1. Agrawal A, Shah H, Arel M, DeDonno M. Preventing seat belt unbuckling in an individual with autism and ADHD: a case study. Disabil Rehabil Assist Technol. 2026: 1-9.

BACKGROUND: Vehicular accidents are a leading cause of mortality among adolescents and young adults. The American Academy of Paediatrics (AAP) advocates for seatbelt use to reduce injuries and fatalities. Individuals with special needs, including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and developmental disabilities, present unique transportation safety challenges like frequent unbuckling. Despite increasing availability and use of aftermarket products designed to prevent unbuckling, their real-world effectiveness remains understudied. PURPOSE: This proof-of-concept single-case observational study describes the use of a customizable, malleable seatbelt cover in a 19-year-old female with ADHD and ASD who faced challenges with safe vehicular transport. METHODS: Data were collected in April 2025 across three conditions, where the subject was secured in the backseat with a seatbelt. She either: (i) rode with the parent driver (control), (ii) rode alongside a 1:1 behaviour therapist with the parent driver, or (iii) rode with the parent driver andseatbelt cover in place. Primary outcomes measured included unbuckling frequency over the approximately 25-minute car ride. In total, 8 rides occurred per condition. RESULTS: Results revealed elimination of unbuckling events while the modifiable seatbelt cover was in place. The control condition yielded frequent unbuckling (mean: 5 events per ride), while the presence of a 1:1 therapist reduced these behaviors (mean: 0.75 events per ride). These exploratory findings show that utilizing the seatbelt cover and behavioral strategies together may reduce harmful unbuckling behaviours in individuals with ASD. CONCLUSION: Further research assessing the generalizability of these interventions and risks/benefits of such aftermarket products is needed to prevent injury and death. Unsafe seatbelt unbuckling can limit safe community mobility and participation for individuals with ASD and ADHD.This case study suggests that a customizable, malleable 3D-printed seatbelt cover may serve as a practical assistive technology intervention to improve transport safety.Low-cost passive devices may reduce reliance on constant in-vehicle behavioral supervision, which may not be feasible for many families.Rehabilitation professionals should consider individualized, user-centered transportation support while balancing effectiveness, accessibility, and emergency removal considerations. eng.

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2. Bahri N, McIntyre LL, Neece C. Parenting Stress in Families of Children With ASD and DD: A Multidimensional Perspective. Am J Intellect Dev Disabil. 2026; 131(2): 83-97.

Parenting stress is a multifaceted experience, particularly for parents of children with autism and children with other developmental disabilities (DD). While much research focuses on child-specific factors, broader contextual influences are often underexplored. Guided by Belsky’s model of parenting stress and ecological systems theory, this study examines how child, parent, and familial factors contribute to parenting stress. Data from 206 families with children aged 3 to 5 years (95 with autism, 111 with DD) were analyzed. Results indicate that child characteristics, such as symptom severity and adaptive behavior, significantly impact parenting stress. Parent (e.g., education level, marital status) and familial variables (e.g., income, number of siblings) also play key roles. Notably, predictors of stress differ across distinct dimensions, suggesting that distinct mechanisms may underlie general distress, daily hassles, and the perceived impact of the child on the family. These findings emphasize the need for targeted, multidimensional intervention strategies.

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3. Barton H, Kover S, Thurman AJ, Finestack L, Sterling A, Berry-Kravis E, Edgin J, Fombonne E, MacFarlane H, Abbeduto L. Expressive Language Sample Concordance With ADOS-2 Scores: Autism, Down Syndrome, Fragile X Syndrome. Am J Intellect Dev Disabil. 2026; 131(3): 212-25.

Mazurek et al. (2019) put forth an Expressive Language (EL) score based on the Autism Diagnostic Observation Schedule, Second Edition Module administered and Item A1, establishing convergent validity with expressive language assessments for autism. The current study examines EL score relationships with transcribed language samples-including sensitivity to change-across 6- to 23-year-old individuals in three diagnostic groups: autism, Down syndrome, and Fragile X syndrome. Results demonstrate convergent validity of EL score with language complexity and lexical diversity, and variable patterns of divergence with talkativeness and nonverbal participation. In contrast to mean length of utterance in morphemes, EL score was not sensitive to 1-year change. These findings support the usefulness of EL score for quickly describing expressive language, but caution against its use as a clinical outcome or measure of change.

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4. Boamah DA, Barbee AP, Jones Graham O. Impact of Secondary Traumatic Stress and Burnout on Organizational Outcomes for the Intellectual and Developmental Disabilities Workforce. Intellect Dev Disabil. 2026; 64(3): 224-36.

This survey study examined how secondary traumatic stress (STS), emotional exhaustion (EE), and other personal and work-related factors of 406 direct support professionals (DSPs) affected job satisfaction and turnover intentions. Regression and structural equation modeling revealed that STS was positively related to EE that was negatively related to job satisfaction and positively related to turnover intentions, thus mediating the relationship between STS and these workplace outcomes. In addition, both resilience and perceived organizational support were positively and directly related to job satisfaction and perceived organizational support was indirectly through EE and directly related to turnover intentions. Findings highlight the need to address STS, the EE aspect of burnout, and organizational support to retain DSPs in high-stress social service roles.

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5. Chen VC, Huang YH, Chen YL, Dewey ME, Hung TH, Wu SI. Mortality and Antidepressants Among Individuals With Autism Spectrum Disorder: A Population-Based Cohort Study. Autism Res. 2026: e70302.

Individuals with autism spectrum disorder (ASD) often experience premature mortality and co-occurring psychiatric conditions, for which antidepressants are commonly prescribed. However, the long-term safety of antidepressant use in this population remains unclear. Using data from the Taiwan National Health Insurance Research Database, we emulated a target trial to examine the association between antidepressant use and mortality among individuals with ASD aged 6-64 years diagnosed between 2000 and 2016. A three-step approach of cloning, censoring, and inverse probability of censoring weighting was applied to address immortal-time bias. Participants were followed for up to 5 years to assess all-cause, suicide, and accidental-cause mortality. Among 33,939 eligible individuals, 779 initiated antidepressants within a 3-month grace period. Antidepressant use was not associated with all-cause or suicide mortality overall. However, it was significantly associated with reduced accidental-cause mortality at both 2 (HR = 0.15; 95% CI, 0.04-0.53) and 5 years (HR = 0.05; 95% CI, 0.01-0.20). Subgroup analysis revealed increased 2-year all-cause mortality among youths (HR = 4.40; 95% CI, 1.10-17.58) but significantly decreased 5-year accidental mortality in the age groups of 6-15 years (HR = 0.06; 95% CI, 0.01-0.41) and over 24 years (HR = 0.06; 95% CI, 0.01-0.42). Additionally, decreased 5-year suicide mortality was observed in the 16-24 age group (HR = 0.17; 95% CI, 0.05-0.61). While antidepressant use may reduce accidental mortality in individuals with ASD, age-specific risks warrant careful consideration and monitoring, particularly among younger populations.

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6. Chien CW, Fong Y, Chong MK, Sze PY, Ng YY, Wan TK, Chow PY, Graham F. A qualitative comparison of parents’ experiences with coaching and consultation to enhance participation of children with developmental disabilities. Disabil Rehabil. 2026: 1-20.

PURPOSE: To qualitatively explore parents’ coaching experiences and to compare these with consultation experiences in a randomized controlled trial aimed at improving the participation of children with developmental disabilities. MATERIALS AND METHODS: Fifty parents of children with developmental disabilities (aged 2-6 years) participated in the trial. Parents in the intervention group received Occupational Performance Coaching, while those in the control group received consultation. Both approaches were delivered online to facilitate children’s participation in everyday activities. Forty-eight parents (24 per group) completed post-intervention interviews about their experiences. Reflexive thematic analysis was applied to the interview data. RESULTS: Three main themes and 15 subthemes emerged across both groups: « Friendship-like relationship, » « Journey of learning and insights, » and « Evolving participation and well-being. » Two subthemes were more prominent in the coaching group, reflecting collaborative partnership with coaches and enhanced autonomy and skill generalization. Although parents in the consultation group reported some similar experiences, the nature of these experiences differed from that in the coaching group. CONCLUSIONS: The study highlights both shared and distinct features of coaching and consultation, providing insights into how each approach supports parents when delivered online. These findings may guide clinicians in selecting and tailoring interventions according to family needs. Online coaching and consultation may facilitate the participation of children with developmental disabilities by strengthening therapist-parent relationships and promoting parent learning.Coaching emphasizes collaborative reflection and co-creation of strategies, whereas consultation involves more structured, therapist-guided discussions.Both approaches promote parents’ learning; however, coaching may foster a sense of autonomy and the generalization of skills beyond specific goals.Clinicians should consider parents’ expectations, learning preferences, and readiness for engagement when selecting between coaching and consultation. eng.

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7. Coates MC, Bromberg J, Rast JE, Hathaway ZR, Glasofer A, Sefcik JS, Fisher K, DiMaria-Ghalili RA. Examining Differences in Hospitalization Among Adults With and Without Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil. 2026; 131(4): 267-80.

The primary aim of this study was to compare the common reasons for hospitalization among adults with and without intellectual and developmental disabilities (IDD) in the United States. We examined hospitalizations for adults with and without IDD using the 2017 to 2019 National Inpatient Sample. Adults with IDD were matched to a sample without IDD, stratified by age (18-49 vs. ≥50), and compared for reasons for hospital admission and outcome differences. Adults with IDD, especially those 18 to 49, were frequently hospitalized for schizophrenia, while septicemia was the primary cause for those ≥50. Epilepsy was common among individuals with IDD and associated with higher healthcare costs and utilization. Those with IDD had more chronic conditions, longer stays, and higher postdischarge care needs. Enhancing community-based services and training a healthcare workforce focused on the specific needs of individuals with IDD can help reduce these disparities.

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8. Cvitanovic M, Vera Szawranskyj A, Doueiri ZN, Steinberg J, Young A, Digre S, Vega C, Hing K, Margetts B, Seay-Morrison T, Taylor S, Clarke L, Rosas LG, King AC, Tabor HK. Engaging Adults with Intellectual and Developmental Disabilities as « Citizen Scientists » to Transform Health Care Accessibility. Intellect Dev Disabil. 2026; 64(4): 314-27.

Adults with intellectual and developmental disabilities (AIDD) experience persistent barriers to accessing and participating in health care yet are rarely engaged as partners in efforts to improve accessibility. This study used the evidence-based Our Voice (OV) citizen science approach to engage AIDD in identifying barriers and facilitators to primary care access and generating actionable solutions. Twelve participants (six AIDD and six adults without IDD) documented accessibility conditions across three medical clinics using photographs and narratives. Analysis of 170 photographs and 154 narratives identified five themes: (1) sensory considerations, (2) informational materials, (3) signage and wayfinding, (4) accommodations, and (5) physical accessibility. Findings demonstrate the feasibility of engaging AIDD in structured, clinic-based accessibility assessment and suggest a participatory framework that may inform research and quality improvement initiatives aimed at promoting disability-inclusive health care.

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9. de Marchena A, Wieckowski AT, Freedman B, Shea L, Locke J, Cronholm PF, Leff SS, Vivanti G, Robins DL. From Waiting to Action: Why the Autism Field Must Embrace Efficient Service Delivery Models for Diagnostic Assessment. Autism. 2026: 13623613261474938.

Waiting lists for an autism evaluation delay timely diagnosis and entry into autism-specific early intervention. To solve this crisis, our field must increase capacity by embracing efficient diagnostic processes. Traditional diagnostic pathways involve complex evaluations and rely on a highly trained but limited pool of specialists, which elongate wait times. Evidence suggests that emerging approaches, including telehealth assessments, primary care diagnosis, and tiered models, reduce barriers. We guide readers through five core issues critical to updating the standard of care for early autism assessment: (1) What are the consequences of maintaining the status quo? (2) What do families prioritize? (3) What evidence supports efficient diagnostic models? (4) What are the consequences of reducing accuracy? and (5) What level of assessment depth is needed to inform action? Our team contends that the critical advantages of adopting efficient service delivery models far outweigh the disadvantages. Collaboration across disciplines, and trust in families’ insights, will help build capacity. We conclude with actionable recommendations for clinicians and policymakers in support of adopting these models.Lay AbstractThe growing demand for autism diagnostic services has outpaced available resources. This creates significant delays in first diagnosis and entry into early intervention services (early diagnosis and intervention improve outcomes). Expert diagnosticians in the field have debated – and tested – streamlined and flexible alternative diagnostic processes to speed up access to services; we believe that the advantages of such approaches outweigh the disadvantages, and that evidence supports updating our current standards.

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10. Dimer NA, Melo APS, Santomauro D, Malta DC, Duncan BB, Goulart BNG. Prevalence, incidence, and years lived with disability due to Autism Spectrum Disorder in Brazil, 1990-2023: Results from the Global Burden of Disease Study 2023. Rev Bras Epidemiol. 2026; 29: e260025.

OBJECTIVE: To describe the prevalence, incidence, and years lived with disability due to autism spectrum disorder in Brazil, as well as the variation of these metrics between 1990 and 2023. METHODS: A time-series analysis using data for Brazil from the 2023 Global Burden of Disease study. Estimates of incidence, prevalence, and years lived with disability attributable to autism spectrum disorder were generated for Brazil and its regions. The study reports absolute frequencies, crude rates, and age-standardized rates per 100,000 inhabitants, all with 95% uncertainty intervals (95% UI), stratified by sex and age group. RESULTS: In 2023, more than 1.1 million (95% UI: 0.58; 1.97) individuals on the autism spectrum were living in Brazil, representing 0.53% of the population (95% UI: 0.27; 0.93). The number of cases increased since 1990, while age-standardized prevalence remained stable over time. In 2023, more than 23,000 new autism spectrum disorder cases were estimated, with a rate of 11.19 per 100,000 individuals (95% UI: 2.47-31.39). Autism spectrum disorder was ranked within the top ten causes of years lived with disability for people younger than 20 years, being a non-fatal health burden. CONCLUSION: In 2023, 0.53% of Brazilians were autistic, corresponding to more than 207,000 years lived with disability. Prevalence was higher in males and children under five years of age. The permanent and complex nature of autism spectrum disorder imposes a significant burden, requiring healthcare and education services to be adequately prepared. Further research is needed to deepen the understanding of autism spectrum disorder and validate screening tools in the Brazilian context.

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11. Dodds RL, Wu H, Toapanta C. Turning Authorizations into Services: Parent Perspectives on Regional Center Utilization for School-Aged Children in California. Intellect Dev Disabil. 2026; 64(4): 328-38.

Program data from a large California Regional Center (RC) showed school-aged clients (5 to <22 years) under-utilized authorized services, with language factors implicated. We conducted semi-structured focus groups/interviews with parents/caregivers (n = 17) from May to August 2024, including a culturally adapted Spanish version. Transcripts underwent modified grounded-theory analysis. Seven themes emerged: advocacy, family stress, positivity/hope, knowledge gaps, obtaining/using services, service coordinators, and school issues. Parents reported persistent advocacy amid time, financial, and administrative burdens; uneven information (often peer-driven); variable coordinator responsiveness; reimbursement/communication gaps; and school shortages. Utilization hinges on navigability, language access, reimbursement design, and RC-school coordination. Recommendations include standardized bilingual onboarding, direct-pay/vendorized options, mentored coordinator onboarding/warm handoffs, and parent-to-parent navigation supports.

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12. Gordon RA, Doernberg EA, Dimitropoulos A, Russ SW. Telehealth Administration of the Affect in Play Scale in Children with Developmental Differences. Am J Intellect Dev Disabil. 2026; 131(3): 204-11.

The Affect in Play Scale (APS) is a standardized pretend play assessment that measures cognitive and affective skills in school-aged children. We examined the comparative utility of the APS via telehealth across three diagnostic groups. Ninety-four children ages 6 to 9 who were either typically developing or had high-functioning autism spectrum disorder or Prader-Willi syndrome completed the APS either in-person or via videoconferencing in a single mode administration design. Equivalence analyses compared in-person versus remote APS scores within diagnostic groups. Paired samples t tests revealed no significant differences between groups on all APS variables (ps > .073). Results support equivalence and feasibility of the remote APS for school-aged children with and without developmental differences. Recommendations for administration are discussed.

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13. Guo Q, Zhang L, Zuo Y, Mei J, Zhang C. Contrasting outcomes of 16p11.2 microdeletion and microduplication in prenatal diagnosis: phenotypic variability and genetic counseling strategies. Psychiatr Genet. 2026; 36(3): 151-5.

BACKGROUND: Copy number variations (CNVs) in the 16p11.2 region are associated with neurodevelopmental disorders, but they exhibit incomplete penetrance and variable expressivity. Prenatal diagnosis of these CNVs presents significant challenges because of the unpredictable phenotypic outcomes. MATERIALS AND METHODS: We retrospectively analyzed two fetal cases diagnosed prenatally via amniocentesis with CNV sequencing (CNV-seq) as having 16p11.2 CNVs, and discussed them in the context of current literature. In this research, GTG-banding karyotype analysis, CNV-seq, and whole-exome sequencing were performed. RESULTS: Case 1 had a de novo 16p11.2 microdeletion [del(16)(p11.2)] accompanied by an ultrasound soft marker (absent nasal bone); the pregnancy was terminated after genetic counseling. Case 2 carried a de novo 16p11.2 microduplication [dup(16)(p11.2)] and was born with a normal phenotype to date. CONCLUSION: 16p11.2 microdeletion and microduplication syndromes exhibit significant phenotypic heterogeneity and incomplete penetrance. When such CNVs are identified prenatally, integrated management – including parental testing, detailed fetal imaging, and comprehensive, nondirective genetic counseling – is essential to provide families with individualized risk assessment and support informed decision-making.

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14. Han F, Gao X. Exploring Parental Experiences of Virtual Reality-Based Family Interventions for Children with Autism Spectrum Disorder: Qualitative Insights from China. Intellect Dev Disabil. 2026; 64(2): 115-28.

This study explores Chinese parents’ experiences with virtual reality (VR)-based family interventions for children with autism spectrum disorder (ASD). Fifteen parents were interviewed, with data analyzed via reflexive thematic analysis. Findings reveal a process of technological mediation where parents personalized VR for caregiving routines and valued its impact on relational care. However, they also navigated challenges including the « hidden labor » of maintenance and a central paradox: while VR’s structured nature improved the overall emotional climate, it sometimes caused emotional disconnection during task-focused sessions. The study underscores the need for VR applications that are culturally sensitive, employ sensory-inclusive design, and support relational caregiving goals.

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15. Hicks TA, Shogren KA, Pace JR. Renorming the Supports Intensity Scale-Adult Version: Evaluating the Impact of Updated Norms on Scores. Am J Intellect Dev Disabil. 2026; 131(2): 135-47.

The Supports Intensity Scale-Adult Version (SIS-A) measures the intensity of support needs of people aged 16 and over with intellectual and developmental disabilities. Since its 2004 release, this tool has informed supports planning across the United States and internationally. In 2023, the second edition of the SIS-A was published, featuring updated norms for the scale. This study examines the alignment of score distributions before and after renorming the SIS-A. Findings reveal a strong correlation between scores derived from the original and updated norms, suggesting continuity in score distributions. However, the use of the updated norms resulted in a more normal distribution of scores. Implications for research, policy, and practice are discussed.

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16. Jafri SK, Mazhar N, Mirza A, Zehra T, Shams Z, Naseem Elahi K, Das JK, Iqbal Siddiqui M, Bhamani S, Tayyab H, Rizvi A, Ibrahim S. Surveillance for neurodevelopmental impairment (NDI) in high-risk neonates: a cohort study at a tertiary care hospital in Pakistan. BMJ Open. 2026; 16(8): e121569.

BACKGROUND: High-risk neonates are at greater risk for neurodevelopmental impairment (NDI) despite improved neonatal survival. In low-income and middle-income countries, including Pakistan, developmental trajectories across infancy and toddlerhood of high-risk neonates are not well studied, especially when the survival is improving. METHODS: This 2-year longitudinal cohort study was performed at the neonatal intensive care unit and Child Development and Rehabilitation Centre of Aga Khan University Hospital in Pakistan. High-risk neonates who met predefined clinical criteria were enrolled and evaluated at 6 months, 12 months and 24 months of age using the Bayley Scales of Infant and Toddler Development, Fourth Edition. NDI has been defined as moderate-severe hearing or visual impairment, cerebral palsy or global developmental delay (ie, ≥2 SD delay in ≥2 Bayley domains). RESULTS: Out of 369 eligible neonates, 198 of them had at least one assessment. NDI prevalence increased to 15.7% at 2 years compared with 8.2% at 6 months. Overall, language impairment showed the largest increase (2.6%-9.6%), while cognitive (5.2%-7.1%) and motor (5.2%-7.6%) impairments rose modestly.Placental abruption was linked to the risk of NDI in univariable analysis (HR=3.53, 95% CI 1.07 to 11.62). Low birth weight was associated with gross motor impairments (HR=2.90, p=0.01), while preterm birth also showed association with gross motor (HR=3.66, p=0.01) and receptive (HR=2.61, p=0.02) impairments. Receptive language impairment was related to pre-eclampsia (HR=2.06, 95% CI 1.17 to 3.64) and preterm premature rupture of membranes (HR=2.24, 95% CI 1.22 to 4.09). Expressive impairment was linked to prolonged hospital stay (HR=1.81, 95% CI 1.04 to 3.14) and lower household income (HR=2.07, 95% CI 1.24 to 3.45). CONCLUSION: Approximately 15% of high-risk neonatal survivors showed evidence of NDI by 2 years of age with evolving language vulnerabilities and persistent gross motor risks. Overall, study findings highlight the need for urgent structured developmental surveillance and early child development intervention programmes for high-risk infants in Pakistan, as part of routine neonatal care pathways.

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17. Johnson K, Annis I, Thomas K. Measuring the Association of Race, Neighborhood Segregation, and Healthcare Use Among People With Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil. 2026; 131(3): 226-38.

Few studies examine the impacts of structural inequities on service access and use for people with intellectual and developmental disabilities (IDD). This secondary data analysis used data from the Medical Expenditure Panel Survey and the American Community Survey to examine the association of race, neighborhood segregation, and hospital and outpatient use among people with IDD. Our sample included children and adults with a diagnosis of IDD. Multilevel logistic regression models with random intercepts were used to assess the association between race, neighborhood segregation, and emergency room (ER), hospital, and any outpatient use. Our analyses adjusted for individual-level predisposing, enabling, and need characteristics. Ninety-four percent of the sample reported use of outpatient services, 15% had at least one ER visit, and 5% had at least one hospitalization. Living in a segregated neighborhood was associated with lower odds of any outpatient use (OR = 0.35, 95% CI: 0.15-0.85). We found no evidence of association between neighborhood segregation and hospital or ER use. Other (vs. White) race was associated with lower odds of any outpatient use (OR = 0.33, CI: 0.12-0.90) and higher odds of hospital use (OR = 8.00, CI: 2.26-28.35). Scholars need larger integrated datasets and more nuanced methods for longitudinal analyses to map associations better between race, neighborhood segregation, and their impact on service use.

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18. Kaan H, Karayağmurlu A, Küçükgergin C, Bingül İ, Soylu N. Investigating Serum miRNA Levels in Autistic Children with and without Bipolar Disorder: A Case-Control Study. Noro Psikiyatr Ars. 2026; 63: 502-9.

INTRODUCTION: The presence of bipolar disorder (BD) in individuals with ASD exacerbates social and cognitive impairments, complicates diagnosis and treatment. The aim of this study was to compare the serum levels of specific miRNAs between children with ASD with and without BD, and to explore their association with BD comorbidity in ASD. METHOD: A group of 41 pediatric patients with comorbid ASD + BD and a group of 47 pediatric patients with ASD without BD were included in the study. Serum miRNA levels were measured using quantitative real-time polymerase chain reactions, focusing specifically on miRNAs such as miR-132-5p, miR-134-5p, miR-206, and miR-126-5p. RESULTS: The ASD + BD group exhibited significantly greater ASD severity than the ASD without BD group. Serum levels of miR-134-5p, miR-206, and miR-126-5p were all higher in the ASD + BD group than in the ASD without BD group (p=0.038, p=0.023, and p=0.026, respectively), while miR-132-5p levels were not significantly different (p=0.105). Furthermore, miR-134-5p levels were correlated with the frequency of manic episodes in the ASD + BD group (p=0.007). CONCLUSION: The study findings suggest that miRNAs may be involved in the pathophysiology of comorbid BD in children with ASD and may potentially represent candidate biomarkers for early diagnosis and intervention, thus contributing to improved clinical outcomes in this population. Further research is now needed to validate these findings and to understand the underlying mechanisms.

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19. Kang J, Fan Z, Xiao Z, Zhang X, Li X, Gu Y. HFG-Net: high-frequency guided multi-view graph convolution and dynamic spatio-temporal fusion for ASD diagnosis. J Neural Eng. 2026; 23(4).

Objective.Autism spectrum disorder (ASD) is a highly heterogeneous neurodevelopmental condition characterized by significant inter-subject variability in electroencephalogram (EEG) features. Existing deep learning approaches often fail to fully capture intrinsic spatio-temporal dependencies or rely on static feature fusion strategies, struggling to characterize complex non-Euclidean topological abnormalities. We aim to address these challenges by proposing a robust and adaptive diagnostic framework.Approach.We propose HFG-Net, a high-frequency guided spatio-temporal synergistic network. This framework incorporates three core innovations: First, a channel-temporal multi-scale attention mechanism captures transient spatio-temporal coupling. Second, a high-frequency guided multi-view graph construction strategy leverages sparse skeletons from beta/gamma bands to filter all-band Pearson correlation and phase locking value matrices, constructing noise-resistant topologies. Third, a dynamic synergistic fusion module employs a gating network for sample-level adaptive feature integration.Main results.Experiments on a clinical dataset of 120 subjects demonstrate that HFG-Net achieves a classification accuracy of 95.79% and an F1-score of 92.89% on an independent test set. The model further achieves a recognition rate of 98.43% for patients with mild ASD.Significance.Interpretability analysis reveals that the model’s focus on high-frequency abnormal connectivity aligns with neuropathological findings. HFG-Net effectively addresses the challenges of synergistic spatio-temporal modeling and heterogeneity adaptation, providing an efficient, robust, and interpretable paradigm for EEG-based diagnosis.

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20. Kaplan ZB, Pearce EN, Miller M, Tancredi D, Hertz-Picciotto I, Shin HM, Schmidt RJ. Maternal Thyroid Dysfunction During Pregnancy and Childhood Autism or Other Developmental Outcomes. Autism Res. 2026: e70346.

Overt maternal hypothyroidism during pregnancy has been associated with cognitive impairment in offspring, but less is known about effects of subclinical hypothyroidism and other maternal thyroid conditions on autism spectrum disorder (ASD). This study examined the relationships between maternal thyroid dysfunction during pregnancy and child neurodevelopmental outcomes. Participants were from a high ASD likelihood pregnancy cohort (MARBLES). Maternal thyroid dysfunction (hypothyroid or hyperthyroid compared to euthyroid) was measured in up to one blood sample per trimester. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) were also examined as exposures. Outcomes were child ASD diagnosis, non-typical development (non-TD), typical development and standardized scores from the Social Responsiveness Scale (SRS). Outcomes were confirmed by study psychometricians. Multinomial logistic and quintile regressions were used to examine associations of maternal thyroid dysfunction (using trimester-specific reference ranges) with developmental outcomes and SRS scores. Among 285 pregnancies, 83.9% were categorized as euthyroid, 9.5% hypothyroid, and 6.7% hyperthyroid. Of 285 children included in analyses, 28.8% were diagnosed with ASD (n = 82; female = 27) and 14.7% with non-TD (n = 42; female = 19). Maternal hypothyroid conditions were associated with increased ASD:TD odds (adjusted RRR = 3.40, 95% CI: 1.22, 9.45; p = 0.02). Significant relationships were also found between hypothyroid conditions and non-TD, and between first trimester TSH and ASD. There was no evidence of a relationship between either TSH or FT4 and preschool SRS scores. Findings suggest that maternal hypothyroid conditions during pregnancy are associated with greater chances of their children developing ASD and other neurodevelopmental differences among children with high familial likelihood of ASD. This study found that mothers with an underactive thyroid during pregnancy (in comparison to mothers with normal thyroid function) were more likely to have a child who was diagnosed with ASD (autism spectrum disorder) or who had other developmental concerns (not ASD) at around age three. More research is needed to understand why an underactive thyroid in the mother during pregnancy might contribute to child developmental differences and to explore other factors that could be involved. eng.

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21. Kitchens JC, Wake D. Understanding Autism Through Indigenous Relational Ecologies: A Phenomenographic Exploratory Study With Potawatomi Participants. Autism. 2026: 13623613261470856.

Autism is commonly conceptualized in research, policy, and clinical contexts as an individual condition defined by diagnostic criteria and functional impairment. While these frameworks shape access to services, they often obscure relational, cultural, and contextual meanings of autism, particularly within Indigenous communities. This article reports findings from an exploratory phenomenographic study examining how autism is understood among five Citizen Potawatomi Nation participants. Guided by Indigenous Knowledge Systems, decolonial leadership, relational epistemologies, and a neurodiversity-affirming paradigm, the study examined qualitative variation in meaning-making rather than consensus or generalizability. Semi-structured interviews were conducted with Autistic adults, parents of Autistic children, and a tribal Knowledge Keeper. Analysis followed Åkerlind’s interpretive phenomenographic approach, resulting in five categories of description illustrating coexisting understandings of autism: system-managed difference, intergenerational family patterning, natural human variation, relational identity and belonging, and spiritual gift with purpose. These categories were organized into an outcome space reflecting a relational ecology of meaning. Findings demonstrate that autism is understood within Potawatomi contexts through intergenerational continuity, relational belonging, and culturally grounded purpose, challenging deficit-based and universalizing frameworks. The study highlights the value of phenomenography for Indigenous autism research and informs future Nation-engaged, relationally accountable inquiry.Lay AbstractAutism is often described in medical, educational, and policy settings as a problem located within an individual. This study explored how five Citizen Potawatomi Nation participants understand autism, including Autistic adults, parents of Autistic children, and a tribal Knowledge Keeper. Rather than seeking one shared definition, the study examined different ways autism is understood based on lived experience, relationships, and cultural teachings. Participants described autism as shaped by health care and school systems, as a pattern across families and generations, as a natural part of human diversity, as part of identity and belonging, and as a spiritually meaningful difference with cultural purpose. The findings suggest that dominant Western frameworks may miss relational, cultural, and spiritual meanings that matter in Potawatomi contexts. Recognizing these meanings can support respectful research and more responsive approaches to education, health care, and community support.

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22. Lasch C, Goldberg AT, Barch DM, Marrus N, Camacho MC, Sylvester CM. Youth Autistic Traits and Brain Activation States During Socioemotional Processing. Am J Psychiatry. 2026: appiajp20251035.

OBJECTIVE: Different aspects of social-emotional processing are linked to unique whole-brain patterns of neural activity termed « activation states. » Autistic traits in youths include impairments in socioemotional processing that vary depending on age and comorbidity. Characterizing differences in activation states associated with these impairments may explain why youths with high autistic traits process socioemotional information differently than peers. METHODS: This study examined the frequency of three previously identified activation states in 545 youths (ages 5-15 years, 39% female, 54% White, 68% non-Hispanic) from the Healthy Brain Network study as they watched a socially engaging movie. Regressions examined associations between autistic traits (measured by the Social Responsiveness Scale, 2nd ed.) and overall time spent in activation states, and whether these associations varied with age or co-occurring attention deficit hyperactivity disorder (ADHD) and anxiety symptoms (measured by the Strengths and Weaknesses Assessment of ADHD and Normal Behavior and the Screen for Child Anxiety Related Disorders). RESULTS: At younger ages (<9 years), children with more autistic traits spent more time in an activation state associated with increased activation in somatomotor and visual networks. At older ages (>14 years), children with more autistic traits spent more time in an activation state characterized by greater default mode and ventral attention network activation. Across all ages, children with more ADHD symptoms spent less time in an activation state associated with greater cingulo-opercular network activation. CONCLUSIONS: Autistic traits are associated with differences in brain activation during socioemotional processing that vary with age and co-occurring mental health symptoms. Youths with more autistic traits may experience an altered developmental trajectory of social-emotional processing compared to peers with fewer autistic traits. Results inform personalized interventions and progress monitoring for youths with social impairments.

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23. Lee PC, Chaidez Ruacho H, Vanegas S, Magaña S. The Role of Language and Parental Nativity in Specialty Services Use Among Latino Families with Children with Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil. 2026; 131(4): 239-50.

Latino children with intellectual and developmental disabilities (IDD) face disparities in accessing specialty services. Using 2020-2023 National Survey of Children’s Health data (N = 2,497), we conducted logistic regressions to examine how parental nativity and household language affect specialty services use among Latino children with IDD. While children of immigrant parents had lower odds of service use, this association was explained by household language. Children in Spanish-speaking households were significantly less likely to receive services (OR = 0.53, CI = 0.33-0.84). The mediation analysis further highlights that language, more than nativity, drives disparities. Therefore, efforts to improve access should include Spanish-speaking providers and culturally responsive care.

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24. Mays TB, Pearson JN, Mikush C. Exploring the Integration of Occupation in Autism Psychoeducational Interventions for Black and Latino Families: A Systematic Content Analysis. Intellect Dev Disabil. 2026; 64(3): 208-23.

Despite the increased prevalence of autism among children of color, disparities in service access persist. Family-centered autism psychoeducational interventions have emerged to empower racially and ethnically marginalized caregivers of children with autism with knowledge and skills to improve child outcomes. This systematic content analysis explored the extent to which psychoeducational interventions for racially and ethnically marginalized families facilitate occupation, also known as activities of everyday life, through their service delivery. Eight studies met the inclusion criteria, representing four psychoeducational interventions. Findings indicated that, while occupation was not emphasized in these curricula, each intervention facilitated occupation. Our content analysis of the interventions highlights opportunities for occupational therapy and psychoeducation to collaborate to increase occupational engagement and improve health and well-being of Black and Latino children with autism and their families.

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25. Moronski LS, Lake ET, McHugh MD. Factors Associated With Readmission and Mortality of Hospitalized Individuals With Intellectual and Developmental Disabilities in Four U.S. States. Am J Intellect Dev Disabil. 2026; 131(4): 281-93.

This study examined demographics, social determinants of health, comorbidities, and outcomes (mortality and readmissions) of hospitalized patients with intellectual and developmental disabilities (IDD). The sample included 39,256 hospital admissions for adult inpatients with IDD from four states. Logistic regression analyzed factors influencing 30-day readmission and in-hospital mortality. Results showed a 17.5% 30-day readmission rate. Black race, Medicare/Medicaid insurance, and admission from another facility were associated with higher odds of readmission. Age, Medicare insurance, and admission from emergency rooms, another hospital, or facility were associated with higher odds of in-hospital mortality. The study highlights the complex interplay of factors affecting outcomes for patients with IDD, emphasizing the need for targeted interventions and improved hospital care to address health disparities in this population.

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26. Pallikarana Tirumala H, Li Y, Zoghbi HY. Deep Brain Stimulation and Repetitive Training Restore Neuronal Activity and Improve Neurological Function in Rett Syndrome Models. Am J Intellect Dev Disabil. 2026; 131(4): 294-303.

Rett syndrome (RTT) is a postnatal neurological disorder caused by loss-of-function mutations in the gene that encodes methyl-CpG binding protein 2. RTT is characterized by initially normal development, followed by developmental regression at 6 to 18 months of age. Individuals with RTT subsequently develop motor deficits, impaired learning and memory, and breathing abnormalities. In this review, we summarize recent findings on how neuronal circuitry is impaired in RTT and how deep brain stimulation and presymptomatic, task-specific training significantly improve learning and memory in RTT mice. Translating these findings to clinical applications, interventional studies have shown initial evidence that structured behavioral exercises can benefit individuals with RTT. Based on the converging evidence from preclinical and clinical research, we advocate for early-stage intensive behavioral training to supplement other therapeutic approaches and enhance treatment outcomes.

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27. Rajesh Kumar V, Choi L, Oram J, Binns A. Common and Differing Elements Across Caregiver-Mediated Social Communication Programs Supporting Autistic Children: A Scoping Review With Content Analysis. Autism. 2026: 13623613261469913.

Caregiver-mediated interventions are widely used to support social communication development in young autistic children. While many such interventions are evidence-informed, limited information exists about their shared and unique elements, making it challenging for caregivers and clinicians to tailor program selection to individual needs and preferences-an essential part of personalized care in autism. This scoping review with content analysis examined 18 commercially available, caregiver-mediated social communication interventions to identify similarities and differences in child skills targeted and caregiver-coached strategies. Data were extracted from program manuals, fidelity tools, published literature, and program websites for eight developmental social pragmatic (DSP) programs and 10 naturalistic developmental behavioral interventions (NDBIs). Programs varied in scope, with some supporting a broad range of child skills and others focusing on specific areas. Across all programs, 70 caregiver-coached strategies were identified, and then thematically grouped into eight categories aligned with the developmental skills the strategies aim to support. Although some strategies were common across all programs, some unique strategies were also identified. In addition, there were notable differences in how these strategies were operationalized despite using similar terminology, underscoring the need for more precise, clearly defined fidelity measures to enable accurate assessment of caregiver implementation and meaningful comparisons across programs. This study lays the groundwork for future research to identify active ingredients of interventions and supports more informed, individualized decision-making in clinical practice.Lay AbstractYoung autistic children may engage with others and communicate in ways that differ from non-autistic peers, and may need support to develop skills to communicate with, and navigate interactions with others. Many programs have been developed for this purpose, with a growing number of programs including caregivers in this process. In programs where caregivers play a primary role, professionals coach them to use certain techniques that can support social communication. Although many such programs exist, we still lack clarity on how these programs are similar or different, making it tough for families to choose among them. To address this gap, we reviewed 18 well-known caregiver-led programs to compare the skills they aim to support children with, and the specific techniques they teach caregivers. We gathered information from program resource materials, published research, and official program websites. We found that some programs focused on supporting a wide range of skills, whereas others targeted only certain developmental areas. In total, we identified 70 distinct caregiver-coached techniques, which we organized into eight categories. Many techniques were common across all programs, but others were unique to specific programs. Even among the shared techniques, there were differences in the way they were practiced, despite using the same strategy name. For example, a technique like « following the child’s lead » could look quite different depending on the program. These findings show that having descriptions of how techniques should be used is important to understanding and comparing different programs. Overall, these findings provide families with information about program ingredients and can be used to guide clinicians toward programs that match individuals’ needs and wants. This work also paves way for future research exploring how these social communication programs work, and evaluating which techniques are most effective for specific groups of children and families.

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28. Sanderson KA, Burke MM. Examining Stress in Parents of Adults with Intellectual and Developmental Disabilities. Intellect Dev Disabil. 2026; 64(3): 187-200.

Many parents of individuals with intellectual and developmental disabilities (IDD) experience high levels of stress. Such stress can negatively impact parents (e.g., create exhaustion, worsen physical and mental health) and their children with IDD (e.g., reduce their quality of care). By identifying specific stressors and their correlates, targeted interventions can be designed to mitigate stress and improve outcomes for families of adults with IDD. In this study, 518 parents of adult children with IDD responded to a national survey about their stress. Top stressors included future planning and a lack of daily activities for their adult children with IDD. Having an adult child with autism and being from collectivistic cultures were consistent correlates of greater stress. Implications for research, policy, and practice are discussed.

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29. Schreier M, Barak-Corren Y, Josowitz R, Vaikunth S, Kim YY, Gillespie MJ, Savla JJ. ASD Occluder Used to Close a Mustard Baffle Leak. JACC Case Rep. 2026; 31(32): 108894.

BACKGROUND: Baffle leaks are a known complication of the atrial switch for D-looped transposition of the great arteries. CASE SUMMARY: A 46-year-old woman with D-looped transposition of the great arteries who underwent an atrial switch (Mustard) presented with a hemodynamically significant baffle leak in close proximity to the systemic tricuspid valve. This report details the first-in-human percutaneous closure of a large baffle leak using a newest generation closure device, the GORE CARDIOFORM ASD Occluder (GCA). DISCUSSION: Baffle leaks are traditionally managed with either surgery or percutaneously with catheter-based devices. The location of the leak in this case was close to the tricuspid valve, and so the newer, softer GCA device was used. NOVELTY: This is the first-in-human percutaneous closure of a baffle leak after an atrial switch using the GCA device. TAKE-HOME MESSAGE: The GCA is the newest generation of closure devices that may convey an advantage over previous technology when closing leaks adjacent to important cardiac structures.

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30. Simonti G, Koutroulis I. Cord blood cytokine signatures and the path toward preemptive autism interventions. Pediatr Res. 2026.

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31. Stone-Heaberlin M, Blackburn AD, Tamm L, Allahverdy A, Kline-Fath B, Parikh NA. Early autism risk factors: a cohort study of children born very preterm at 5-years. J Perinatol. 2026.

OBJECTIVE: Explore the association of prenatal, perinatal, and postnatal risk factors with autism risk at 5-years corrected age in very preterm (VPT) children. STUDY DESIGN: Data from a longitudinal cohort study of 315 VPT and 172 term-born children at a US-based academic medical center were analyzed, exploring antecedents of autism risk using elastic net regression. RESULTS: More children born VPT (8.9%) had a Social Communication Questionnaire score associated with autism (i.e., SCQ ≥ 15) than term-born controls (2.9%; p = 0.012). For VPT children, cerebellar abnormalities at term-equivalent age (OR = 1.339, 95% CI = 1.010-1.778) and moderate-severe histologic chorioamnionitis (OR = 4.148, CI = 1.294-13.368) were significantly associated with autism risk, in addition to male sex and social risk. VPT children with SCQ ≥ 15 had poorer adaptive, behavioral, cognitive, and executive functioning (all ps < 0.001). CONCLUSION: Early screening for children with these risk factors can facilitate early intervention for those at most risk for poorer neurodevelopmental outcomes.

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32. Sulmonetti LC, Rodrigues VL, Herrera Espinosa G, Hodapp RM. Children with Intellectual and Developmental Disabilities and Mental Health Challenges: Caregiver Familiarity with Clinical Services. Intellect Dev Disabil. 2026; 64(2): 160-72.

Although children with intellectual and developmental disabilities (IDD) more often experience mental health concerns, they do not always receive mental health services. This study examined the barrier of caregiver familiarity with services. Analyzing a statewide survey of 137 caregivers of children with IDD and mental health concerns, high percentages (35%-60%) were unfamiliar with common school-based child, community-based child, and (community-based) family mental health services. Especially concerning family services (e.g., family therapy, behavioral parent training, caregiver therapy), caregivers did not know what services to ask for or where to find them. Caregivers’ service familiarity increased when children received a formal mental health diagnosis, but not when the child had an Individualized Education Program. Implications are discussed for research, policy, and practice.

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33. Tadesse S, Safayi BL, Sherfa A, Jemal M, Lahole BK, Cheme MC, Belay S, Gebremariam AG, Tuke G, Zewudie A, Wodessa G, Dube GN. Prevalence of Autism Spectrum Disorders and the Years Lived With Disability in Eastern Sub-Saharan Africa, From 1990 to 2023. Brain Behav. 2026; 16(8): e71663.

BACKGROUND: Autism spectrum disorders are lifelong neurodevelopmental conditions affecting social interaction, communication, and behavior. Despite rising global burden, data from Eastern Sub-Saharan African region are limited. This study estimated the prevalence of ASD and the years lived with disability in the region from 1990 to 2023. METHODS: We analyzed input data from the Global Burden of Diseases 2023 study for the ESSA countries. Prevalence and years lived with disability were estimated using disease modeling with Bayesian meta-regression and spatiotemporal Gaussian process regression. Age-standardized rates were calculated, and 95% uncertainty intervals (UIs) were generated. Trends were assessed for statistical significance based on UIs. RESULTS: In 2023, an estimated 4.24 million individuals (95% UI: 2.02, 8.80) were living with ASD in the ESSA region, with an age-standardized prevalence of 814 per 100,000 population (95% UI: 405, 1481). Autism spectrum disorders contributed 0.8 million YLDs (95% UI: 0.3, 1.9), and the age-standardized YLDs rate was 154 per 100,000 population (95% UI: 70, 333). Prevalence and YLDs showed no significant sex or location differences and remained nearly unchanged from 1990 to 2023. CONCLUSION: The study indicated that ASD is a significant and persistent health burden in the ESSA region, affecting young children and adolescents disproportionately. There is an urgent need for early detection of cases, strengthening collaborative initiatives, and implementing culturally sensitive, community-based interventions to support individuals with ASD and their caregivers. Moreover, improved surveillance and standardized diagnostic practices are important to guide policy and resource allocation.

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34. Tassé MJ, Ford ME, Schalock RL, Luckasson R. Need for Stability and Predictability in Terminology in Times of Change and Challenges. Am J Intellect Dev Disabil. 2026; 131(3): 159-70.

This article provides solutions to reduce terminology-related confusion and inconsistencies in the field of intellectual and developmental disabilities. Solutions involve distinguishing between a disability and a disorder, using the consensus definitions of intellectual disability and developmental disability; recognizing the important distinction among different types of definitions; differentiating the constructs of intellectual disability and developmental disability; not combining the terms intellectual disability and developmental disability into a new diagnostic term; and using appropriate initials to denote the respective condition. Solutions are based on information obtained from three sources: current diagnostic manuals, disability-related public laws and administrative rules and regulations of federal agencies with jurisdiction regarding people with a disability, and relevant published literature.

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35. Taylor BJ, Peura CB, Riddell ER, Strathmann WR, Northrup JB, Mazefsky CA, Andalib Y, Siegel M. Wearable Biosensors in Youth With Autism With High Behavioral Acuity: Supportive Practices, Acceptability, and the Importance of Nonverbal Signs of Assent to Research Participation. Am J Intellect Dev Disabil. 2026; 131(2): 112-7.

Wearable biosensors can provide insight into the internal states of individuals with autism with communication challenges; however, sensory sensitivities may make wearable biosensors uncomfortable. We describe our approach for introducing a wrist-worn biosensor (Empatica E4) to participants and using supportive techniques. Most participants (76.6%) were able to wear the biosensor for a duration of 15 minutes. The option to wear a colorful sweatband over the biosensor, verbal encouragement, and edible rewards were found to be helpful. Data collection was unsuccessful for the 23.4% of participants who did not accept wearing the device, which was more common for minimally speaking participants. Tailored approaches and attention to nonverbal signs of assent or discomfort are essential for conducting wearable biosensor research with individuals with autism.

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36. Tian X, Qian W, Zhang J, Li J, Chen B, Li X, Yan X. An evidence-informed psychosocial intervention program for caregiver burden among family caregivers of children with autism spectrum disorder: a multi-stage development and Delphi study. PLoS One. 2026; 21(8): e0354823.

BACKGROUND: Family caregivers of children with autism spectrum disorder (ASD) often experience substantial and multidimensional caregiver burden, which may adversely affect their physical and psychological well-being, family functioning, and the child’s rehabilitation. Although caregiver-focused psychosocial interventions have shown promise, structured and theory-informed programs specifically designed to address caregiver burden in this population remain limited. METHODS: A multi-stage intervention development design was used, guided by an integrated framework of the ABC-X family stress model and stress and coping theory. First, best-available evidence was synthesized to identify relevant intervention strategies. Second, findings from prior quantitative and qualitative phases of a mixed-methods research program were integrated to define intervention targets and draft content. Third, the draft program was refined through a two-round asynchronous modified Delphi consultation to improve content relevance, clarity, and implementation planning. RESULTS: The finalized program comprised three core modules (stressors, cognitive appraisal, and coping), seven themes, and 22 components. It incorporated psychoeducation, mindfulness-based approaches, gratitude-based expressive writing, acceptance and commitment-informed strategies, self-compassion training, and problem-solving skills. Expert response and authority were high; however, Kendall’s W values were modest across the two rounds (0.23 and 0.25). These findings suggest that the Delphi process contributed to systematic refinement and expert appraisal of the program and reflected experts’ perceptions of the relevance, clarity, and appropriateness of its content; practical feasibility remains to be tested directly with caregivers. CONCLUSIONS: This study developed a theory-driven and evidence-informed psychosocial intervention framework for caregiver burden among family caregivers of children with autism spectrum disorder. The program provides a structured basis for ongoing caregiver-informed feasibility testing and subsequent effectiveness evaluation; its acceptability, delivery fidelity, and later effectiveness require further empirical validation.

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37. Wang X, Ji Y, Fan X. Beyond Stereotypes: Understanding Romantic Relationships and Dating Perspectives of Chinese Youth with Intellectual and Developmental Disabilities. Intellect Dev Disabil. 2026; 64(2): 145-59.

This study explored the romantic relationship perspectives and experiences of Chinese youth with intellectual and developmental disabilities (IDD) through semi-structured interviews with 18 participants. Analysis revealed three themes: conceptualizations of love and relationships; barriers and facilitators to relationship pursuit; and support systems for romantic aspirations. Findings suggest that participants possess complex understandings of romantic relationships, face multi-layered barriers including family attitudes and limited social opportunities, and benefit from both formal and informal supports. Results highlight the need for comprehensive relationship education and culturally responsive approaches that balance individual aspirations with Chinese family values.

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38. Wilkinson E, Pai K, Hastings R, Jahoda A, Bal VH. Parent-Reported Indicators of Depression in Non- and Minimally Speaking Adults With Autism. Am J Intellect Dev Disabil. 2026; 131(3): 171-86.

There is little knowledge of how to identify depression in the 30% of adults with autism who are non- or minimally speaking (NMS). The current study aims to address this by using parent-reported behaviors to curate a list of indicators of depression in this population. When asked to describe why they think the person is depressed, qualitative analyses found parents (N = 152) frequently identified anhedonia and low mood. Endorsement patterns on existing depression surveys identify traditional depression symptoms like sleep, crying, and activity participation. On the other hand, many items (e.g., repetitive behaviors) were endorsed across groups with and without suspected depression, possibly capturing features of autism. Results inform our understanding of the manifestation of depression in NMS adults with autism and the development of screening tools.

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39. Xiao G, Li X, Qin Y, Zhao W, Li X, Qian Y, Tian J, Chen X, Li W, Wang L. Structural brain alterations associated with brain age may link to social dysfunction in male adults with autism spectrum disorder. Front Neurosci. 2026; 20: 1795744.

BACKGROUND: While atypical brain development in autism spectrum disorder (ASD) has been extensively characterized during childhood and adolescence, it remains unclear how these neurodevelopmental deviations persist into adulthood and affect brain aging. Existing studies relying on single morphometric measures have yielded inconsistent findings, underscoring the need for integrative, multiscale neuroimaging approaches. MATERIALS AND METHODS: Using data from the Autism Brain Imaging Data Exchange I (ABIDE-I) dataset, we investigated brain structural alterations in 90 adult males with ASD and 132 age-matched typically developing (TD) controls. All participants were right-handed and aged 18-55 years. Voxel-based morphometry (VBM) was employed to assess gray matter volume (GMV), and surface-based morphometry (SBM) was used to quantify cortical fractal dimension (FD). Global brain aging was evaluated using MRI-derived brain age estimation, from which the brain age gap (BAG) was calculated. Site-related effects were harmonized using the ComBat method. Group comparisons were performed for GMV, FD, and BAG using multiple linear regression, with age, full-scale IQ, and total intracranial volume included as covariates. Associations between neuroimaging metrics and Autism Diagnostic Observation Schedule (ADOS) scores were further examined. RESULTS: Cross-sectional comparisons demonstrated that adults with ASD exhibited higher estimated BAG values relative to TD controls (F = 6.838, p = 0.01, partial η(2) = 0.031). ComBat-harmonized morphometric analyses revealed exploratory localized GMV and FD differences, including increased GMV and FD in the right precuneus and increased FD in the lingual gyrus and lateral orbitofrontal cortex. GMV in the right precuneus showed an exploratory positive correlation with ADOS social-domain scores (r = 0.214, q = 0.044). CONCLUSION: Adults with ASD exhibited higher estimated BAG relative to TD controls in this cross-sectional sample. An exploratory association between right precuneus GMV and ADOS social-domain scores suggests a possible link between localized structural variation and social symptom severity, although this finding requires replication in longitudinal and clinically richer datasets given their sensitivity to the harmonization strategy.

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40. Zeng Y, Wang F, Li S, Liu Q, Liu L, Song B. Gut microbiota dysbiosis in autism spectrum disorder: 10 years of progress on compositional alterations, metabolic/immune mechanisms, and therapeutic strategies. Front Neurosci. 2026; 20: 1873864.

Autism spectrum disorder (ASD) is a common neurodevelopmental condition frequently accompanied by gastrointestinal symptoms, pointing to a potential role of the gut microbiota-brain axis. To explore this connection, the present review synthesizes findings from studies published between 2016 and 2026, including observational studies, meta-analyses, animal experiments, and clinical trials, with the aim of characterizing gut microbiota alterations in ASD, elucidating underlying mechanisms, and evaluating emerging therapeutic strategies. Across diverse populations, the most consistent microbial signatures in ASD include reduced abundances of Bifidobacterium and Akkermansia muciniphila, together with increased abundances of Clostridium, Bacteroides, and Escherichia-Shigella; however, geographic, age-, and sex-specific variations exist. In addition to bacterial changes, the gut virome and mycobiome are also perturbed, as evidenced by enrichment of Candida albicans and Clostridium phages. Mechanistically, these alterations are linked to reduced short-chain fatty acids (especially butyrate), disrupted tryptophan-serotonin metabolism, and elevated neuroinflammatory cytokines (e.g., TNF-α, IL-6). Causal evidence from animal models using fecal microbiota transplantation further demonstrates that ASD microbiota can directly induce autistic-like behaviors. Building on this causal link, early-phase clinical trials indicate that fecal microbiota transplantation, probiotics, prebiotics, and dietary interventions (e.g., ketogenic diet) can improve both gastrointestinal and behavioral symptoms, although larger double-blind, placebo-controlled trials are needed to confirm efficacy. Furthermore, multi-omics integration and host epigenetic signatures show promise for developing non-invasive diagnostic biomarkers. In conclusion, gut dysbiosis plays a causal role in ASD pathophysiology, and microbiome-based interventions represent a rational and potentially transformative therapeutic avenue.

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41. Zhu J, Chen S, Zhang W, Li J, Lin X, Jin R, Peng W. Pain Expectation in Individuals With High Autistic Traits: Decision-Evaluation Processes and Oxytocin Modulation. Ann N Y Acad Sci. 2026; 1562(1): e70365.

Pain reflects both sensory input and predictive processes shaped by expectations. Individuals with high autistic traits (HATs) often exhibit atypical pain responses, potentially due to alterations in anticipatory processing. This study investigated pain anticipation in HAT individuals and examined the modulatory effects of oxytocin using behavioral, computational, and pharmacological approaches. In experiment 1, HAT and low autistic trait (LAT) individuals completed a cue-based pain anticipation task. Anticipatory processing was characterized through two components: decision-related processes and evaluative responses. HAT individuals showed altered decision-making, characterized by greater caution under uncertainty and reduced processing efficiency under certain high-pain conditions. They also exhibited more negative evaluative responses, which were associated with poorer psychological health. In experiment 2, HAT participants received intranasal oxytocin or placebo. Oxytocin selectively influenced decision-related processes under uncertainty, increasing evidence accumulation and reducing nondecision time while also increasing the tendency to choose high-pain outcomes under ambiguous conditions. In contrast, oxytocin showed limited effects on evaluative measures. These findings suggest that pain anticipation in HAT individuals involves partially distinct decision-related and evaluative components and that oxytocin exerts process-specific effects on anticipatory processing.

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