1. Altinisik I, Ipek H, Sisman Z, Emul M. Psychiatric decompensation following AI chatbot use in autism spectrum disorder. Asian J Psychiatr;2026 (Feb 7);117:104889.

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2. Bakam A, Raina S, Reddy YCJ. Periodic Catatonia in an Adult With Autism Spectrum Disorder Responding to Lithium: A Case Report. Prim Care Companion CNS Disord;2026 (Feb 3);28(1)

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3. Ben Kish A, Binyamin Y, Michaelovski A, Meiri G, Menashe I. Exposure to anesthesia during delivery and risk of autism spectrum disorder: A retrospective cohort study. Acta Obstet Gynecol Scand;2026 (Feb 11)

INTRODUCTION: Despite the growing use of pain management during delivery, evidence regarding the association between different modes of obstetric anesthesia and autism spectrum disorder in offspring is mixed. MATERIAL AND METHODS: We conducted a retrospective cohort study of 98 630 singleton live births at a single hospital (2011-2019), with follow-up through January 2023. Participants were grouped by delivery and anesthesia type: (1) vaginal delivery without analgesia, (2) vaginal delivery with epidural, (3) cesarean with neuraxial anesthesia, and (4) cesarean with general anesthesia. Autism spectrum disorder (ASD) diagnosis was the primary outcome. Kaplan-Meier plots and Cox regression were used to assess cumulative incidence and hazard ratios. RESULTS: Of the cohort (51.2% male, 62.0% Bedouin), 21.2% were born by vaginal delivery with epidural, 3.8% by cesarean with neuraxial anesthesia, and 11.4% by cesarean with general anesthesia. Cumulative ASD incidence was higher in all exposure groups (vaginal delivery with epidural: 1.25%, cesarean with neuraxial anesthesia: 1.56%, cesarean with general anesthesia: 1.50%) than in vaginal delivery without analgesia (0.55%). Nevertheless, after adjustment for covariates, only cesarean with general anesthesia was significantly associated with increased ASD risk (aHR = 1.571; 99% CI: 1.12-2.22). CONCLUSIONS: These findings suggest that general anesthesia during cesarean delivery, but not neuraxial anesthesia or epidural use, might be associated with ASD risk. Further studies are needed to understand the underlying mechanisms.

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4. Ben Mansour N, Jarraya S, Masmoudi L, Abdelkefi I, Jallalli D, Dahmen R. Enhancing motor skills through a mindfulness-based program in adolescents with intellectual and developmental disabilities: A randomized controlled trial. Res Dev Disabil;2026 (Feb 11);170:105253.

OBJECTIVES: This single-site randomized controlled trial evaluated the effects of an 8-week mindfulness program on motor performance in adolescents with intellectual and developmental disabilities (IDD). METHOD: A total of forty-seven male participants (mean age: 15.49 ± 0.51 years; mean weight: 61.79 ± 4.19 kg; mean height: 172.53 ± 2.8 cm) were recruited and randomly assigned to one of three groups: a mindfulness group (MG; n = 15), a physical activity group (PAG; n = 16), and a control group (CG; n = 16). The intervention consisted of 16 sessions, lasting 30 min for the MG and 45 min for the PAG, while the CG received no intervention. Motor skills were assessed at baseline (T0) and after the 8-week intervention (T1) using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition Short Form (BOT-2 SF). RESULTS: Following the intervention, the MG showed significant improvements across (1) fine motor precision (p < 0.001), (2) fine motor integration (p < 0.001), (3) manual dexterity (p < 0.001), (4) bilateral coordination (p = 0.002), (5) balance (p = 0.001), (6) running speed and agility (p < 0.001), (7) upper-limb coordination (p < 0.001) and (8) strength (p < 0.001). CONCLUSIONS: Mindfulness practice is an effective, accessible, and low-cost method to improve motor performance in adolescents with IDD, and its integration into school and therapeutic settings supports their physical development and inclusion.

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5. Borges MH, Guimarães VC, Fernandes FDM, Oliveira AE, Sousa IF. Perception of pragmatic skills by speech therapists and parents of children with autism spectrum disorder. Codas;2026;38(1):e20240354.

PURPOSE: To analyze the perceptions of speech therapists and parents or guardians regarding the performance of pragmatic skills of children with autism spectrum disorder (ASD), between 2 and 12 years old, undergoing speech therapy. METHOD: Cross-sectional, prospective, observational, analytical study, conducted in a speech therapy clinic in the Midwestern Region of Brazil, including two groups and convenience sampling: Group 1. nine speech therapists who were caring for 70 children with ASD, in the established age range; Group 2. 70 parents or guardians or caregivers of these children. Participants responded to the Protocol for the Assessment of Pragmatic Skills of Children with Autism Spectrum Disorders (PAHPEA). Descriptive analyses were conducted to identify the children’s pragmatic difficulties perceived by the two groups, Mann-Whitney U test to compare the perceptions of participants in the two groups about the children’s pragmatic skills, and Spearman rho correlational analysis to verify the occurrence of an association between these perceptions of participants in both groups. RESULTS: A statistically significant difference was found in three of the five factors covered by PAHPEA (responsiveness, functionality, and inadequacy), as the members of Group 1 interpreted the children’s performance differently from that of the participants in Group 2. CONCLUSION: Overall, the perceptions of speech therapists and parents or guardians were similar in almost all factors and questions evaluated.

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6. Chen WX, Huang ZF, Feng FM, Yu J, Wei WQ, Su WT, Liu H, Lu XW, Jiang JM, Huang JY, Chen LM. Randomized controlled trial of family involved core features target intervention for young autistic children. Acta Psychol (Amst);2026 (Feb 9);264:106410.

BACKGROUND: Current study aims to explore the efficacy of short-term core feature target intervention (CFTI) (one self-design psycho-behavioral training with family involved program) for young autistic children. METHOD: Autistic children aged between 1 year and 7 years old were randomly allocated to treatment group (n = 56) or control group (n = 45) matched by severity of autism and chronological age. The treatment group accepted a short-term CFTI while the control group received no treatment or treatment-as-usual (school educational program). A total of 20 intervention sessions over four weeks were given. The primary outcome measures included Aberrant Behavior Checklist, Autism Treatment Evaluation Checklist (ATEC), Ritvo-Freeman Real Life Scale, and Clinical Global Impression-Improvement Scale (CGII). Secondary outcome measures consisted of Gesell Developmental Diagnosis Scale/Wechsler Preschool and Primary Scale of Intelligence-Fourth edition, and Psychoeducational Profile-Third Edition (PEP-3). RESULTS: In the multivariate analysis, after adjusting for sex, age, maternal socioeconomical status, severity of autism, and developmental/intelligence quotient (DQ/IQ), significant improvements were observed in the speech/language/communication domains of ATEC (adjustedβ = 2.67)，DQ/IQ (adjustedβ = -5.35), CGI-I (adjustedβ = 0.48), and in the several subtests of the PEP-3: cognitive verbal/preverbal (adjustedβ = -4.53), receptive language (adjustedβ = -3.37), fine motor (adjustedβ = 4.25), visual-motor imitation (adjustedβ = -2.25), social reciprocity (adjustedβ = -2.70) and problem behavior (adjustedβ = -2.28). CONCLUSIONS: A short-term, four-week (20 sessions) course of CFTI significantly improved communication and social reciprocity domains and related specific functions for autistic children.

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7. Feng P, Han Y, Xue X, Li H, Zhao Y, Zhao P, Zhao S, Li E. Integrated probiotic benefits of Limosilactobacillus fermentum PY-1 from the traditional fermented food « Suancai » drive antioxidant enhancement, immune protection, and gut microbiota regulation to attenuate autism-like behaviors in rats. Food Funct;2026 (Feb 11)

Autism spectrum disorder (ASD) is a neurodevelopmental condition frequently associated with elevated gastrointestinal oxidative stress. Although probiotics can mitigate oxidative stress in the gut microbiota, their specific antioxidant mechanisms in ASD remain unclear. In this study, rats were administered Limosilactobacillus fermentum PY-1, a bacterial strain isolated from traditional fermented foods and characterized by robust antioxidant activity, for one month to achieve gut colonization. Results showed that this intervention significantly ameliorated autism-like behaviors including social interaction deficits and repetitive actions, while concurrently reducing oxidative stress markers and inflammation, and enhancing intestinal barrier integrity. Histopathological analysis further revealed that liver damage was also attenuated. Notably, the treatment induced a marked reshaping of the composition of gut microbiota, characterized by the enrichment of beneficial taxa including Adlercreutzia, Christensenellaceae, Turicibacter, and Ruminococcus, while suppressing pathogenic bacteria like Erysipelatoclostridium. Metabolomic profiling validated the upregulation of indole-3-acetate, a metabolite with neuroprotective properties, alongside reduced levels of compounds linked to cognitive impairment, specifically asymmetric dimethylarginine and homogentisic acid. These findings underscore the therapeutic potential of Limosilactobacillus fermentum PY-1 in modulating gut-brain axis dynamics for reducing oxidative stress, and offer a novel strategy for ASD intervention.

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8. Ghadiri M, Dehkordi ZV, Amini-Khoei H. Modulation of Neuroinflammation and Nitrite Imbalance in the Hippocampus by Simvastatin: Therapeutic Potential in Maternal Separation-Induced Autism Spectrum Disorder. Int J Dev Neurosci;2026 (Feb);86(1):e70105.

OBJECTIVES: Autism spectrum disorder (ASD) is an increasingly occurring neurobiological condition. As a main risk factor, maternal separation (MS) stress has a role in the foundation of ASD. Simvastatin possessed neuroprotective effects. We intended to estimate the impact of simvastatin on autism-related behaviours in mice subjected to the MS paradigm, concentrating on its likely effects on hippocampal oxidative stress imbalance and neuroinflammation. METHODS: Forty mice were unintentionally assigned into 5 groups: including control group (normal saline treated [10 mL/kg]) and MS groups respectively administrated with normal saline (10 mL/kg) or simvastatin at doses of 2.5, 5 and 10 mg/kg for 2 weeks. Shuttle box, marble burying (MB) and three-chamber sociability trials were performed. Hippocampal malondialdehyde (MDA), nitrite, total antioxidant capacity (TAC) and expression of proinflammatory cytokines, counting TLR4, TNF-α, IL-1β and NLRP3, were measured. RESULTS: Simvastatin in MS mice led to notable improvements in behaviour and cognition as elevating social interaction indices in the three-chamber test, enhancing passive avoidance memory in the shuttle box test and reducing repetitive actions as observed in the marble burying test. Simvastatin abridged the hippocampal nitrite content and neuroinflammatory response. CONCLUSIONS: Simvastatin, perhaps through weakening the hippocampal nitrite imbalance and neuroinflammation, alleviated autism-related behaviours in MS mice.

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9. Ghumman U, DiSalvo M, Iorini M, Srinivasan A, Saeed A, O’Connor M, Ghaziuddin M, Uchida M, Ceranoglu A, Wozniak J, Joshi G. Correction: Clinical Correlates of Major Depression in Psychiatrically Referred Youth With and Without Autism: A Controlled Study. J Autism Dev Disord;2026 (Feb 11)

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10. Guo X, Zhang L, Zhuang K. Dlgap2 deficiency disrupts synaptic homeostasis by promoting ubiquitin-mediated Itsn1 degradation in a valproic acid-induced autism-like model. Sci Rep;2026 (Feb 11)

Prenatal valproic acid (VPA) exposure increases the risk of neurodevelopmental disorders, though its synaptic mechanisms remain unclear. Using multi-omics analyses, we identified Dlgap2 as a consistently dysregulated protein in VPA models. Mice with Dlgap2 knockdown exhibited synaptic deficits and autism-like behaviors, including social and cognitive impairments. Proteomics of postsynaptic density following Dlgap2 knockdown revealed disruption of synaptic organization and a specific reduction in Intersectin-1 (Itsn1), which interacts with Dlgap2 and undergoes ubiquitin-mediated degradation upon Dlgap2 deficiency. Our study defines a Dlgap2-Itsn1 regulatory axis that underlies VPA-induced synaptic dysfunction.

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11. Hao Q, Wang J, Yang J, Li W, Hu S, Lv Z. Evaluating the Efficacy of Repetitive Transcranial Magnetic Stimulation Combined With Auditory Integration Training for Children With Autism Spectrum Disorder: Protocol for a Randomized Sham-Controlled Trial. JMIR Res Protoc;2026 (Feb 11);15:e80243.

BACKGROUND: Autism spectrum disorder (ASD) represents a significant public health challenge characterized by persistent social communication deficits and restricted, repetitive patterns of behavior. Current interventions show limited efficacy, particularly for core symptoms. Repetitive transcranial magnetic stimulation (rTMS) and auditory integration training (AIT) have independently demonstrated promise in addressing neurophysiological abnormalities associated with ASD. OBJECTIVE: This study aims to evaluate the clinical efficacy of a combined rTMS and AIT intervention compared to rTMS alone and sham stimulation in children with ASD. METHODS: This is a randomized, sham-controlled trial that will recruit 80 children aged 2 to 6 years with a confirmed ASD diagnosis. The randomization of the first 8 participants in this study used a 1:1:1 ratio. To more effectively test the core hypothesis (ie, the efficacy of the combined intervention), greater statistical power will be concentrated on the intervention group (rTMS+AIT), and the randomization ratio was ultimately adjusted to 2:1:1-specifically, (1) rTMS combined with AIT (n=40), (2) rTMS alone (n=20), or (3) sham rTMS (n=20). Primary outcome measures include the Autism Behavior Checklist and Childhood Autism Rating Scale. Secondary outcomes are the Strengths and Difficulties Questionnaire and Repetitive Behavior Scale-Revised. Assessments will be conducted at baseline, an interim time point, and immediately after the intervention. Data will be analyzed using SPSS (version 25.0; IBM Corp). RESULTS: This study has received funding, with data collection commencing in April 2024. Due to the small initial sample size of 8 participants (5 male and 3 female), no formal statistical comparisons of baseline characteristics between groups have been conducted at this time. It is anticipated that the rTMS combined with AIT intervention will exhibit superior efficacy compared to rTMS only. CONCLUSIONS: This will be the first sham-controlled trial to systematically investigate the potential synergistic effects of a combined rTMS and AIT intervention in children with ASD. The results will provide valuable insights into the neurotherapeutic potential of this combined approach and contribute to the development of evidence-based interventions for ASD.

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12. Howard C, Mekhail J, Ravikoff LM, Milanaik R. Clinical concerns and considerations for leucovorin use in autism spectrum disorder. Curr Opin Pediatr;2026 (Feb 3)

PURPOSE OF REVIEW: To provide pediatric clinicians with an overview of current research on leucovorin use in children with autism spectrum disorder (ASD) and a guide to patient evaluation and treatment. RECENT FINDINGS: An association between cerebral folate deficiency (CFD) and ASD has been suggested in some studies. Autoantibodies that block folate entry into the brain are a cause of CFD and have been detected in 71% of patients with ASD. Leucovorin is a synthetic drug that increases folate concentrations in the brain despite the presence of autoantibodies. Certain studies have indicated reductions in communication deficits in nonverbal children with ASD, particularly those with these autoantibodies, following consistent leucovorin use. However, other studies have found no change in symptoms despite leucovorin intake. The American Academy of Pediatrics (AAP) currently does not recommend use of leucovorin in children with ASD. SUMMARY: Due to recent popularity among policymakers and on social media, many pediatricians have reported increased requests by families for leucovorin prescriptions to treat ASD in pediatric patients. This review provides clinicians with an overview of the biological rationale, clinical evidence, and potential benefits and limitations of leucovorin use in children with ASD.

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13. Lindsay-Webb K, Clayton P, Simonoff E, Hollocks MJ. Examining the Relationship Between Social Motivation and Internalizing Symptoms in Autistic People: A Systematic Review and Meta-Analysis. Autism Res;2026 (Feb 11):e70185.

The social motivation theory hypothesizes that autistic individuals’ experience diminished social motivation due to reduced social reward, social orienting, and social maintaining. Low social motivation has been linked to increased vulnerability to internalizing difficulties within this population. This systematic review and meta-analysis examined the relationship between social motivation and internalizing symptoms across the lifespan in autistic individuals. Relevant research papers until February 2025 were identified by searching EMBASE, PsycINFO, PubMed, and Web of Science databases (PROSPERO protocol: CRD42024547863). The systematic review included 14 studies (n = 4590). A total of three meta-analyses were run using Pearson’s correlation coefficients between social motivation and (1) anxiety, (2) depression, and (3) social anxiety, and the moderating effect of age, sex, and study quality were assessed using meta-regressions. Sensitivity analyses were run to assess whether one study was influencing the results of the meta-analysis. Greater difficulties with social motivation are associated with increased anxiety, depression, and social anxiety, with a moderate pooled effect size across all domains. Sensitivity analyses did not significantly alter any of the results. Age, sex, and quality of study were nonsignificant moderators. Reduced social motivation may be associated with an increased vulnerability to internalizing difficulties in autistic individuals. The stability across age, sex, and study quality highlights social motivation as a potential transdiagnostic target for intervention in autistic individuals. Autistic individuals can experience reduced social motivation. Differences in social motivation have in turn been found to be associated with difficulties such as anxiety and depression in samples of autistic people. Here we conducted the first systematic review and meta‐analysis of this proposed association. Our results suggest that reduced social motivation may be associated with an increased vulnerability to anxiety and depression in autistic individuals. eng

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14. Liu K, Sun B, Wang BK, Chen J, Westover MB, Tian FY, Sun H, Kong XJ. An Electroencephalographic Study of Sleep Spindle and Infraslow Oscillation in Children With Autism Spectrum Disorder. J Sleep Res;2026 (Feb 10):e70309.

We investigated whether sleep microstructures show spatial differences in young children with autism compared with typically developing peers. 32-channel electroencephalography (EEG) during natural sleep after 5-6 h of partial sleep deprivation was recorded from 53 children (26 with autism, 27 typically developing; 1.1-5.1 years). Quantified EEG features included spindle density, frequency, morphology, slow oscillations and the relative power of infraslow oscillations (0.005-0.03 Hz). Clinical associations were examined using the Autism Diagnostic Observation Schedule, the Childhood Autism Rating Scale and the Gesell Developmental Schedules. Children with autism showed greater modulation of spindle frequency by the phase of slow oscillations at a right frontal scalp electrode (F8). An infraslow peak slightly below 0.02 Hz was present in both groups. Although group differences in infraslow power did not remain significant after correction for multiple comparisons, infraslow power correlated positively with autism severity in males, over posterior and temporal regions. These findings indicate that sleep microstructures in early childhood reflect thalamocortical and cortical dysfunction with sex-specific clinical associations.

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15. Osborne K, Liew Z, Cui X, Walker DI, Jones DP, Lin Y, O’Sharkey K, Heck JE, Paul KC, Ritz B. Prenatal exposure to per- and polyfluoroalkyl substances and risk of autism spectrum disorder in the California Central Valley, 2004-2010. Environ Epidemiol;2026 (Apr);10(2):e464.

BACKGROUND: There is mixed evidence regarding the association between per- and polyfluoroalkyl substances (PFAS) and autism spectrum disorder (ASD). METHODS: We matched 294 ASD cases to 286 controls by sex, birth year, and exposure to selected pesticides and air pollution. All participants were born in the California Central Valley from 2004 to 2010. Using high-resolution metabolomic profiling, three PFAS were measured in >60% of maternal serum samples: perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid, and perfluorooctane sulfonate (PFOS). Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression to examine relationships between PFAS and ASD. Nonlinear associations were examined using restricted cubic spline regression, and a quantile-based g-computation approach was utilized to examine the association between a PFAS mixture and ASD. RESULTS: We found an elevated aOR for ASD comparing the highest to the lowest PFOA exposure quartile (aOR = 1.71; 95% CI = 0.96, 3.06); this was not seen with perfluorohexanesulfonic acid or PFOS. We saw a J-shaped exposure-outcome relationship for PFOA. No apparent associations were found for the PFAS mixture and ASD. Maternal education modified associations for PFOA and PFOS; among children of mothers with lower education levels, the highest PFOA quartile was strongly associated with ASD compared with the lowest quartile (aOR = 2.97; 95% CI = 1.43, 6.18). This association was not seen with higher education levels (aOR = 0.62; 95% CI = 0.24, 1.64). CONCLUSIONS: We found that prenatal exposure to PFOA was associated with ASD in children, particularly among mothers with lower education levels. Larger studies are warranted to replicate our findings.

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16. Qiu MH, Zhong ZG, Song PW, Tao GJ, Zhang JT, Chen YH, Song TJ, Qu WM, Zhang R, Huang ZL. Early-life sleep disruption in Shank3-deficient rats: A preclinical model for autism-related sleep mechanisms and interventions. Transl Psychiatry;2026 (Feb 10)

Sleep disturbances are among the most prevalent and early-emerging features of autism spectrum disorder (ASD), often preceding core behavioral symptoms. Despite their clinical relevance, the neurobiological mechanisms driving early-life sleep disruption in ASD remain poorly understood. Shank3, encoding a synaptic scaffolding protein at excitatory synapses, is one of the most well-established monogenic risk factors for ASD. Here, we systematically investigated sleep architecture and homeostatic regulation in juvenile Shank3(Δe11-21) rats, which lack Shank3 protein and display ASD-like behavioral and sensory phenotypes. EEG/EMG recordings revealed sex-specific abnormalities: males exhibited fragmented sleep with frequent brief arousals, whereas females showed prolonged wakefulness. Both sexes demonstrated reduced NREM sleep δ power, indicating diminished sleep depth. Following 6-h sleep deprivation, Shank3(-/-) rats displayed blunted homeostatic rebound. Additionally, Clock and Bmal1 mRNA were significantly downregulated in prefrontal cortex and striatum, implicating circadian dysregulation within corticostriatal circuits. Collectively, these findings indicate that Shank3 deficiency leads to early-onset, low-quality sleep accompanied by impaired homeostatic and circadian regulation. This phenotype mirrors clinical sleep disturbances in children with ASD, supporting sleep dysfunction as an intrinsic, early feature of Shank3-related pathophysiology. Together with prior behavioral evidence, this study establishes the Shank3(Δe11-21) rat as a preclinical model for elucidating mechanisms of Shank3-related neurodevelopmental disorders and for evaluating potential early-life therapeutic interventions, including sleep-targeted strategies.

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17. Solek P, Nurfitri E, Prasetya T, Rizqiamuti AF, Sahril I, Burhan, Gamayani U, Rusmil K, Afriandi I, Chandra LA, Gunawan K. Predictors of functional ability in autism spectrum disorder: A scoping review. Tzu Chi Med J;2026 (Jan-Mar);38(1):48-58.

Autism spectrum disorder (ASD) is a group of diverse neurodevelopmental conditions characterized by deficits in social communication and interaction, as well as confined and repetitive patterns of behaviors, interests, or activities. Currently, there are no standardized techniques for predicting functional ability in children with ASD, which can lead to undetected clinical impairments and delayed targeted treatments. To address this issue, a scoping review was conducted following the preferred reporting items for systematic reviews and meta-analyses criteria. Twelve articles met the inclusion criteria for this review. This study summarized the potential tools and parameters that may benefit in predicting abilities used in the daily lives of children with ASD. The collected tools varied widely, including clinical questionnaires, physical symptoms, laboratory tests, and imaging studies. These tools provided descriptions of various functional abilities that are altered in ASD, offering insights into the diverse manifestations of the disorder and potential approaches for assessment and intervention.

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18. Thompson-Hodgetts S, Conlon O, Ferrige E, Jeannot P, Kohlhaas S, Ryan J, McKillop A. Inclusion of autistic children in mainstream community recreation programs: a collective case-study. Disabil Rehabil;2026 (Feb 11):1-15.

PURPOSE: All children have the right to inclusion across contexts, yet Autistic children are often excluded from community-based programs. We aimed to understand how inclusion is conceptualized and enacted within community-based programs from the perspectives of parents of Autistic children and program staff. METHODS: A collective case study across three community-based recreation programs that all identified as inclusive was used. Semi-structured interviews were conducted with five program staff and seven parents of Autistic children. Program documents, researcher observations and reflexive notes were also data. Reflexive thematic analysis was used. FINDINGS: Two themes that influenced experiences of in/exclusion were identified: (1) Inclusion as Culture-Feeling Welcomed, reflected a program’s culture of acceptance, opportunity and belonging, and (2) Inclusion as Practice-Being Welcomed, described approaches used to support equal and active participation and the influence of front-line staff. CONCLUSION: Experiences of inclusion reflected the culture and practices of each organization, centered on equal and active participation with others, and feelings of belonging and being valued. These experiences were desired, but not common. Rather, othering and ableism were prominent, even in programs that identified as inclusive. Findings can be used to shift how inclusion is envisioned and enacted in community programs. Autistic children are often excluded from community recreation programs.Othering and ableism were commonly experienced by autistic children in community recreation, even in some programs that identified as inclusive.Strategies to support inclusion in community programs include reinforcing the value of diversity and implementing universal design strategies.Additional approaches include decreasing extraneous sensory stimuli, training staff, and collaborating with families. eng

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19. Wadhwani D, Patel SS. Gestational hyperglycemia and autism spectrum disorder: Mechanistic pathways and emerging preventive strategies. Behav Brain Res;2026 (Feb 11);504:116099.

Autism spectrum disorder is a neurodevelopmental disorder characterised by deficits in social communication, restricted interests, and repetitive behaviours. The severity and presentation of symptoms vary greatly among autistic individuals. The etiology of autism is multifactorial, including metabolic, environmental, and genetic factors. Emerging evidence suggests that the maternal metabolic environment, especially gestational diabetes mellitus, has a major impact on fetal neurodevelopment and the subsequent risk of autism spectrum disorder. Epidemiological studies have found that children born to mothers with gestational diabetes mellitus are much more likely to be diagnosed with autism, especially if GDM is identified before 26 weeks of pregnancy. The mechanistic pathways that link maternal hyperglycemia to autism are explored in this review. These include epigenetic suppression of SOD2, impaired neuronal migration through disrupted reelin signalling, elevated oxidative stress from advanced glycation end products, gut dysbiosis and many more, caused by GDM. The cumulative effect of the above factors involves disturbances in the intrauterine environment, which results in abnormal synaptic formation, neuroinflammation, and mitochondrial dysfunction in the developing fetal brain. This review also examines the new therapeutic strategies that can target these pathways, such as RORα agonist, SGLT-2 and DPP4 inhibitors, antioxidants and gut microbiota modification through various dietary interventions and supplementation to support the growth of beneficial microbiota. Thus, early detection and treatment of maternal metabolic disorders during pregnancy may be a promising way to lower the risk of autism in infants and enhance the neurodevelopmental outcomes.

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