQ, and assigned to 1 of 3 intervention arms: therapeutic horseback riding (THR), no horse contact barn activity (BA), or waiting period followed by a BA/THR hybrid. Caregivers completed outcome measures. Speech outcomes were evaluated by blinded raters. Intervention methods expand those from a previous efficacy trial. RESULTS: Intent-to-treat analyses with 169 participants completing at least 1 intervention lesson revealed that compared with the waitlist control (n = 28), both THR (n = 74) and BA (n = 67) interventions showed clinically significant reductions in co-primary outcomes of irritability (P < .0001; THR effect size d = 1.15; BA effect size d = 1.04) and hyperactivity (THR P < .0001, effect size d = 1.06; BA P = .005, effect size d = 0.68). The THR group showed significantly greater reductions in hyperactivity compared with the BA group (P = .03; effect size d = 0.39) beginning at intervention week 4. Additional significant improvements in THR and BA groups vs the waitlist control were seen in emotional regulation and social behaviors. CONCLUSIONS: Equine-assisted activities are an effective intervention to address behavior challenges in youth with autism and psychiatric comorbidity; THR may offer additive reductions in hyperactivity.

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12. Giardino M, Pasquini V. Converging etiopathogenetic pathways and early prevention opportunities for autism and neurodevelopmental disorders in the first 1000 days of life: a brief narrative review. Neuropsychiatr. 2026.

Neurodevelopmental disorders, including autism spectrum disorder, result from complex interactions between genetic susceptibility and early-life environmental exposures that shape brain development. Their increasing prevalence represents a major public health challenge, highlighting the need for effective preventive strategies. This brief narrative review synthesizes current evidence on the converging etiopathogenetic pathways-including genetic vulnerability, environmental risk factors, epigenetic regulation, neuroinflammation, and gut microbiome alterations-that operate during the first 1000 days of life and collectively influence neurodevelopmental trajectories. We also discuss early prevention opportunities targeting modifiable risk factors during this critical developmental window, when heightened neuroplasticity may maximize the effectiveness of preventive interventions. Viewing autism spectrum disorder and related neurodevelopmental disorders through the lens of shared biological mechanisms, provides a framework for precision prevention, facilitates earlier identification of at-risk individuals, and supports the development of multidisciplinary strategies aimed at improving lifelong neurodevelopmental health and reducing the long-term burden on affected individuals, families, and healthcare systems.

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13. Hatahet M, Chau NM, Sárváry A, Sárváry A. Complementary and Alternative Medicine Use Among Families of Children with Autism Spectrum Disorder Attending Five Autism Centres in Arab Countries: Associations with Sociodemographic Factors and Health Literacy. Healthcare (Basel). 2026; 14(19).

Background: Complementary and alternative medicine (CAM) therapies are commonly used among children with autism spectrum disorder (ASD). This study aimed to examine parental attitudes toward CAM, in addition to patterns of its use and associated factors among children with ASD in Arab countries. Methods: In this cross-sectional survey, 142 questionnaires from five Arab countries (Qatar, the Kingdom of Saudi Arabia [KSA], Kuwait, Jordan, and Libya) were analysed. Results: The most reported CAM modalities included dietary supplements such as multivitamins and fish oil, as well as the questionnaire item labelled « holding therapy ». The main reason for CAM use reported by parents was the desire to try all possible therapy options for their child and reduce stress (35.5%), followed by improving their child’s quality of life (32.6%). The regression models showed that better verbal ability was associated with greater use of these therapies (use of short/complex sentences vs. does not talk: biologically based therapies, OR = 5.35, 95% CI 1.58-18.56; mind and body practices, OR = 4.30, 95% CI 1.66-11.23). The models also showed an association between the male sex and the use of mind and body practices (OR = 3.28, 95% CI 1.23-8.92). Conclusions: CAM use was common in this sample. Healthcare professionals should provide balanced, evidence-based information and encourage non-judgmental discussion of CAM use. Improving health literacy and access to reliable information may support safer decision-making.

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14. Hegarty JP, 2nd, Komaki H, Gu M, Young K, Ogbonnaya N, Spielman DM, Hardan AY. Cerebellar Crus I and Crus II Structure and Excitation/Inhibition Balance in Autism Spectrum Disorder. J Autism Dev Disord. 2026.

PURPOSE: Cerebro-cerebellar network dynamics are highly implicated in autism spectrum disorder (ASD), particularly the posterolateral cerebellar hemispheres. Cellular alterations in the cerebellum are also consistently reported in post-mortem research, suggesting potential impacts on the balance between excitatory glutamatergic (Glu) and inhibitory GABAergic signaling (E/I). Emerging evidence further indicates that the cerebellum supports multiple cognitive and behavioral domains associated with the diagnostic criteria for ASD. METHODS: The current study collected structural T1-weighted MRI and novel (1)H MR spectroscopy data (MEGA-SPECIAL) to examine neurometabolites of Glu and GABA from the cerebellar hemispheres of autistic (n=13) and neurotypical children (n =16). We also explored preliminary comparisons with autistic adolescents (n=7) and assessed relationships for social communication, restricted and repetitive behaviors, and sensory processing differences. RESULTS: Crus I and II were significantly thinner in autistic children compared to neurotypical children. While there were no significant group differences in the subset of participants with quality neurometabolite measurements, p > 0.05, there were salient relationships between E/I, cerebellar structure, and core ASD domains. Thinner Crus I grey matter and smaller Crus II volume were correlated with higher E/I, especially for Glu in left Crus I and right Crus II. Morphometric properties and E/I were also associated with self-injurious and other restricted and repetitive behaviors. CONCLUSION: Our preliminary findings are limited by the small sample size but suggest a potential relationship between cerebellar structure, the balance of excitation-inhibition in cerebro-cerebellar networks, and the core domains of autism spectrum disorder.

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15. Ho LC, Wei LC. Social Anxiety Should be a Routine, Autistic-Led Treatment Target. Autism Res. 2026: e70377.

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16. Kemp E, Yates S, Quincy L, Watson-Grace A, Crasta J. Treatment Fidelity of AquOTic: An Occupational Therapy-Based Aquatic Intervention for Children on the Autism Spectrum. Am J Occup Ther. 2026: 19437676261493015.

ImportanceChildren on the autism spectrum face significantly higher risks for unintentional drowning, yet aquatic interventions often lack the standardized specification necessary for evidence-based replication.ObjectiveTo examine the treatment fidelity of AquOTic.DesignDescriptive design based on a larger randomized controlled trial.SettingCounty Board of Developmental Disabilities therapy pool.ParticipantsChildren on the autism spectrum (N = 37) ages 5 to 9 year and graduate-level therapy students (swim buddies, N = 18).InterventionAquOTic is a manualized 10-week occupational therapy-based water competency intervention for children on the autism spectrum.Outcomes and MeasuresAdherence was measured via a 13-item fidelity self-checklist and video-coding analysis.ResultsHigh overall fidelity was achieved, with mean swim buddy adherence at 95.93%. Component-level fidelity averaged 97.36%, with core ingredients such as play-based strategies, modeling, and water property integration consistently appearing in 100% of analyzed sessions.Conclusions and RelevanceThe AquOTic intervention demonstrates high treatment fidelity, confirming that theorized active ingredients are consistently implemented. Use of fidelity practices and intervention specification supports the reproducibility and clinical translation of occupational therapy-led aquatic interventions to improve water safety for autistic children. Children on the autism spectrum are at higher risk of accidental drowning, but many therapeutic water safety programs are not clearly described, making them hard to repeat and study. This study looked at the delivery of AquOTic, a 10-week, occupational therapy-based water competency intervention. We worked with 37 autistic children and 18 trained graduate therapy students (“swim buddies”). We measured how well the intervention was followed using a checklist and by reviewing videos of sessions. We found that AquOTic was delivered very consistently. Key components, such as play-based activities, modeling skills, and using the properties of water to support learning, were used in every session we analyzed. These results show that AquOTic can be delivered reliably. This is important because clearly defined and consistent programs are easier to use in real-world settings. Ultimately, this may help improve water safety and reduce drowning risk for autistic children. eng.

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17. Kim B, Luyster R, Bishop J. Spaciousness as an acoustic measure of prosody in autistic children. JASA Express Lett. 2026; 6(10).

Distinctive prosody has been reported in autism, yet acoustic studies have yielded inconsistent findings, particularly for F0-related measures. Two dynamic measures, spaciousness (magnitude of pitch excursions) and wiggliness (rate of pitch-direction changes), offer alternatives, but spaciousness has not yet been applied to English-speaking autistic children. The present study therefore compared acoustic characteristics of prosody from autistic and language-skill matched nonautistic children (age 3-7) using spaciousness, wiggliness, F0 measures (mean, standard deviation, and range), and speech rate. Linear mixed-effects models revealed that only spaciousness showed significant group differences, and these differences were independent of utterance length. Replication in larger samples is warranted.

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18. Kuşdoğan E, Bingül İ, Soylu N, Küçükgergin C, Karayağmurlu A. Serum levels of FGF-2, VEGF, and EGF and repetitive behaviors in pediatric ASD, OCD, and comorbid groups. J Psychiatr Res. 2026; 204: 38-48.

Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) exhibit notable phenomenological overlaps. However, relatively few studies have simultaneously examined both the biological mechanisms and phenomenological overlaps of these two conditions. The aim of this study is to examine serum fibroblast growth factor 2 (FGF-2), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) levels and their phenomenological characteristics in patients diagnosed with ASD, OCD, and ASD + OCD. The study sample consisted of 84 children categorized into ASD, OCD, and comorbid ASD + OCD groups. Serum concentrations of FGF-2, VEGF, and EGF were quantified using the enzyme-linked immunosorbent assays method. Concurrent clinical severity and symptom profiles were rigorously assessed using the Childhood Autism Rating Scale, Children’s Yale-Brown Obsessive Compulsive Scale, and Repetitive Behavior Scale-Revised. FGF-2 levels were significantly lower in the comorbid group p < .001, clearly distinguishing this from the two single-diagnosis groups. Serum VEGF and EGF levels did not differ significantly across the diagnostic groups (both p > .05). Repetitive behavioral symptoms differed significantly between the groups and were more prevalent in the comorbid group (p = .019). The results suggest that alterations in FGF-2 levels may be associated with the co-occurrence of ASD and OCD. Further studies are needed for a better understanding of this topic.

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19. Lian A, Yang Y, Jiang Y, Liu Y. Cross-cohort convergence of a microglial transcriptional state balance in idiopathic autism and Dup15q syndrome. Front Psychiatry. 2026; 17: 1952880.

BACKGROUND: Autism spectrum disorder (ASD) encompasses diverse etiologies, creating a need for molecular measurements that retain biological meaning across cortical resources. We examined a predefined transcriptional balance within microglia-annotated nuclei and asked which expression component accounted for its disease-associated direction. METHODS: Population A and Population B were defined as PsychENCODE/Wamsley clusters 0 and 2. A primary all-donor signature comprised 150 genes per direction derived from 44 donors with at least 10 nuclei in each population; a control-derived signature used 20 eligible controls. The same gene lists were projected separately into Velmeshev idiopathic ASD and Perez Dup15q data. Associations were evaluated using donor-level regression or donor-random-intercept models, with component and sensitivity analyses. RESULTS: Primary B-minus-A coefficients were positive in PsychENCODE (beta=0.058, P = 0.247, Benjamini-Hochberg q=0.247), Velmeshev (beta=0.154, P = 0.104, q=0.156), and Perez Dup15q (beta=0.151, P = 0.014, q=0.041). Dup15q provided the clearest primary statistical evidence; the idiopathic ASD estimates were directionally concordant but individually nonsignificant. External Population A coefficients were negative (Velmeshev beta=-0.157; Perez beta=-0.147), whereas Population B estimates were closer to zero. Positive B-minus-A direction was retained across alternative signature derivation, Perez cell definitions, tested technical adjustments, contamination/doublet exclusion masks, conservative gene exclusion, and all donor-removal refits within each external resource. CONCLUSION: A predefined state-balance measurement identifies a shared direction across the analyzed ASD-related resources, with the clearest evidence in Dup15q. Component analysis favors lower Population A-associated expression over a generalized increase in Population B-associated expression. This defines an interpretable molecular phenotype for mechanistic follow-up without assigning either population to a purified cell subtype.

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20. Liu M, Ma G, Zhang Y, Li K, Li F, Peng T, Qin C, López-Huerta VG, Arias-Garcia MA, Wang W, Feng D, Wu S, Guo B. Effects of early-life tactile experience enrichment on autistic-like behaviors and synaptic alterations in Shank3 mutant mice. Fundam Res. 2026; 6(5): 3457-70.

Autism spectrum disorder (ASD) presents a significant therapeutic challenge due to limited treatment options. While non-pharmacological approaches based on sensory stimulation have shown promise in clinical practice, the underlying mechanisms remain poorly understood. This study explored the therapeutic potential of tactile experience enrichment (TEE) during specific developmental windows in Shank3 KO mice, a model of ASD. We found that pre-weaning TEE robustly rescued core behavioral deficits, including social interaction and repetitive grooming, whereas juvenile TEE only improved social behavior. RNA sequencing of the anterior cingulate cortex (ACC) and dorsolateral striatum (DLS) revealed TEE-induced alterations in synaptic gene expression, including the upregulation of the Polo-like kinase 1 (PLK-1) pathway, which may modulate synaptic maturation. Furthermore, pre-weaning TEE restored dendritic spine density and morphology, along with synaptic transmission, in both the ACC and DLS. These findings indicate that early tactile enrichment, particularly during the pre-weaning period, can effectively alleviate core ASD-related behaviors in Shank3 KO mice by modulating synaptic structure and function, highlighting its potential as a therapeutic intervention for ASD.

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21. M SS, A ST. A geometric rs-fMRI connectome descriptor reveals individual stability without robust autism group differences. Cogn Neurodyn. 2026; 20(1): 199.

Autism spectrum disorder (ASD) has resisted reproducible case-control characterization in resting-state functional connectivity, leaving open whether reported group differences reflect genuine biology or methodological variability. We introduce a geometric framework that represents functional connectomes on the symmetric positive-definite Riemannian manifold and quantifies individual deviation as tangent-space dispersion, complemented by normative modeling of graph topology. Using the multi-site Autism Brain Imaging Data Exchange (ABIDE I) cohort (N=1035 subjects), we evaluate this descriptor under stringent robustness conditions and report three findings. First, individual connectome geometry is a stable, individually unique descriptor. The magnitude of a subject’s deviation is highly reliable across split halves (intraclass correlation ICC[Formula: see text]) but is dominated by an acquisition-site scale, whereas its high-dimensional shape identifies subjects within-session with 98.9% accuracy once that scale is removed. Second, the case-control difference in dispersion is null and, by two one-sided equivalence tests against Cohen’s d = 0.2, statistically equivalent to zero in all ABIDE I analysis cohorts (full cohort d = -0.007, N = 1035; strict cohort d = +0.038, N = 635); a nominal single-atlas effect (dispersion ratio 1.05, p = 0.046) does not survive multi-atlas reanalysis. Third, acquisition site explains 69% of dispersion variance while diagnosis explains 0.0001%; deviations form no discrete subtypes and do not predict symptom severity (minimum p=0.15 across tested graph-deviation predictors). Geometric dispersion is therefore a reproducible, individually unique connectome descriptor but not a case-control biomarker of ASD, which helps to explain the inconsistency of connectomic findings in autism.

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22. Mbonigaba J, Assenga SS. Quality of life burden of autism spectrum disorder within households: The role of severity and family dynamics in urban Tanzania. Res Dev Disabil. 2026; 178: 105399.

BACKGROUND: Previous research on quality of life (QoL) among families affected by autism spectrum disorder (ASD) has focused mainly on diagnosis rather than severity, overlooked how the QoL burden is distributed across household members, and rarely examined multiple dimensions of QoL. Evidence from low-income settings remains particularly limited. OBJECTIVES: This study examined how the QoL burden associated with ASD is distributed among autistic children, parents and caregivers, and families as a whole, and to identify factors associated with QoL among affected households in urban Dar es Salaam, Tanzania. METHODS: QoL was compared between autistic and non-autistic households, across ASD severity levels, and among children, parents/caregivers, and families using t-tests and chi-square tests. Regression analysis identified factors associated with QoL. Qualitative analysis supplemented quantitative evidence. RESULTS: Findings show that ASD status significantly affects QoL, and autism severity is the principal driver of disparities in QoL. Households caring for children with severe ASD reported substantially lower QoL than those with moderate and mild ASD. Access to treatment services, higher educational attainment, larger household size, and higher household income were associated with improved family QoL. Children with ASD experienced functional dependence, behavioural regulation difficulties, and school exclusion; parents faced caregiving burden, employment disruption, psychological distress, and financial strain; and families reported debt accumulation, reduced intra-household resource allocation, and social isolation, exacerbated by stigma and limited community awareness. CONCLUSION: ASD-related well-being is driven primarily by care intensity rather than diagnosis alone, with families facing interconnected social, psychological, educational, and financial challenges. Policy should prioritise affordable treatment, family-centred care, inclusive education, caregiver support, and psychosocial services.

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23. McKenna F, Hemmerling KJ, Molholm S, Zhu DC. Reduced medial periventricular diffusion markers are associated with depressive symptoms and social deficits in ASD. Psychiatry Res Neuroimaging. 2026; 364: 112348.

The glymphatic system is a candidate mechanism in autism spectrum disorder (ASD), linked to altered cerebrospinal fluid (CSF) dynamics, perivascular space (PVS) enlargement, and neuroinflammation, yet its relation to brain structure and clinical outcomes remains unexamined. We analyzed multimodal MRI (T2 FLAIR, T1, diffusion) in 58 adult males (29 ASD, 29 TD) from ABIDE-II, quantifying regional DTI-ALPS indices, free water metrics, white matter hyperintensities, and PVS and CSF volumes. ASD showed a more pronounced anterior peak in the DTI-ALPS anterior-to-posterior profile (group × position: β = 0.0020, p < .001), though this attenuated under random slopes (p = .160); scalar indices showed no group differences. Within ASD, medial DTI-ALPS was the sole marker associating with both depression (r = -0.51) and social communication (r = -0.56), while tissue radial diffusivity was the strongest correlate of depressive symptoms (p < .001). Left basal ganglia PVS correlated negatively with medial DTI-ALPS (partial r = -0.58, p = .005), and mediation showed PVS related to social functioning only indirectly, via medial DTI-ALPS. Regional associations persisted after free-water correction, consistent with a tissue-microstructural basis. These ASD-specific findings suggest dissociable microstructural and neurofluid mechanisms in mood and social dysfunction.

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24. Mendrinou V, Papadopoulou AK, Panopoulou I, Vlachos F, Ocklenburg S, Ahtam B, Badcock NA, Phylactou P, Papadatou-Pastou M. Cerebral Lateralization for Language as a Potential Biomarker for the Broad Autism Phenotype: A Functional Transcranial Doppler Ultrasonography Investigation. Brain Behav. 2026; 16(10): e71803.

INTRODUCTION: Autism spectrum disorder (ASD) is associated with language deficits, while growing evidence suggests that atypical cerebral lateralization for language could serve as a potential neural marker for ASD. The present study seeks to investigate cerebral lateralization for language not only in terms of ASD, but also as a potential biomarker for the broad autism phenotype (BAP)-a sum of subclinical traits similar to those of ASD. BAP is often observed in family members of individuals with ASD, and encompasses personality, linguistic, social, communicative, and behavioral challenges that fall short of the diagnostic threshold for ASD. We hypothesize that individuals with ASD will show atypical patterns of cerebral lateralization for language relative to neurotypical controls, with individuals exhibiting BAP characteristics expected to fall between these two groups. METHODS: To test this hypothesis, neurophysiological and behavioral assessments of cerebral lateralization for language, alongside cerebral lateralization of visuospatial functions-to confirm that the expected differences are specific to language lateralization-will be performed in at least 26 children and adults with high-functioning ASD, 26 BAP-positive siblings (BAP group), and 26 neurotypical controls. Behavioral lateralization, namely handedness, will be assessed through neuropsychological tools, while cerebral lateralization will be measured utilizing functional transcranial Doppler ultrasonography (fTCD), a validated and reliable tool specialized for cerebral lateralization assessment. RESULTS: This is a Stage-1 registered report; therefore, no results are available at this time point. CONCLUSION: Findings are expected to inform improved understanding and, potentially, early identification and screening for both ASD and BAP.

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25. Mohammadi F, Rezaei-Hachesu P, Asadzadeh A, Shahrokhi H. Artificial Intelligence-Based Approaches for Autism Screening Using Facial Images and DSM-5 Checklist Data: A Methodological Study. Health Sci Rep. 2026; 9(10): e73360.

BACKGROUND AND AIMS: Artificial intelligence methods may support research on autism spectrum disorder (ASD)-related screening, but they cannot replace comprehensive clinical assessment. We evaluated two image-training scenarios public Kaggle data alone and a manually prepared combined training set containing Kaggle images plus local images and separately examined a structured DSM-5 checklist model. A child-level reanalysis was used to evaluate public-to-local transfer and local adaptation while ensuring that images from the same child were not assigned to different partitions. METHODS: This methodological study used 268 retrospectively abstracted DSM-5 records (134 ASD and 134 non-ASD) and 162 local facial images from 92 children (43 ASD and 49 non-ASD). The image experiment evaluated EfficientNet-B2 and ResNet50 under two training scenarios: Kaggle-only training with 2536 images (1268 per class) and a manually prepared combined training set with 2580 images (1290 per class), formed by adding 22 local images per class to the Kaggle training folders. Local images were linked to anonymous child identifiers before partitioning. RESULTS: The checklist model achieved 92.5% accuracy (248/268; 95% CI, 89.6%-95.5%) and ROC-AUC 0.984 (95% CI, 0.971-0.993) in internal out-of-fold evaluation. In the child-level reanalysis, the Kaggle-only scenario produced zero-shot/adapted accuracies of 42.1%/68.4% for EfficientNet-B2% and 68.4%/89.5% for ResNet50 in 19 locked test children. With the 2580-image combined training set, zero-shot/adapted accuracies were 71.4%/78.6% for EfficientNet-B2% and 57.1%/85.7% for ResNet50 in 14 locked test children. These image results are preliminary and based on small local test cohorts. CONCLUSION: The checklist analysis showed high internal agreement with an existing psychiatrist-assigned label, whereas image performance varied by architecture, training scenario, population transfer, and local adaptation. The results do not establish clinical validity or autonomous diagnosis. Future prospective, multicenter, participant-level evaluation with independent reference standards is required before any clinical use.

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26. Narkis G, Dolgin V, Sued-Hendrickson S, Zahran J, Kanengisser-Pines B, Smooha-Schechter G, Carmon L, Shorer Z, Michaelovsky A, Birk OS. A lethal form of ASCC3 disease: Severe global developmental delay, axial hypotonia, hypoplasia of corpus callosum, hypothyroidism, and micropenis. HGG Adv. 2026; 7(4): 100637.

Activating Signal Cointegrator 1 Complex, Subunit 3 (ASCC3) encodes a DNA helicase that is pivotal in transcriptional regulation, DNA damage response, and ribosomal quality control. Bi-allelic ASCC3 variants have been recently associated with a wide spectrum of non-lethal neuromuscular and neurodevelopmental disorders, with no consistent brain malformations or endocrine dysfunction. We describe a severe lethal form of ASCC3 disease: eight individuals of three consanguineous Bedouin families presented with a consistent phenotype of severe global developmental delay, axial hypotonia, and hypoplasia of the corpus callosum, lethal in infancy. Shared dysmorphic features included narrow palpebral fissures, a sunken flat nasal bridge with a short nasal tip and anteverted nares, and low-set ears. Congenital hypothyroidism was evident in most affected individuals, and all males had micropenis/cryptorchidism. Linkage analysis identified a chromosome 6q16.3 locus segregating within the families consistent with autosomal recessive inheritance (maximum multipoint LOD score: 3.1). Whole-exome sequencing followed by segregation analysis identified within this locus a single disease-associated variant: ASCC3 c.3061T>A (GenBank: NM_006828.4) (p.Phe1021Ile). The phenotype, consistent across all affected individuals, significantly broadens the phenotypic spectrum of ASCC3-related disorders, with unique dysmorphism, previously unreported agenesis of the corpus callosum, micropenis/cryptorchidism, congenital hypothyroidism (possibly relevant to ASCC3’s pituitary and thyroid expression and its thyroid hormone receptor interacting protein 4 [TRIP4] interaction), and early lethality.

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27. Nukala KM, Williquett B, Lilienthal AJ, Thompson DM, Massingham JN, Lye SH, Yu A, Lear BC, Neely GG, Chtarbanova S, Manak JR. Drosophila prickle mutants display comorbid neurological phenotypes and present with autism spectrum disorder-associated phenotypes. Neurobiol Dis. 2026; 230: 107623.

Epilepsy affects approximately 30% of individuals with autism spectrum disorder (ASD). Consistent with these observations, while PRICKLE mutations are primarily linked with epilepsy, there is an enrichment of pathogenic DNA sequence variants in PRICKLE genes carried by individuals with ASD. Nonetheless, a connection between PRICKLE function and ASD warrants further investigation. Here, we show that a seizure-prone Drosophila prickle mutant (prickle-spiny-legs, or pk(sple)) exhibits learning and memory deficits, increased pain sensitivity, both communication and social interaction difficulties, and restrictive repetitive grooming behaviors, all of which are strongly correlated with ASD, while a non-seizure prone prickle mutant (prickle-prickle, or pk(pk)) does not, thereby associating epilepsy and ASD through prickle. Comparing headed versus headless pk(sple) mutants, we also show that the excessive grooming requires higher level cognitive processing from the brain. Finally, both pk(sple) and pk(pk) mutants exhibit circadian rhythm defects, another feature correlated with ASD, as well as distinct yet overlapping neurological anomalies in processes that include innate immune response, oxidative stress response, neuronal cell death, neurodegeneration, motor dysfunction and reduced lifespan, likely reflecting the unique isoform expression patterns observed in the developing CNS. Collectively, this study highlights the broadscale effects of PRICKLE mutations that extend beyond the primary clinical features of epilepsy to include several of the core features of ASD.

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28. Oh H, Lee J. Serial qEEG as a Neurophysiological Profiling and Treatment Monitoring Tool in dTMS-Treated Autism Spectrum Disorder: A Case Report. Clin EEG Neurosci. 2026: 15500594261474265.

Autism spectrum disorder (ASD) is a neurobiologically heterogeneous neurodevelopmental condition, yet current treatment approaches – predominantly behavioral and communicative – pharmacological option limited to symptomatic relief, with limited benefit for individuals with more severe presentations. Here we report an 8-year-old male with ASD presenting with social withdrawal, anxiety, and self-injurious behavior (SIB), who underwent quantitative electroencephalography(qEEG)-guided deep transcranial magnetic stimulation (dTMS) over 40 sessions. Baseline qEEG demonstrated generalized cortical hyperexcitability – characterized by elevated absolute power across most frequency bands and diffuse coherence elevation – consistent with a maturational lag pattern previously described in ASD. We hypothesized that this profile might offer a neurobiological rationale for BDNF-activating neuromodulatory approach via dTMS. Serial qEEG assessments every 10 sessions enabled quantitative monitoring of treatment response; introduction of the H7 coil from the 21st session associated with subsequent delta reduction and partial resolution of central/posterior high-beta activity. CARS-2 scores decreased from 34 at baseline to 20 at treatment completion – a 41% reduction, representing a shift to the non-autistic range – coinciding with reduced anxiety-related behaviors, improved language, and overall reduction in SIB. This case illustrates the potential dual utility of qEEG as a neurophysiological profiling tool and a quantitative biomarker of treatment response, contributing preliminary evidence for the clinical utility of dTMS in ASD and highlighting the value of neurophysiologically informed, precision-based approach to psychiatric care.

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29. Pizarro-Carmona A, Nunes C, Baena S, Jiménez L. Spanish validation of the Mindfulness Attention Awareness Scale (MAAS) in parents of individuals with ASD. Front Psychol. 2026; 17: 1932970.

INTRODUCTION: The Mindful Attention Awareness Scale (MAAS) is a widespread instrument to assess individual differences in the frequency of mindful states over time, and it has been validated in a variety of populations, countries, and settings. Nevertheless, validation with parents of individuals with autism spectrum disorder (ASD) still remains a gap in the current research field. METHODS: This cross-sectional study aimed to validate the MAAS in Spanish parents of individuals with ASD (N = 118; 74 mothers and 44 fathers), assessing its psychometric properties and factor structure, invariance according to gender, convergent validity considering family quality of life, parenting alliance and satisfaction with life measures and divergent validity with parenting stress. RESULTS: The confirmatory factor analysis resulted in a single-factor model with excellent internal consistency. Measurement invariance according to gender showed satisfactory results in configural and metric analyses, but only partial scalar invariance was confirmed. Moreover, there was evidence for convergent and discriminant validity, with significant relationships between the measures in the expected directions. DISCUSSION: The findings suggest that the 15-items version of the MAAS is a valid and reliable instrument that can be used to assess mindfulness attention among Spanish parents of individuals with ASD.

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30. Rahman Z, Rice J, Edwards L, Sanad E, Jacob R. Respondent-Reported Acceptability and Tolerability of a Nurse-Assisted, Self-Collected Human Papillomavirus (HPV) Cervical Cancer Screening Model in Adults With Intellectual and Developmental Disabilities: A Preliminary Report. Cureus. 2026; 18(10): e117558.

Background and objective Adults with intellectual and developmental disabilities (IDD) are screened for cervical cancer at substantially lower rates than adults without disabilities. Communication differences, sensory sensitivities, and difficulty tolerating speculum-based examination all contribute. Deferred screening is frequently recorded as patient refusal rather than as an unmet need for adapted care. Human papillomavirus (HPV) testing on self-collected vaginal specimens is now recognized as an acceptable screening option, but published implementation strategies for this population are limited. The objective of this study was to evaluate respondent-reported acceptability, tolerability, and level of assistance required for a nurse-assisted self-collected HPV screening model in an interdisciplinary primary care clinic serving adults with IDD. Methods We conducted a prospective, single-site, minimal-risk observational study at the Program for Adults with Intellectual and Developmental Disabilities (PAIDD) at University of Florida Health Jacksonville. Vaginal specimens for HPV testing were collected in the clinic by the patient under nurse guidance, with hands-on assistance from a trained program nurse or a caregiver as needed. The model also included structured pre-visit planning, an animated patient education video, and caregiver engagement. A structured post-visit survey administered in REDCap assessed the level and appropriateness of assistance, patient tolerance, observable distress, acceptability, and support for future use. The survey was designed as a caregiver proxy instrument and was completed directly by the patient where able; outcomes are therefore described as respondent-reported, with proxy and direct responses distinguished explicitly. Results are reported as n (%). Recruitment is ongoing toward a planned enrollment of 30, and these are preliminary findings. Results Of 23 patients identified as eligible, 18 (78.3%) were offered the pathway. Among those offered, 14 (77.8%) completed collection, and four (22.2%) declined; zero (0%) attempted collection without completing it. Uptake was 14 of 23 (60.9%) among those identified as eligible. All 14 specimens (100%) returned negative high-risk HPV results. Complete survey data were available for 13 of the 14 completed collections. Among these 13 encounters, tolerance was rated very good in 11 (84.6%) and good in two (15.4%), with zero (0%) rated fair, poor, or very poor; no distress was observed in 12 (92.3%) and mild distress in one (7.7%), with zero (0%) moderate or severe. All 13 encounters with available assistance data (100%) required hands-on assistance, provided by the nurse in nine (69.2%) and by a caregiver in four (30.8%); zero (0%) were completed unaided or with verbal coaching alone, and zero (0%) were unable to be completed despite assistance. All 13 respondents (100%) judged the level of assistance appropriate, rated the process acceptable or very acceptable, and would support offering it again. Conclusions A nurse-assisted self-collected HPV screening model was well tolerated and highly acceptable to respondents in an academic primary care clinic for adults with IDD. Every encounter with available assistance data required hands-on assistance, indicating that nursing support is integral to the model rather than incidental. Clinic efficiency, physician time, and scalability were not measured and remain hypotheses for future evaluation. Recruitment continues.

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31. Reddy N, Call N, Burger RK. Nitrous Oxide Use in Autistic Children: A Descriptive Study. Pediatr Emerg Care. 2026.

OBJECTIVES: Describe the population of autistic children who undergo nitrous oxide sedation and the rate of associated adverse events (AEs). Analyze patient- and procedure-level factors associated with AEs in autistic children receiving nitrous oxide outside the dental setting. METHODS: A retrospective, descriptive study of autistic children, 3 to 18 years, who received nitrous oxide for procedural sedation during an emergency department or sedation encounter within a single hospital system between January 2014 and December 2023. Data extracted included patient demographics and comorbidities, as well as indication, maximum concentration, duration of administration, and AEs of nitrous oxide. Descriptive statistics were used to summarize the data. RESULTS: Analysis was performed on 186 patients [median age: 8 years (interquartile range: 5.2-12.75), 74.2% male]. Intravenous line placement was the most common indication in all locations. Most received 70% nitrous oxide with a median duration of 6 minutes (interquartile range: 4 -9.75). AEs were rare, occurring in only 3 patients (1.6%), with zero vomiting or aborted procedures. Given the rarity of AEs, no associated factors were able to be identified. CONCLUSIONS: Nitrous oxide is a safe, effective, and well-tolerated option for procedural sedation in autistic children, with a low rate of AEs. These findings add to the limited literature supporting its use in nondental settings and suggest it may be a valuable tool for facilitating minor procedures in this population. Future prospective studies are needed to optimize nitrous oxide delivery and determine factors contributing to AEs.

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32. Şimşek Ç, Kabukçu Başay B, Barış Moğul C, Dodurga Y. Altered toll-like receptor expression in autism spectrum disorder: Evidence from mRNA and serum protein analyses. J Psychiatr Res. 2026; 204: 49-56.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition in which immune dysregulation and neuroinflammatory processes are increasingly implicated. Toll-like receptors (TLRs), as key components of innate immunity, may represent a biological interface between peripheral immune activity and neurobehavioral manifestations; however, comprehensive investigations of the full TLR family in ASD remain scarce. This study aimed to evaluate peripheral blood mRNA expression of all human TLRs (TLR1-TLR10) and corresponding serum protein levels in children and adolescents with ASD. Thirty-one drug-naive participants with ASD and 31 age- and sex-matched healthy controls aged 4-18 years were enrolled. Clinical assessments included the Childhood Autism Rating Scale (CARS) and the Aberrant Behavior Checklist (ABC). TLR mRNA expression was quantified using RT-qPCR, and serum protein levels were measured by ELISA. The ASD group exhibited significantly higher mRNA expression of TLR1, TLR4, TLR5, and TLR8 and lower expression of TLR6 (all p < .01). Concordantly, serum protein levels of TLR1, TLR4, TLR5, and TLR8 were increased, whereas TLR6 levels were decreased (all p < .001). No differences were observed for TLR2, TLR3, TLR7, TLR9, or TLR10. Circulating levels of TLR1, TLR4, TLR5, TLR6, and TLR8 were significantly associated with ASD severity and behavioral symptoms (p < .05). These findings provide novel evidence of coordinated alterations in multiple TLR subtypes in ASD beyond previously reported TLR4 dysregulation. The results suggest that TLR-mediated innate immune signaling may be linked to clinical symptomatology and highlight specific TLRs as potential targets for future biomarker-oriented research.

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33. Supianto. Enhancing Professional Development for Educators Supporting Autistic Students. Evid Based Pract Child Adolesc Ment Health. 2026; 11(1): 162-3.

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34. Swanepoel A. Editorial Perspective: Evolutionary psychiatry as a scientific framework for neurodiversity: implications for ADHD and ASD in children and young people. J Child Psychol Psychiatry. 2026.

The neurodiversity movement has gained considerable momentum in recent years, asserting that conditions such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) represent natural variations in human neurodevelopment rather than pathological disorders (Baron-Cohen, 2017). This perspective has found increasing resonance among people with lived experience, advocacy groups and a growing number of clinicians. Yet, it has also attracted criticism for lacking a rigorous scientific foundation, leaving it vulnerable to the charge that it is more ideological than evidence based (Sonuga-Barke & Thapar, 2021). We argue that evolutionary psychiatry provides precisely the scientific framework that the neurodiversity movement needs. By asking why ADHD and ASD have persisted across human history, and answering through the mechanisms of natural selection, evolutionary theory transforms neurodiversity from an advocacy position into a scientifically grounded account of human variation.

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35. Toffalini E, Calderan M, Pagan R, Tobia V, Sonuga-Barke E. Categories or dimensions? A critical systematic review of taxometric evidence in autism, ADHD, and language disorders. JCPP Adv. 2026: e70177.

BACKGROUND: Taxometric analysis is designed to test whether the latent structure underlying clinical conditions is categorical (taxonic) or dimensional. Despite its relevance to ongoing debates on neurodevelopmental conditions, its application to this field remains limited. METHODS: We conducted a preregistered systematic review (OSF) searching PsycINFO, PubMed, Scopus, and Web of Science from inception to April 2025, with a supplementary search made in January 2026. We included peer-reviewed empirical studies applying at least one taxometric procedure (e.g., MAMBAC, MAXEIG, MAXCOV, L-Mode) to neurodevelopmental conditions/traits and reporting a categorical versus dimensional conclusion (or sufficient indices to infer it). Two reviewers independently screened and extracted data. Study quality (risk of bias for taxometric inference) was appraised using an ad hoc checklist focused on key threats, especially artificial admixture/compound sampling, and on reporting of indicator validity, nuisance covariance, and skewness. Findings were synthesized descriptively. RESULTS: We identified 126 records across the main database search (n = 110) and the supplementary search (n = 16). Fourteen studies were included. ADHD and language impairment studies largely supported dimensional models, whereas most autism and subtype studies reported taxonic patterns. Artificial admixture was very common in studies reaching taxonic conclusions, especially for autism. In Monte Carlo simulations, admixture consistently generated false-positive taxonic findings from dimensional data. CONCLUSION: Based on the best available evidence, ADHD and language impairment appear continuous dimensions rather than discrete categories. Evidence for a categorical structure is stronger for autism, but a definitive conclusion is frustrated by sampling-related biases, especially artificial admixture. More population-based, methodologically transparent taxometric studies are needed.

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36. Triantafyllidou S, Tsangala MC, Tsounia EA, Moscholouri C, Besios T, Paras G, Morales AT, Chandolias K. Greek Translation and Preliminary Test-Retest Reliability of the AQUA CHILD Questionnaire in Children With Developmental Disabilities. Physiother Res Int. 2026; 31(4): e70357.

BACKGROUND AND PURPOSE: AQUA CHILD is a parent-proxy questionnaire for pre-aquatic assessment. This study describes its Greek translation and examines preliminary test-retest agreement, with explicit verification of response coding and the limits of score interpretation. METHODS: In a methodological repeated-measures study, 47 parents completed the questionnaire 7 days apart. The retained electronic paired files contained 99 of the 102 numbered items on the supplied forms. Swimming responses were analysed categorically; 20 non-swimming domain summaries were analysed as exploratory raw-code sums, excluding non-applicable responses and using complete domain pairs (n = 43-47). Intraclass correlation coefficients for absolute agreement, ICC(A, 1), and 95% confidence intervals (CIs), systematic differences, measurement-error estimates, and participant-level Bland-Altman analyses were calculated. No overall score was retained. RESULTS: Swimming-item exact agreement was 91.5%-97.9% (unweighted kappa, 0.899-0.974). Non-swimming ICCs ranged from 0.878 to 0.968, with lower 95% CI limits of 0.786-0.942. Only undertaking a single task retained a mean retest increase after Holm adjustment: 0.22 raw-code points (95% CI, 0.09-0.34; adjusted p = 0.019). Baseline domain alpha coefficients ranged from -0.375 to 0.329. At T2, 41 non-swimming responses from 24 of 47 participants were ‘not relevant’, all ‘not capable’ at T1; none were ‘not relevant’ at T1. Two domain analyses used incomplete item sets. Normal-theory limits of agreement were sensitive to the discrete, zero-heavy differences. DISCUSSION: These estimates describe the retained electronic records. The original paper questionnaires are no longer available, so the accuracy and origin of the 41 transitions could not be independently verified; this unresolved data-quality issue may bias reliability estimates. Unconfirmed clinical stability, incomplete adaptation records, and missing items further limit inference. The findings do not establish validated domain scales, diagnosis-specific reliability, or an overall score. Prospective validation with independent source-data verification remains necessary before individual treatment decisions.

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37. Ward McIntosh C, Monahan M, Bennett L, Curry AE, Sartin EB. Toward Scalable Driver Readiness Screenings for Autistic Teens: Clinical Measures Correlated With Real-World Evaluations. Am J Occup Ther. 2026; 80(6): 981-91.

ImportanceThere are no standardized pathways to guide autistic adolescents through the learning-to-drive process, beginning with deciding whether they are ready to pursue driving.ObjectiveTo examine whether commonly used clinical assessments correlate with driver readiness determinations.DesignCross-sectional, nonexperimental study using a single in-person visit comprised of a clinical assessment and on-road passenger activities.SettingA primary care clinic in an urban city.ParticipantsTwenty-one autistic adolescents aged 15-19 years without a learner’s permit were recruited via email outreach. Inclusion criteria required English fluency and ability to complete an in-person 4-h visit.Outcomes and MeasuresParticipants completed a clinical battery and on-road passenger activities. Readiness determinations were dichotomized into « Not Ready » or « Ready » for a formal driver evaluation. We conducted descriptive statistics, correlations, and positive predictive and negative predictive value tests to assess differences by clinical measures scores and readiness determinations.ResultsSeven participants were categorized as « Not Ready » and 14 as « Ready. » Strongest correlations with readiness were observed for Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) Short Form scores and Beery Visual-Motor Integration (VMI) scores. Potential cut points between groups included <22 on the Beery VMI raw score, >65 on the BOT-2 Total Point Score, >36 on the BOT-2 Standard Score, and ≥5 on the BOT-2 Transferring Pennies score. NIH Toolbox working memory and cognitive flexibility tasks showed moderate associations.Conclusions and RelevanceCommonly used clinical assessments show preliminary associations with driver readiness outcomes. Findings support future development of a standardized screening battery to guide referral decisions and predriving skill development. Many autistic teenagers and their families want guidance about when to begin learning to drive, but there are no standard tools to help decide who is ready for a formal driver evaluation. In this study, autistic teens completed a set of common clinical tests and rode in a car with a trained driving specialist who observed their readiness to pursue driving. We compared the clinical test results to the specialist’s final recommendations. We found that tests of motor skills and visual–motor integration (such as copying drawings or coordinating movements) were most strongly related to being ready for a driving evaluation. Some cognitive tests, such as working memory and flexible thinking, were also helpful. These results suggest that widely available tests could one day help professionals provide earlier, clearer guidance to autistic teens and families about driving readiness. eng.

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38. Yaffe Y. Parenting children and adolescents with autism spectrum disorder: an analysis of parenting styles, parental stress, and child anxiety and behavioral difficulties. Eur Child Adolesc Psychiatry. 2026.

This study examined whether parenting differences between families of typically developing and autistic children and adolescents can be understood in relation to child- and parent-level patterns of association. A sample of 121 parents (76 ASD, 45 TD) completed measures of parenting styles, parental stress, child anxiety, and behavioral difficulties. Two path models were tested, examining parental stress alongside either child anxiety or behavioral difficulties as mediators. Results indicated that parents of autistic children reported higher parental stress, elevated child anxiety and behavioral difficulties, and greater use of non-authoritative parenting. However, direct effects of developmental group on parenting styles were no longer significant after accounting for mediators. Parental stress consistently mediated associations with authoritarian and permissive parenting across models. In the anxiety model, significant indirect effects were observed through child anxiety and parental stress. In the behavioral difficulties model, the individual indirect effect through behavioral difficulties was non-significant, whereas the sequential indirect effect involving behavioral difficulties and parental stress was significant. These findings suggest that parenting differences between families of typically developing and autistic children are better understood through family-level patterns of association rather than diagnostic status alone.

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39. Yokota-Moreno BY, Silva A, Nóbrega IS, Rossetti LB, Maiorka PC, Sertié AL, Mori CMC. The utility of animal models in hiPSC-based studies of autism spectrum disorder: a systematic review. Einstein (Sao Paulo). 2026; 24: eRW1868.

INTRODUCTION: Autism spectrum disorder is a highly prevalent and heritable neurodevelopmental condition. To investigate its pathogenesis, genetic and non-genetic animal models have been developed. However, no animal model can fully capture the human-specific characteristics and genetic complexity of autism spectrum disorder. In this context, human induced pluripotent stem cell (hiPSC) derived models have emerged as powerful tools in autism spectrum disorder research, offering the potential to reduce or replace animal experiments. Despite this potential, many hiPSC-based studies still incorporate animal use. OBJECTIVE: To analyze the use of animals in hiPSC-based studies of autism spectrum disorder, with the aim of assessing the necessity of their inclusion and their contribution to our understanding of disease mechanisms. METHODS: Following the PRISMA guidelines, we searched PubMed, Scopus, and Web of Science for articles published between 2009 and 2024 using the search terms « autism », « ASD », and « autism spectrum disorder » combined with « iPSC », « induced pluripotent stem cells and « organoid* ». RESULTS: A total of 207 studies using hiPSCs to investigate Autism spectrum disorder were identified. Of these, 79 studies (38.16%) also involved animals or animal-derived cells. While nearly half of these studies used autism spectrum disorder animal models to explore neurobiological mechanisms of the disorder, the remaining studies employed animals for purposes not directly related to understanding autism spectrum disorder pathophysiology. These included teratoma formation assays to validate hiPSC pluripotency and the extraction of primary astrocytes for co-culture with hiPSC-derived neurons, an approach that may introduce confounding variables. CONCLUSION: Our review highlights the frequent and, in some cases, unnecessary use of animals in hiPSC-based studies of autism spectrum disorder.

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40. Zhang Y, Chen C, Zheng W, Luo S. The effects of virtual reality interventions on outcomes related to well-being among autistic children: a systematic review and meta-analysis of randomized controlled trials. Front Psychol. 2026; 17: 1924814.

BACKGROUND: Virtual reality (VR) interventions have been increasingly employed in therapeutic and educational contexts for autistic children. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials to examine the effects of VR interventions on outcomes related to subjective well-being (SWB) and psychological well-being (PWB) among autistic children. METHOD: This meta-analysis was performed in accordance with the PRISMA guidelines. First, seven electronic databases were searched: PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, ProQuest Central, and IEEE Xplore. Subsequently, ten eligible studies were identified. Finally, data extraction was conducted, and effect sizes were pooled using random-effects models for SWB-related outcomes and PWB-related outcomes, respectively. Heterogeneity tests, sensitivity analyses, publication bias tests, and quality assessment were also performed. RESULTS: VR yielded a positive yet nonsignificant effect on SWB-related outcomes (g = 0.37, 95% CI [-0.03, 0.78], z = 1.80, p = 0.07), whereas VR produced a statistically significant positive effect on PWB-related outcomes (g = 0.45, 95% CI [0.27, 0.63], z = 4.87, p < 0.05). CONCLUSION: Pooled analyses revealed a statistically significant positive effect of VR interventions on PWB-related outcomes among autistic children. However, this finding should be interpreted with caution given that 70% of included randomized trials had some concerns regarding risk of bias and only eight effect sizes contributed to this pooled estimate. Current evidence supports tentative promise for VR within research-oriented clinical and educational contexts rather than immediate real-world clinical application, while its potential for enhancing SWB-related outcomes remains to be further investigated. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261411309.

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41. Zhao M, Chen C, Shen Y, Zhao J, Sun J. The effects of aquatic interventions on emotional and behavioral outcomes in children with autism spectrum disorder. Front Psychol. 2026; 17: 1929354.

Children with autism spectrum disorder (ASD) commonly experience emotional and behavioral difficulties that may arise from atypical sensory processing, and the sensory properties of water closely correspond to these characteristics. We systematically evaluated the effects of aquatic interventions on four pre-specified outcome domains-emotion-related functioning, social-emotional functioning, behavioral outcomes, and quality of life-in children with ASD. Eight bibliographic databases and one trial registry were searched from inception to July 2026 using a two-concept strategy without language restriction, for studies involving children with ASD who received a structured aquatic intervention and reported a validated outcome. Methodological quality was assessed using RoB 2, ROBINS-I, and single-case design criteria, and the certainty of evidence was evaluated with GRADE. Owing to heterogeneous outcome instruments and the small number of controlled studies, a meta-analysis was not conducted; in accordance with the Synthesis Without Meta-analysis (SWiM) guideline, findings were synthesized narratively by domain, with the direction of effect and statistical significance tabulated and illustrated in an effect-direction (harvest) plot. Nineteen publications, describing up to 18 independent studies (approximately 320 participants in total from 10 countries, including non-ASD comparison participants; the number of unique participants with ASD is uncertain), with diverse designs and varying methodological quality were included, most of which were uncontrolled and had a high risk of bias. Across all four domains, the direction of effect supported aquatic intervention, and no study showed an effect favoring the comparator. The evidence was most concentrated and internally consistent for behavioral outcomes, for which all six controlled studies favored aquatic intervention, and five reported statistically significant results-although this tally reflects direction only and should not be equated with demonstrated effectiveness, whereas findings for social-emotional, emotion-related, and quality-of-life outcomes were positive in direction but mostly non-significant. Only one trial included an active land-based comparator, so a water-specific effect could not be distinguished. The available evidence suggests a consistent favorable direction across emotional and behavioral domains in children with ASD, but the evidence remains limited, heterogeneous, and at high risk of bias; sufficiently powered trials using active comparators and validated common outcome measures are needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261390044, Identifier: CRD420261390044.

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42. Zhu Q, Kong F. Art therapy interventions and developmental outcomes in children with ASD: a systematic review. Front Psychol. 2026; 17: 1771615.

Although the prevalence of autism spectrum disorder (ASD) has increased globally, evidence-based interventions that address both emotional and social dimensions in low-cost, real-world settings remain limited. Art therapy, characterized by nonverbal and multisensory engagement, has been applied in clinical and educational contexts for children with ASD. However, recent studies have largely emphasized overall outcomes, with limited synthesis of intervention processes and research trends. This systematic review followed PRISMA 2020 guidelines. A search of Web of Science, Scopus, and PubMed identified 915 records, of which 22 empirical studies (2016-July 2025) were included, covering quantitative, qualitative, and mixed-method designs involving art therapy interventions for children with ASD. Study characteristics were extracted and synthesized using a narrative thematic synthesis approach. The findings identify four recurring themes: (1) Emotional Expression and Regulation, (2) Social Skills Development, (3) Creative and Nonverbal Processes, and (4) Sensory and Relational Integration. Across studies, interventions commonly involved multisensory art-making, nonverbal expression, and relational engagement within structured social contexts. Building on these four themes, the Creative-Relational Art Therapy Framework (CRATF) is proposed as a preliminary conceptual framework that integrates emotional, social, creative, and sensory-relational aspects, offering a basis for future intervention design and empirical evaluation in clinical and educational settings.

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43. Žic Ralić A, Vrankić Pavon M, Alimović S. Corrigendum to « Strengthening family time: Child abilities and parental support as predictors of participation in children with disabilities » [Research in Developmental Disabilities 170 (2026) 105252]. Res Dev Disabil. 2026: 105403.

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