1. 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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2. Beradze M, Fichman S, Meir N. Exploring Maze Patterns in Bilingual and Monolingual Children With and Without Autism: A Pragmatic Perspective. J Speech Lang Hear Res;2026 (Feb 12);69(2):462-486.

PURPOSE: Monolingual autistic children show distinct patterns of linguistic mazes (disfluencies), such as fewer filled pauses (e.g., « uh, » « um ») and utterance-initial connectives (e.g., « and »), than non-autistic peers. Maze types are multifunctional, but some (e.g., filled pauses) are used primarily for pragmatic, listener-oriented purposes such as signaling an upcoming delay, while others (e.g., repetitions) reflect speaker-internal processes such as lexical retrieval. This study examined the separate and combined effects of autism and bilingualism on children’s maze production, exploring whether different types are primarily listener- or speaker-oriented, thereby contributing to the ongoing debate about their function in spontaneous speech. METHOD: Four groups of children aged 5-9 years participated: bilingual Russian-Hebrew autistic (n = 20), bilingual non-autistic (n = 27), monolingual Hebrew autistic (n = 17), and monolingual non-autistic (n = 22). Narratives, elicited using the LITMUS Multilingual Assessment Instrument for Narratives, were analyzed for various maze types. RESULTS: The results indicated that while autism and bilingualism alone did not predict maze rate, their joint influence systematically interacted with specific maze types. Monolingual autistic children showed higher rates of phonological fragments, inter-utterance silent pauses, and prolongations, but lower rates of the utterance-initial connectives ve « and » and filled pauses than non-autistic peers. Bilinguals in both groups produced more intra-utterance silent pauses. Among autistic children, bilinguals used connectives more often but produced fewer prolongations and inter-utterance silent pauses than monolinguals. CONCLUSION: Bilingualism may enhance communicative adaptability in autistic children by strengthening narrative cohesion through greater use of connectives and fewer inter-utterance silent pauses.

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3. Che Daud AZ, Mohd Nayan NA, Toran H, Ilias K, Kamal Nor N, Md Isa KA, Yang WW, Tengku Mohd TAM, Baharom N, Kamaralzaman S. How Screening and Diagnostic Tools Shape Autism Prevalence in School-Aged Children: A Bibliometric-Systematic Review (2015-2025). Autism Res;2026 (Feb 12):e70196.

Autism spectrum disorder (ASD) prevalence estimates vary widely across countries and over time, partly due to differences in the screening and diagnostic tools used. This study combined bibliometric analysis and systematic review methods to examine global publication trends and evaluate the use of standardized assessment tools in ASD prevalence studies involving school-aged children (typically 6-12 years). A bibliometric search of the Scopus database (2015-2025) identified 107 publications, which were analyzed for citation patterns, research themes, and geographic distribution. Of these, 18 studies met systematic review inclusion criteria, reporting ASD prevalence in the general population and high-risk samples across diverse regions. The most frequently used screening tools were the Social Communication Questionnaire (SCQ) and Childhood Autism Spectrum Test (CAST), while gold-standard diagnostic tools such as the Autism Diagnostic Observation Schedule (ADOS/ADOS-2) and Autism Diagnostic Interview-Revised (ADI-R) were common for diagnostic confirmation. However, psychometric performance and cultural adaptation processes varied, and many tools were not validated for the study population. Tool selection and adaptation were found to directly influence prevalence estimates, with implications for research comparability and policy planning. Findings highlight the need for culturally validated instruments, standardized sampling approaches, and increased representation of low- and middle-income countries in ASD prevalence research to ensure equitable and accurate identification. This study reviewed research from around the world to see which tests and questionnaires are used to identify autism in school‐aged children. We found that the choice of tools and how they are adapted for different cultures can greatly affect how many children are identified with autism. These results can help researchers and policymakers choose better tools to ensure accurate and fair identification for all children. eng

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4. Fan J, Zeng J, Li H. Effects of conversational AI-enhanced peer-mediated intervention by peers with intellectual disabilities on conversational skills in children with ASD. Res Dev Disabil;2026 (Feb 10);170:105249.

BACKGROUND/AIMS: Children with autism spectrum disorder (ASD) often experience conversational difficulties that hinder social interactions and peer relationships. This study examined whether a conversational AI-enhanced peer-mediated intervention delivered by peers with intellectual disabilities (CAI-PMI-ID) yielded superior outcomes in improving conversational skills in children with ASD compared with PMI-ID-only. METHOD: This study employed a multiple-probe across participants design and an alternating treatments design to compare the effects of CAI-PMI-ID and PMI-ID-only. Conversational outcomes included quantitative measures (frequency of appropriate initiations and responses) and qualitative measures (mean length of utterance in morphemes, MLU-M; number of different words, NDW; and total number of words, TNW). RESULTS: CAI-PMI-ID produced greater improvements in the frequency of appropriate conversational initiations and responses than PMI-ID-only. It also yielded superior outcomes in lexical diversity and productivity, as reflected in NDW and TNW. The two intervention conditions resulted in limited and variable effects on MLU-M. CAI-PMI-ID facilitated the successful generalization of conversational skills to interact with different peers. CONCLUSIONS/IMPLICATIONS: These preliminary findings support the feasibility and added value of CAI-PMI-ID for enhancing core conversational behaviors and lexical productivity among children with ASD. Future research should integrate evidence-based syntactic supports to promote MLU-M, leverage multimodal and scenario-based AI in natural settings, strengthen AI-peer collaboration, and improve AI speech recognition to enhance intervention effects.

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5. Gladfelter A, Parr A, Cannone A, O’Connor S. A Multistate Look Into Early Intervention Speech-Language Pathologists’ Confidence Identifying and Diagnosing Autism. Am J Speech Lang Pathol;2026 (Feb 12):1-18.

PURPOSE: Although autism can be reliably diagnosed by 18 months of age, long wait times and limited access to qualified providers prevent families from obtaining timely diagnostic services. Trained speech-language pathologists (SLPs) are qualified to diagnose autism, ideally as part of a multidisciplinary team. SLPs working on early intervention (EI) teams are well-situated to help close this diagnostic wait time gap. The purpose of this survey study was to explore EI SLPs’ experiences serving autistic children, confidence in identifying and diagnosing autism, and their perceptions of barriers or facilitators to diagnostic confidence and wait times. METHOD: Two hundred eighty-seven EI SLPs from 23 states responded to survey questions about experiences, beliefs, and confidence in diagnosing autism. Descriptive and inferential statistics were conducted to determine self-reported confidence, barriers, and facilitators. RESULTS: An overwhelming majority of EI SLPs felt confident in their ability to identify autism in toddlers. However, reported confidence in their ability to diagnose autism was much lower. Greater awareness of diagnosis as within our scope of practice, promoting autism acceptance (reducing caregiver resistance), and access to diagnostic tool training and diagnostic experts would reportedly increase confidence and potentially facilitate more timely diagnosis. CONCLUSIONS: Findings indicate that EI SLPs are confident in their ability to identify autism in toddlers; however, several barriers prevent them from diagnosing autism. Eliminating these barriers could help EI SLPs reduce the long diagnostic wait times experienced by families. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31245082.

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6. 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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7. Hedlund Å, Eriksson Wester M, Edenvik P, Ingard C, Isakson K, Kron Sabel L, Uneus D, Bertilsdotter Rosqvist H. Methodological insights from the inside: developing autistic-friendly interviewing in a group interview space. Front Psychiatry;2025;16:1659580.

BACKGROUND: A neurodiversity-informed approach recognizes the perspectives and experiences of autistic people from an insider perspective, yet little attention has been given to adapting qualitative methods to account for the impact of cognition, sociality, and communication style of both interviewers and participants. The aim of this paper was to contribute to the development of autistic-friendly interviewing in a group interview space. METHODS: The paper is a collective reflexive pilot study, exploring experiences of autistic interviewer and autistic participants in group interviews. The method followed five steps, from deciding what type of interview questions to use to test them in the group interviews. An autistic interviewer conducted three group interviews, each with two to three autistic participants. Interviews and analyses were conducted in Swedish, and the data were then translated into English by the authors. RESULTS: The study identified key insights around four areas: participants’ mixed views on the interview guide, the need to accommodate autistic processing styles, the importance of recognizing autistic forms of sociality, and the significance of conducting interviews within an autistic-friendly space that fosters comfort and understanding. CONCLUSION: The paper outlines step by step the procedure of conducting group interviews with autistic people. We illustrate ways to capture the possibilities of autistic-friendly interviewing by working with-rather than against-autistic cognition, sociality, and communication styles in interviews with autistic people.

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8. İnci R, Emrem M, Yıldız M, Yazici B, Uygun D. The impact of autism awareness of mothers of preschool children on the level of microbiota awareness. Sci Rep;2026 (Feb 12)

The relationship between gut microbiota and autism spectrum disorder (ASD) has gained significant attention in recent years, with growing evidence This study explores whether heightened awareness of autism, particularly regarding microbiota, influences the perceptions and knowledge of mothers, and whether this awareness correlates with a more informed approach to managing microbiota in children with autism. This descriptive cross-sectional study was conducted with 434 mothers of preschool children in Turkey between March and August 2024. G*Power 3.1 and SPSS-22 program were used in the analysis of the study. The regression model developed to reveal the impacts of Autism Awareness level on microbiota awareness level was found to be significant F(1,432) = 66.386, p = 0.001 and 13.3% of the variance in the dependent variable (R2=0.133) was explained by the independent variable. Autism Awareness level has a positive and significant impact on microbiota awareness level (β = 0.365; t (432) = 8.148, p = 0.001). It was determined that increased autism awareness of individuals increased microbiota awareness. Longitudinal studies on autism awareness in mothers of preschool children are recommended. Investigating the relationship between autism awareness and microbiota in mothers of preschool children could significantly contribute to the development of holistic approaches to child development and health, as well as effective parent education programs.

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9. Janus J, Meyer D, Byrne E, Court K, Castle DJ, Rossell SL. Body dysmorphic symptoms in autism and attention-deficit hyperactivity disorder: A comorbidity study. Aust N Z J Psychiatry;2026 (Feb 12):48674261418840.

Body dysmorphic disorder (BDD) is a persistently under-recognised psychiatric condition. Evidence suggests a degree of shared cognitive dysfunction and clinical presentation of BDD with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). The current study is the first to investigate the co-occurrence of BDD, ASD and ADHD in a large online community sample. Utilising data from an online survey, we investigated the comorbidity frequency of BDD, ASD and ADHD, as well as the presence of possible undiagnosed BDD in these neurodevelopmental populations (N = 6844). Individuals with BDD did not report a higher frequency of ASD or ADHD comorbidity than those without BDD. However, individuals with neurodevelopmental diagnoses were significantly more likely to have possible undiagnosed BDD than those without a neurodevelopmental diagnosis (ASD adjusted odds ratio [AOR] = 3.55, ADHD AOR = 2.45). These preliminary findings cautiously suggest that elevated body image concern and possible BDD in ASD and ADHD are potentially missed or misattributed to individuals’ neurodevelopmental diagnoses without further investigation.

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10. Kiliç Tülü B, Özbek AB, Girli A. A Comparative Study of Self-Efficacy, Loneliness, and Well-Being in Adolescents Diagnosed With Autism Spectrum Disorder and Specific Learning Disorder. J Autism Dev Disord;2026 (Feb 12)

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11. Kim E, Hong JS. Autism and Its Lookalikes: A Case Report of a Child Whose Autism Diagnosis No Longer Fit Years Later. Case Rep Psychiatry;2026;2026:8279416.

BACKGROUND: Autism spectrum disorders (ASDs) involve deficits in social communication and interactions as well as restricted, repetitive behaviors that can be reliably diagnosed in children as young as 14 months old, mostly by 36 months old, although signs of ASD may be present before then. CASE PRESENTATION: We present a case of a 5-year-old male who was diagnosed with ASD at 48 months and was found to no longer meet criteria for ASD upon reevaluation at 62 months after receiving medication treatment for his underlying attention-deficit/hyperactivity disorder (ADHD) and severe mood dysregulation. CONCLUSIONS: In this report, we discussed the need to consider a broad differential of diagnoses that may resemble ASD and the need to reevaluate a child for ASD, especially if their ASD symptoms were mild on initial evaluation.

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12. Li SP, Zhang J, Zhao WH, Tan SQ, Chen HL, Chen XY, Zhang Q, Cai D, Dong GH, Zeng XW. Early F-53B Exposure Induces Autism Spectrum Disorder-like Hypomyelination and Oligodendrocytes-Derived Exosomal Protein-Dependent Axonal Energy Imbalance. Environ Sci Technol;2026 (Feb 12)

Recent epidemiological evidence links prenatal exposure to chlorinated polyfluorinated ether sulfonate (F-53B) to autism spectrum disorder (ASD)-associated neurodevelopmental deficits. However, mechanisms underlying F-53B-induced ASD-like pathology and oligodendrocyte dysfunction remain unclear. In this study, we exposed Sprague-Dawley rats to F-53B (0, 8, 80, 800 μg/kg/d from preconception through postweaning) and compared adverse outcomes to a valproic acid-induced ASD model. We found that F-53B crossed the blood-brain barrier, deposited in offspring brain, and induced ASD-like neurobehaviors, including social deficits, stereotypic behaviors, memory impairments, and reduced novelty preference. Neuropathologically, F-53B triggered hippocampal and callosal hypomyelination, delayed oligodendrocyte maturation, and disrupted neuronal mitochondrial cristae. Interestingly, plasma oligodendrocytes-derived exosomes (ODEXs) from F-53B-exposed offspring failed to restore neuronal adenosine triphosphate (ATP) levels and mitochondrial membrane potential in vitro. Proteomic profiling of ODEXs identified suppression of ATP synthesis-related proteins, notably chromodomain helicase DNA binding protein 8 (an ASD-characterized biomarker) and ATP citrate lyase. Molecular docking suggested F-53B could bind to their amino acid residues. Downregulation of these proteins in the hippocampus and corpus callosum aligned with behavioral and myelination abnormalities in rat offsprings. Our study establishes ODEX-mediated ATP synthesis disruption as central to F-53B-induced ASD-like pathology, urging reevaluation of perfluorooctanesulfonate alternatives for neurotoxicity.

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13. Li Y, Liu R, Zhang Y, Lai M, Davydzenka V, Moffitt C, England N, Barbera G, Chen R, Lin DT. Graph Theory Identifies Autistic Patterns in the Prefrontal Circuit of a Mouse Model of Autism. Res Sq;2026 (Feb 3)

As a well-developed branch of mathematics, graph theory provides unique tools to quantifiably assess various properties of complex networks. Applied to brain circuits, network-level analyses can illustrate disruptions to brain organization that yield both mechanistic and diagnostic insights. Previously, graph theory has been used with functional magnetic resonance imaging datasets to quantify connections among different brain regions, readily capturing the macroscopic-scaled differences in brain networks between healthy and Alzheimer’s subjects. Here, we applied graph theory on the microscopic scale, using miniscope-based calcium imaging from the freely behaving wild type (WT) and Shank3 (fx) mice (a mouse model of autism), and compared functional connections among individual neurons in the prefrontal microcircuits during social behavior. We demonstrated that Shank3 (fx) mice displayed reduced neural activity, less-integrated network, and fewer network changes in the prefrontal microcircuits between the presence and absence of social targets. Furthermore, we employed machine learning to test whether graph-theoretic metrics extracted from the prefrontal microcircuits could be predictive of genotype and genotype-associated social behavior difference between Shank3 (fx) and WT mice. Our results indicate a strong link between altered prefrontal microcircuits and social behavior deficits in an autism mouse model, highlighting prefrontal microcircuitry as a potential diagnostic and therapeutic target for autism.

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14. Lim YH, Lawlor C, Bergmann M, Zhang J, So R, Napolitano GM, Hevia-Ramos G, Andersson Nystedt T, Pira K, Malmqvist E, Oudin A, Andersen ZJ. Prenatal exposure to air pollution and the development of autism spectrum disorder from birth to adolescence: A nationwide Danish cohort study. Environ Epidemiol;2026 (Apr);10(2):e462.

BACKGROUND: Prenatal exposure to ambient air pollution has been linked to autism spectrum disorder (ASD), but evidence from low-exposure settings such as Denmark remains limited. OBJECTIVE: We aimed to examine the association between prenatal exposure to particulate matter with a diameter of ≤2.5 µm (PM(2.5)), black carbon (BC), and nitrogen dioxide (NO(2)) and ASD in children, and to identify the most susceptible groups. METHODS: We included 850,361 children born in Denmark between 1990 and 2004 and followed them for ASD diagnoses in the Danish Patient Register until age 15 years. We assigned prenatal PM(2.5), BC, and NO(2) levels (Danish Eulerian Hemispheric Model/Urban Background Model) at the mother’s residential address at delivery, and examined the association with ASD using logistic regression with a random intercept for municipality, including interaction terms to assess effect modification by sex, maternal age, smoking status, and socioeconomic status (SES). RESULTS: An interquartile range increase in prenatal exposure to PM(2.5), BC, and NO(2) was associated with ASD (adjusted odds ratio; 95% confidence interval = 1.04; 1.00-1.07 per 2.8 µg/m(3), 1.05; 1.03-1.08 per 0.3 µg/m(3), and 1.15; 1.11-1.19 per 8 µg/m(3), respectively). The association between BC and ASD persisted even after adjusting for PM(2.5). Additionally, the associations between prenatal air pollution exposure and ASD were stronger among children born to older mothers. CONCLUSION: We found that prenatal exposure to air pollution was associated with ASD even at the relatively low exposure levels observed in Denmark, underscoring the importance of air pollution reduction for ASD prevention. The association with BC was independent of that with PM(2.5), and children born to older mothers appeared to be particularly vulnerable.

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15. Liu T, Davison KE, Kershenbaum AM, Weed E, Gabrieli JDE, Tager-Flusberg H, Zuk J. Rethinking Prosody Production in Autism: Nuanced Insights From Individual Differences and Network Analysis Approaches. J Speech Lang Hear Res;2026 (Feb 12);69(2):660-678.

PURPOSE: Prosodic differences between autistic and non-autistic individuals are recognized, but there is a lack of consensus on the specific prosodic features that characterize the « autistic voice » due to widespread heterogeneity and mixed findings. This study seeks to build further understanding of the nuances of prosody in autism through individual differences and network analyses. METHOD: Acoustic analyses were conducted from 66 school-age autistic and non-autistic children and adolescents’ narrative generation. Between-groups analyses of pitch- and timing-related prosodic features were conducted, followed by within-group analyses investigating associations between prosodic features and individual differences in overall language skills. Thereafter, established network analysis methods were adopted to detect the communities of participants based on similar prosodic features. RESULTS: Initial between-groups analyses revealed greater pitch range and variation among autistic compared to non-autistic participants, as well as slower speech and articulation rates, although subsequent analyses revealed that speech and articulation rates were associated with overall language skills. Similar to Weed et al. (2024), the community detection algorithm identified three communities of participants clustered by prosodic features (pitch variation, speech and articulation rates, jitter), with various proportions of autistic participants in each community that did not effectively distinguish between autistic and non-autistic participants. CONCLUSIONS: Although between-groups differences consistent with similar previous literature have been indicated, community detection analyses further support the notion that prosody in autism may be « different in different ways. » This work highlights the importance of moving beyond group-difference approaches in uncovering nuances to individual differences in prosody via within-group and data-driven analysis approaches. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31011862.

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16. Luglio DG, Yu X, Lin JC, Chow T, Martinez MP, Chen Z, Eckel SP, Schwartz J, Lurmann FW, Pavlovic N, McConnell R, Xiang AH, Rahman MM. Prenatal exposure to extreme heat and autism in children. Sci Total Environ;2026 (Feb 12):181373.

Increasing global temperatures have been associated with neural tube defects and neurodevelopmental delays. Effects of gestational temperature exposures on autism, another neurodevelopmental outcome with prenatal risk factors, have not been previously investigated. This study examined associations of weekly maximum and minimum temperature (T(max) and T(min), representing daytime and nighttime temperatures respectively) on development of autism in children in a retrospective birth cohort study from Kaiser Permanente Southern California hospitals from 2001 to 2014. Autism diagnosis by age 5 was identified in electronic medical records with corresponding ICD codes. Weekly average T(max) and T(min) were estimated at the maternal residential addresses during pregnancy using the gridMET model. Cox proportional hazard models with nonlinear distributed lags were used to identify critical windows of exposure with hazard ratios (HR) comparing exposure to temperature at the 90th and 99th percentiles versus the 50th percentile. A total of 4076 children (80% male) in the cohort of 294,937 had autism diagnosis by age 5. Exposure to extreme T(min) during gestational weeks 1-10 and 30-37 were associated with increased risk of autism, with HR (95% CI) 1.154 (1.040, 1.288) for exposure during weeks 1-10, and 1.132 (1.030, 1.246) for weeks 30-37 comparing the 99th percentile to the 50th percentile. No association was observed for T(max). Exposures to high nighttime temperature during early and late pregnancy were associated with autism risk in children, a result of concern in a warming world. Further research is needed to understand why daytime temperature was not associated with autism risk.

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17. McNaughton KA, Russell AS, Lyons M, Parish-Morris J, Harrop C. Development is key to understanding autism: How longitudinal approaches shape our understanding of autism. Autism;2026 (Feb 12):13623613261425302.

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18. Meguro-Horike M, Iwata K, Matsuzaki H, Horike SI. Haploinsufficiency of MBD5 and MBD6 impairs mitochondrial respiration through chromatin-mediated gene regulation. Biochem Biophys Res Commun;2026 (Feb 12);800:153288.

Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorder, yet the molecular mechanisms linking ASD-associated genes to cellular dysfunction remain incompletely understood. Among methyl-CpG binding domain (MBD) proteins, MBD5 and MBD6 are recurrently disrupted in individuals with ASD, but their roles in neuronal cells remain poorly defined. Here, we investigated the cellular and transcriptional consequences of MBD5 and MBD6 haploinsufficiency using human neuroblastoma SH-SY5Y cells. We established MBD5-and MBD6-heterozygous SH-SY5Y cell lines by genome editing and performed genome-wide transcriptome analysis. Microarray profiling revealed widespread transcriptional dysregulation characterized by predominant gene upregulation, consistent with repressive roles for both proteins. Notably, a shared subset of downregulated genes was enriched for mitochondrial-related functions, including COX17, COX4I2, DHRS2, MCUB, and PDK1. These expression changes were validated by quantitative real-time PCR. Analysis of publicly available ChIP-seq datasets further demonstrated co-localization of MBD5, MBD6, and components of the BAP1 complex at the COX17 promoter, suggesting direct chromatin-mediated regulation. Functionally, MBD5 and MBD6 haploinsufficiency impaired mitochondrial respiration, as evidenced by reduced basal and ATP-linked oxygen consumption rates without changes in mitochondrial content. Consistent with this defect, heterozygous cells exhibited severe growth impairment under galactose conditions and a compensatory shift toward glycolytic metabolism. Together, these findings uncover a previously unrecognized chromatin-mitochondria regulatory axis linking MBD5 and MBD6 haploinsufficiency to mitochondrial dysfunction, providing mechanistic insight into how epigenetic dysregulation may contribute to ASD pathogenesis.

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19. Nautiyal H, Roy KK, Dwivedi S. BDNF- Dysregulation as a Neurobiological Bridge between Polycystic Ovarian Syndrome and Autism Spectrum Disorder. ACS Chem Neurosci;2026 (Feb 12)

Polycystic ovary syndrome (PCOS), a prevalent endocrine disorder characterized by hyperandrogenism, has been increasingly associated with a high risk of autism spectrum disorder (ASD) in offspring. The emerging interaction between reproductive endocrinology and neurodevelopmental biology suggests that excessive androgen exposure during gestation may perturb neurotrophic signaling and impair neural circuit formation. Brain-derived neurotrophic factor (BDNF) acts through tropomyosin receptor kinase B receptor to activate downstream phosphoinositide 3-kinase/protein kinase B and extracellular signal-regulated kinase/mitogen-activated protein kinase pathways, both of which are fundamental to neuronal survival and synaptogenesis. Disruption of these signaling cascades under hyperandrogenic conditions may lead to altered neuroarchitecture, impaired synaptic connectivity, and ASD-like behavioral phenotypes. Clinical and experimental studies also implicate aberrant BDNF expression in ovarian dysfunction, oocyte maturation deficits, and placental steroidogenic imbalance, highlighting a shared endocrine-neurodevelopmental axis in PCOS. Moreover, androgen excess may induce epigenetic modifications and post translational alterations of BDNF or tropomyosin receptor kinases B receptors, further compromising downstream signaling. These molecular events can dysregulate the transcriptional control of multiple synaptic and neurodevelopmental genes, thereby promoting atypical neuronal circuit formation. Understanding the interaction between BDNF signaling and androgen excess provides a mechanistic framework to explain how maternal endocrine imbalance influences neurodevelopment of offspring. This review integrates multidisciplinary findings spanning clinical cohorts, animal models, and molecular studies to delineate how androgen-BDNF interactions amplified by epigenetic, transcriptional, and post translational dysregulation underpin key neurodevelopmental disruptions observed in ASD. Furthermore, it emphasizes the translational potential of targeting BDNF-related pathways as early biomarkers or therapeutic entry points to mitigate the intergenerational neurodevelopmental consequences of PCOS.

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20. Obregón Gómez LR, Juanes M, Touzon MS, Romero A, Maenza L, Borgani K, Alonso C, Reyes G, Caraballo R. GRIN2D-Related Developmental and Epileptic Encephalopathy Associated With Polymorphic Seizures Including Epileptic Spasms. Int J Dev Neurosci;2026 (Feb);86(1):e70108.

Alterations in genes involved in glutamatergic neurotransmission are associated with developmental and epileptic encephalopathies (DEE). One of the most extensively studied pathways involves N-methyl-D-aspartate receptors (NMDAR), which play a key role in brain development, synaptic plasticity, learning and memory. We present the case of an 11-month-old boy with DEE who began at 2 months of age with afebrile focal-to-generalized tonic seizures and focal activity on electroencephalography (EEG). The patient showed developmental delay, resistance to antiseizure medications and frequent, multiple seizure types-including motor focal seizures, epileptic spasms with and without hypsarrhythmia and generalized seizures-together with abnormal movements and EEG findings consistent with epileptic encephalopathy. Whole-exome sequencing identified a de novo likely pathogenic variant in the GRIN2D gene, affecting one of the transmembrane domains (M3), which is essential for normal NMDAR function and harbours most of the pathogenic variants reported to date. Our case represents the 14th documented case in the literature to date of a patient with GRIN2D-related DEE, contributing to the phenotypic characterization of this entity.

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21. Parsons K, Payne S, Wallace J, Holt N. Personas: A market segmentation approach to describe physical activity behavior in autistic populations using the capability, opportunity, motivation, behavior (COM-B) framework. Health Mark Q;2026 (Feb 12):1-13.

Physical activity, defined as « any bodily movement produced by skeletal muscle that results in energy expenditure » has the potential to mitigate some of the high rates of noncommunicable diseases, which autistic individuals are more susceptible to than are their peers; however, physical inactivity remains a challenge in this population. Unique drivers and barriers have been identified in previous research, but these are rarely described in a practitioner-friendly way that might inform intervention design and delivery. Taking a novel segmentation approach, this research aims to draw on behavioral science frameworks to describe groups or « Personas » that can be considered in intervention implementation. Results identified three distinct segments in the sample. Analysis of variance (ANOVA) showed sufficient group differences between capability, opportunity, motivation, and behavior framework (COM-B) constructs to form clusters (p < 0.001 for all). Qualitative themes included reframing and disguising physical activity, lack of self-efficacy, social comparison, unsuitable physical activity environments, strong interests, and sensory challenges. Three Personas were described as the Interested and Engaged, the Unsure and Uncertain, and the Uneasy and Averse.

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22. Philip P, Lim M, Armstrong G, Grills N. Dental service utilisation and perceptions amongst Indian rural children with intellectual and developmental disabilities. Eur Arch Paediatr Dent;2026 (Feb 12)

PURPOSE: The present study investigated the factors affecting dental visits and the perceived need for dental care amongst children and adolescents with intellectual and developmental disabilities (IDD) living in rural India. METHODS: A cross-sectional study was conducted using a convenience sample of 160 caregivers, of whom 79% were mothers with a mean age of 32 ± 8.67 years, caring for children with a mean age of 7.45 ± 3.72 years. The caregivers completed a questionnaire that explored various factors affecting dental service utilisation and perceived need for dental care. Indicators of influencing factors were adopted from validated instruments assessing healthcare access and including demographic and socioeconomic variables. Simple univariable logistic regression models were fitted to determine the odds of dental visits and perceived dental need. RESULTS: Twenty-three per cent of participants reported dental visits, whilst 29% perceived a need for dental care. Factors that significantly affected dental visits were demographic variables such as type of disability (OR 3.34; 95% CI 1.32, 8.48), child’s age (OR 4.87; 95% CI 1.59, 14.91), and the availability of information regarding oral care (OR 3.51; 95% CI 1.56, 7.90). Other factors that significantly affected dental utilisation were caregivers’ perception regarding child’s oral health (OR 3.67; 95% CI 1.68, 8.02) and the proximity to dental clinics (OR 4.18; 95% CI 1.56, 11.15). Similarly, these variables were associated with increased odds of perceived need for dental care, except for the caregiver’s perception of the child’s oral health (OR 0.21; 95% CI 0.09, 0.46). Additionally, caregivers’ perception of the quality of dental care impacted their perceived need for care (OR 0.79; 95% CI 0.67, 0.94). CONCLUSION: Dental visits and perceived need for care were low amongst children and adolescents with IDD in rural India. The lack of information, proximity to dental clinics and quality of care affected dental service utilisation.

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23. Roisenberg BB, Boulton KA, Thomas EE, Guastella AJ. Does Camouflaging Predict Functioning, Distress, and Quality of Life for Autistic Adults?. Autism Res;2026 (Feb 12):e70199.

It has been proposed that autistic individuals adopt camouflaging strategies to mask their autistic traits and conform to social norms, and that these camouflaging strategies have been linked to adverse mental health outcomes. This study examined whether camouflaging, measured by the Camouflaging Autistic Traits Questionnaire (CAT-Q), predicted functioning, distress, and quality of life beyond standard clinical measures of social responsiveness and social anxiety. We analysed data from 113 autistic adults experiencing social anxiety who expressed interest in anxiety interventions. Hierarchical regression analyses assessed the unique contribution of camouflaging after accounting for social responsiveness and social anxiety. Results indicated that social responsiveness and social anxiety significantly predicted depression, psychological distress, and disability, whereas camouflaging did not explain additional variance in these outcomes. Although camouflaging correlated with poorer mental health and reduced quality of life, it did not independently predict these outcomes beyond social anxiety and responsiveness. These findings suggest current camouflaging measures may capture overlapping constructs, highlighting the need for more precise conceptualization and measurement tools. Some autistic people use “camouflaging” strategies to hide their autistic traits to fit in with social expectations. While this can sometimes help them get through social situations, research has shown that camouflaging is linked to negative mental health outcomes, such as higher stress, anxiety, and depression. What remains unclear is whether camouflaging itself predicts poor mental health, or whether these difficulties are already explained by other factors, such as social anxiety or social responsiveness (the way people respond to social cues). In this study, 113 autistic adults who experienced social anxiety and were interested in anxiety treatments completed questionnaires about camouflaging, social responsiveness, social anxiety, and mental health. The researchers used statistical methods (hierarchical regression analyses) to test whether camouflaging added any unique explanation of poor mental health outcomes, such as depression, psychological distress, disability, and quality of life, beyond what was already explained by social anxiety and social responsiveness. The results showed that social anxiety and social responsiveness were strong predictors of depression, distress, and disability. Camouflaging was related to these outcomes, but it did not explain the additional differences once social anxiety and responsiveness were considered. This suggests that current tools used to measure camouflaging may overlap with what is already being measured by social anxiety and responsiveness questionnaires. More refined ways of assessing camouflaging are needed to better understand its specific impact on autistic people’s well‐being. eng

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24. Sauer AK, Stanton JE, Grabrucker AM. Is autism a developmental zinc deficiency?. Clin Nutr;2026 (Jan 31);58:106592.

Autism spectrum disorder (ASD) is a complex condition influenced by genetic and environmental factors, particularly prenatal ones such as maternal infections, medications, toxins, and nutritional deficiencies. These factors interfere with brain development, leading to the core traits of ASD. Despite extensive research using animal and cell models, few fully replicate the complexity of ASD, highlighting the need to reassess our understanding of its biological processes. Prenatal zinc deficiency has emerged as a significant risk factor, inducing various ASD-related pathologies in studies and potentially uncovering fundamental disrupted biological processes. We propose that a core issue in ASD is metal homeostasis, especially abnormal zinc signaling. This review consolidates current evidence linking zinc to ASD and examines its critical roles in biological functions often affected in individuals with ASD. The findings suggest that prenatal zinc deficiency could reveal the fundamental biological processes disrupted in ASD, which other risk factors might mimic to a lesser extent. Consequently, this narrative review, based on a thorough synthesis of secondary data, provides a critical overview of the growing evidence connecting zinc to ASD while exploring its vital roles in biological functions frequently impaired in affected individuals.

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25. Sivamaruthi BS, Kesika P, Chaiyasut C, Ragu Varman D. Gut dysbiosis in neurodevelopmental disorders: linking microbiota signatures to cognitive rigidity in autism spectrum disorder. Front Microbiol;2026;17:1760635.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterised not only by social-communication difficulties but also by restricted interests, stereotyped behaviours, and marked cognitive rigidity. Over the past decade, converging lines of evidence have implicated gut dysbiosis, an imbalance in intestinal microbial composition and function, as a potentially important modulator of these behavioural phenotypes via the microbiota-gut-brain axis. In this narrative review, we integrate preclinical and clinical data to examine how specific microbial signatures, metabolic pathways, and immune and synaptic mechanisms may contribute to inflexible cognition in ASD. The manuscript outlines the organisation of the microbiota gut-brain axis in neurodevelopment and summarises reproducible microbial alterations reported in ASD cohorts. We then discuss how microbial metabolites, including short-chain fatty acids and tryptophan-derived neuroactive molecules, as well as immune mediators and neurotransmitter precursors, converge on pathways regulating excitatory-inhibitory balance, synaptic plasticity, and corticostriatal circuit function. Evidence from germ-free, genetic, and environmental rodent models provides causal support for microbiota-dependent modulation of repetitive and rigid behaviours, whilst clinical studies reveal associations between dysbiosis, metabolomic profiles, gastrointestinal symptoms, and ASD severity. Finally, we consider the translational landscape of microbiota-targeted interventions, probiotics, prebiotics, dietary strategies, and faecal microbiota transplantation and highlight key methodological and ethical challenges for moving toward precision microbiome-based therapies. Taken together, current data support gut dysbiosis as both a mechanistic contributor and a tractable therapeutic target for cognitive rigidity in ASD.

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26. Śliwiński P. An entropic explanation of insistence on sameness in autism. Front Comput Neurosci;2025;19:1714428.

PURPOSE: An information theory-based framework is proposed in attempt to explain insistence on sameness in autism as an instance of a general behavior pattern in which an individual tries to reduce surprise and uncertainty. It offers a new definition of autism as an impairment in which cognitive functions are restricted to discrimination, memorization and prediction of tangible properties of the environment. METHODS: An analogy between insistence on sameness and constrained minimization of the entropy metric is observed and examined for a set of assumptions that describe cognitive limitations of a person with autism. The metric is given by the formula D (H) (R, M) = H(R|M)+H(M|R), where R represents sequences of random stimuli, M is a memory that stores and retrieves them, and where H(·|·) denotes their conditional entropies interpreted as surprise and uncertainty, respectively. RESULTS: It is first inferred that to minimize the metric an individual can learn about R (and store that knowledge in M) or can restrict R to the already known M. Then, it is concluded that insistence on sameness is a manifestation of the latter. Moreover, it is shown that the proposed framework: (1) Helps to quantify the concepts of surprise, uncertainty, sensory overload and deprivation, anxiety, comfort zone, disappointment, disorientation, pedantry, rigidness, observance or aberrant precision. (2) Leads to a list of guidelines for learning therapies and daily care routines, and allows them to be defined as optimization algorithms and implemented as programs for robotic live-in caregivers. (3) Can be validated with the help of a Turing test-like approach that requires no experiments involving individuals with autism. CONCLUSION: The framework-if positively validated-will provide advantages of both theoretical and practical importance: it explains the insistent on sameness as a consequence of cognitive restrictions and offers formal foundations and design guidelines for therapies aimed at improving self-reliance of individuals with autism in basic activities of daily living.

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27. Stokke Jensen S, Midya V, Arora M, Eek Brandlistuen R, Havdahl A, Dehli Andersen G, Klock KS. Pre- and postnatal trace element levels in primary teeth of children with and without an autism spectrum diagnosis. Environ Res;2026 (Feb 9);295:124001.

BACKGROUND: The global prevalence of autism spectrum diagnosis (ASD) is increasing. Fetal and early-life exposure to trace elements has been associated with increased likelihood of ASD, but evidence regarding timing of exposure remains limited. AIM: This study investigates prenatal and early-life exposure to non-essential and essential elements, individually and as mixtures, in children with and without ASD, stratified by child sex. METHODS: The sample included 170 children from the Norwegian Mother, Father and Child Cohort Study (MoBa), of whom 75 were clinically diagnosed with ASD and 95 were not. Elemental levels were measured in primary tooth dentine using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) to investigate case-control differences in levels of pre-and postnatal non-essential and essential elements as well as their mixtures. RESULTS: Significant differences in lead (Pb) levels were observed between ASD case and control groups: The ASD male group had lower Pb levels from 15 to 11 weeks prenatally, while ASD female group had lower levels from birth to 4 weeks postnatally, compared to controls. Males with ASD had higher prenatal magnesium (Mg) and lower postnatal Mg levels, as well as lower prenatal lithium (Li) levels and higher postnatal Li levels compared to controls. Additionally, males with ASD had higher prenatal and lower postnatal essential element mixture levels than controls. DISCUSSION: These findings suggest that there may be differential patterns of exposure to non-essential and essential element levels during specific developmental windows in fetal and early postnatal life in children with and without ASD.

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28. Terui A, Saito M, Kuki A, Shimoyama S, Sakamoto Y, Yoshida K, Osato A, Nakamura K. Correlation between sleep problems and morning serum melatonin and ferritin levels in Japanese 5-year-old children with autism spectrum disorder. PCN Rep;2026 (Mar);5(1):e70294.

AIM: Children with autism spectrum disorder (ASD) are more likely to have sleep problems. Few studies have investigated the relationship between sleep problems and blood melatonin and ferritin levels. The objective of this study was to determine the correlation between sleep problems and morning serum melatonin and ferritin levels, and the differences in serum melatonin and ferritin levels between children with ASD and those without ASD. METHODS: Four years of data from population-based 5-year-old checkups were referenced. Fifty-five children were divided into the ASD group (N = 45) and the non-ASD group (N = 10). Blood samples were collected at 8:30 a.m. The Japanese Sleep Questionnaire for Preschoolers (JSQP) was used to assess sleep problems. Correlation analysis, the Mann-Whitney U test, and multiple regression analysis were used. RESULTS: In the ASD group, the score of Sleep habit was significantly correlated with the serum ferritin level (ρ = 0.496, p < 0.001). No significant regression equation was found. However, the partial correlation coefficient calculated indicated a significant value between the score of Insomnia or Circadian rhythm disorder and serum melatonin level (β = 0.502, p < 0.05), and the score of Sleep habit and the serum ferritin level (β = 0.546 p < 0.01). The serum ferritin level in the ASD group (23.48 ± 9.14 ng/mL) was significantly higher than in the non-ASD group (14.84 ± 7.09 ng/mL) (p < 0.05). CONCLUSION: This study indicated that children with ASD were more likely to have some sleep problems and higher morning serum ferritin levels than those without ASD. Further research is recommended on the correlation between sleep problems and morning serum melatonin and ferritin levels.

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29. 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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30. Vyas P, Khoury ES, Sah N, Sharma A, Allende Labastida J, Wilkinson EL, Lac K, Damiba NNL, Fowler A, Liu J, Bedner A, Majer P, Tichý T, Thomas AG, Rais R, Slusher BS, Kannan RM, Kannan S. Dendrimer-Conjugated Glutamine Antagonist, D-TTM020, Ameliorates Brain Immune Dysregulation and Improves Neurobehavioral Deficits in the Mecp2-Deficient Mouse Model. Cells;2026 (Feb 1);15(3)

Rett Syndrome (RTT) is a neurodevelopmental disorder characterized by mutations in the MeCP2 gene, predominantly affecting females. Recent work with MeCP2-deficient mouse models showed a significant role in glutamatergic transmission, specifically microglia-produced glutamate and glutaminase upregulation, in RTT pathology. The glutamine antagonist 6-diazo-5-oxo-L-norleucine (DON) is a potent glutaminase inhibitor; however, its use is limited due to systemic toxicities arising from its non-specific inhibition of glutamine-utilizing reactions. In this work, we determined whether dendrimer conjugation of a DON analog, TTM020 (or D-TTM020), results in targeted microglial glutaminase inhibition and behavioral changes in Mecp2 KO and heterozygous mice upon systemic administration. D-TTM020 at 1 mg/kg (drug basis) selectively and significantly inhibits glutaminase enzyme activity in the microglia of Mecp2 KO mice. Biweekly systemic treatment with 1 mg/kg of D-TTM020 improved the neurobehavioral phenotype in symptomatic Mecp2 KO and het mice. D-TTM020 also restored long-term retrieval of conditioned fear memory and improved cue responses during fear extinction after 8 weeks of treatment in symptomatic Mecp2 het mice. Our data indicate that selectively targeting glutamine metabolism in dysregulated glia using dendrimers represents a promising strategy that may offer a therapeutic approach for addressing glutamate dysregulation in RTT.

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