1. Organized sports-based interventions and motor outcomes in children diagnosed with autism spectrum disorder: A systematic review. Dev Med Child Neurol. 2026.

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2. Anderson KA, Ne’eman A, Lee WL, Ventimiglia J, McLean KJ, Shea L. National Profile of Adult SSI Recipients With Autism or Intellectual Disability in Medicaid. Intellect Dev Disabil. 2026; 64(1): 15-28.

This study uses 2019 national Medicaid data to examine Supplemental Security Income (SSI) recipients, focusing on working-aged beneficiaries with autism or intellectual disability (ID). Our findings reveal higher-than-average SSI participation among these groups, with a significant concentration of transition-aged recipients (18 to 25 years). Notably, outpatient psychiatric services were more commonly used by SSI recipients, despite overall similar service utilization between recipients and non-recipients. Automatic enrollment states have higher SSI participation compared to states requiring separate applications, particularly in those with more restrictive Medicaid eligibility criteria, suggesting that the absence of SSI recipients not enrolled in Medicaid from the data may bias results. These insights emphasize the need for targeted policy interventions to better address the unique needs of this population.

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3. Appleby B, Bollard M, Barratt J, Kempson S. International Exploration of Health and Care Professionals Advanced Level of Practice in Intellectual Disability and/or Autism, Applied Through a UK, Health Education England Lens: Scoping Review. J Clin Nurs. 2026.

AIM: To explore, identify and describe the journey for health and care professionals (HCPs) working towards developing advanced level practice in intellectual disability and autism. BACKGROUND: The review proposes there is an acknowledged gap in understanding the identity and positionality of advanced practice for people with autism and/or a learning disability. DESIGN: Scoping review. METHODS: PRISMA-ScR guidelines were used to report the review. The published protocol was registered with the Health Science Network. DATA SOURCES: Five academic databases were searched from 1994 to 2024 to capture the historical and contemporary trajectory of developments in advanced practice. Data extracted was in reference to the four pillars of Advanced Practice: Education, Leadership and Management, Clinical Practice and Research. RESULTS: Forty-four papers provided new insights into activities of advanced practice. Advanced practice was identified in ‘Assessing and Managing Care’; ‘Working in Partnership’; ‘Interprofessional Collaborative Working’; ‘Knowledge, Attitude and Competence’; and ‘Role Evaluation, Models and Tools’. DISCUSSION: Explored the context and development of advanced practice, the positionality in intellectual disability and autism and thirdly the impact of advanced practice for this population group. CONCLUSION: Drawing on international literature, this review identified the types of advanced practice activities, the challenges for Health Care Professionals and the impact in their provision and management of care. Highlighting also the gaps and opportunities to develop advanced practice in education, leadership, management, clinical practice and research. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: In the absence of international advanced practice role comparators in this review, more research and workforce development is required to standardise a professional framework for this group of people. IMPACT: Provides new and nuanced understanding internationally, in the ‘what’, ‘where’ and ‘what type’ of advanced practice. Has developed a conceptual picture of the international evidence-base and reported different types of impact in ‘Clinical Practice’, ‘Leadership’, ‘Education’ and ‘Practice Development and Research’. REPORTING METHOD: We adhered to EQUATOR guidelines and used the PRISMA-ScR extension for scoping reviews to report the review. TRIAL REGISTRATION: Open Science Framework: DOI: https://doi.org/10.17605/OSF.IO/RT5DW PATIENT OR PUBLIC CONTRIBUTION: N/A: a literature review.

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4. Attar SM, Benavidez H, Gicheru C, Alabi C, Sapano R, Stone WL. Facilitating Autism Service Navigation, Parenting, and Self-Care Within a Community-Based Organization: A Pilot Feasibility Study With Culturally and Linguistically Diverse Families. Autism. 2026: 13623613261469915.

Health care and early education systems are common entry points for autism identification and specialized services. However, culturally and linguistically diverse families are less likely to experience timely or positive interactions within these systems. This pilot feasibility study examined implementation outcomes of using non-specialist providers (NSPs) within a community-based non-profit organization to support early service navigation while also promoting caregiver use of evidence-based parenting and self-care strategies. Six multilingual NSPs completed a web-based training and delivered a four-session program, the Family Care Project, to 35 families of children aged 16 months to 5 years for whom there were developmental concerns. Implementation outcomes were assessed using Proctor’s taxonomy, including acceptability, feasibility, appropriateness, adoption, penetration, and sustainability. All families completed all four sessions within 5 weeks. NSPs reported high acceptability, feasibility, and appropriateness of the training and caregiver-facing materials; adoption was high, with 95% of planned module content delivered. At the 5-month follow-up, NSPs reported continued program use with additional families, providing evidence of organizational penetration and sustainability. Results suggest that a low-resource, culturally responsive curriculum can be acceptable, feasible, and appropriate for NSP-led delivery in community-based settings and may offer a scalable complement to health care-based navigation models.Lay AbstractMedical professionals and educators are often the first to identify concerns about a child’s development and help families seek care. However, families who speak languages other than English or who come from diverse cultural backgrounds may face barriers to accessing this support. This study examined whether trusted community providers, who share language and cultural backgrounds with families but do not have specialized clinical training, can deliver autism-related support within a community-based non-profit organization. Six community-based providers who speak a range of African and Middle Eastern languages completed an online training through the Family Care Project and used this program to support 35 families of young children. Providers reported that the program was easy to use and fit well with the work they already do. All families completed the program within 5 weeks. Six months later, providers had continued delivering the program and had supported an additional 24 families. These findings suggest that a low-cost, community-based program led by trusted providers from the same communities as participating families can support early autism-related service navigation. The Family Care Project may help more families access information, resources, and support early in their child’s development.

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5. Baraniuk C. Trump signs order on childhood vaccines while making unproved links between jabs and autism. Bmj. 2026; 394: e100549.

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6. Cervantes PE, Seag DEM, Baroni A, Wiener E, Tay ET, Horwitz SM. Suicide Risk Screening for Youth with Developmental Disabilities in the Pediatric Emergency Department. Intellect Dev Disabil. 2026; 64(1): 29-37.

Youth with developmental disabilities (DD) are often at increased suicide risk. However, clinician guidance on suicide prevention practices specific to the DD population is rarely available, which may result in care disparities. The current study examined whether rates of standard suicide risk screening in two pediatric emergency departments (ED) differed for youth with and without DD. Then, using data from a NIMH-funded initiative, we compared youth with and without DD on demographic, visit, and clinical characteristics to identify possible factors related to differences in screening rates. Disparities in the completion of suicide risk screening with youth with DD were identified in standard care but few differences were found across groups to suggest a rationale, holding important clinical and research implications.

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7. Chakraborti A, Singhi AK. Transcatheter ASD Closure in a Bidirectional Cardiopulmonary Diagnostic Blind Spot: When Dyspnea Does Not Fit. JACC Case Rep. 2026: 109757.

BACKGROUND: Dyspnea in adults with secundum atrial septal defect (ASD) is often attributed to shunt physiology, whereas coexisting airway disease may remain unrecognized. Conversely, clinically significant ASD may be overlooked in patients presenting with predominant respiratory symptoms, creating a bidirectional cardiopulmonary diagnostic blind spot. CASE SUMMARY: We retrospectively identified 8 adults (median age 55.5 years; 5 women) with secundum ASD (15-30 mm) and clinically significant airway disease through bidirectional cardiology-pulmonology referral (6 cardiology-to-pulmonology; 2 pulmonology-to-cardiology). Airway physiology was obstructive in 6, restrictive in 1, and mixed in 1, with bronchodilator reversibility in 5. Integrated cardiopulmonary evaluation and respiratory optimization improved symptom attribution and guided individualized management. Seven patients underwent transcatheter ASD closure (median device size, 38 mm), including fenestrated closure in 2 after balloon occlusion testing identified impaired left ventricular compliance; 1 deferred closure after symptomatic improvement with respiratory therapy alone. No procedural complications occurred, and 1 noncardiac death occurred 5 years after intervention. TAKE-HOME MESSAGES: Dyspnea in adults with ASD may reflect combined cardiac and airway disease. Disproportionate symptoms should prompt integrated cardiopulmonary evaluation. Accurate symptom attribution underpins respiratory optimization and individualized ASD closure.

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8. Chou SH, Cheng Y, Tseng SH, Martínez RM, Chen C, Fan YT. Combined Transcranial Direct Current Stimulation With Sensory-Based Treatments in Autism: Preliminary Report. Am J Intellect Dev Disabil. 2026; 131(1): 1-12.

This study investigated the effects of sensory-based treatments (SBT) combined with active transcranial direct current stimulation (tDCS) of the left prefrontal cortex (SBT+AtDCS), and SBT combined with sham tDCS (SBT+StDCS) in autism spectrum condition (ASC). Eleven ASC children were randomly assigned to receive either SBT+AtDCS or SBT+StDCS for 10 sessions over 2 weeks. All children exhibited significant improvement in their ability to regulate and respond to sensory stimuli after treatment. The SBT+AtDCS group showed significant reductions in autism severity and behavioral difficulties compared to the SBT+StDCS group. This preliminary report is the first to suggest that SBT combined with active tDCS may alleviate symptoms associated with ASC. Future research with a larger sample, neural measures, and a longitudinal design is required for validation.

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9. Failla C, Minutoli R, Chilà P, Doria G, Scarcella I, Marraffa C, Corpina F, Roccaforte G, Crifò N, Meduri A, Pioggia G, Marino F. Immersive wearable virtual reality for autism: a systematic review of current evidence. Front Psychiatry. 2026; 17: 1771573.

INTRODUCTION: Immersive and wearable virtual reality (VR) is an emerging technology with growing potential to support assessment and intervention ifor autistic people. The methodological heterogeneity of existing studies limits the interpretation and generalization of current evidence. METHODS: A systematic review with a narrative synthesis was conducted in accordance with the PRISMA guidelines. Electronic searches were performed in PubMed, Scopus, IEEE Xplore, Web of Science, and Google Scholar, identifying studies published between 2015 and August 2025. Twenty-two studies investigating wearable and immersive VR interventions in children and adults with ASD met the eligibility criteria. RESULTS: The included studies demonstrated that wearable VR interventions may improve social communication, joint attention, emotional regulation, daily living skills, executive functioning, and user engagement. Innovative technologies, including eye-tracking and artificial intelligence-based systems, also enabled objective assessment of gaze behaviour, social interaction, and physiological responses. Nevertheless, the evidence was characterized by considerable methodological heterogeneity, predominantly small sample sizes, limited use of randomized controlled designs, and scarce long-term follow-up, reducing the generalizability of the findings. DISCUSSION: Wearable VR represents a promising tool for personalized assessment and intervention in ASD. Based on the current evidence, we propose a structured pre-intervention assessment integrating sensory, cognitive, emotional, and VR tolerance profiles to support individualized intervention planning. Future research should prioritize standardized outcome measures, rigorous study designs, and longitudinal investigations to strengthen the clinical translation of VR-based interventions in autism.

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10. Garcia-Argibay M, Kuja-Halkola R, D’Onofrio BM, Lichtenstein P, Chang Z, Larsson H, Cortese S. Real-world ADHD pharmacological treatment patterns and their association with negative clinical outcomes in youth with comorbid autism: a Swedish population-based study. BMJ Ment Health. 2026; 29(1).

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) medications can reduce ADHD symptom severity in individuals with comorbid autism spectrum disorder (ASD). However, clinical guidance on pharmacological treatment of ADHD in this clinical population remains limited and inconsistent. Characterising real-world treatment patterns (ie, initiation timing, medication choices, switching, discontinuation) and the impact of alternative medication choices on clinical outcomes is critical for informing evidence-based management strategies. OBJECTIVE: To (1) characterise ADHD pharmacological treatment patterns in youth with ADHD+ASD versus ADHD alone and (2) assess whether using alternative ADHD medications versus methylphenidate is associated with differential changes in negative clinical outcomes among youth with ADHD+ASD. METHODS: This is a population-based cohort study using Swedish national registers. The study included children (<13 years) and adolescents (13-17 years) with an incident ADHD diagnosis between 2007 and 2018 and followed-up until 2021, comparing youth with co-occurring ASD (n=24 117) and ADHD alone (n=79 830). Descriptive outcomes included time to pharmacological treatment initiation, medication type, number of medication switches and discontinuations. The primary outcome was changes in rates of inpatient psychiatric hospitalisations, accidental injuries and specialist care visits for substance use, depressive or anxiety disorders in the 1 year after versus the 1 year before medication initiation. FINDINGS: Individuals with ADHD+ASD experienced longer delays to treatment initiation (12-14% initiated >12 months after diagnosis vs 7-8% in ADHD alone). Children with ADHD+ASD were slightly more likely to discontinue treatment within 3 months (16% vs 12%) and had the highest average number of medication switches within 3 years (2.6; IQR 0.0-2.0). In within-individual analyses, comparisons of alternative ADHD medications versus methylphenidate did not yield statistically significant differences after correcting for multiple comparisons. CONCLUSIONS: Children with ADHD+ASD experienced longer delays to treatment initiation and more frequent medication switching compared with those with ADHD only. The effects of alternative ADHD medication options on key negative clinical outcomes appeared similar to those of methylphenidate. CLINICAL IMPLICATIONS: These findings suggest that, rather than recommending fixed first-line and second-line treatments for individuals with ADHD-ASD, clinical guidelines should emphasise appropriate training as well as prompt and individualised treatment based on a shared decision-making process.

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11. Jonker F, Bouwmeester S, de Looff P, Didden R. Adaptive Functioning in Clients With Intellectual Disabilities or Borderline Intellectual Functioning and Psychiatric Comorbidity. J Appl Res Intellect Disabil. 2026; 39(4): e70292.

BACKGROUND: Assessment of adaptive functioning is part of the classification of intellectual disability and borderline intellectual functioning and important in estimating support needs. Adaptive functioning may be impaired in clients with psychiatric comorbidity. We investigated relationships between adaptive functioning and psychiatric comorbidity in individuals with intellectual disabilities or borderline intellectual functioning using the ADAPT. METHOD: ADAPT scores of clients with comorbid psychiatric disorders were compared with those of clients without comorbidity (N = 4376). RESULTS: In clients with intellectual disabilities, ASD was associated with lower ADAPT scores while depressive mood disorder was associated with higher ADAPT scores. We found a negative relationship between number of psychiatric disorders and mean total ADAPT score. CONCLUSION: When determining the severity of an intellectual disability or using the V-code borderline intellectual functioning, ASD and multiple comorbidities must be taken into account to prevent an intellectual disability or borderline intellectual functioning from being incorrectly classified.

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12. Jung AW, Supptitz J, Hummes PN, Rodrigues RJK, Nunes ML. The relationship between congenital infections and autism spectrum disorder: a systematic review. J Pediatr (Rio J). 2026; 102(5): 101591.

OBJECTIVE: The aim of this systematic review (SR) is to evaluate the relationship between congenital infections (Toxoplasmosis, Cytomegalovirus, Rubella, Herpes simplex type 1 and 2, HIV, Zika, and Syphilis) and the development of Autism Spectrum Disorder (ASD). DATA SOURCE: The authors seek to identify loopholes in the current knowledge about this content and to understand the role of congenital infections in children’s neurodevelopment. After the systematic search, 32 articles were included. Quality of articles was evaluated by the e Newcastle-Ottawa Scale (NOS). FINDINGS: The data obtained were heterogeneous; the NOS varied from 4 to 9. In 19 studies, an association between congenital infection and the development of ASD and/or features of this spectrum was not observed. Furthermore, the present findings indicate that the link between congenital infections and ASD varies depending on the pathogen and there is no common causal factor among the diseases, as their mechanisms are not yet fully understood. CONCLUSION: This review highlights that there is a possible correlation between some congenital infections and the development of ASD, as is the case with CMV, Zika, Rubella and Toxoplasmosis infection. As the mechanisms are not yet fully understood, there is a need for further studies and research on this topic to bridge the existing knowledge gap regarding its mechanisms.

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13. Kido M, Shinohara T, Ishikawa I, Nakamura Y. Correction: Relationship Between Wechsler Intelligence Scale for Children-IV Profiles and School Refusal in Children With Autism Spectrum Disorder. Cureus. 2026; 18(8): c470.

[This corrects the article DOI: 10.7759/cureus.109855.].

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14. Lin L, Gao B, Hou Y, Huang W, Li X, Wang L, Shen Y, Ou J. The Structure and Individual Patterns of Emotional and Behavioral Problems in Preschool Children With Autism Spectrum Disorder: Evidence From Network and Cluster Analyses. Autism Res. 2026: e70343.

This study explored the interactions between emotional and behavioral symptoms in preschool children with autism spectrum disorder (ASD) and identified potential clinical subtypes based on these interrelationships. A total of 1886 preschool children with ASD and 285 age-matched typically developing (TD) children were assessed using the Child Behavior Checklist for ages 1.5-5. Symptom networks were estimated using the EBICglasso algorithm, and group differences were evaluated via network comparison tests. Subgroups within the ASD sample were identified using Individual Difference Symptom Networks (IDSN) with k-means clustering. The results revealed distinct network structures between the ASD and TD groups, with emotional reactivity demonstrating the highest centrality in the ASD network. Two distinct ASD subgroups (ASD-A and ASD-B) were identified, which showed significant differences from the TD group across all emotional and behavioral dimensionsin the CBCL 1.5-5. The subgroups differed significantly in overall network strength and specific edge connections, particularly between aggressive behavior and withdrawal problems. The findings indicate that emotional reactivity may play a central role in the symptom network of preschool children with ASD. The identification of two clinical subgroups with distinct symptom connectivity patterns provides valuable insights for developing more individualized and targeted intervention strategies. ASD-A subgroup points to the potential value of comprehensive early intervention programs, whereas ASD-B subgroup highlights the need for functional communication training and social engagement strategies.

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15. Movaghar A, Smith DaWalt L, Brilliant M, Kho A, Magana S, Berry-Kravis EM, Mailick MR. Fragile X Syndrome in Adulthood: A Study of Electronic Health Records. Am J Intellect Dev Disabil. 2026; 131(1): 53-68.

We analyzed the electronic health records of 323 Black and White non-Hispanic adults with Fragile X syndrome who were served by CAPriCORN, a network of healthcare systems in an urban area in the Midwest. Black patients with Fragile X syndrome were found to have a substantially elevated frequency of mental, neurological, and physical health conditions compared to Black controls. Further, Black and White patients with Fragile X syndrome had a dominant pattern of similarity across the hundreds of conditions that appeared in their records. This study broadens understanding of the health conditions associated with Fragile X syndrome during adulthood by extending the patient population to include Blacks as well as Whites.

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16. Pan J, Zhang H, Zhai Y, Zhang J, Deng H. Exploring atypical spatial-functional coupling in adolescent autism spectrum disorder: insights from neurodevelopment and transcriptomic architecture. Front Neurosci. 2026; 20: 1780430.

Autism Spectrum Disorder (ASD) is associated with atypical large-scale brain network organization, yet how spatial-functional dependencies relate to clinical features and molecular reference maps remains incompletely understood. To quantify spatial functional heterogeneity (Sill) and coherence persistence (Range), we analyzed resting-state fMRI data from 162 ASD and 175 TD adolescents, all aged 12-18. Compared with TD, adolescents with ASD exhibited significantly increased Sill within higher-order association networks, including the left Language and right Posterior Multimodal networks, whereas no group differences in Range survived multiple-comparison correction. Within the ASD group, elevated Sill was selectively associated with greater social-affective symptom severity but not restricted and repetitive behaviors. To explore potential biological correlates, we integrated cortical gene expression reference data and identified transcriptomic patterns associated with regional Sill differences. These genes showed enrichment for synaptic signaling, mitochondrial processes, and glial-related functions, highlighting multiscale correspondence between spatial-functional organization and molecular reference maps. Together, these results demonstrate statistical associations among altered spatial-functional properties, clinical severity, and transcriptomic profiles related to synaptic signaling, mitochondrial processes, and glial-related functions in ASD, providing a complementary spatial perspective on large-scale functional organization.

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17. Prabhakaran N, Kaku SM, Moncy AM, N R, Srikanth N, Raman V. Gender-Based Differences in Autism Spectrum Disorder: Evidence From an Indian Clinical Cohort. J Autism Dev Disord. 2026.

PURPOSE: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and repetitive, restricted behaviors or interests. The global male-to-female ratio ranges between 3:1 and 4:1, attributed to factors such as the female protective effect, extreme male brain theory, female autism phenotype, and camouflaging. Understanding gender-based differences is essential to reveal the true burden of ASD within the Indian context. METHODS: A cross-sectional retrospective study was conducted on 515 children diagnosed with ASD at a tertiary care center in Bengaluru, India. Participants aged 12 months to 21 years were assessed using standardized measures: WISC-IV, WPPSI-IV, VABS-II (cognitive functioning); ISAA, SRS (ASD severity and comorbidities); and COM DEALL, BSID-III (development). Sociodemographic and clinical variables were analyzed for gender differences after age adjustment. RESULTS: The male-to-female ratio was 4:1. Median annual family income was higher among females (₹14,00,000) than males (₹9,50,000). Girls exhibited greater ASD severity on the SRS-II, showing severe difficulties in social communication, autistic mannerisms, and social awareness. A positive family history of developmental disorders was more prevalent in females (11.8%) than males (4.9%; OR 2.57). Asthma was also more common in girls (5.8% vs. 1.8%; OR 3.35). CONCLUSION: Although the observed 4:1 ratio aligns with global trends, our findings suggest under-identification of females. Greater symptom severity, higher familial risk, and socioeconomic disparities support the female protective effect and camouflaging hypotheses. Gender-sensitive diagnostic tools are needed to improve detection and understanding of ASD in females.

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18. Prescott KE, Larson C, Stabile MJ, Eigsti IM. Sound-symbol correspondence in autism: The Bouba-Kiki effect. Res Autism. 2026; 131.

Autistic and non-autistic adolescents and adults with cognitive and language skills in the average range completed a brief task assessing their susceptibility to the effects of image-sound associations, known as the Bouba-Kiki effect. Results indicated significant group differences such that the autism group was less likely to respond in accordance with the Bouba-Kiki effect. Further, nonverbal IQ and self-reported sensory-motor processing each influenced Bouba-Kiki responding. In contrast, language abilities (grammaticality judgment) did not. While findings based on a brief measure are not conclusive, results suggest that multisensory integration is less robust in autism and lend support to « embodied cognition » accounts of autism.

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19. Prohn SM, Taylor M, Dinora P, Bogenschutz M, Broda MD, Lineberry S, West A. Assessing Privacy: What Aspects of Privacy Are Reported and Whose Experiences Are Not Represented?. Intellect Dev Disabil. 2026; 64(1): 75-86.

Standards of privacy are required for people with intellectual and developmental disabilities (IDD) receiving Medicaid Home and Community-Based Services (HCBS). The National Core Indicators In-Person Survey is one tool that people with IDD use to assess the presence, absence, and quality of their privacy. This study describes privacy assessments from a sample of 2,196 service users with IDD from 2021-2023 and shows that patterns of missing assessments are predicted by level of intellectual disability and nonverbal forms of communication. Missing privacy data, especially from those at greatest risk, poses a threat to community integration for people with IDD and requires the development of more accessible methods for collecting personal outcome data.

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20. Rashid N, Peckham A, Yakkala VK, Cosand L, Rajagopalan K. Characteristics of adult individuals with Rett syndrome treated or untreated with trofinetide in the United States. Front Neurol. 2026; 17: 1856312.

BACKGROUND: Rett syndrome (RTT) is a rare, progressive MECP2-related neurodevelopmental disorder with substantial lifelong morbidity that persists into adulthood. Although survival has improved, adults often experience evolving multisystem complications and fragmented transition care. Trofinetide (TROF) is approved for ages ≥2 years old, yet data on adults with RTT in the real-world setting remains limited; this study evaluated demographics and characteristics of adults >20 years of age who are treated vs. untreated with TROF. METHODS: A retrospective analysis of individuals with RTT diagnosis (ICD-10-CM: F84.2) from a linked medical claims and specialty pharmacy database from 01/01/2021 to 09/30/2024 was conducted. RTT individuals were categorized into two groups based on treatment status: treated group (index date: 1st TROF prescription (RX) 04/01/2023 to 03/31/2024) and untreated group (index date: assigned date using a risk set sampling method). Individuals who were ≤20 years of age at index date or had diagnosis for brain trauma or cerebrovascular disease prior to RTT diagnosis were excluded. RTT individuals were required to have continuous enrollment for ≥6 months pre-index and post-index. Demographics and clinical characteristics were assessed during pre-index among the treated and untreated groups. Continuous variables were summarized as means and SD; categorical variables as counts and percentages. RESULTS: There were 1,820 adult RTT individuals (>20 year old) eligible for the analysis: treated group (n = 290 [15.9%]) and untreated group (n = 1,530 [84.1%]). Mean age (SD) at index date was 30.9 (9.9) years (treated group) vs. 33.5 (10.0) years (untreated); and 5.5% vs. 6.7% were males in the treated vs. untreated groups, respectively. Treated group had higher rates of differential diagnoses, but similar rates of baseline comorbidities among both. Treated group also had higher rates of RTT related clinical features vs. untreated group. CONCLUSION: In this real-world analysis, only 16% of eligible adult RTT individuals were initiated on TROF, while 84% remain untreated. There is a high unmet need for adult individuals with RTT to initiate treatment with TROF. Treated group had higher rates of RTT related clinical features and differential diagnoses; however, the observation that TROF is being used in adults with greater to similar baseline complexity compared to untreated may provide reassurance for prescribers to consider TROF in adults who were untreated.

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21. Rios K, Hong H. Examining the Relationship Among Parental Stress, Knowledge, and Family Empowerment for Latinx Parents of Children With Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil. 2026; 131(1): 26-37.

Latinx parents of children with intellectual and developmental disabilities (IDD) face unique challenges, including heightened stress, limited access to resources, and systemic barriers. This study explores the relationships among parental stress, knowledge of special education, and family empowerment using structural equation modeling. Data were collected from 96 Latinx parents participating in a culturally responsive advocacy training program. Results revealed that greater knowledge was associated with increased empowerment but also heightened stress, reflecting the dual-edged nature of knowledge acquisition. Empowerment, however, mitigated stress related to dysfunctional parent-child interactions and a difficult child. These findings underscore the need for culturally responsive interventions that balance knowledge building with stress management, promoting resilience and empowerment among Latinx families navigating the complexities of raising children with IDD.

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22. Rubenstein LD, Nsiah E, Xiong Q, Love AMA, Morehouse N, Ruble L. Transition Planning for Students With Autism: Building Effective Teams Through Role Recognition, Communication, and Trust. Intellect Dev Disabil. 2026; 64(1): 1-14.

Postsecondary outcomes for students with autism remain among the poorest across disability categories. This qualitative study used focus groups to explore the perspectives of 25 caregivers, special education teachers, and Pre-Employment Transition Service (Pre-ETS) providers to identify how transition teams can be strengthened to support students with autism. We identified three key findings: (1) transition planning is most effective when team members’ complementary expertise is recognized and utilized, (2) both personal and systemic communication barriers hinder collaboration but can be addressed through intentional structures, and (3) trust develops through role clarity, consistent communication, and early shared successes. Findings highlight the need for school systems and agencies to provide structured role definitions, adaptive communication tools for team members, and support for relationship building.

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23. Song W, Bromberg J, Rast JE. Choices and Control in Daily Life and Services Among Adults With Autism Using Services in the United States: The Role of Race and Ethnicity. Am J Intellect Dev Disabil. 2026; 131(1): 38-52.

This study explores how adults with autism exercise choice and control. Using the 2018-2019 National Core Indicator-In-Person Survey, it compares choices in life and everyday decisions between adults with autism and those with other developmental disabilities (DD) receiving services and examines differences across race/ethnicity within adults with autism. Results showed that adults with autism had fewer life choices than adults with other DD. Hispanic adults with autism had less choice in daily schedules, free time, and spending money than non-Hispanic Whites. Non-Hispanic Black adults with autism also showed less choice in daily schedules and free time but reported having enough choices in these areas. The study highlights disparities among racial and ethnic minorities, underscoring the need for culturally sensitive and inclusive support strategies.

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24. Wang X, Tong J, Lu M, Luo L, Liu Y, Huang Q, Lv P, Zheng Y, Gan H, Geng M, Tao S, Tao X, Yan S, Gao G, Wu X, Huang K, Cao Y, Gao H, Tao F. Sex- and Trimester-Specific Associations of Prenatal Co-Exposure to Organophosphate Esters and Phthalates with Preschoolers’ Trajectories of Co-Occurring ADHD and ASD Symptoms: Cord Blood Metabolomic Study in the Ma’anshan Birth Cohort. Environ Sci Technol. 2026; 60(31): 21465-79.

Although neurotoxic, prenatal exposure to organophosphate esters (OPEs) and phthalic acid esters (PAEs) and their effects on preschoolers’ autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) cotrajectories and underlying metabolic mechanisms remain unclear, we aimed to elucidate these links. Maternal urinary OPEs/PAEs were measured in 3040 dyads from the Ma’anshan Birth Cohort across three trimesters. Child ADHD/ASD symptom scale scores were assessed at ages 3, 5, and 6, and cotrajectories were identified using group-based multitrajectory modeling. Single-pollutant models revealed that bis(2-ethylhexyl) phosphate (BEHP) across pregnancy was positively associated with high-score trajectories (HST) (OR = 1.20, 95% CI: 1.06, 1.37), whereas bis(2-butoxyethyl) phosphate (BBOEP) exhibited U-shaped associations. Second-trimester diphenyl phosphate (DPHP) (OR = 1.13, 95% CI: 1.01, 1.26), BEHP (OR = 1.14, 95% CI: 1.04, 1.24), and monobutyl phthalate (OR = 1.15, 95% CI: 1.00, 1.32) were positively associated with HST. First-trimester DPHP exhibited a positive correlation with moderate-score trajectories and HST in girls, while bis(1-chloro-2-propyl) phosphate across pregnancy was inversely associated with HST in boys (psex-int < 0.05). No mixed effects were detected. BBOEP across pregnancy was negatively associated with ADHD symptoms, whereas BEHP was positively associated. BEHP, monomethyl phthalate, and mono-(2-ethyl-5-oxohexyl) phthalate were positively associated with ASD symptoms, whereas dibutyl phosphate and monoethyl phthalate were negatively associated (p < 0.05). Cord blood metabolomics identified pyrimidine, biotin, lysine, cysteine, and methionine metabolism as key mediators of OPE-induced cotrajectories, and purine metabolism mediated PAEs' effects (p < 0.05). This study highlights OPE/PAE neurotoxicity and reveals novel cord metabolomic insights.

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25. Yin T, Qin S, Zhang Y, Wang J, Xu L, Han X, Hu X, Wang Y, Sun M, Qu L, Lu H, Zhao H, Liu M, Liu Q. Prosodic Synchrony Profiles in Mandarin-Speaking Children With Autism, Developmental Delay, and Typical Development: A Multi-Timescale Analysis. J Speech Lang Hear Res. 2026; 69(8): 3641-56.

PURPOSE: Prosodic synchrony differences between autistic and non-autistic individuals have been increasingly documented, but findings remain heterogeneous. This study delineates a multi-timescale profile of static and dynamic pitch synchrony in autistic children during naturalistic Mandarin caregiver-child interactions to deepen understanding of interactional characteristics in autism. METHOD: Sixty Mandarin-speaking children with autism spectrum disorder (ASD), developmental delay, or typical development (TD) participated in 10-min caregiver-child free-play interactions (20 per group). Prosodic synchrony was indexed from fundamental frequency (F0) using a multi-timescale analytical framework informed by Wynn and Borrie (2022), with dynamic time warping (DTW) for utterance alignment and pseudo-pair normalization for synchrony estimation. Analyses were performed at three timescales: turn level (adjacent caregiver-to-child utterance pairs), block level (short sequences of alternating turns separated by brief pauses), and conversation level (the full interaction). Static synchrony captured overall similarity averaged within a timescale, while dynamic synchrony captured systematic time-varying changes in synchrony over the interaction. Group effects and temporal structure were evaluated using linear mixed-effects models and generalized additive mixed models (GAMMs). RESULTS: The results indicated that children with ASD demonstrated significantly reduced static prosodic synchrony compared to their TD peers, consistently observed across turn-level (p = .005), block-level (p = .001), and conversation-level analyses (p = .005). Although dynamic synchrony was rarely observed, group-wise comparisons of smooth trajectories revealed that children with developmental disorders showed pronounced deviations in prosodic synchrony relative to their TD peers within specific temporal segments. Moreover, group differences emerged in trajectory variability, with the ASD group showing greater range and standard deviation of dynamic synchrony trajectories (p < .001). CONCLUSIONS: The results offer a multi-scale behavioral profile of prosodic synchrony in neurodevelopmental conditions. Turn-level synchrony may be informative for early screening, and dynamic-trajectory variability may support differential characterization and intervention tracking. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.32867315.

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26. Zhang J. Challenging Face-to-Face Communication in Clinical Ethics: Autism as an Illustrative Case. Am J Bioeth. 2026: 1-12.

This paper examines the ethical status of face-to-face communication in clinical practice, using autism as an illustrative case. Drawing on phenomenological accounts of embodiment and first-person descriptions of autistic experience, it argues that face-to-face interaction-characterized by immediacy, multimodality, and unpredictability-can impose significant perceptual and cognitive burdens on autistic patients. Digitally mediated communication, by contrast, provides greater temporal flexibility, semiotic stability, and user control, thereby reducing communicative pressure and supporting more accessible participation. Reframing communication through the principles of autonomy, non-maleficence, and relational care, the paper argues that communicative practices should be understood as context-sensitive and responsive to patients’ perceptual conditions rather than governed by a default preference for face-to-face interaction. It concludes that presence should be reconceptualized as a relational achievement grounded in responsiveness rather than physical co-presence alone, with implications for how ethical communication in clinical care is understood.

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