1. Anchan V, C T, Sahoo S, Chandhok S, Rao BCS, Singh R, P PM, C VS, Kotian R, Srikanth N. Multidimensional Evaluation of the Efficacy of a Comprehensive Ayurveda Approach as an Add-On to Conventional Therapy in Children With Autism Spectrum Disorder: Protocol for a Randomized, Open-Label, Parallel-Group, Active-Controlled Clinical Trial. JMIR Res Protoc. 2026; 15: e99910.

BACKGROUND: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder characterized by impairments in social communication, restricted and repetitive behaviors, and deficits across multiple developmental domains. Although conventional interventions, including speech, behavioral, and occupational therapies, improve functional outcomes, many children continue to experience persistent cognitive and adaptive impairments. Ayurvedic formulations such as Saraswata Ghrita and Ayush Manas possess neuroprotective, anti-inflammatory, antioxidant, and cognition-enhancing properties, but robust clinical evidence supporting their adjunctive use in ASD is limited. OBJECTIVE: The study aims to evaluate the efficacy of a comprehensive Ayurveda intervention as an adjunct to conventional therapy in children with ASD by assessing changes in behavioral symptoms, intellectual functioning, adaptive behavior, parental quality of life, and exploratory inflammatory biomarkers. METHODS: This randomized, open-label, parallel-group, active-controlled clinical trial will enroll 80 children aged 6 to 15 years diagnosed with ASD according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria at the Central Ayurveda Research Institute (CARI), Bengaluru, in collaboration with selected autism therapy centers. Participants will be randomized in a 1:1 ratio to receive either conventional therapy alone or conventional therapy combined with Saraswata Ghrita and Ayush Manas for 6 months. Outcome assessments will be performed at predefined intervals using the Autism Treatment Evaluation Checklist (ATEC), Indian Scale for Assessment of Autism (ISAA), Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), Vineland Adaptive Behavior Scales, Third Edition (VABS-III), and Quality of Life in Autism (QoLA) questionnaire. Exploratory laboratory assessments include high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha (TNF-α). Safety will be evaluated through adverse event monitoring and laboratory investigations. Statistical analysis will be performed after data verification. Data normality will be assessed using the Shapiro-Wilk test. Variables will be represented as frequencies (%), mean (SD), or median with IQR. Preintervention and postintervention comparisons will use repeated-measures ANOVA or the Friedman test, as appropriate, with significance set at P<.05, using STATA software (version 18.0; StataCorp LLC). RESULTS: Ethical approval was obtained before study initiation, and the trial was registered with the Clinical Trials Registry-India (CTRI/2025/04/085035). Participant recruitment commenced on December 3, 2025. As of July 17, 2026, 20 participants had been enrolled and completed baseline assessments; 14 had completed the 90-day follow-up, and 2 had completed the 6-month intervention. Recruitment is expected to continue until August 2027, followed by completion of participant follow-up, data analysis, and dissemination of study findings. CONCLUSIONS: The study will provide high-quality evidence regarding the effectiveness of integrating Ayurveda with conventional therapy for children with ASD. By simultaneously evaluating behavioral, cognitive, adaptive, quality-of-life, and exploratory biological outcomes, the trial is expected to strengthen the evidence base for multidisciplinary integrative care and inform the development of standardized treatment strategies for ASD.

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2. Arage SM, Dagnaw M, Indracanti M, Pothapragada R, Govindraj D, Gunturu C, Kasim H, Albabtain BA, Malik T. Assessment of parental knowledge on childhood developmental milestones and associated factors among parents of children under 5 years in Addis Ababa, Ethiopia. Medicine (Baltimore). 2026; 105(41): e51035.

Parents’ knowledge of developmental milestones helps promote healthy development and appropriate expectations. Limited knowledge may contribute to neglect, abuse, and delayed recognition of developmental problems. Despite efforts to prevent developmental delays in Ethiopia, evidence on parental knowledge of developmental milestones remains limited. Therefore, this study aimed to assess parental knowledge of child developmental milestones and associated factors among parents of children under 5 years in Addis Ababa, Ethiopia. A community-based cross-sectional study design was conducted among 3 sub-cities from July 15 to August 30, 2024, among 423 parents selected by a systematic random sampling technique. The data was collected by using interviewer-administered questionnaires. The descriptive part was presented using narration, tables, and figures. A bivariable logistic regression statistical analysis was used to identify potential candidate variables (P < .25) for multivariable logistic regression analysis to control potential confounding variables; the regression result was presented using adjusted odds ratio (AOR) with 95% confidence interval (CI) and P value <.05 as level of significance. Overall, 30%, 95% CI: (25.6-34.3%) of parents had good knowledge about childhood developmental milestones. Sex (being female) AOR = 3.54, 95% CI:(1.30-9.67), family size (≥5) AOR = 2.73, 95% CI: (1.45-5.14), and source of information (social media) AOR = 2.34, 95% CI: (1.88-3.12) were factors that had a significant association with parental knowledge of childhood developmental milestones. Overall, fewer than one-third of parents had good knowledge of childhood developmental milestones. Parental knowledge was significantly associated with sex, family size, and source of information. These findings highlight the need for targeted educational interventions to improve parents' knowledge of childhood developmental milestones.

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3. Constantinou M, Al-Thani D, Qaraqe M, Yankouskaya A. Integrating Identity and Emotion Information in Faces: Capacity Limits of Information Processing in Autism. Multisens Res. 2026: 1-30.

The ability to combine identity and emotional information when viewing faces allows typically developing individuals to process facial information efficiently. The aim of this study was to examine whether autistic adults share this ability and test if it reflects a broader pattern of integrative information processing. Nineteen autistic adults and nineteen typically developing adults completed a divided-attention task where they had to indicate when a target was present. Each participant completed two separate experiments: (i) the face experiment, which required detecting targets based on identity and emotional expression; and (ii) the object experiment, which required detecting targets based on colour and shape. Analyses assessed whether, and how, participants responded more efficiently in the presence of both targets, compared to either single target. By employing mathematical modelling tools developed in the System Factorial Technology (SFT) framework, results showed that autistic individuals process faces at the rate of typically developing individuals, but failed to exhibit integrative properties (supercapacity) seen in typically developing adults in either domain. In autistic adults, this pattern ranged from limited capacity for faces to capacity consistent with independent parallel processing for objects. Implications of these findings generalise to personalisation practices in education and can be used to inform the development of assistive technologies in autism.

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4. Danhofer P, Vyhnalová M, Stroupkova L, Všianská P, Knedlíková L, Kolář S, Ošlejšková H. Case Report: Autism-like phenomenology in functional neurological disorder in the social-media era: over- and under-diagnosis of autism as a bidirectional clinical problem. Front Psychiatry. 2026; 17: 1952291.

Social media increasingly influence how adolescents and young adults understand and communicate neuropsychiatric symptoms, including symptoms attributed to autism spectrum disorder (ASD). This creates a particular diagnostic challenge in functional neurological disorder (FND), a condition in which neurological symptoms are genuine and disabling but are understood as arising from altered nervous-system functioning rather than structural neurological disease. Recent literature indicates that FND and ASD co-occur more often than would be expected by chance, although estimates vary substantially across studies and clinical populations. At the same time, autistic-like features such as sensory hypersensitivity, social difficulties, alexithymia, and altered interoceptive processing may occur across diagnostic boundaries and may therefore complicate differential diagnosis. The present case concerns a 17-year-old female patient with complex FND and prominent autistic-like phenomenology who attributed her difficulties to ASD largely through social-media exposure, while standardized assessment and retrospective developmental history did not support an ASD diagnosis. The case therefore provides an opportunity to examine two related but distinct questions: how genuine ASD may co-occur with FND, and how autistic-like experiences may arise in patients with FND without a developmental basis for ASD. We further consider whether, in a subset of patients, such phenomenology could represent a functionally mediated cognitive-behavioural construct shaped by predictive processing, interoception, alexithymia, and exposure to diagnostic narratives.

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5. Du Q, Zhou Q, Yu L, Ye Y, Wu X. Essential element and toxic metal dyshomeostasis in childhood autism spectrum disorder: a comprehensive narrative review of correlations, tissue-specific distribution, and multifactorial regulation. Front Behav Neurosci. 2026; 20: 1944510.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social communication and repetitive stereotyped behaviors, with a rising global prevalence. Its etiology involves genetic, environmental, and epigenetic interactions, among which essential elements [including trace elements such as zinc (Zn), selenium (Se), copper (Cu), iron (Fe), manganese (Mn) and macrominerals like magnesium (Mg)] and toxic metals (lead (Pb), mercury (Hg), cadmium (Cd)) are key environmental regulators of neurodevelopment. This narrative review systematically summarizes the association between these elements and ASD in children. Core findings confirm that Zn/Se/Fe/Mg deficiency, tissue-specific Cu imbalance (elevated plasma, reduced hair), Pb/Hg accumulation, and Zn-Cu ratio imbalance are significantly correlated with ASD occurrence and severity. These abnormalities disrupt neurotransmitter homeostasis, oxidative stress balance, and synaptic plasticity, which pathways closely linked to ASD pathogenesis. Critically, we highlight the tissue-specific distribution patterns of these elements (differences across blood, hair, urine, and nails) and the multifactorial regulatory network involving genetic variants (e.g., metal transporter genes, metallothioneins), environmental exposures (diet, pollutants, pesticides), individual differences (age, gender), and comorbidities (gastrointestinal dysfunction). Intervention evidence shows that supplementing deficient essential elements or reducing toxic metal exposure may alleviate ASD symptoms, though study quality and methodological heterogeneity limit causal inferences. This review provides a theoretical basis for ASD pathogenesis research, early diagnosis, and targeted element-based interventions.

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6. Furneaux R. ADHD and autism review: NHS must move away from diagnosis linked support system, report says. Bmj. 2026; 395: e101104.

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7. Giannakopoulos G, Martinos MM, Ntre V, Farmakopoulou I, Vasalios F, Sofrona E, Tagkouli E, Pehlivanidis A, Papanikolaou K. Autistic Young Adults’ Experiences of Support and Participation in Postsecondary Education in Greece. Autism. 2026: 13623613261493644.

Autistic students are increasingly entering postsecondary education, but limited evidence describes how they experience support, participation and everyday learning in Greece. This qualitative study explored autistic young adults’ experiences of postsecondary education in Greece. Semi-structured interviews were conducted with 12 autistic young adults who were enrolled in, or had completed, a postsecondary education programme in Greece. Data were analysed using reflexive thematic analysis. The first author led primary coding and theme development, which were discussed within the research team. The analysis generated four themes: ‘Being Listened To’, ‘Making University Navigable’, ‘Structure That Teaches’ and ‘Quiet Belonging’. Across themes, inclusion was shaped less by formal access than by whether staff, services and peers made university life accessible, predictable and socially manageable. Support was useful when a reliable person or service listened, responded and helped turn difficulties into concrete next steps; teaching became more accessible when task requirements were explicit, instructions concrete and materials organised; and belonging was often experienced when social demands were low, but proximity to others remained possible. The findings highlight the potential value of clearer support pathways, autism-informed staff practices, explicit and organised teaching and lower-pressure forms of participation in Greek postsecondary education.Lay AbstractMany autistic young people enter postsecondary education, but everyday university life can be difficult when support, teaching and social participation are not designed around their needs. In this study, we spoke with 12 autistic adults aged 19-26 who were studying in, or had completed, a postsecondary education programme in Greece. Participants described the importance of having at least one person who listened and helped them identify a concrete next step. Learning was easier when instructions were detailed, examples were concrete and teaching materials were organised and understandable. Many also wanted ‘quiet belonging’: calm spaces and connection with respectful, accepting people without pressure for constant interaction. The findings highlight the potential value of visible support pathways, explicit teaching and lower-pressure forms of participation.

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8. Gündoğmuş E, Demirok T, Irmak DE, Abaoğlu H, Bumin G. Parental Mealtime Practices in Children with Autism Spectrum Disorder: A Comparative Study. Am J Occup Ther. 2026: 19437676261495432.

ImportanceFeeding difficulties are highly prevalent among children diagnosed with autism and can significantly affect family well-being. Parental mealtime practices play a critical role in shaping children’s eating behaviors, yet their interaction in children diagnosed with autism remains insufficiently understood.ObjectiveTo examine the associations between children’s feeding behaviors and parental mealtime practices in children diagnosed with autism and to compare these practices with those of typically developing (TD) children.DesignCross-sectional comparative study.SettingPediatric clinic.ParticipantsA total of 187 parents of children aged 2-7 years participated (97 children diagnosed with autism, 90 TD).Outcomes and MeasuresAutism traits were assessed using the Childhood Autism Rating Scale, feeding behaviors using the Brief Autism Mealtime Behavior Inventory, and parental mealtime practices using the Parent Mealtime Action Scale (PMAS).ResultsCaregivers of children diagnosed with autism reported significantly different mealtime practices compared with caregivers of TD children. After controlling for child age and BMI, significant group differences were observed for the PMAS subscales Positive Persuasion (p < .001), Daily Fruit and Vegetable Availability (p < .001), and Special Meals (p < .001). Higher levels of autistic traits were associated with greater food refusal (r = 0.42, p < .001), autism-related mealtime behaviors (r = 0.30, p = .003), and greater caregiver use of Special Meals (r = 0.38, p < .001).Conclusions and RelevanceAutism traits are associated with feeding difficulties, and parental practices differ between children diagnosed with autism and TD groups. Understanding these relationships is essential for developing family-centered, occupation-based interventions to improve mealtime participation. This study looked at how children diagnosed with autism and their parents behave during mealtimes. We found that children with autism often have more feeding difficulties, such as refusing food or eating a limited variety. These difficulties were stronger in children with more severe autism traits. Parents of children with autism also used different feeding strategies compared to parents of TD children. For example, they were more likely to insist on eating or prepare special meals.These results show that children's eating behaviors and parents' actions are closely connected. Understanding this relationship can help occupational therapists design better, family-centered interventions to improve mealtime routines. Supporting both the child and the parent may lead to more positive and less stressful mealtime experiences. eng.

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9. Huang Y, Liu Y, Liu Y, Liang H, Tong Y, Li R, Zhang X, Wang Y, Deng Y, Wu J, Shu Y, Lu Q, Qiu Y, Chen J, Ba Y, Fang J, Hao J, Li W, Xiao H, Huang W, Xiang AP. HPSC-derived mesenchymal stromal cells ameliorate murine autistic-like phenotypes through activating oxytocinergic neurons. Sci Adv. 2026; 12(41): eadt4995.

Autism spectrum disorder (ASD) is a heritable neurodevelopmental disorder marked by social deficits, repetitive behaviors, and psychiatric comorbidities. Despite its rising global prevalence, effective treatments remain elusive. Mesenchymal stromal cells (MSCs) offer therapeutic promise for ASD, although their mechanisms are unclear. Here, we show that induced pluripotent stem cell (iPSC)-derived MSCs alleviate anxiety, grooming, and social impairments in Shank3B knockout mice, a monogenic ASD model. Intravenously infused MSCs localize to the neurohypophysis, interface with oxytocin (OT)-producing neuron axons, and activate OT(+) neurons in the paraventricular nucleus (PVN). MSC treatment also reduces autistic-like phenotypes in BTBR T + Itpr3tf/J mice, a model of idiopathic ASD, in an OT(+) neuron-dependent manner. Mechanistically, prostaglandin E2 (PGE2) secreted by MSCs instigates the activation of OT(+) neuron, while suppression of PGE2 production via short hairpin RNA (shRNA)-mediated knockdown of PTGS1 and PTGES diminishes their therapeutic efficacy. These findings reveal a mechanism whereby MSCs modulate OT(+) neuroendocrine circuits to improve ASD-related behaviors.

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10. Karaçam Doğan M, Prachason T, Scalmati S, Lin BD, Pries LK, Klingenberg B, Arias-Magnasco A, Menne-Lothmann C, Decoster J, van Winkel R, Collip D, Delespaul P, De Hert M, Derom C, Thiery E, Jacobs N, Wichers M, Rutten BPF, van Os J, Fusar-Poli L, Guloksuz S. Examining the association between autistic traits and psychopathology in the general population: are there sex differences?. Eur Arch Psychiatry Clin Neurosci. 2026.

INTRODUCTION: Autistic traits (ATs) are linked to increased vulnerability to psychopathology. While sex differences are studied in clinical autism, little is known about these associations in the general population. This study examines sex-specific associations between ATs and psychopathology in a community sample of adolescents and young adults. METHODS: Data from 788 participants (475 females), aged 15-35 years (mean = 17.48 ± 3.60) in the TwinssCan cohort were used. ATs were assessed using Autism Spectrum Quotient (AQ), while psychopathology and psychosis expression were measured with the Symptom Checklist-90 Revised (SCL-90) and Community Assessment of Psychic Experiences (CAPE). Sex-stratified linear regression models examined associations with SCL-90 and CAPE scores. Chow’s test was used for exploratory sex comparisons. RESULTS: In both sexes, total AQ scores were positively associated with the total SCL-90 score and all its subscales, as well as with total CAPE and all its subscales. No significant sex difference was found for either total SCL-90 or total CAPE. In exploratory post-hoc comparisons, a nominally statistically significant sex difference was observed for the obsessive-compulsive SCL-90 subscale (p = 0.03), where AQ accounted for 5.6% of the variance in males compared to 15.86% in females. A nominally statistically significant sex difference was found in the CAPE depressive subscale as well (p = 0.03), where AQ explained 4.78% of the variance in males versus 13.53% in females. DISCUSSION: The findings highlight that ATs relate to broad psychopathology across sexes, whereas domain-specific sex differences emerged in exploratory post-hoc comparisons. Future studies should replicate findings in clinical and longitudinal samples.

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11. Ke Y, He Q, Jiang W, Chen Y, Ke Y. Multiple classification of childhood and juvenile autism spectrum disorder from ABIDE-II sMRI using BN-GO-CNN. Biomed Tech (Berl). 2026.

OBJECTIVES: Autism spectrum disorder (ASD) shows heterogeneous neurodevelopmental patterns across childhood, juvenile development, and adulthood, so binary MRI classification may not fully capture age-and sex-related variation. This study proposes a proof-of-concept framework for multiple classification using ABIDE-II T1-weighted structural MRI (sMRI). METHODS: After image-quality screening, sMRI slices were processed using Canny edge detection, brain-region cropping, 224 × 224 resizing, and augmentation. Images were organized into sex-based four-class, age-based four-class, and combined age-and-sex eight-class datasets, separating child, young, juvenile, adult, male, and female groups. A Batch-Normalized Grid-Optimized CNN (BN-GO-CNN) was developed to learn structural representations directly from preprocessed sMRI, with grid search used to select key CNN hyperparameters. The model was compared with VGG16, DenseNet201, MobileNetV2, and EfficientNet-B0 using identical image partitions. RESULTS: BN-GO-CNN achieved validation accuracies of 67.0 %, 64.0 %, and 60.5 % for sex-based, age-based, and combined age-and-sex classification, respectively. These outcomes remained above chance but showed limited class separability. CONCLUSIONS: The modest performance suggests that label-related sMRI differences are subtle, supporting this framework as a preliminary test of CNN-assisted sMRI classification for future research use rather than a clinically reliable ASD diagnostic system.

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12. Korkmaz S, De Sainte Agathe JM, Cliquet F, Martin LC, Barthome E, Fleury M, Segers J, Bonnot-Briey S, Grimaldi de Puget V, Zhou Y, Wolke D, Grove J, Børglum AD, Delorme R, Leblond CS, Bourgeron T. The genetic orchestra of autism and its intersections with epilepsy, intellectual disability, and ADHD. Biol Psychiatry. 2026.

Autism is a complex condition with marked phenotypic variability and a multifactorial etiology orchestrated by diverse genetic and environmental influences. In this review, we dissect what we refer to as autism’s « genetic orchestra », spanning from the high-impact « soloists », de novo and ultra-rare variants with large effect sizes, to the « polyphonic background » of common variants which individually exert modest effects but collectively have significant impact. We examine how this orchestra wires neural circuits, with convergent biological pathways modulating synaptic function and chromatin remodeling. Although de novo, rare, and common variants are often studied independently, converging evidence supports a model whereby their influences are largely additive. This genetic orchestra is not condition-specific; autism frequently co-occurs with other neurodevelopmental and psychiatric conditions, reflecting substantial pleiotropy across both rare and common variant landscapes. Notably, ultra-rare variants tend to associate with co-occurring intellectual disability, ADHD, epilepsy, and psychiatric conditions highlighting their high phenotypic impact. Beyond genetics, layers of environmental and contextual factors further modulate clinical outcomes. In this framework, we also discuss the challenges of identifying genetic variants associated with autism through clinical genetic testing, where yields remain context-dependent, varying by sex and co-occurring conditions. Finally, we address current limitations and future directions in refining our understanding of autism’s genetic basis.

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13. Lehenaff R, Rutledge RC, Kim P, Pinto Taylor E. Supporting Patients with Autism Spectrum Disorder and Neurodivergence in Serious Illness Decision-Making. J Gen Intern Med. 2026.

Neurodivergence and developmental disorders can influence how a patient interacts with their health, medical team, and the healthcare system overall. We present the case of a man with autism spectrum disorder (ASD) who was referred to palliative care clinic for assistance in determining his decision-making capacity to defer treatment for his progressive prostate cancer. Though many validated tools exist to assist providers in discussions of serious illness, none is validated in populations with neurodivergence, who have specific needs and challenges. As this population of adults living with ASD ages, it will be essential to support their decision-making surrounding diagnostic tests and medical treatments. Through this case, we highlight key components to engage patients with neurodivergence in health-related decisions. These strategies include using visual aids, avoiding abstractions, maintaining a low-stimulation sensory environment, and involving key stakeholders (e.g., family members and/or caregivers) to support decision-making. We also highlight the complex impact of multiple comorbid neuropsychiatric conditions on healthcare decision-making, and the resultant need for careful thought and innovative communication strategies this necessitates.

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14. Makin L, Tchanturia K. Considering Autism in Binge-Type Eating Disorders: Broadening Beyond an Anorexia Nervosa-Focused Model. Curr Psychiatry Rep. 2026; 28(1).

PURPOSE OF REVIEW: Research on Autism in eating disorders (EDs) has historically focused on anorexia nervosa (AN), with comparatively limited attention given to binge-type EDs such as bulimia nervosa (BN) and binge eating disorder (BED). This review summarises emerging evidence on Autism in binge-type EDs and highlights key clinical and research implications. RECENT FINDINGS: Emerging evidence suggests that Autism is over-represented in BN and BED, although prevalence appears lower than in AN and research remains methodologically limited. Recent studies suggest that affective and reward-related processes, alongside sensory differences, may contribute to binge-type presentations. Co-occurring ADHD appears particularly relevant and may complicate recognition, clinical presentation, and treatment. Autism also remains under-recognised in binge-type EDs by ED services, where existing adaptations remain largely derived from AN models. Current AN-centric models may inadequately capture Neurodivergence in binge-type EDs. More transdiagnostic, mechanism-informed research and treatment approaches are needed.

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15. Marianti L, Badani B, Sinthia R, Elita Y, Saputra R. Beyond performance gains: towards autonomy-centred and ecologically valid XR outcomes for autistic people. Disabil Rehabil Assist Technol. 2026: 1-3.

IMPLICATIONS FOR REHABILITATIONXR outcomes for autistic people should extend beyond virtual task performance to include real-world transfer, maintenance, and person-defined participation.Autistic people should help define valued goals, acceptable assistance, sensory and communication settings, pacing, and stopping options.Clinicians and researchers should document environmental facilitators and barriers and pair XR performance metrics with at least one natural-context measure.Session duration should be individualised according to tolerability, sensory load, and user choice rather than treated as a fixed minimum dose.

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16. Meyer-Schuman R, Cherry F, Sui Y, Papastathopoulos-Katsaros A, Zhong Y, Li Y, Wang T, Hennick K, Karunakaran D, Berk-Rauch H, Liu Z, Chakravarti A, Nowakowski T, Eichler EE, Zoghbi H. A massively parallel reporter assay of MECP2cis-regulatory elements reveals genetic candidates for male-biased autism. Am J Hum Genet. 2026.

Autism affects male individuals four times more often than female individuals, yet the basis of this sex bias remains unclear. One hypothesis is that this sex bias is due to genetic variants in X chromosome genes where haploinsufficiency causes neurodevelopmental disorders (NDDs). In heterozygous XX female probands, a complete loss-of-function variant in one of these genes often causes syndromic NDD, but the same variant is too deleterious for survival in hemizygous XY males. A mild hypomorphic variant, however, may be tolerated in a female carrier but may produce milder neurological phenotypes in a male proband. We tested this by investigating cis-regulatory elements (CREs) of MECP2, a dosage-sensitive gene on the X chromosome where total loss-of-function variants cause Rett syndrome in female children and severe, usually fatal neonatal encephalopathies in male infants. Using a massively parallel reporter assay in human neurons, we mapped transcription factor binding sites within MECP2 CREs and tested autism-associated variants for functional impact. We identified two noncoding variants that change CRE activity and are associated with male-biased autism phenotypes in the proband pedigrees. One of these, a promoter variant, disrupts NFY binding and reduces MECP2 expression by ∼30%, a magnitude that produces social deficits, hyperactivity, and anxiety-like phenotypes in mice. These findings suggest noncoding MECP2 variants can cause idiopathic, male-biased autism and provide a framework for uncovering regulatory variants in other X chromosome neurodevelopmental genes that may contribute to autism’s missing heritability.

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17. Milojevic S, Mitovic N, Stojkovic M, Milenkovic D, Tosti T, Protic D. Effects of Gallic Acid on Sleep and Circadian Rhythm in a Drosophila melanogaster Model of Fragile X Syndrome: An Integrative Behavioral and Bioinformatic Approach for Target Predictions. Yale J Biol Med. 2026; 99(2): 368-89.

Sleep and circadian rhythm (CR) disturbances are hallmark features of fragile X syndrome (FXS), a rare genetic disorder caused by a full mutation of the FMR1 gene, resulting in reduced or absent FMR1 protein (FMRP). Despite the clear genetic etiology, targeted treatment for FXS remains unavailable. Natural polyphenol gallic acid (GA) has great potential to modulate neurobiological effects and is attracting increased pharmacological interest due to its low toxicity and capacity to modulate neuronal signaling. Therefore, this study aimed to investigate the effects of GA on sleep and CR in the Drosophila melanogaster model of FXS and to further explore and propose potential gene and protein targets using a bioinformatic approach. GA effects on sleep and CR in seven different concentrations (100-1000 µM) were evaluated in dFmr1(B55) mutants through high-resolution video monitoring. Bioinformatic analysis included protein-protein interaction and functional enrichment analysis linking the dFmr1 gene with GA. Behavioral results demonstrated that GA significantly modulates sleep and CR parameters in the fruit fly model of FXS in a concentration-dependent manner, with the most pronounced effect noticed at the lower tested concentration. Bioinformatic findings suggest that these effects may be mediated through the regulation of genes and proteins, including Rac1, bsk, Jra, Cyfip, and Dscam1, which are functionally connected to dFmr1 and implicated in sleep and CR processes. These results provide novel insights and preliminary findings into the potential of GA to ameliorate sleep and CR disturbances in the fruit fly model of FXS, offering a framework for future experimental validation.

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18. Pereira L, Ormazábal I, Kohn G, Dillems M, Garretón R, Simonovis C. Ophthalmologic manifestations in children with autism spectrum disorder. Arq Bras Oftalmol. 2026; 89(5): e20260074.

PURPOSE: To determine the frequency and clinical characteristics of ophthalmologic manifestations in children aged ≤16 years with autism spectrum disorder who were evaluated at a private academic healthcare network and a public tertiary hospital. METHODS: This retrospective descriptive study was conducted through a review of the medical records of children aged <16 years with autism spectrum disorder who were examined between 2023 and 2024. Demographic characteristics, visual function testability, refractive errors, strabismus, and prescribed treatments were analyzed. Dynamic retinoscopy was used to objectively assess the binocular accommodative response. Statistical analyses included 95% confidence intervals (Wilson score method) and exploratory multivariate logistic regression. RESULTS: A total of 144 children were included; 79.2% were male, and the mean age was 6.3±2.7 years. Refractive errors were identified in 81.9% of children, of whom 63.2% had clinically significant errors requiring optical correction. Strabismus was diagnosed in 32.6% of cases, with exotropia being the most prevalent type. Stereopsis was successfully assessed in 72.2% of children. Notably, dynamic retinoscopy demonstrated perfect agreement (κ=1.000, p<0.001) with the presence of clinically significant refractive errors. Multivariate regression showed that increasing age was strongly associated with successful visual acuity testing, whereas neurological comorbidities and greater autism spectrum disorder severity significantly increased the odds of non-testability. Among children who continued follow-up, 63.9% experienced significant improvement in visual acuity. Although optical correction was generally well tolerated, adherence to occlusion therapy was notably low (6.8%), and 42.4% of the cohort was lost to follow-up. CONCLUSIONS: Ophthalmologic abnormalities, particularly refractive errors and strabismus, are highly prevalent among children with autism spectrum disorder. Given the limited reliability of subjective visual assessment in this population, objective measures, particularly dynamic retinoscopy and cycloplegic refraction, are essential for accurate diagnosis. The substantial loss to follow-up further highlights the need for adapted clinical strategies to ensure continuity of ophthalmologic care in this population.

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19. Peristeri E, Kosma M, Panagiotidou E, Tagkouli E, Andreou M. Narrative discourse comprehension in Greek-speaking children with autism spectrum disorder: evidence from Aesop’s fables. Front Psychol. 2026; 17: 1877679.

INTRODUCTION: Theory of Mind, i.e., the ability to attribute mental states to others, is critical for social communication but is often impaired in autism. Although narrative tasks have been extensively used to study Theory of Mind in autism, moral judgement of the story protagonists’ actions has not received equal attention. The current study aimed to assess cognitive and affective Theory of Mind, as well as moral reasoning skills in autistic children through Aesop’s fable comprehension. METHODS: In this study, 25 autistic children and two equally-sized groups of typically-developing age- and language-matched children listened to two fables, and answered questions assessing the attribution of affective and cognitive mental states to fable protagonists, as well as their judgment about the moral of each fable. Crucially, the two fables differed in terms of language complexity, which was operationalized in terms of vocabulary and syntax, as well as in the use of decontextualized language, i.e., expressions that anchor events in the past. RESULTS: We found that the autistic children showed significantly lower comprehension performance than typically-developing age-matched children in affective and cognitive Theory of Mind questions, while no differences were found between autistic and typically-developing language-matched children. Also, the autistic children exhibited considerable weaknesses in verbalizing the moral, however, this weakness depended on the language complexity of the fables. DISCUSSION: The findings demonstrate that autistic children face challenges in both Theory of Mind and moral judgment in narrative comprehension, particularly when the stimuli are linguistically demanding. Aesop’s fables seem to offer a promising venue as a window into the moral judgment skills of autistic children.

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20. Rashid M, Karisa A, Makhapila E, Onyango S. Navigating the healthcare systems for primary caregivers of children with developmental disabilities: experiences from a rural setting in Kenya. Rural Remote Health. 2026; 26(4): 10139.

INTRODUCTION: Families with children who have developmental disabilities in Sub-Saharan Africa often face significant challenges in accessing healthcare services and are more than three times more likely to encounter difficulties in obtaining necessary care. Despite global advancements in disability-related policies, caregivers in low-resource settings continue to face obstacles when navigating the healthcare system. This article examines how primary caregivers of children with developmental disabilities navigate healthcare systems in rural Kenya. METHODS: A phenomenological qualitative approach was used to explore the lived experiences of 19 primary caregivers of children with developmental disabilities in rural Kenya through in-depth interviews. Data were analyzed using inductive thematic analysis. The social model of disability studies guided the analysis. RESULTS: Four themes emerged: caregivers’ explanatory models of disability and their influence on care-seeking, structural barriers in healthcare access and quality, the multidimensional burden of caregiving (emotional, physical, and economic), and community and institutional support mechanisms. This article shows that informal support systems – including extended family, church, and community members – play a critical role in sustaining caregivers of children with developmental disabilities in Siaya County, offering practical assistance and emotional resilience. However, persistent gender disparities in caregiving responsibilities and systemic gaps in healthcare guidance exacerbate caregivers’ burdens. CONCLUSION: The study highlights how caregivers endure care responsibilities in a highly constrained context supported by community networks, while revealing critical gaps in gender equity and healthcare guidance. It underscores the need for targeted, community-based interventions that strengthen informal support systems and address structural barriers to inclusive care for children with developmental disabilities.

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21. Ren H, Duan Y, Li H, Jiang S, Zhang J, Pavlidou M, Rodriguez-Labrada R, Peng T, Luo C, Liu C. Gray matter subtyping with SuStaIn reveals neuroanatomical patterns in autism spectrum disorder. Brain Imaging Behav. 2026; 20(5).

Autism spectrum disorder (ASD) is highly heterogeneous, and structural magnetic resonance imaging (MRI) studies have reported both increased and decreased gray matter volume relative to typically developing controls. This variability may obscure distinct neuroanatomical patterns in conventional group-level analyses. It therefore motivates subtyping approaches that can characterize neuroanatomical heterogeneity beyond conventional group-level analyses. We applied Subtype and Stage Inference (SuStaIn) to structural MRI data from the Autism Brain Imaging Data Exchange (ABIDE) to identify gray matter subtypes and stage-like variation in ASD. Original and sign-reversed z-score representations were modeled to capture gray matter deviations above and below the control reference. We then evaluated whether the organization of subtype-related brain regions was consistent across deviation directions. Cross-direction consistency, within-ABIDE cross-cohort separability, and structural covariance network (SCN) differences between stage groups were assessed using subtype alignment, Dice coefficients, cross-cohort machine-learning classification, and structural covariance analyses. We identified two gray matter subtype patterns in ASD that were consistent across deviation directions. Subtype 1 was centered on cerebellar-limbic-striatal regions, whereas Subtype 2 involved anterior fronto-cingulo-insular regions. In exploratory covariate-adjusted analyses, higher stage in sign-reversed-model S1 was associated with lower verbal intelligence quotient (IQ) scores, whereas S2 showed modestly higher Autism Diagnostic Observation Schedule (ADOS) scores. The two subtypes showed regionally distinct volume profiles. The two-subtype solution showed strong cross-direction agreement, and within-ABIDE cross-cohort classification supported structural separability of the aligned subtypes. In the sign-reversed model, SCN analyses further identified stage-group structural covariance differences within each subtype, with little evidence for a stable covariance difference between subtypes. This study identifies two gray matter-based ASD subtype patterns that were consistent across the original and sign-reversed z-score representations, with distinct regional volume profiles, selective clinical associations, and stage-group structural covariance differences. The findings provide a neuroanatomical framework for organizing ASD heterogeneity and for examining brain-behavior variation in future studies.

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22. Rigobello R, Driver M, Robak LA, Scott DA, Vossaert L, Chibuk J, Meng L, Xia F, Eng CM, Giannikopoulos P, Zhao X. Diagnostic yield of genome sequencing for children with intellectual disability and developmental delay. Front Neurol. 2026; 17: 1966246.

BACKGROUND: Genome sequencing (GS) has recently been considered as a first-tier diagnostic tool for individuals with intellectual disability (ID) and developmental delay (DD). In this study, we assess the diagnostic yield of GS for a large cohort of children with ID/DD and describe variants contributing to genetic diagnoses in this cohort. METHODS: A retrospective analysis of consecutive GS results for individuals under 18 years of age with a clinical indication of ID/DD was conducted using data from a clinical diagnostic laboratory. The present analysis included 666 individuals. RESULTS: In this cohort, 31.1% (207/666) of children received positive GS results. There were 186 children who received a genetic diagnosis that was at least partially associated with their history of ID/DD, leading to a phenotype-specific diagnostic yield of GS for ID/DD of 27.9%. For individuals without known prior genetic testing, 35.3% (103/292) had positive GS results. There were 259 variants that led to genetic diagnoses in this cohort. Of these, 7.7% (20/259) were variants with limited to no coverage on exome sequencing. CONCLUSION: GS identified at least one genetic diagnosis associated with ID/DD in 27.9% of children with ID/DD as a clinical indication. An additional 3.2% of children received positive GS results associated with other features of their clinical indication. Almost 8% of variants related to the genetic diagnoses in this cohort may not have been detected through other standalone genomic technologies. These findings further support the recommendation by medical and professional societies of GS as a first-tier diagnostic test for individuals with ID/DD.

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23. Sim J, Choi KS, Lee DH. Exploring the Neural Mechanisms of Acupuncture Stimulation in Autism Spectrum Disorder: Protocol for a Randomized, Sham-Controlled, Multimodal Neuroimaging Trial. JMIR Res Protoc. 2026; 15: e97910.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by restricted and repetitive behaviors and disturbances in social communication and interaction. Currently, there is no fundamental treatment for ASD, with only a few medications available for use on a limited basis to manage concomitant neuropsychiatric symptoms. The primary therapeutic goal of such treatments is to alleviate symptoms while maximizing the functional independence and quality of life of affected individuals. Many complementary and alternative medicine therapies have been reported to have effects on ASD symptoms; however, evidence is insufficient to confirm their clinical effectiveness. Acupuncture has traditionally been used as a complementary intervention to manage various neurological and neuropsychiatric diseases, including ASD, in East Asia. However, how acupuncture stimulation modulates neural activity at the macroscale level in individuals with ASD remains largely unknown. OBJECTIVE: This study aims to elucidate disease-related brain alterations and explore the acute neural mechanisms underlying acupuncture stimulation in patients with ASD and in typically developing (TD) individuals, using a multimodal neuroimaging approach. METHODS: This study was designed as a randomized, sham-controlled trial. In this stratified 2×2 design, 70 participants, including individuals with ASD (n=35) and TD controls (n=35), will each be randomly assigned to either the verum or sham acupuncture group, resulting in 4 groups. The verum acupuncture group will receive stimulation at specific acupoints clinically indicated for ASD, eliciting a deqi sensation. The sham acupuncture group will receive superficial needling at nonacupoints unrelated to ASD symptoms. Each group will undergo clinical assessments and multimodal neuroimaging measurements, including functional near-infrared spectroscopy and electroencephalography, before and after acupuncture stimulation. The primary outcome will be differences in resting state network metrics and relative band power in frontal areas by disease status. Secondary outcomes will include differences in these neural markers following acupuncture stimulation between the verum and sham groups, reflecting the group × intervention interaction. Exploratory outcomes will focus on identifying neural markers that correlate with clinical indicators of ASD. RESULTS: Recruitment began in April 2025. To date, 23 individuals with ASD and 21 TD individuals have participated in this study. The recruitment process is expected to continue until December 2026. CONCLUSIONS: ASD presents a significant socioeconomic burden, with no definitive treatment established to date. Although acupuncture is a widely applied intervention for various neurological conditions, including ASD, its large-scale neural mechanisms remain poorly understood. By using multimodal neuroimaging, the present study aims to investigate the immediate neural substrates underlying acupuncture stimulation in patients with ASD. These findings are expected to provide a robust neurobiological foundation for future longitudinal research and the development of evidence-based integrative strategies.

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24. Tanner S, Eisner A, Novakovic B, Holland L, Mansell T, England-Mason G, Merrill S, Dewey D, O’Hely M, Symeonides C, Saffery R, Tang MLK, Sly PD, Vuillermin P, Jung CH, Park D, Ponsonby AL. Prenatal exposure to the plasticizer DEHP increases the likelihood of early-life autism and ADHD symptoms through epigenetic programming. Med. 2026; 7(10): 101291.

BACKGROUND: Growing evidence implicates prenatal exposure to di-(2-ethylhexyl) phthalate (DEHP), a common endocrine-disrupting plasticizer, in the development of autism and attention-deficit/hyperactivity disorder (ADHD). Yet underlying mechanisms remain unclear. METHODS: Here, we examined whether cord blood DNA methylation, a key epigenetic marker, mediates the association between prenatal DEHP exposure and autism and ADHD symptoms in 847 children from the Barwon Infant Study. Autism and ADHD are complex phenotypes driven by alterations in higher-level gene networks and neuronal circuits, where diverse genetic and environmental risk factors converge. Accordingly, rather than a gene-by-gene approach, we employed a data-driven strategy to elucidate broader functional epigenetic signatures of autism and ADHD elicited by DEHP exposure. This included (1) a methylation profile score for DEHP exposure (MPS(DEHP)), and (2) a targeted analysis of DEHP-associated co-methylated gene networks. FINDINGS: Causal mediation analysis showed that both MPS(DEHP) and a network of 531 co-methylated genes mediated the effect of DEHP on increased autism and ADHD symptoms at ages 2 and 4 years (proportion mediated: 0.21-0.80). The co-methylation network was enriched for neural cell-type markers, autism and ADHD risk genes (including FOXP1, SHANK2, and PLXNB1), and targets of endocrine receptors previously linked to DEHP (including estrogen and glucocorticoid receptors), providing biological plausibility. We validated key results in independent blood (n = 66) and postmortem brain (n = 40) DNA methylation datasets. CONCLUSION: These findings provide mechanistic evidence linking DEHP to adverse neurodevelopment and reinforce mounting concerns regarding the risks of prenatal exposure. FUNDING: Funding was obtained from the NHMRC, the Minderoo Foundation, and additional sources (detailed in acknowledgments).

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25. Tian P, Yu X, Bai M, Bian B, Liu Z, Liang Y, Zhu X, Jia F, Li D. Brain functional mediation of vitamin D and development in children with autism spectrum disorder. Psychiatry Res. 2026; 367: 117507.

BACKGROUND: Children with autism spectrum disorder (ASD) often present with developmental delays and brain functional abnormalities. Vitamin D is thought to play an important role in neurodevelopment and brain function, but its association with brain functional metrics in ASD remains unclear. This study aimed to examine the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels, brain function, and developmental outcomes in children with ASD. METHODS: We included 207 children with ASD and 209 typically developing (TD) children. Serum 25(OH)D levels were measured in all participants. Clinical assessments and resting-state functional magnetic resonance imaging (rs-fMRI) were conducted in the ASD group. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) were used to characterize rs-fMRI metrics, and mediation analyses were performed to assess whether these measures mediated the relationship between 25(OH)D levels and developmental outcomes. RESULTS: Children with ASD showed significantly lower serum 25(OH)D levels compared with TD children. Among ASD children, higher 25(OH)D levels were associated with lower Childhood Autism Rating Scale (CARS) scores and better performance in multiple developmental domains. Mediation analyses revealed that ReHo in the left lingual gyrus and right fusiform gyrus significantly mediated the associations between 25(OH)D levels and specific developmental outcomes. CONCLUSIONS: Children with ASD exhibited reduced serum 25(OH)D levels, and serum 25(OH)D levels were significantly associated with both clinical measures and specific rs-fMRI metrics within the ASD group. Specific brain functional metrics may play mediating roles in the associations between vitamin D status and developmental outcomes, providing insights into potential neurobiological pathways related to ASD.

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26. Trotta A. Early trauma and psychotic experiences in autism: a neurodevelopmental framework integrating allostatic overload, symbolisation, and stress reactivity. Front Psychiatry. 2026; 17: 1898132.

Adverse childhood experiences are common worldwide and are associated with enduring mental and physical health consequences. Autism, a complex and heterogeneous neurodevelopmental condition shaped by both genetic and environmental influences, has a global prevalence of approximately 1% and is associated with increased exposure to adversity, including bullying, social exclusion, and interpersonal misattunement. Such exposures may partially mediate associations between autistic traits and later psychotic experiences independently of genetic liability. Developmental trauma is increasingly recognized as an environmental factor that may shape the emergence of psychotic experiences in autism by interacting with neurodevelopmental differences. Neurobiological findings in trauma-exposed populations implicate dysregulated stress-response systems and alterations in circuits supporting threat detection and affect regulation, including heightened amygdala reactivity, reduced hippocampal volume linked to impaired contextual processing, and altered ventromedial prefrontal functioning. Integrating epidemiological, neurobiological, and developmental perspectives, this paper proposes a framework linking three interrelated mechanisms: (i) dissociation and reduced integration of affective and relational experience, (ii) constraints on symbolisation and narrative meaning-making, and (iii) heightened stress reactivity that amplifies threat-based processing and alters salience attribution. In autistic individuals, pre-existing differences in sensory processing and intersubjective functioning may compound the impact of adversity, lowering the threshold at which anomalous experiences acquire distressing or aberrant meaning, particularly during sensitive developmental periods such as childhood and adolescence. This article is intended as a Perspective that brings together findings from autism, trauma, psychosis, and developmental psychology to generate a theoretical framework and set of testable hypotheses. It does not present a systematic review of the literature or seek to establish causal relationships but rather proposes potential mechanisms through which early trauma may influence the emergence of psychotic experiences in a subgroup of autistic individuals. The model presented highlights trauma as a modifiable environmental pathway with implications for trauma-informed assessment, early intervention, and future multilevel research.

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27. V N, K A. An Effective Autism Spectrum Disorder Detection Framework Using Adaptive Serial Hybrid Network With Self-Calibrated Feature Extraction on Brain MRI Images. Int J Dev Neurosci. 2026; 86(6): e70187.

Autism spectrum disorder (ASD) is a medical condition commonly categorized as a neurodevelopmental disorder. Patients with ASD are not limited to common symptoms, and it often requires long-term hospital visits and specialists for definitive evaluation. Research has highlighted the importance of early intervention and care for ASD patients, as it can benefit their lifestyle. Automated detection techniques through deep learners have shown great progress in detecting ASD, as they excel in handling highly complex features and functional activity patterns by evaluating magnetic resonance imaging (MRI). However, as the ASD-associated neuroimaging patterns are not explicitly shown in the MRI, several challenges remain in identifying the ASD related features from MRI evaluation. To overcome these challenges, an advanced deep learning framework has been developed for detecting ASD. In this proposed model, MRI scans are collected from accessible datasets and applied to the feature extraction process. Here, feature extraction was carried out with the support of the proposed Self-Calibrated Dense Convolution Vision Transformer (SC-DCVT). This proposed feature extraction model integrates dense connections and self-calibration mechanisms to capture rich, contextual features from the MRI images, improving the representation of complex patterns. Then, the extracted features are fed to the proposed Adaptive Serial Hybrid Autism Spectrum Disorder Detection Network (ASHASDDetN) model, which integrates two components, such as Residual-Temporal Convolutional Network (Res-TCN) with Dense Conditional Random Field (DCRF), to process ASD detection by capturing relevant features and ensuring its consistency. The reliability of the proposed ASHASDDetN model is enhanced by optimizing the parameters of Res-TCN and DCRF with the support of the Improved Position Updating Actor Optimization Algorithm (IPU-AOA) for the ASD detection task. The effectiveness of the proposed model is proven by conducting extensive experimentation among state-of-the-art techniques.

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28. Yi T, Wei W, Cai Q, Jin K. Corrigendum to ‘Recognition value of diffusion basis spectrum imaging brain network analysis for preschool children with autism spectrum disorder’ [Psychiatry Research: Neuroimaging 364 (2027) 112340]. Psychiatry Res Neuroimaging. 2026: 112349.

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