1. Abbasian H. Bilingualism, Autism, and Mental Health: Implications for Social Work. Cureus. 2026; 18(2): e103129.

Bilingual children with autism grow up in families navigating complex social, cultural, and structural contexts. In addition to challenges common to many families, they may experience distinct stressors related to migration, minoritized language status, and navigating differences between home cultural norms and those of the dominant society. Language guidance in autism care refers to clinical and professional recommendations about family language use, including whether and how multiple languages are supported in home, educational, and therapeutic settings. Because language practices structure daily interaction, caregiving routines, and children’s access to relationships and community, such guidance can meaningfully influence family routines, emotional connection, and access to culturally grounded support networks that are important for mental health and well-being. This conceptual editorial, based on the existing interdisciplinary literature, examines bilingualism through a social work perspective, discussing how practitioners can support families in ways that respect both neurodiversity and cultural identity. Culturally responsive and intersectional approaches enable social workers to consider overlapping social identities, structural factors, and community networks that shape mental health outcomes. By facilitating informed family decision-making and integrating language guidance with broader community support, social workers can help families maintain connection, resilience, and agency. Considering bilingualism as a meaningful aspect of development allows social workers to support family well-being, promote equity, and provide community-based support in autism care.

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2. Alimoğlu EB, Sezer Efe Y, Caner N, Demirci E, Evgin D. Positive parenting and posttraumatic growth in mothers of children with autism spectrum disorder in Türkiye. BMC Pediatr. 2026.

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3. AlShammari RZ, AlMuraisel MA. Use of M-CHAT for autism screening in well-baby clinics of a primary health care center in Dhahran, Saudi Arabia: a retrospective cross-sectional study. BMC Pediatr. 2026.

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4. Beckerson ME, Kurtz MR, Valles-Capetillo E, Kana RK. Brain network disruption underlying externalizing behaviors. Neuropsychologia. 2026; 223: 109379.

Externalizing behaviors such as aggression, defiance, and hyperactivity are common in autistic and non-autistic children. Research suggests that externalizing behaviors are not associated with intellectual functioning (FSIQ), gender, language, or autism symptom severity. Instead, recent studies suggest externalizing behaviors are more related to and are often linked to difficulties in executive functioning (EF). The current study examined behavioral and neural predictors of externalizing behaviors in a transdiagnostic sample of school-age children (N = 90; ages 7-13 years; 48 autistic, 42 non-autistic). Parents completed measures of EF (Behavior Rating Inventory of Executive Function, Second Edition; BRIEF-2) and externalizing behaviors (Behavior Assessment System for Children, Third Edition; BASC-3). Children completed resting-state fMRI scans. After controlling for age and FSIQ, the BRIEF-2 composite index scores (Behavioral, Emotional, and Cognitive Regulation) significantly predicted externalizing behaviors. Seed-to-seed analyses revealed positive associations between externalizing behaviors and connectivity among the left superior parietal lobule, left inferior parietal lobule, anterior insula, and lateral frontal ECN nodes. Seed-to-voxel analyses showed widespread alterations, including increased connectivity within frontoparietal executive regions alongside reduced connectivity in salience-related areas, such as cingulate and insula. This dual connectivity profile suggests a neural mechanism involving compensatory executive engagement paired with diminished salience processing that may contribute to behavioral dysregulation. These results suggest that executive dysfunction, at both the behavioral and neural levels, is associated with externalizing behaviors in children regardless of diagnostic status. Findings underscore the potential utility of EF-based interventions for mitigating externalizing problems in both autistic and non-autistic populations.

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5. Felemban RA, Bamaga AK, Alharbi A, Alsenani F, Alzahrani MS, Algarni MA, Baali FH, Ramzy S, Almalki AH. Spectrofluorimetric determination of serum homovanillic acid using horseradish peroxidase and its association with autism spectrum disorder. Sci Rep. 2026; 16(1).

Dopaminergic dysfunction during neural development correlates with developmental disorders, including autism spectrum disorder. Homovanillic acid, a dopamine metabolite, serves as a biomarker for central dopaminergic activity. The aim of the present study is to establish a validated spectrofluorimetric method for exploring the association between serum homovanillic acid level and autism spectrum disorder. The spectrofluorimetric method is based on the transformation of homovanillic acid into a highly fluorescent dimer via catalytic oxidation facilitated by horseradish peroxidase in the presence of hydrogen peroxide. The resultant dimer of homovanillic acid demonstrated a pronounced emission peak at 430 nm subsequent to excitation at 335 nm. The methodology underwent validation in accordance with ICH M10 guidelines, and endogenous homovanillic acid concentrations were determined utilizing the standard addition technique. The method was successfully applied for estimating the homovanillic acid level in the serum of children diagnosed with autism spectrum disorder, as well as in healthy children. The findings indicated that the concentration of homovanillic acid was markedly elevated in the serum of children with ASD (mean value of 89 µg/L, n = 24) in comparison to that of their healthy counterparts (mean value of 56 µg/L, n = 15), P < 0.01.

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6. Fielding S. FDA approves leucovorin-but not for autism, despite Trump hype. Bmj. 2026; 392: s485.

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7. Gupta N, Boyes D, Hanlon-Taylor H, Gupta M. Systematic review: Safety and efficacy of atomoxetine in children and adolescents with autism spectrum disorder. JCPP Adv. 2026; 6(1): e70022.

BACKGROUND: This systematic review aimed to assess the current evidence on the efficacy and safety of Atomoxetine in common clinical attention-deficit hyperactivity disorder (ADHD) symptoms in the context of autism spectrum disorder (ASD) for children and adolescents. Some of these common clinical symptoms of ADHD in the context of ASD include core symptoms of ASD, ADHD, depression, anxiety, mood instability/irritability, and cognitive symptoms. METHODS: Major medical literature were searched for randomized controlled trials (RCTs), open-label trials, and other relevant studies or clinical trials reporting on pediatric (age <18 years) patients with ASD treated with Atomoxetine for any reason. Databases were searched January of 2024 and include PubMed, Google Scholar, Web of Science, Scopus, PsycINFO, and Embase. Exclusion criteria were unpublished data and multiple reports from the same data set. RESULTS: A total of 100 abstracts were screened, and 16 clinical trials were selected for inclusion. Out of these 16 clinical trials there were two RCTs (n = 128 and 97), four open-label trials (n = 24, 12, 12, and 16), eight extension studies (n = 128, 97, 88, 97, 97, 117, 128, and 94), one observational study (n = 4), and one crossover study (n = 16). Meta-analysis was not performed due to a lack of homogeneity in the two RCTs. There were limited studies available with a need for more high-power studies. In the current studies, most suggested that Atomoxetine was well tolerated and safe in pediatric patients with ASD. In fact, Atomoxetine response rates were found to be similar to those of methylphenidate in ASD studies, while inducing fewer adverse events and tolerated better. CONCLUSION: Further trials are warranted to make conclusive recommendations on Atomoxetine for improvement of common clinical symptoms of ADHD in the ASD pediatric population. Given limited approved therapies for common clinical symptoms of ASD in children and adolescents, Atomoxetine could be used as a safe off-label option due to a favorable tolerability profile and minimal adverse effects.

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8. Long A, Revanur N, Crowder K. Generalized environmental fear hypothesis and the effects of schematic restructuring in autism. Front Psychiatry. 2026; 17: 1725265.

Current Models of Autism Spectrum Disorder (ASD) are very complex and exploratory in nature, it is the general consensus that there is not one underlying cause of autism. This article seeks to contest that claim by supporting a hypothesis that accounts for multiple, if not all, subgroups with a single common factor. At the same time, this hypothesis would lead to the use of Cognitive Behavioral Therapy (CBT) for researching therapeutic methods for people with ASD, and this article outlines why that is not advisable. It is hypothesized that upon realization of awareness in the womb, people with ASD conditioned a fear response to their environment. This fear response generalized upon the realization of new cognitive awareness, leading to the symptoms of ASD. In regards to CBT, it is hypothesized that schematic restructuring (a result of CBT) can lead to symptoms associated with CPTSD and schizophrenia. We further hypothesize that addressing schema in reverse order of acquisition will reduce the risk hypothesized to be associated with CBT. Drawing on schema theory, developmental stages, and neurobiology this article argues for the validity of these hypotheses. The implications of these models are vast, not only for the field of Autism research, but for the field as a whole. While some of the implications may seem negative for the field (CBT), the authors ultimately support the use of CBT for many situations other than ASD.

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9. Long X, Dong S, Zhu Y, Xu Q, Gao X, Wu H, Xu P, Hong J, Chen H, Xu X. Application of video feedback in assessment skills training with autism level 1 screening. Front Psychiatry. 2025; 16: 1658102.

OBJECTIVE: To apply video feedback method in the training of primary screening and assessment skills for autism among community child care workers, and evaluate its effectiveness, providing ideas for future operational training at the grassroots level. METHODS: After conducting centralized training and supervision on the first level screening of autism for community child care workers, they will shoot videos of the first level screening operation skills according to the key points. They will use monthly community meetings to report on the videos and discuss and analyze them. After a period of time, they will provide feedback on the videos again to enhance the first level screening skills of community child care workers for autism. Evaluate the effectiveness of video feedback method in learning primary screening skills for autism through video ratings, questionnaire surveys, interviews, and other methods. RESULTS: After three consecutive months of video feedback training, 58 grassroots staff members in the district mastered the key operational points of autism screening through behavioral observation assessments. This standardized the first-level autism screening process across 13 community health service centers and 18 pediatric care clinics in Jiading District. Participants believe that the video feedback method has a good effect on skill learning. After conducting video feedback learning, the child protection team’s performance in several indicators such as reasonable positioning during screening (P = 0.022), parental interference (P = 0.029), guidance language (P = 0.002), and body movements in language items (P = 0.016) has improved, and the overall video score has also increased (P < 0.001). CONCLUSION: After the centralized operational training, multiple video feedbacks may effectively improve the screening.

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10. Magnuson JE, King LS, Feldman JI, Clark SM, Pulliam G, Dunham-Carr K, Golden A, Kaysılı BK, Humphreys KL, Woynaroski TG. Parenting Stress and Stressful Life Events Among Caregivers of Toddler Siblings of Autistic and Non-Autistic Children. Autism Res. 2026: e70217.

This study measured experiences of parenting stress and stressful life events in caregivers of families with a toddler who has either an autistic or non-autistic older sibling(s). Caregivers of toddlers (12-18 months old) with older autistic siblings (Sibs-autism; n = 58) and toddlers with older non-autistic siblings (Sibs-NA; n = 46) completed questionnaires assessing stress related to parenting their toddler and their exposure to stressful life events since their toddler’s birth. We compared levels of parenting stress and stressful life events between caregivers of Sibs-autism and Sibs-NA and examined the association between these measures. Caregivers of Sibs-autism reported significantly higher levels of parenting stress and stressful life events relative to caregivers of Sibs-NA, with small to moderate effects. Parenting stress and stressful life events were moderately correlated. Across these groups of caregivers, parenting stress and stressful life events appear to be related, but partially distinct aspects of caregiver stress. These findings highlight the importance of assessing multiple aspects of stress to better understand how stress may influence both caregiver wellbeing and the development of children with autistic siblings. In this study, we compared the stress levels of caregivers who care for toddlers with older siblings diagnosed with autism to the stress levels of parents/guardians of toddlers with older siblings who are not diagnosed with autism. We assessed perceived parenting‐related stress and obtained reports on the number of stressful life events the parents/guardians had experienced since the toddlers in the study were born. We found that parents/guardians of toddlers with older autistic siblings reported higher levels of parenting stress and more stressful life events relative to parents of toddlers without older autistic siblings. Future work should study how to best support parents/guardians who are experiencing high levels of stress. eng.

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11. Marquis S, O’Leary R, Baumbusch J. A Rapid Realist Review of Interventions for Parents of Adults with Intellectual/Developmental Disabilities. Gerontologist. 2026.

BACKGROUND AND OBJECTIVES: The lifespan of adults with an intellectual/development disability has increased. Caregiving for these adults is often provided by their parents. Few programs address the needs of these older parents, and even fewer have been reviewed for their effectiveness. Our purpose was to answer the question, what are the conditions and features of support programs or interventions that are effective in improving the psychological and social aspects of the lives of parents of adults who have an intellectual/developmental disability? RESEARCH DESIGN AND METHODS: The authors conducted a rapid realist review of interventions for parents of adults with an intellectual/developmental disability. We applied midrange theories of family systems, life course perspective, and caregiving to focus on the participant contexts, program mechanisms, and intervention outcomes that were effective. RESULTS: The interventions in the review were psychoeducation, financial grants, mindfulness, acceptance and commitment therapy, peer support, expressive arts therapy, and institutional placement. All of the interventions reported some success in improving parent wellbeing. DISCUSSION: We developed five program theories: « Do not add to my burden », « I am in need of self-care », « My needs change as I age » « My life is complex » and « Peer knowledge and support are valuable to me. » We also recommended that programs accommodate parents’ time constraints, include other family members and caregivers and address the eventual transition of caregiving from parents to others. IMPLICATIONS: Program theories and our observations are offered to support the development of new interventions and to improve the effectiveness of existing programs.

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12. Maureira D, Rubilar C, López J, Santander P, Moldenhauer H, Silva I, Cruz P, Riquelme D, Baeza J, González W, Orio P, Servili E, Troncoso M, Leiva-Salcedo E, Cerda O. A KCNC1 variant linked to Rett syndrome disrupts ER to Golgi trafficking of Kv3.1 channel. Proc Natl Acad Sci U S A. 2026; 123(11): e2424514123.

Intrinsic neuronal excitability, defined by the balance between input and output signals, is crucial to neural function, and its disruption underlies various neurological diseases. Kv3.1 channels, encoded by KCNC1, are essential for high-frequency action potential firing. Variants in these channels are associated with several subtypes of epilepsy. We report a patient with developmental regression and epilepsy, meeting Rett syndrome criteria, who carries a KCNC1 variant encoding the S474C substitution in Kv3.1 (Kv3.1(S474C)). Electrophysiological and biochemical assays reveal that Kv3.1(S474C) reduces channel presence in the plasma membrane and is retained in the endoplasmic reticulum. In murine primary cortical neuron cultures expressing Kv3.1(S474C), we observed reduced neuronal firing frequency and exclusion of the channel from the axon initial segment. Consistently, we found a decreased firing frequency using a conductance-based computational neuronal model. In summary, this study identifies a link between a KCNC1 variant and Rett syndrome, highlighting the importance of S474 residue in Kv3.1 channel trafficking and function in neurons.

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13. Morgan A, Pham A, Beeley S, Dunn E, Hite A, Curtin M. MECP2-Associated Rett Syndrome Without Developmental Regression-A Case Series. J Child Neurol. 2026: 8830738261420277.

Clinical phenotype expansion of neurodevelopmental disorders is increasingly important. With accessibility and diagnostic ability of genetic testing expanding, new clinical criteria will continue to be elucidated. Here we describe a case series of 4 female pediatric patients seen for global developmental delay in non-genetic, specialty clinics who received unexpected genetic diagnoses of MECP2-associated Rett syndrome (RS). These results highlight broadening clinical presentation for RS. None of the patients in this cohort met clinical RS diagnostic criteria at the time of genetic testing, as there was no period of typical development or developmental regression. These cases demonstrate both the importance of broad genomic sequencing for patients with global developmental delay and that increasing understanding of atypical and mild presentations of syndromes like RS will continue to evolve as genetic testing becomes standard of care for clinical features like developmental delay.

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14. Neul JL, Benke TA, Marsh ED, Peters SU, Fu C, Merritt JK, Percy AK. Trajectory of skill acquisition, loss, and regain in females with classic Rett syndrome. J Neurodev Disord. 2026.

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15. Ong CSY, Rodgers J, Cooper MN, Dempsey Z, Eaton R, Haines K, Kuzminski R, Magiati I, Maybery MT, Uljarević M, Wray J, Whitehouse AJO, Alvares GA. Targeting intolerance of uncertainty in young children diagnosed with autism: A randomized controlled trial of a parent-mediated group intervention. JCPP Adv. 2026; 6(1): e70027.

BACKGROUND: Young children diagnosed with autism experience high rates of co-occurring anxiety, with uncertainty-related concerns commonly reported. This randomized controlled trial investigated an 8-week parent-mediated group anxiety intervention, « Coping with Uncertainty in Everyday Situations » (CUES-Junior©). METHODS: Parents of 4-7-year-old children diagnosed with autism and experiencing uncertainty-related anxiety were recruited. The primary outcome was change from baseline in blinded assessor ratings of child responses to uncertainty and impact on family, measured post-intervention and 2-month follow-up. Secondary outcomes were parent-reported child anxiety and intolerance of uncertainty (IU), parental IU and mental health, parenting sense of competence, along with intervention feasibility and acceptability. RESULTS: Sixty-four children were randomized to CUES-Junior© (n = 33) or waitlist (n = 31); five families withdrew post-randomization. Immediately post-intervention, significantly more CUES-Junior© participants were rated as clinically improved from baseline in child responses to uncertainty (OR = 34.48; 95% CI = 1.72-690.04, p = 0.02) and in family impact (OR = 8.99; 95% CI = 1.52-53.05, p = 0.02) compared to waitlist. Significant improvements were also observed in parent-reported child IU and parenting satisfaction, favoring CUES-Junior©. At subsequent 2-month follow-up, CUES-Junior© participants showed sustained improvements in the impact of uncertainty on children, and parental ratings of child IU and anxiety, parenting sense of competence, and parental stress, compared to baseline. The program was feasible to administer and acceptable to parents. CONCLUSIONS: CUES-Junior© had an immediate treatment effect on child responses to uncertain situations and impact on families, with maintained improvements observed at follow-up. This novel mechanism-targeted and autism-informed program holds promise for addressing early uncertainty-related anxiety in young children diagnosed with autism.

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16. Özmeral Erarkadaş K, Erarkadaş M, Altuğ Özboduroğlu A, Şişmanlar Ş G. Adult Clinical Outcomes, Diagnostic Loss and Predictors in Individuals Diagnosed With Autism in Childhood. J Autism Dev Disord. 2026.

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17. Popčević K, Ivšac Pavliša J, Hržica G. Language Subdomains in Children on the Autism Spectrum: Cross-Sectional Study of Morphologically Rich Language. Folia Phoniatr Logop. 2026: 1-23.

INTRODUCTION: Children on the autism spectrum (AS) show considerable individual differences in language development. It remains unclear whether their lexical and grammatical skills develop in a typical pattern, with or without delays in both domains, or whether they exhibit an atypical language profile in which lexical and grammatical development are differentially affected. Since most existing studies involve English-speaking children, the relationship between these language domains in morphologically rich languages such as Croatian remains underexplored. The aim of this study was to examine the relationship between lexical and grammatical (morphological and syntactic) skills in Croatian-speaking children on the AS and to determine whether they display a typical or atypical language profile. METHOD: The study employed a cross-sectional design. The sample consisted of 30 children on the AS and 30 vocabulary-matched typically developing (TD) two-year-old children. Lexical, morphological, and syntactic abilities were assessed using parent reports, and data were analyzed both within and between the groups. RESULTS: Significant positive correlations were found between vocabulary and grammatical measures in both groups, with no significant differences in grammatical abilities between vocabulary-matched AS and TD children. Although both groups demonstrated more advanced lexical than morphological abilities, this pattern reflects typical Croatian language acquisition rather than a characteristic specific to autism spectrum. CONCLUSION: The findings support the hypothesis of a typical, though often delayed, language profile in children on the AS, in which grammatical development follows lexical growth. The grammatical development of children on the AS acquiring a morphologically rich language did not differ from that of younger vocabulary-matched TD peers. These results underscore the importance of assessing and targeting both vocabulary and grammar in parallel during early intervention for children on the AS.

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18. Scott-Solache J, Pei J, Drew J, López-Doménech G, Jolivet RB, Nieto-Rostro M, Davenport EC, Arancibia-Cárcamo IL, Attwell D, Kittler JT. Control of microglial dynamics by the Arp2/3 complex and the autism- and schizophrenia-associated protein CYFIP1. Proc Natl Acad Sci U S A. 2026; 123(11): e2532488123.

Microglia use a highly complex and dynamic network of branched processes to sense and respond to their surroundings. Despite emerging evidence that microglial motility plays important roles in brain development, neurodegeneration, and neuropsychiatric disease, little is known about the intracellular machinery orchestrating microglial process dynamics. Here, we identify roles for regulators of the actin cytoskeleton in controlling microglial behavior. We show that the actin branching Arp2/3 complex is critical for maintaining microglial morphology and is required for surveillance but not chemotactic motility. Neuropsychiatric disease-associated CYFIP1, a core component of the WAVE regulatory complex linking upstream signaling pathways to activation of the Arp2/3 complex, is highly expressed in microglia but has an unknown function. We report that conditional deletion of Cyfip1 in mouse microglia reduces their morphological complexity and surveillance of the brain parenchyma, with no effect on chemotaxis. Deletion of Cyfip1 also increased microglial CD68 positive lysosome volume and engulfment of presynapses. Thus, actin remodeling by CYFIP1 and the Arp2/3 complex controls microglial dynamics and shifts microglia away from a homeostatic state with potential implications for neuropsychiatric disease.

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19. Sonuga-Barke EJS, Palmer M, Griffiths K, Wyatt A, Danese A, Chandler S, Stahl D, Lukito S, Pavlopoulou G, Simonoff E. Why do attention-deficit/hyperactive disorder and/or autism traits place adolescents at risk for depression? Protocol for a longitudinal comparison of the mediating role of emotion regulation deficits versus emotional burden. JCPP Adv. 2026; 6(1): e70052.

BACKGROUND: Depression levels increase dramatically during adolescence in the general population. This effect is exacerbated in adolescents with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), autism, or both. Here we detail the protocol for the My Emotions and Me Over Time (MEMO) study, a 12-month longitudinal study with the primary aim to compare two competing hypotheses for why this is the case. The first, established hypothesis is that depression risk associated with ADHD and/or autism is mediated by emotion regulation deficits (ERD). The second and new perspective is that it is mediated by the experience of elevated emotional burden (EB) created by (i) greater exposure to upsetting events and encounters, which are (ii) experienced more intensely. Cross-lagged path models will test the relative importance of the ERD and EB pathways to the relationship between autism and ADHD traits and depression symptoms. Exploratory analyses examining secondary mediators (i.e., self-esteem) and moderators (rumination, resilience and alexithymia) will also be conducted. METHODS: A sample of 600 adolescents aged 11-16 years, enriched for the presence of autism and ADHD diagnosed cases, and their parent/guardian will be recruited via schools, local NHS (South London and Maudsley) and ADHD and autism charities. Measures of ADHD, autism and depression, ERD, EB, self-esteem, rumination, resilience and alexithymia will be completed at baseline, 6 months and/or 12 months by parents and/or participants. Background factors such as age, sex, cognitive abilities and socioeconomic status as well as service use and medication status will also be collected. RESULTS: The pathways between ADHD/autism and depression, along with their mediators and moderators, will be analysed using structural equation modelling. CONCLUSION: The findings from MEMO will feed into the other studies within the RE-STAR programme to support the development of an intervention to reduce ADHD and/or autism-related depression risk in adolescence.

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20. Spencer D, Innocente N, Bendo D. Legal Counsel, Moral Expectations, and Youth with Intellectual and Developmental Disabilities: Economies of Worth in Youth Courts. Soc Leg Stud. 2026; 35(2): 255-72.

The Youth Criminal Justice Act (YCJA) is the law that governs the Canadian youth justice system and applies to young people between the ages of twelve and seventeen. The YCJA’s Declaration of Principle broadly states that measures taken against young people should consider their « special requirements. » Such vague provisions have led young people with mental health issues and intellectual and developmental disabilities to not receive much-needed and legally required accommodations. Based on interviews with 38 legal professionals, we analyze their interpretations of the failure of the youth justice system to accommodate youth with intellectual and developmental disabilities in conflict with the law. We draw from Boltanski and Thevenot’s model of situated moral judgment to understand crown attorney and defense counsel’s reflections on, and criticisms of, their work environments in relation to the positioning of young people with intellectual and developmental disabilities.

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21. St John T, Corrigan NM, Rokem A, Estes AM, Hazlett HC, Pandey J, Schultz RT, Marrus N, Zwaigenbaum L, Lee CM, Dager SR, Piven J. Longitudinal profiles of executive function in autistic and non-autistic children at high likelihood of autism. J Neurodev Disord. 2026.

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22. Vielmetti L, Rajagopal A, Manus R, Veis S, deRegnier RA. Autism Screening Using Parent’s Observations of Social Interactions (POSI) in High-Risk Infants. J Autism Dev Disord. 2026.

PURPOSE: The Parent’s Observations of Social Interactions (POSI) is a brief, targeted screening measure for autism spectrum disorder (ASD). There is minimal data on its use in infants at high risk for developmental delays. The objective was to evaluate the use of the POSI as an ASD screener in a cohort of infants at high risk for neurodevelopmental impairments. Our hypothesis was that positive POSI scores would be associated with developmental delays and the later diagnosis of ASD. METHODS: This retrospective cohort study included toddlers born between 2016 and 2019 assessed using the POSI and Bayley Scales of Infant and Toddler Development (BSITD) at 18-33 months corrected age. Children with positive and negative POSI screens were compared for developmental delays, cerebral palsy, and later diagnoses of ASD by a developmental pediatrician as noted in the electronic health record. RESULTS: Positive POSI scores were noted in 106/291 (36.4%) children, with 25/291 (8.6%) subsequently diagnosed with ASD. Toddlers with a positive score were more likely to have developmental delays and cerebral palsy compared with those with negative scores. The sensitivity of a positive POSI score for a later diagnosis of autism was 76% with a specificity of 66.7%. CONCLUSIONS: The POSI was a feasible method of ASD screening for high-risk children, in conjunction with other developmental evaluations. Due to low specificity, future research is warranted to improve the accuracy of early ASD screening in high-risk infants and long-term follow up.

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