1. Armas-González M, González-González NL, González-Dávila E, Orribo-Morales O, Castro-Conde JR, González-Campos C, Flores C, Lorenzo-Salazar JM, González-Montelongo R, Muñoz-Barrera A, Padrón-Pérez E, Tascón-Padrón L, Núñez Catalán M. Targeted 3.34-Million CpG Site Sequencing Reveals Preliminary Cord Blood Epigenetic Alterations of Autism Spectrum Disorder: A Pilot Study Highlighting the PCDHA1-PCDHA8 Cluster. Int J Mol Sci. 2026; 27(18).

Rising reported Autism Spectrum Disorder (ASD) prevalence underscores the need to explore early perinatal biological markers. To conduct an exploratory pilot investigation of cord blood DNA methylation patterns as potential early epigenetic candidate loci associated with ASD in infants born to mothers with obesity and gestational diabetes. This prospective pilot study analyzed 14 mother-infant pairs comprising infants born to mothers with obesity and gestational diabetes later diagnosed with ASD (n = 2); healthy infants born to mothers with obesity and diabetes (IODM, n = 6); and healthy controls (IHM, n = 6). Targeted methyl-capture sequencing (covering 3.34 million CpG sites) identified differentially methylated region (DMR)-associated genes. Neurodevelopment was evaluated at 24-26 months using Bayley-III scales. ASD infants showed lower Bayley-III scores across all domains. In this small cohort (n = 2 ASD cases), we identified 249 DMR-associated genes common to both ASD vs. IHM and ASD vs. IODM comparisons, representing preliminary candidate loci. Enrichment analysis identified homophilic cell-cell adhesion as the most significant pathway (fold enrichment = 8.28; FDR = 6.31 × 10(-6)), driven by the PCDH1-PCDHA8 cluster, alongside morphogenesis in neuron differentiation (fold enrichment = 3.45; FDR = 2.08 × 10(-2)). Although prospective validation in larger independent cohorts is required, these pilot results suggest that cord blood PCDHA1-PCDHA8 cluster methylation alterations represent preliminary candidate loci for hypothesis generation and future biomarker evaluation, regardless of maternal metabolic status.

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2. Barrios-Fernandez S, Salas-Gómez D, Romero-Ayuso D, Gozalo-Delgado M. Preliminary evidence for the ability of the Basic Activities of Daily Living Evaluation-School-Aged Version (BADL-E) to differentiate functional performance between children on the autism spectrum and the general population. Res Dev Disabil. 2026; 177: 105380.

BACKGROUND: Few instruments have been specifically developed to assess the basic activities of daily living in school-aged children on the autism spectrum, particularly in Spanish-speaking contexts. AIMS: This study provides preliminary evidence on the psychometric properties of the Basic Activities of Daily Living Evaluation – School-Aged Version (BADL-E) and its ability to differentiate between groups. METHODS AND PROCEDURES: The sample included 312 children (271 from the general population and 41 with autism spectrum disorder) aged 7-12 years. The BADL-E comprises four scales: Eating, Personal Hygiene, Dressing, and Daily Functioning, including executive functioning-related demands (EF). Group differences were analyzed using Mann-Whitney U test and receiver operating characteristic (ROC) curves. Evidence of validity based on internal structure was examined through correlations among the scales and their underlying factors. OUTCOMES AND RESULTS: Statistically significant differences were observed between children from the general population and those on the autism spectrum across all scales, with large effect sizes (rrb = 0.59-0.72). The areas under the curve ranged from 0.78 to 0.86, indicating acceptable to excellent discriminative ability between the groups. Correlational analyses supported the instrument’s internal structure, with correlations between scales ranging from rho = 0.526-0.832. At the factor level, the strongest association was between Hygiene and Grooming and Independent Dressing Tasks (rho = 0.808), which also correlated strongly with Showering (rho = 0.785) and moderately with Manual Dexterity. Higher-order EF showed stronger associations with everyday performance than Core EF. CONCLUSIONS AND IMPLICATIONS: These findings provide preliminary evidence supporting the BADL-E as an occupation-centred instrument for assessing basic activities of daily living in school-aged children on the autism spectrum.

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3. Bates JR. Transing the archive: Toward a trans-autistic historiography of neurodivergent futures. Med Anthropol Q. 2026: e70096.

This article advances transing the archive as a methodological intervention into how autism’s canonical history became institutionally secured through archival processes operating within clinical and bureaucratic regimes, not simply through omission. Drawing on archival and digital ethnographic research, I trace how translation hierarchies, citation regimes, and diagnostic inscription consolidated particular clinicians and deficit framings while marginalizing more relational figures such as Grunya Sukhareva and Anni Weiss. I argue that these processes function as recognition infrastructures, shaping what becomes documentable, citable, and actionable across institutional systems. I analyze autistic digital counter-archives-hashtag recirculation, annotation, and diagnostic reinterpretation-as patterned historiographical work that intervenes by re-translating, re-citing, and re-inscribing medical knowledge. By reframing archives as contested infrastructures, this article extends medical anthropology’s engagement with evidence, temporality, and epistemic authority.

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4. Burkhart K, Palumbo A, Sanford K, Olczyk A, Minich N. Clinical Profile of First-Time Diagnosis of Autism Spectrum Disorder in School-Aged Youth. Children (Basel). 2026; 13(9).

BACKGROUND/OBJECTIVES: There is limited research on clinical profiles of school-aged children receiving a first-time diagnosis of autism spectrum disorder (ASD) Level 1 and mixed findings related to sex differences in phenotype. This study aimed to describe the clinical profile of school-aged children receiving a first-time diagnosis of ASD Level 1, explore sex differences in phenotype by symptom severity and symptom domain profiles, and compare parent and teacher ratings on standardized measures of social, emotional, and behavioral functioning. METHODS: A retrospective chart review of an ASD assessment clinic was completed. Eighty-one school-aged children were diagnosed with ASD Level 1. Measures of social, emotional, adaptive, and behavioral functioning were completed. RESULTS: Females were significantly older at the time of diagnosis (M = 9.7 years) in comparison to males (M = 8.5 years). Additionally, over half of children diagnosed with ASD Level 1 presented with ADHD and over a third presented with an anxiety disorder. Approximately one-fourth of those diagnosed were currently taking psychotropic medication, and a substantial proportion had reported speech or language delay. Approximately half presented with food selectivity and sleep problems, with only 38% currently receiving behavioral health therapy services. Caregivers reported significantly higher internalizing symptoms and externalizing behavior on all Achenbach scales in comparison to teachers. Caregivers also reported significantly greater autism-specific social concerns. No statistically significant sex differences were found in parent or teacher ratings of domain scores. Based on caregiver reports, males demonstrated greater severity of aggressive behavior. Females displayed greater deficits in social communication and motivation based on both parent and teacher reports. Overall cognitive ability fell in the average range, while adaptive behavioral functioning was in the moderately low range. CONCLUSIONS: ASD Level 1 in school-aged children presents a distinct clinical profile marked by high rates of co-occurring conditions (ADHD and anxiety), existing academic accommodations/modifications, physician referral for evaluation, and varied symptom severity by informant type, all of which may contribute to diagnostic overshadowing and delay, especially in females.

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5. Cano S, Vásconez JP, Villarroel K, Geraldo JC, Albiol-Pérez S. Affective Computing Approaches in Child-Robot Interaction: A Systematic Review and Taxonomy. Sensors (Basel). 2026; 26(18).

Affective computing has become increasingly relevant in child-robot interaction (CRI), particularly in social robotics, emotion recognition, engagement assessment, and autism-related interventions. This systematic review with a critical and integrative synthesis analyzes 105 included studies to examine how affect is sensed, represented, processed, expressed, and evaluated in CRI. The literature search was conducted in IEEE Xplore, Web of Science, Scopus, and PubMed, following a systematic screening process guided by the review objectives. A descriptive and structured narrative synthesis was conducted considering publication characteristics, robot platform and morphology, target population, sensing modalities and observed affect-relevant features, affective constructs and representation models, computational and control mechanisms, robot affective expression, evaluation strategies, and remaining research gaps. The findings show a strong emphasis on ASD-related contexts, visually observable and behavioral features, facial emotion recognition, body movement analysis, and engagement assessment. The review also identifies important limitations, including reliance on camera-based affect recognition, comparatively limited use of physiological and other complementary sensing modalities, unclear alignment between robot roles and interaction strategies, insufficient reporting of robot emotional expressiveness and control mechanisms, and limited attention to explainability, data governance, and long-term ethical implications. Based on these findings, an integrative taxonomy of affective computing in CRI is proposed, comprising six interconnected dimensions: interaction context; sensing modalities and observed features; affective constructs and representation models; computational and control mechanisms; robot affective expression; and evaluation and adaptation strategies. Rather than treating these dimensions as entirely novel categories, the taxonomy consolidates and extends previously fragmented classifications into a child-centered representation of the affective interaction process. Overall, this review argues that affective CRI should move beyond automatic emotion recognition toward multimodal, embodied, developmentally appropriate, explainable, and ethically grounded robot interaction.

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6. Chen H, Zhou Z, Chen D, Wang Y, Gao T, Liu X, Chen J. DynaSPARC: a dynamic single-trial P300 paradigm for assessing motor response capability in autism spectrum disorder. J Neural Eng. 2026; 23(5).

Objective.EEG-based assessment of motor response capability is critical for understanding the heterogeneous cognitive profiles of children with autism spectrum disorder (ASD), e.g. typically P300 event assessment. However, mainstream methods generally struggle to address the entangled trial-to-trial variability and temporal instability of P300 signatures in ASD, fixed time windows or trial-averaging primarily effective only for typically developing subjects.Approach.To overcome this limitation, this paper introducesDynaSPARC(DynamicSingle-trialP300Assessment ofResponseCapability), a framework based on the premise that behavioral reaction time () provides a latent regulation for inferring trial-specific cognitive dynamics.DynaSPARCenables reliable assessment of motor response capability in ASD through: (1)Dynamic Temporal Windowing, which uses a nonlinear mapping of standardizeddifferences to adaptively parameterize the start and length of the P300 window for each trial within a physiologically constrained range (e.g. 300-800 ms); (2)Collaborative Spatio-temporal Attention, which employs a learnable temporal filter to pinpoint P300 latency and a knowledge-guided channel weighting scheme for a reliable reconstruction of the P300 signature.Main results.Evaluation on an EEG dataset from 67 children (29 with ASD vs 38 typically developing) through a motor-cognitive task demonstrates thatDynaSPARCachieves superior performance over fixed-window methods: (1) A more temporally localized and spatially plausible single-trial P300 was obtained, and a substantially stronger-peak-latency coupling was preserved (Spearman= 0.61,= 1.33vs= 0.11, p = 0.391), consistent with more stable peak-latency estimates (reduced jitter); (2) The peak scalp topography showed a more canonical, spatially focused centro-parietal positivity; (3) The classification accuracy,F1score, recall, and precision reached 84.77%, 78.43%, 84.03%, and 76.14%, respectively.Significance.This work establishes a new paradigm for EEG-based assessment, moving beyond static averaging to model the dynamic interplay between neural latency and behavioral output.

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7. Chiem E, Amirtha Ganesh SS, Dodson J, Dapretto M, Hernandez LM. Effects of polygenic liability for autism on neonatal thalamocortical connectivity and behavioral outcomes across sex. Biol Psychiatry Cogn Neurosci Neuroimaging. 2026.

BACKGROUND: Functional brain networks are altered in Autism Spectrum Disorder (ASD), with differences in thalamocortical connectivity detectable as early as infancy. ASD shows distinct sex differences, not only in diagnostic rates, but also in brain and behavioral manifestations of the condition. Although common variants account for much of the genetic liability for ASD, little is known about the impact of ASD-associated genetic variation on functional brain connectivity and behavioral outcomes in early life or how this may differ between males and females. METHODS: Here, we utilize functional MRI (fMRI), genetic, and behavioral data from the Developing Human Connectome Project (dHCP) to investigate sex differences in the association between ASD polygenic scores (PGS), thalamocortical functional connectivity (37-44 weeks postmenstrual age), and normative behavioral outcomes (18 months) in European term-born male (N = 136) and female (N = 135) infants. RESULTS: We show that across the full sample, higher ASD PGS is associated with weaker thalamic connectivity with posterior parietal cortex. Sex differences in the relationship between ASD PGS and thalamic connectivity largely encompassed sensorimotor, posterior parietal, temporal, and insular cortices. Further, in female infants, thalamic connectivity patterns associated with greater genetic liability for ASD were related to poorer motor development. CONCLUSIONS: These findings suggest genetic predisposition for ASD shapes early thalamocortical functional connectivity in a sex-specific manner in the general pediatric population.

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8. Cun Z, Ye Y. Scrolling into hope and anxiety: a qualitative study of how short-video platforms shape psychological adjustment among Chinese parents of children with autism. Front Psychol. 2026; 17: 1952061.

BACKGROUND: Short-video platforms have become important sources of autism-related information, intervention guidance, and emotional support for parents of children with autism. However, algorithmic recommendations, selective presentation, and heterogeneous content may also heighten anxiety and complicate caregiving decisions. This study explored how short-video platforms shape the psychological adjustment of Chinese parents of children with autism. METHODS: This study employed an exploratory qualitative design. Twenty-four parents (13 mothers and 11 fathers) were recruited using purposive and snowball sampling. Semi-structured, in-depth interviews lasting 45-75 min were conducted. Data were analyzed using thematic analysis, with social support theory and social comparison theory used as complementary interpretive frameworks. RESULTS: Three themes and 12 subthemes were identified. Through audiovisual demonstrations, algorithmic recommendations, parent narratives, and longitudinal records of children’s development, short videos provided informational support, emotional resonance, and hope. Conversely, decontextualized intervention advice, repeated recommendations, selective success narratives, urgency-based messaging, and commercial promotion contributed to informational confusion, comparisons of children’s development and parental effort, self-doubt, and intervention-related anxiety. With increasing platform experience, parents recalibrated credibility judgments, comparison standards, emotional boundaries, and caregiving decisions by integrating online information with professional advice and their children’s individual needs. CONCLUSION: Short-video platforms have both supportive and stress-inducing effects on the psychological adjustment of parents of children with autism. These effects are shaped by interactions among platform algorithms, content presentation, family circumstances, and parental interpretation. Psychological adjustment involved recalibrating credibility, comparison, emotional responses, and caregiving decisions. Professionals should strengthen parents’ information-evaluation skills and digital health literacy, while platforms should improve content moderation, disclose creators’ qualifications and commercial interests, and regulate promotional content.

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9. Dong D, Xu L, Thompson-Hodgetts S, Jou H, Vohra S. Efficacy and Safety of Laser Acupuncture in the Treatment of Children With Autism Spectrum Disorder: A Systematic Review. Glob Adv Integr Med Health. 2026; 15: 27536130261487432.

BACKGROUND: Preliminary evidence suggests acupuncture may be helpful for pediatric autism; however, needles may be a source of healthcare trauma, so non-needle options should be prioritized. OBJECTIVES: To conduct a systematic review (SR) to synthesize the current evidence on the efficacy and safety of laser acupuncture for pediatric autism. METHODS: We searched the following databases from inception until Nov 14, 2024: MEDLINE, CINAHL, EMBASE, Scopus, PsycINFO, Cochrane Library, SinoMed and China National Knowledge Infrastructure and J-Stage. Randomised controlled trials of laser acupuncture on children up to age 18 years of age with ASD were included. Outcomes were autism symptoms, adverse effects and language development indicators. The PRISMA-A checklist was used to guide conduct and reporting. RESULTS: A total of two trials (n=76) were included. The quality of evidence for most indicators were considered low to very low by GRADE criteria. Meta-analysis was not possible due to heterogeneity in populations and outcomes. Results suggest acupuncture groups benefited compared to no treatment. There were no adverse effects reported by parents of the participants in either trial. CONCLUSIONS: Two studies indicate benefits of laser acupuncture in children with autism but given the low quality of evidence, results should be regarded with caution. Additional well conducted randomized controlled trials with larger sample sizes are required to build evidence. PROTOCOL REGISTRATION: This protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42024576887.

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10. Estupiñán-Pérez VH, Jiménez-Urrego Á M, Botero Carvajal A. Clinical and environmental risk factors for childhood developmental disabilities: A narrative review (1990-2025). World J Clin Pediatr. 2026; 15(3): 119109.

Developmental disabilities (DD) affect millions of children worldwide and disproportionately burden low- and middle-income countries. Modifiable risks include early-life clinical procedures and environmental/psychosocial exposures, but syntheses spanning 1990-2025, including the coronavirus disease 2019, remain limited. To narratively review evidence on clinical and environmental risk factors for DD in children < 18 years. PubMed (1990-2025) was searched using SPIDER. Clinical trials, cohorts, and population-based studies were thematically synthesized across clinical procedural and environmental/psychosocial domains. Thirty-two studies were included (19 clinical/procedural; 13 environmental/psychosocial/early intervention), enrolling > 100000 participants; registry studies added > 1.8 million. Cardiac surgery for congenital heart disease was associated with below-average cognitive and motor scores, driven mainly by perioperative complexity, low birth weight, and prolonged intensive care rather than surgical technique. Maternal mental illness was linked to adverse neurodevelopmental outcomes (adjusted odds ratio: Approximately 3-4). Multidomain, family-centered interventions – including telehealth – improved developmental outcomes and reduced delay. Several cohorts reported increased developmental concerns during and after coronavirus disease 2019, particularly in communication and social-emotional domains. Clinical and environmental/psychosocial factors are major, potentially modifiable determinants of DD; priorities include strengthened developmental surveillance, caregiver mental health assessment, and equitable access to early intervention.

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11. Gad N, Mirghani HO, Abdalla AA, Ghmaird A, Baattiah R, Sindi MT, Albalawi M. Preexisting diabetes and gestational diabetes as risk factors for autism spectrum disorder: an umbrella review. Front Public Health. 2026; 14: 1833825.

BACKGROUND: Maternal diabetes during pregnancy, including preexisting type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes mellitus (GDM), has been investigated as a potential risk factor for autism spectrum disorder (ASD) in offspring. However, the consistency and strength of evidence across published meta-analyses remain uncertain. This umbrella review aimed to synthesize and critically appraise the existing meta-analytic evidence on this association. METHODS: Following the PRISMA 2020 guidelines, we conducted an umbrella review of meta-analyses identified through PubMed, Web of Science, and Google Scholar from inception to March 31, 2026. Eligible studies quantitatively assessed the association between maternal diabetes and the risk of ASD. Of 636 records identified, 11 meta-analyses met the inclusion criteria. Data on effect estimates, heterogeneity, and potential bias were extracted. Study quality was assessed using AMSTAR 2, and overlap among primary studies was evaluated using the corrected covered area (CCA). Given the substantial overlap and methodological variability, the most robust meta-analysis for each exposure was prioritized, and findings were synthesized descriptively without conducting a de novo meta-analysis. RESULTS: Across included meta-analyses, maternal diabetes was consistently associated with increased ASD risk in offspring. Preexisting diabetes showed a more consistent and stronger association compared with GDM, which also demonstrated a positive but more variable association. Heterogeneity was commonly moderate to high, and publication bias was variably reported. Overall evidence ranged from suggestive to weak, with higher credibility observed for preexisting diabetes than for GDM. CONCLUSION: A consistent and statistically significant association was observed between maternal diabetes-including both preexisting diabetes and GDM-and ASD, with evidence suggesting a risk gradient according to diabetes type. These findings highlight the importance of maternal metabolic health during pregnancy and support further research into the underlying mechanisms and potential preventive strategies. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261334307, 2026CRD420261334307.

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12. Gisbert-Gustemps L, Martínez-Ramírez M, Setién-Ramos I, Restoy D, Ramos-Quiroga JA, Lugo-Marín J. Research Priorities in Autism From a Clinical Setting: Voices of Autistic Adults and Families of Children and Adolescents With Autism Spectrum Disorder. Autism. 2026: 13623613261483298.

This study explored the research priorities of autistic adults and families of children and adolescents with autism spectrum disorder within a hospital-based diagnostic service in Spain. Using a mixed-methods design with interviews and a survey aligned with the Spanish Autism Strategic Plan (2023-2027), 42 participants shared what research they consider most relevant. Both groups prioritized applied research that improves daily life-communication, sensory processing, flexibility, mental health, education, employment, and quality of life. Families also emphasized biomedical topics such as genetics, microbiota, and pharmacological treatments, noting that etiological research should enhance well-being rather than aim to « cure » autism. Autistic adults highlighted the need for more accurate and timely diagnosis, especially for women and late-diagnosed adults, as well as research on masking, autonomy, workplace adaptations, and independent living. Participants perceived limited real-world impact from current autism research due to poor dissemination and scarce practical application, yet interest in future involvement was high, with many willing to collaborate or act as co-researchers. The study shows that participatory research can be successfully embedded in clinical settings and underscores the need for a national research agenda grounded in lived experience and focused on improving everyday well-being.Lay AbstractThis study aimed to identify which research topics are most important to autistic adults and to families of children and adolescents with autism spectrum disorder in Spain. Participants were also asked for their views on publicly funded autism research projects from 2020 to 2023 in order to assess whether funding priorities align with what they consider most relevant. A total of 42 people took part (23 family members and 19 autistic adults), all invited through a hospital-based autism diagnostic program in Barcelona. Data were collected through interviews and a survey based on the Spanish Strategic Plan for Autism (2023-2027). Both families and autistic adults agreed that the most useful research is that which improves daily life, particularly in areas such as communication, flexibility, sensory processing, education, employment, mental health, and quality of life. Studies on the causes or genetics of autism were also seen as relevant, provided their goal is to improve the quality of life of autistic people and their families, rather than the eradication of autism. Families placed greater importance on professional training and good health care practices, whereas autistic adults emphasized the need for research on independence, aging, and sensory experiences. Nearly all participants had previously taken part in research and showed strong interest in continuing to do so. Many autistic adults expressed a desire to participate not only as subjects but also as collaborators or co-researchers. This study demonstrates that participatory research can be conducted within a clinical setting, integrating the voices of autistic people and their families into the health care system itself. This approach helps build a more inclusive, respectful, and practically useful autism science.

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13. Kang L, Fan L, Tian Y, Jin J, Zhang N, Sun C, Liu Y. A case-control analysis: changes in gut microbiota composition in children with autism spectrum disorder. Front Microbiol. 2026; 17: 1890167.

BACKGROUND: Gut microbiota dysbiosis has been increasingly implicated in autism spectrum disorder (ASD), with the gut-brain axis proposed as a potential mechanistic link. However, ASD-specific microbial signatures remain inconsistent across studies, and whether reported associations reflect primary dysbiosis or ASD-related confounders such as dietary restriction and gastrointestinal comorbidities remains debated. METHODS: A case-control study was conducted enrolling 54 children with ASD and 46 age- and sex-matched typically developing (TD) children. Full-length 16S rRNA gene sequencing was performed on the PacBio Sequel IIe third-generation platform using universal primers 27F/1492R, generating high-fidelity (HiFi) reads via on-instrument circular consensus sequencing (CCS). Gut microbiota differences were assessed using α- and β-diversity analyses, phylum-level composition, Gut Microbiome Health Index (GMHI), Microbial Dysbiosis Index (MDI), differential abundance testing, and LEfSe analysis. RESULTS: No significant differences were observed in α-diversity between groups, whereas significant differences were identified in β-diversity, GMHI, and MDI. Phylum-level analysis revealed a significantly reduced Bacillota/Bacteroidota ratio in the ASD group. More than 80% of ASD samples had negative GMHI values vs. more than 75% of TD samples with positive values, demonstrating superior discriminative performance compared with traditional diversity indices. Differential abundance analysis identified 15 differentially abundant species: 10 enriched in the TD group, predominantly butyrate-producing bacteria and Bifidobacterium spp., and 5 enriched in the ASD group, predominantly Bacteroides-affiliated taxa. LEfSe confirmed 16 differentially abundant taxa (LDA score ≥ 3.0). CONCLUSION: Children with ASD exhibited significant differences in gut microbiota composition compared with TD children, characterized by a functional compositional imbalance-systematic depletion of butyrate-producing bacteria and Bifidobacterium spp. alongside enrichment of specific Bacteroides members-rather than alterations in overall species diversity. These findings are consistent with gut-brain axis dysregulation in ASD, though the cross-sectional design precludes causal inference and the possibility that observed differences reflect ASD-related dietary behavior cannot be excluded. GMHI demonstrated superior discriminative performance compared with traditional diversity indices in this cohort, though its application in pediatric ASD populations remains exploratory and requires independent validation in larger multicenter cohorts.

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14. Kirby AV, Siddeek Z, Duncan-Ishcomer B, Kripke-Ludwig R, Joyce A, Rodriguez K, Lee W, Murthi K, Feldman K, Atisme A, Darlington A, Wexler L, Nicolaidis C. Pilot Test of the Forming Love around Autistic people to Prevent Suicide Program. Autism Adulthood. 2026.

Notable proportions of autistic people experience suicidal thinking and actions (i.e., suicidality). Many of the identified influences on suicidality for autistic people necessitate broad changes in societal attitudes, services, and supports. Yet most suicide-prevention efforts focus on clinical interventions targeting change for autistic individuals themselves. We used a community-based participatory research approach to develop a novel program for autism-focused (or autism-relevant) community organizations. The program is called Forming Love around Autistic people to Prevent Suicide (FLAPS). FLAPS is a four-part virtual education and capacity-building intervention focused on supporting organizations to incorporate broad autism suicide prevention efforts into their ongoing work. We pilot tested this new program in a single-arm trial. A team of autistic and nonautistic co-facilitators delivered the full FLAPS program three times to grouped organizations. Fifty-one participants, from a total of 11 organizations, enrolled in the program. Our primary outcome measure was the tailored Steps Toward Prevention – Autism Community Suicide Prevention questionnaire, administered at pre-program, post-program, and three-month follow-up. We observed significant increases, with moderate to high effect sizes, in knowledge & capacity and actions. The majority of participants who provided feedback (74%) agreed that FLAPS encouraged them to think in new ways, that it was worth their time, and that their organization can use the information. At the three-month follow-up, over 75% of respondents reported that they sometimes or frequently used concepts from the program. Future work is needed to further evaluate program outcomes, including determining any measurable impact on autistic individuals served within participating organizations. TRIAL REGISTRATION: ClinicalTrials.gov https://clinicaltrials.gov/study/NCT06552871.

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15. Kolar S, Horvath T, Stroupkova L, Vyhnalova M, Bittnerova AM, Novakova N, Packanova I, Knedlikova L, Repko R, Munster P, Danhofer P. Telehealth autism evaluation under suboptimal network conditions: Technical parameters and clinical implications. PLoS One. 2026; 21(9): e0357146.

Telehealth expands access to autism diagnostics, but scoring reliability depends on connection stability. Using an optical-fiber testbed, we imposed controlled packet loss and Wi-Fi attenuation to derive four freeze patterns (1-second freezes every 16.7, 11.1, 8.3, or 5.0 seconds), then applied these to 10 children’s BOSA videos (40 clips) scored by four blinded psychologists. Analyses included Fisher’s exact tests with Benjamini-Hochberg correction, Spearman correlation, and per-item logistic regression with Bonferroni correction. Performance degraded in a dose-dependent manner rather than collapsing: below a Received Signal Strength Indicator (RSSI) of -70 dBm or above ~0.04% packet loss, freeze frequency increased from ~1/16.7 s to ~1/5.0 s. Time-sensitive items-Spontaneous Joint Attention (B10), Integration of Gaze and Behavior (B4), Immediate Echolalia (A4), and Stereotyped/Idiosyncratic Language (A5)-were 4-9 × more likely to be coded unscorable, and poorer stream quality correlated with more unscored items (ρ ≈ -0.58). Importantly, overall BOSA scoring remained stable, with no individual item reaching significance after correction and substantial inter-rater consistency under mild degradation (ICC = 0.93, Cohen’s κ = 0.76), indicating robustness to moderate degradation. In this pilot study, these results support BOSA as a first-line option when packet loss remains below ~0.04% and RSSI stays above -70 dBm, pending validation in larger, more diverse cohorts. Where possible, using wired connections and awareness of item-level sensitivities can further preserve diagnostic confidence.

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16. Li M, Kurita K, Yamada T, Wang Y, Izumoto M, Iwatani Y, Mohri I, Shou Q, Yamashita M, Hamatani S, Matsuzaki H, Okazawa H, Yoshida T, Kitagawa H, Sasaki T, Matsumoto K, Nagano T, Isobe Y, Kamashita R, Sudo Y, Shimizu E, Kawasaki R, Hirano Y, Mizuno Y, Kagitani-Shimono K. Atypical development of white matter structural networks in children and adolescents with autism spectrum disorder: a graph theory study. Front Neurosci. 2026; 20: 1844698.

BACKGROUND: Atypical brain connectivity is considered a key neurobiological feature underlying the heterogeneous clinical manifestations of autism spectrum disorder (ASD). However, findings on brain networks in ASD are inconsistent, likely owing to the effects of developmental factors. In addition, how large-scale brain networks in ASD differ across developmental stages remains unclear. We aimed to elucidate the atypical developmental patterns of white matter (WM) structural networks in children and adolescents with ASD using a graph-theoretical approach. METHODS: Diffusion/T1-weighted brain imaging data were acquired from 69 individuals with ASD (age: 6-17 years) and 71 age- and sex-matched typically developing controls. Global and nodal topological properties of WM structural networks were computed, and 28 social-related regions were examined through subnetwork and nodal analyses. Case-control comparisons of global and nodal graph metrics were conducted separately for children and adolescents. RESULTS: The children with ASD exhibited reduced integration of the whole-brain network, reflected by increased characteristic path length and decreased global efficiency. In contrast, the adolescents with ASD showed enhanced segregation within the social-brain subnetwork, indicated by increased clustering coefficient and local efficiency. Nodal analyses revealed reduced nodal efficiency across several social-related regions (e.g., the left inferior frontal gyrus, insula, amygdala, supramarginal gyrus, bilateral superior temporal poles) in children with ASD. CONCLUSION: Topological disorganization in the autistic brain network varies across developmental stages, shifting from reduced global integration in childhood to enhanced segregation of social-brain circuits in adolescence. Such atypical WM structural organization may underlie the persistent social cognitive deficits observed in ASD.

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17. Liang X, Jin W, Bu X, Yuan M, Zheng M, Feng S, Zhu L, Lu Y, Zhou JX, Hamdy NM, Zhong CC, Lin Q, Huang X, Chen W. Autism spectrum disorder burden across 798 locations, 1990-2023: frontier and inequality mapping in the context of child injury prevention and safety promotion. Front Public Health. 2026; 14: 1930391.

INTRODUCTION: Autism spectrum disorder (ASD) is commonly identified in childhood and can affect communication, adaptive functioning, supervision, and access to health and educational services. These needs may be relevant to child safety planning, but this study did not measure injury outcomes. METHODS: We analyzed Global Burden of Disease 1990-2023 estimates of ASD incidence and disability-adjusted life-year (DALY) rates across 798 locations. Age-standardized and under-20 rates were benchmarked against a Socio-demographic Index-related frontier using free disposal hull analysis. Socioeconomic inequalities were assessed using the slope index of inequality and concentration index. RESULTS: In 2023, 98 countries and territories (48.0%) were classified as behind the age-standardized incidence frontier and 78 (38.2%) as behind the age-standardized DALY frontier. Among individuals younger than 20 years, 100 (49.0%) were behind the incidence frontier and 123 (60.2%) were behind the DALY frontier. Frontier deviation increased in most countries between 1990 and 2023. Sweden had the largest reduction across all four national metrics, whereas Japan had the largest increase. Japan also had the largest 2023 deviations for age-standardized incidence, age-standardized DALYs, and under-20 DALYs; Brunei Darussalam had the largest under-20 incidence deviation. Selected Japanese prefectures were prominent subnational outliers, while locations in Pakistan and Nigeria showed the largest reductions. Recorded under-20 DALY burden became more concentrated in higher-SDI populations globally, whereas disadvantaged populations within low-SDI settings retained substantial absolute inequality. DISCUSSION: These findings provide descriptive benchmarks for ASD surveillance, early recognition, service organization, and equitable healthcare planning. They should not be interpreted as direct measures of service quality, unmet need, or injury risk.

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18. Lima Braga de Jesus M. Whey protein and creatine supplementation in autistic adult women: a call for sex- and age-specific research. Front Nutr. 2026; 13: 1902181.

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19. Miller SL, Bourke-Taylor H, Dixon K, Upreti R. Experiences of autistic transgender and gender diverse adults undergoing gender-affirming hormone therapy and the influence on occupational identity outcomes. Aust Occup Ther J. 2026; 73(5): e70121.

INTRODUCTION: Autistic transgender and gender diverse (TGD) adults often report additional barriers to health-care access and occupational participation. Gender-affirming hormone therapy (GAHT) consists of hormonal medications a person may choose to take to increase alignment of physical features with their gender identity. CONSUMER AND COMMUNITY INVOLVEMENT: This research project was conducted in response to patient and clinician feedback; however, no consumers were involved in the setup or analysis of the study. METHODS: Six autistic TGD adults undergoing GAHT at a statewide tertiary gender endocrinology clinic participated in in-depth semi-structured interviews and underwent an Adolescent/Adult Sensory Profile (AASP) assessment. Secondary analysis of qualitative data utilised thematic analysis and triangulation with AASP results through the lens of the doing, being, becoming, belonging framework to understand how autistic TGD adults achieve occupational identity. RESULTS: Autistic TGD adults experienced improved quality of life, mental health, and occupational identity outcomes as a result of GAHT. Being TGD and autistic posed unique challenges for autistic TGD adults in doing tasks associated with GAHT, including navigating health-care and social environments. Gender-affirming physical changes and experiences increased participants’ engagement in gendered occupations and roles. CONCLUSION: For autistic TGD adults who choose to medically transition, GAHT can be an important gender-affirming occupation in enabling occupational identity acquisition. The results of this study highlight a role for occupational therapists within gender-affirming care settings to enhance patient care. Trans and gender diverse (TGD) refers to individuals who identify with a gender that differs from their sex assigned at birth. This includes trans men (people assigned female at birth who identify as men) and trans women (people assigned male at birth who identify as women), as well as other gender identities such as non‐binary (people assigned male or female at birth whose gender identity exists outside of the typical gender binary) and agender (people who do not identify as having a gender). Many TGD adults desire either masculinising or feminising gender‐affirming hormone therapy (GAHT) to help align their physical characteristics with their identified gender. There is a well‐recognised link between autism and gender diversity; however, there is limited understanding of the experiences of autistic TGD individuals on GAHT. This study is a detailed analysis of interviews and sensory profile results from six autistic TGD adults currently on GAHT. We show that autistic TGD adults experience unique challenges related to taking GAHT as prescribed, as a result of sensory processing and executive function difficulties, societal stigma, and often fragmented care. Physical changes with GAHT increased participants’ engagement in occupations and roles typically associated with their gender and affirmed their sense of identity and belonging. Our study demonstrates that accessing gender‐affirming care and taking GAHT are gender‐affirming occupations for many autistic TGD individuals. Providing autistic TGD adults with access to occupational therapy input may improve their occupational outcomes on GAHT. eng.

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20. Ng R, Fanara P, Meier L, Harris J. The social behavioral phenotype of Kabuki syndrome. Arch Clin Neuropsychol. 2026; 41(7).

OBJECTIVE: This study describes the social-communication and behavioral profile associated with Kabuki syndrome (KS), including exploratory comparisons between individuals with a pathogenic variant in KMT2D (KS1) versus KDM6A (KS2). METHOD: Thirty-five caregivers of children/adults with KS (25F, Mage = 13.45, SD = 7.60) completed the Social Responsiveness Scale 2nd Edition (SRS-2), Colorado Learning Difficulties Questionnaire, and/or Strengths and Difficulties Questionnaire. Descriptive analyses and non-parametric tests were conducted to examine behavioral trends in the entire cohort and to explore differences in social behaviors and autism characteristics between those with KS1 versus KS2. RESULTS: About a third of the sample have a prior diagnosis of autism spectrum disorder, with rates more elevated in KS2 versus KS1 (67% vs. 23%). In the full cohort, 72% fell in borderline/clinical ranges for Peer Problems, while only 3% yielded atypical scores for Prosocial Behaviors. Those with KS1 were rated to show most challenges in restricted/repetitive behaviors (RRBs), which fell in the moderately severe range, compared to other social domains (social communication, social awareness, social motivation). In contrast, social motivation was the sole area rated within normal limits. CONCLUSION: Those with KS2 showed greater difficulties across all social behavior/cognitive domains than KS1 counterparts, albeit both presented with similar severity in RRB and prosocial behaviors. Prominent features of the KS social behavioral phenotype include pronounced difficulties with inflexible behaviors and restricted interests juxtaposed with strong prosocial tendencies. KS2 may confer increased risk for autism-related characteristics, underscoring the need for more systematic investigations.

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21. Parlakkaya Yıldız FB, Kurtulmuş A, Çelik Z, Ereğli B, Görmez A. Autistic traits in unaffected first-degree relatives of individuals with schizophrenia and bipolar disorder: implications for shared familial neurodevelopmental vulnerability. Front Psychiatry. 2026; 17: 1933974.

BACKGROUND: Autistic traits have increasingly been linked to schizophrenia (SCH) and bipolar disorder (BD) within a shared neurodevelopmental framework. However, whether these traits are similarly expressed in unaffected first-degree relatives of individuals with SCH and BD remains poorly understood. METHODS: This cross-sectional study included 135 participants: first-degree relatives of individuals with schizophrenia (SCH-FDR, n=45), first-degree relatives of individuals with bipolar disorder (BD-FDR, n=45), and healthy controls (HCs, n=45). Autistic traits were assessed using the Autism Spectrum Quotient (AQ). Participants also underwent clinical psychiatric evaluation, including structured diagnostic assessment, to exclude psychiatric disorders and autism spectrum disorder. RESULTS: Significant group differences were observed for AQ total score (p=0.002), Communication (p=0.004), and Imagination (p<0.001) subscales. Communication scores were significantly higher in SCH-FDR than in HCs (p=0.003). Imagination scores were higher in both BD-FDR (p=0.016) and SCH-FDR (p<0.001) groups compared with HCs. Total AQ scores were also higher in both relative groups than in HCs (BD-FDR: p=0.015; SCH-FDR: p=0.003). The proportion of participants with AQ scores ≥26 was higher in SCH-FDR (17.8%) and BD-FDR (13.3%) than in HCs (2.2%; p=0.045). CONCLUSIONS: Autistic traits were more pronounced in SCH-FDR and BD-FDR than in healthy controls. Differences were most evident in total AQ scores and the Imagination subscale across both relative groups, whereas communication difficulties were specifically elevated in schizophrenia relatives. These findings are consistent with the concept of shared familial neurodevelopmental vulnerability across schizophrenia and bipolar disorder.

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22. Polat MY, Kılıçaslan F. Orthodontic and Oral Health Assessment in Children With Autism: A Comparative Study With Typically Developing Children. Orthod Craniofac Res. 2026.

OBJECTIVE: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that may influence oral health and orthodontic characteristics due to associated behavioural, sensory, and motor challenges. This study aimed to compare orthodontic treatment need, Angle classification, and oral hygiene status between children with ASD and typically developing children. MATERIALS AND METHODS: This cross-sectional comparative study included 50 children aged 6-18 years with ASD and 43 age- and sex-matched typically developing children. Malocclusion and orthodontic treatment need were assessed using Angle classification and the Index of Complexity, Outcome, and Need (ICON), respectively. Oral hygiene was evaluated with the Simplified Oral Hygiene Index (OHI-S). Intra-rater reliability was assessed with the intraclass correlation coefficient (ICC = 0.96). Group differences were assessed using the Mann-Whitney U, chi-square, or Fisher’s exact tests, as appropriate. Spearman’s correlation and age- and sex-adjusted multivariable regression analyses were also performed. RESULTS: ICON scores were significantly higher in children with ASD than in typically developing children (p = 0.024). Oral hygiene was significantly poorer in the ASD group (p < 0.001), whereas Angle classification did not differ significantly between the groups (p = 0.118). After adjustment for age and sex, ASD diagnosis remained significantly associated with higher ICON scores (adjusted B = 9.74, 95% CI: 2.95-16.53, p = 0.005) and greater odds of being classified in a poorer oral hygiene category (adjusted OR = 4.65, 95% CI: 2.05-10.56, p < 0.001). CARS scores were not significantly correlated with ICON scores (rho = -0.152, p = 0.291). CONCLUSION: Within the limitations of this study sample, children with ASD showed higher ICON scores and poorer oral hygiene status compared with typically developing children. These findings indicate an association between ASD status, orthodontic treatment need as assessed by ICON, and oral hygiene status in the study population. Further studies are needed to better understand the factors influencing orthodontic and oral health outcomes in children with ASD.

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23. Roemhild E, Sanford K, Ronis SD, Burkhart K. Extending the HealthySteps Program to Improve Access to Autism Spectrum Disorder Assessment Services: A Pilot Study. J Prim Care Community Health. 2026; 17: 21501319261488480.

There has been a significant increase in the need for early identification and diagnosis of autism spectrum disorder (ASD). Limited access to care and long wait times are barriers to timely diagnosis. Integrated primary care is a promising avenue for early identification of signs and symptoms of ASD. This paper provides preliminary evidence for the effectiveness of an extension of the HealthySteps (HS) program for identifying and diagnosing ASD within an integrated pediatric primary care setting. The pilot extension resulted in shorter wait times for an ASD evaluation, more timely diagnoses leading to referrals to intervention at a younger age, and increased access to services addressing psychosocial risk factors that may serve as barriers to receiving care. Additionally, this article discusses implications and future directions for adapting the HS model in integrated behavioral health practices.

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24. Rosenberg M, Mixer M, Perez Coulter A, Pepper V, Banever G, Tashjian D, Moriarty K, Tirabassi M. Ruptured appendicitis in pediatric patients with autism, ADHD, and depression: Communication is key. J Pediatr Surg. 2026; 61(12): 163463.

INTRODUCTION: Symptom duration correlated with appendiceal rupture. This study aimed to investigate whether communication barriers associated with attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or major depressive disorder (MDD) correlated with higher incidence of appendiceal rupture. METHODS: A retrospective review was conducted of patients younger than 18 years old at a single center with acute appendicitis between 1/1/2013-6/1/2025. Data included age, symptom duration, non-ruptured versus ruptured, and complications. Patients were stratified into ADHD, ASD, MDD, or none. Communication barrier was defined as documented verbal delay or communication impairment prior to presentation. Patients <5 years old were excluded due to the expected trajectory of language acquisition. Student's t-test and Mann-Whitney U test were used for cohort comparison. RESULTS: 1147 patients met inclusion criteria. The mean (SD) age at presentation was 11.7 (3.7) years. 31.7% had ruptured appendicitis. For patients <5 years old, 16.6% of patients had a neuropsychiatric diagnosis of interest: 10.9% ADHD, 1.7% ASD, and 1.9% MDD. Some children had more than one diagnosis: 1.1% ADHD and ASD, 0.3% had ADHD and MDD. There was no difference in the incidence of ruptured appendicitis based on neuropsychiatric diagnosis (p = 0.12). Of those with neuropsychiatric diagnoses, those with no communication barrier were less likely to present with ruptured appendicitis than those with a communication barrier (9.5% versus 21.2%, p = 0.04). CONCLUSION: Neuropsychiatric diagnosis did not correlate with risk for ruptured appendicitis. The presence of a communication barrier in those with a neuropsychiatric diagnosis, however, is associated with an increased risk of appendiceal rupture.

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25. Silva E, Hoffmann LV, Castro K, Valle SC, Vaz JDS. Usual micronutrient intake and food selectivity among Brazilian children and adolescents with autism spectrum disorder: a cross-sectional study. J Acad Nutr Diet. 2026: 156876.

BACKGROUND: Feeding difficulties, particularly food selectivity, are commonly reported in individuals with autism spectrum disorder (ASD), raising the possibility that these aspects may affect dietary intake, including essential micronutrients. Many studies on this topic fail to adequately adjust for within-person variability, potentially misrepresenting usual nutrient intake. OBJECTIVE: This study evaluates micronutrient adequacy among children and adolescents with ASD with and without food selectivity, based on usual intake estimations. DESIGN: This study used a cross-sectional design and included data collected between July 2021 and April 2025. PARTICIPANTS/SETTING: Data were obtained from 303 participants aged between 2 and 18 years attending the public neuropediatric outpatient clinic of the Federal University of Pelotas, southern Brazil. MAIN OUTCOME MEASURES: Food consumption was obtained from three non-consecutive days of a 24-hour dietary recall, and food selectivity was assessed based on the consumption of food group items and item 10 of the Brief Autism Mealtime Behavior Inventory. STATISTICAL ANALYSES PERFORMED: The distribution of usual micronutrient intake was estimated using the Multiple Source Method® (version 1.0.1), and the resulting values were compared with the corresponding dietary reference intakes. RESULTS: Food selectivity was observed in 77% of the participants. When comparing individuals with and without food selectivity, a high frequency of inadequacy was observed in both groups for copper, potassium, calcium, and retinol, while sodium intake was excessive. Significant differences in usual micronutrient adequacy between the groups were observed only for vitamin C and phosphorus. CONCLUSION: Food selectivity did not substantially differentiate micronutrient adequacy in this sample, and both groups showed relevant inadequacies. These findings highlight the need for routine nutritional screening for all individuals with ASD, regardless of food selectivity status, to ensure accurate evaluation of nutrient intake and better inform nutritional interventions.

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26. Tarp ME, Lousdal ML, Rask CU, Keyes KM, Formánek T, Brikell I, Liu X, Maseras GT, Plana-Ripoll O. Changes in Characteristics Associated With ADHD and ASD Diagnoses Over Time. JAMA Psychiatry. 2026.

IMPORTANCE: Diagnoses of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have increased substantially in recent decades, but it is unclear whether associations of prediagnostic characteristics with these diagnoses have changed over time. OBJECTIVE: To examine temporal trends in associations between well-defined risk factors and subsequent diagnoses of ADHD and ASD. DESIGN, SETTING, AND PARTICIPANTS: This population-based matched case-control study was conducted using nationwide Danish registry data for individuals born between January 1, 1994, and December 31, 2022, followed up to age 18 years. Individuals diagnosed with ADHD or ASD before age 18 years between 2012 and 2022 were included as cases. Each case was matched to 10 controls without these diagnoses by sex, birth year, municipality of residence, and country of birth. Data were analyzed from April 2025 through June 2026. EXPOSURE: A list of 19 prediagnostic characteristics, including parental and family factors, birth and perinatal factors, and health care use. MAIN OUTCOMES AND MEASURES: Associations between prediagnostic characteristics and ADHD or ASD diagnoses by year of diagnosis, estimated as odds ratios (ORs) with 95% CIs using conditional logistic regression. RESULTS: Of 2 194 951 children and adolescents in the registry, 100 323 individuals (4.6%) were diagnosed with ADHD or ASD before age 18 years, among whom 71 317 children and adolescents were diagnosed between 2012 and 2022 and included as cases (26 452 female [37.1%]; median [IQR] age at diagnosis, 11.4 [8.1 to 14.9] years), matched with 713 170 controls. Individuals diagnosed with ADHD or ASD differed from controls across all characteristics, but differences diminished over time, with ORs attenuating toward the null, particularly for socioeconomic and perinatal factors. For example, the OR for low birth weight decreased from 1.54 (95% CI, 1.41 to 1.68) in 2012 to 2013 to 1.17 (95% CI, 1.10 to 1.24) in 2020 to 2022. Attenuation was greater for ADHD than ASD (eg, household income: mean yearly change in OR, 6.5% [95% CI, 5.7% to 7.3%] for ADHD; mean yearly change in OR, 0.7% [95% C, -0.1% to 1.5%] for ASD) and more pronounced among individuals diagnosed at ages 10 to 17 years than at younger ages. Patterns were similar across sexes and in analyses restricted to cases with higher diagnostic certainty. CONCLUSIONS AND RELEVANCE: This study found that from 2012 to 2022, children and adolescents diagnosed with ADHD or ASD became increasingly similar to peers without these diagnoses. These findings suggest that increasing diagnostic rates may reflect changes in diagnostic practices or health care capacity rather than changes in underlying risk alone and should not be interpreted as evidence that ADHD or ASD have become less impairing at the individual level.

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27. Uslu B, Aslan İ, Çevik FA. Deconstructing the Diet-Language Myth in Autism: A Divergent V-Type Model. J Autism Dev Disord. 2026.

PURPOSE: To investigate whether eating behaviors and diet quality predict receptive and expressive language development in children with autism spectrum disorder (ASD), independent of autism severity. METHODS: Seventy-one children with ASD (mean age 55.61 ± 15.88 months) were assessed using the TEIıL (language), GARS-2-TV (autism severity), CEBQ (eating behaviors), and KIDMED (diet quality). Analyses included hierarchical regression, 5000-bootstrap mediation, moderation, and exploratory K-means cluster analysis. RESULTS: Autism severity strongly predicted both receptive and expressive language (explained variance = 53%). After controlling for severity and age, eating behaviors and diet quality provided no significant incremental variance ( $ΔR² = .020 and .012) and showed no significant partial correlations with language (all p > .15). Furthermore, all 11 mediation and 6 moderation models yielded non-significant effects. Exploratory clustering revealed a paradox: children with the most severe autism and highest food selectivity exhibited the highest Mediterranean diet adherence, likely reflecting rigid parental dietary control. CONCLUSION: Nutritional variables do not directly or indirectly predict language development in ASD when controlling for core symptom severity. We propose a divergent « V-Type » conceptual model, suggesting that autism severity independently drives both language delays and eating disruptions. Nutritional interventions and speech-language therapy should be pursued as parallel, independent targets.

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28. Verma S, Bhatia T, Chakraborty S, Beniwal RP, Deshpande SN. Screening children and adolescents with mild to moderate intellectual disability for autistic symptoms with the Indian Autism Screening Questionnaire (IASQ). Indian J Psychiatry. 2026; 68(Suppl 2): S359-s65.

INTRODUCTION: Intellectual disability (ID) is frequently associated with autistic symptoms. Considering the prevalence of ID and the large numbers involved, a simple easy-to-use screening instrument is required. The present study aimed to screen a group of children with ID using the Indian Autism Screening Questionnaire (IASQ), a screening instrument for identifying autism in the general population but not tested among children with ID. OBJECTIVES: To screen for the presence and prevalence of autistic symptoms among Indian children with ID and to evaluate IASQ scale properties in this group. METHODS: In a cross-sectional observational study, 120 children/adolescents between the ages of 3 and 18 (both genders) with mild to moderate ID were assessed using the Vineland Social Maturity Scale for Social Quotient, IASQ, and the Indian Scale for Assessment of Autism (ISAA). RESULTS: Using the ISAA, 37.2% of children with mild ID (mild symptoms 27, moderate 5) and 52.9% with moderate ID (mild 16, moderate 2) reported autistic symptoms. The sensitivity and specificity for IASQ against the ISAA were acceptable – high sensitivity at cutoffs 1 to 5 and high specificity at cutoffs 4 and 5. CONCLUSION: The IASQ can be used for screening for autistic symptoms among children with mild or moderate ID at cutoff 1, while the specificity is high at cutoff 4. Autistic features were reported among 1/3(rd) and 1/2(nd) of children with mild and moderate ID, respectively.

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29. Xiang F, Wan X, Han X, Zhuang T, Wang H. Shared gut microbiota features between children with autism spectrum disorder and their mothers. Front Med (Lausanne). 2026; 13: 1873159.

OBJECTIVE: To explore shared gut microbiota and short-chain fatty acid (SCFA) features between children with autism spectrum disorder (ASD) and their mothers, and to identify key taxa potentially influencing ASD via vertical transmission. METHODS: Thirty seven mother-child dyads with ASD were enrolled. Fecal samples were analyzed by 16S rRNA gene sequencing and targeted SCFA metabolomics. RESULTS: The average mother-child shared ASV proportion was 23.92% (relative to child total). Fifteen genera showed significant positive correlations between mothers and children after FDR correction (P < 0.05), including Faecalibacterium (r = 0.518), Subdoligranulum (r = 0.462), and Roseburia hominis (r = 0.458). Propionic acid also exhibited a significant positive correlation (r = 0.418, P = 0.024). Stratified analysis showed that vaginal delivery was associated with significantly higher sharing than Cesarean section. External validation in two public datasets identified Intestinibacter as a consistently ASD-enriched genus. CONCLUSION: There is moderate gut microbiota overlap between ASD children and their mothers. Fifteen genera and propionic acid may be vertically transmitted and contribute to ASD, offering potential targets for early intervention.

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30. Yamamuro K, Yamauchi T, Makinodan M. Guanfacine and HCN channels: bridging neuroinflammation and prefrontal cortex function in autism spectrum disorder. Front Mol Neurosci. 2026; 19: 1915506.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social communication differences and restricted, repetitive behaviors. Convergent evidence implicates prefrontal cortex (PFC) circuit dysregulation and chronic neuroimmune activation in ASD. Despite increasing off-label use of guanfacine in children and adolescents with autism, its molecular and immunological rationale remains incompletely synthesized. OBJECTIVE: To synthesize current evidence regarding the molecular, neurophysiological, and immunological mechanisms through which guanfacine may influence ASD-related neural and immune dysfunction. METHODS: In this narrative review, we integrated evidence from pharmacology, systems neuroscience, immunology, and clinical studies to examine two converging mechanisms by which guanfacine may act in ASD and related conditions. RESULTS: Guanfacine suppresses cAMP signaling through α2A-adrenoceptor activation, producing dual neuronal and immune effects. In PFC pyramidal neurons, reduced cAMP signaling promotes closure of hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, strengthening network firing that supports working memory, attention, and emotion regulation. In parallel, activation of α2A-adrenoceptors on microglia and macrophages reduces production of pro-inflammatory cytokines, including tumor necrosis factor-α, interleukin-1β, and interleukin-6, while promoting anti-inflammatory phenotypes through nuclear factor kappa B suppression and peroxisome proliferator-activated receptor gamma activation. Evidence from human studies and ASD models indicates that α2A-adrenoceptor signaling, HCN channel function, and microglial reactivity are altered in autism and converge on synaptic refinement, dendritic spine stability, and PFC-dependent behavior. We further review clinical evidence for guanfacine in individuals with autism and in related conditions, including attention-deficit/hyperactivity disorder, post-traumatic stress disorder, traumatic brain injury, post-COVID cognitive impairment, delirium, and age-related cognitive decline. CONCLUSION: Collectively, the available evidence supports a mechanistic framework linking guanfacine, HCN channel modulation, and neuroimmune regulation, thereby bridging neuroinflammation and PFC function in ASD. The broader α2A-HCN-microglia axis may represent a promising therapeutic target for PFC- and neuroimmune-related features of ASD; however, adequately powered autism-specific randomized trials and biomarker-informed stratification strategies are needed to establish clinical efficacy and validate this framework.

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31. Yidi CA, Jiménez S, Solano NA, De Jesús Rodríguez A, Porras A. Expansion of the allelic and phenotypic spectrum of MED25-related developmental disorder: novel compound heterozygous variants with structural domain implications. Neurogenetics. 2026; 27(1).

MED25-related developmental disorder (Basel-Vanagaite-Smirin-Yosef syndrome) is a rare autosomal recessive disorder, defined by severe neurodevelopmental delay, corpus callosum abnormalities, ocular involvement, epilepsy, and marked facial appearance. MED25 pathogenic variants interfere with the functioning of the Mediator complex, which is responsible for RNA polymerase II transcription. We report a 9-year-old girl who presents with significant global developmental delay, agenesis of the corpus callosum, congenital cataracts, epilepsy, hypotonia, musculoskeletal abnormalities, and typical craniofacial features. Trio-based whole-exome sequencing revealed compound heterozygous variants in MED25: a maternally transmitted truncating variant (c.1366 C > T; p.Gln456*) and a paternally inherited missense variant (c.430 C > T; p.Leu144Phe). The new classification of the missense variant as potentially pathogenic is supported by a systematic ACMG re-evaluation supported by segregation analysis, phenotypic specificity, computational prediction, and structural localization in the MED25 Activator Interaction Domain (ACID). Comparative phenotypic analyses show strong agreement with reported cases but add more data to fine-tune clinical spectrum. This article broadens the allelic and phenotypic spectrum of MED25-related developmental disorder and highlights the need for comprehensive evaluation across molecular, structural, and phenotypic pathways to elucidate variant signature in rare genetic disease models correctly.

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32. Zhou X, Xie H, Yu H, Zhang Z, Qi Y, Jiang K, Lin S. A rare de novo contiguous 15q11.1-q13.3 duplication with tetrasomy (CN=4) and adjacent trisomy (CN=3) associated with severe global developmental delay, autism spectrum disorder, and subclinical epileptiform discharges: a case report and literature review. Front Genet. 2026; 17: 1953023.

BACKGROUND: 15q11.2-q13 duplication syndrome (Dup15q; OMIM #608636) is a rare neurodevelopmental disorder. While interstitial duplications (copy number = 3) are relatively well characterized, contiguous rearrangements comprising both tetrasomic (copy number = 4) and adjacent trisomic (copy number = 3) segments are rare. We report a Chinese girl with a de novo contiguous 15q11.1-q13.3 duplication, whose underlying genetic diagnosis was initially delayed because her early neurodevelopmental abnormalities were partly attributed to prematurity. CASE PRESENTATION: The patient was born at 35+2 weeks of gestation and presented with global developmental delay, severe autism spectrum disorder (CARS: 44), and profound cognitive and language impairment (GQ 30, GMQ 57 at 2 years 4 months). Brain MRI demonstrated delayed myelination, and magnetic resonance spectroscopy showed metabolic abnormalities in the left frontal lobe. Video-electroencephalography at 3 years of age revealed sleep-activated frontocentral epileptiform discharges without clinical seizures. Trio whole-genome sequencing with copy number variation analysis identified a de novo contiguous duplication consisting of a ∼10.34 Mb tetrasomic segment (15q11.1-q13.2; CN = 4) and an adjacent ∼2.40 Mb trisomic segment (15q13.2-q13.3; CN = 3). Despite long-term rehabilitation, the patient remained nonverbal and exhibited persistent severe neurodevelopmental impairment. CONCLUSION: This case expands the genomic spectrum of complex proximal 15q rearrangements and highlights the value of high-resolution genomic testing for resolving complex neurodevelopmental disorders. It also emphasizes that severe genetic etiologies may be overlooked when developmental abnormalities are initially attributed to prematurity. These findings support early comprehensive genomic evaluation in children with profound developmental delay, autism spectrum disorder, or persistent developmental impairment despite conventional rehabilitation.

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