1. Arutiunian V, Sullivan CAW, Santhosh M, Neuhaus E, Borland H, Bernier RA, Bookheimer SY, Dapretto M, Jack A, Jeste S, McPartland JC, Naples A, Van Horn JD, Pelphrey KA, Webb SJ, Gupta AR. Excitation/inhibition balance subtypes in autism and their genetic, neural, and clinical profiles. J Neural Transm (Vienna). 2026.

Excitation (E)/inhibition (I) imbalance is considered a key mechanism in Autism Spectrum Disorder (ASD). However, E/I imbalance can have different etiologies with increased E relative to I (E > I) and increased I relative to E (E < I). Both neural profiles can be associated with altered clinical phenotype, suggesting "bell"-shape brain-behavior relationships. We derived E/I balance measures from resting-state EEG in a large sex-balanced sample of youths with and without autism (N = 310; 164 youths with ASD and 146 typically developing (TD) youths) to address group discriminative power of neural markers, their relation to social skills, and the potential to define different neural subtypes within the autistic group. We also conducted genome-wide copy number variant (CNV) and gene expression analyses to provide additional insight into distinct neural subtypes in autism. A high-density 128-channel electroencephalography (EEG) was used to register neural activity of participants, blood samples were collected from the ASD youths to obtain genomic DNA, and rich behavioral phenotyping was provided for each participant. The results revealed three subgroups within the autistic cohort with the presence of "typical" E/I, E > I, and E < I neural profiles. The two subgroups with E/I imbalance had altered clinical phenotypes. In addition, these subgroups had different genetic profiles, showing that genes within identified CNVs had distinct expression patterns with the evidence of more prenatal (E < I) vs. postnatal (E > I) gene expression. The study suggests that the proposed clustering approach has relevance for the identification of clinically meaningful neural and genetic subtypes within a heterogeneous autistic cohort.

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2. Esprit JL, Youngstrom EA, Kim SY, Norris M, Levine A, Butter EM, Stephenson KG. In Search of Subtypes of Children With Developmental Disabilities Using the WISC-V: A Latent Profile Analysis. J Autism Dev Disord. 2026.

PURPOSE: Identifying subtypes within autism spectrum disorder (ASD) has often been attempted to better understand the significant heterogeneity within the spectrum. Profiles of cognitive functioning have frequently been investigated as possible subtype definitions, but most studies have relied on relatively small sample sizes and higher-functioning samples, and few have used advanced statistical techniques to obtain estimates of underlying profiles of IQ in ASD. The purpose of this study was to use latent profile analysis to identify possible subgroups of children with ASD and other neurodevelopmental disabilities using the Wechsler Intelligence Scale for Children-5th Edition (WISC-V) across a range of ability levels. METHODS: We used latent profile analysis with a clinical sample of 727 youth (ages 6-16) referred for neurodevelopmental evaluations. We also completed a multigroup bifactor confirmatory factor analysis of the clinical sample compared to the WISC-V standardization sample. RESULTS: We did not find distinct cognitive profiles based on the WISC-V index scores; results indicated a continuum of the g factor of intelligence instead of distinct patterns of strengths and weaknesses across IQ subscales. A multigroup bifactor confirmatory factor analysis revealed partial strong invariance when comparing the two clinical groups to the WISC-V standardization sample, but full strong invariance within the neurodevelopmental groups and substantive explained variance of the processing speed index above and beyond FSIQ. CONCLUSION: Alternative methods and measurements are needed to identify potential cognitive subtypes of children with autism and other neurodevelopmental disabilities. Processing speed (but not other WISC-V indexes) may be of unique clinical interpretability above and beyond FSIQ.

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3. Kaufmann WE, Horn PS. Profile of Behavioral Comorbidities in Children With Fragile X Syndrome. J Autism Dev Disord. 2026.

PURPOSE: Fragile X syndrome (FXS) presents with a variety of behavioral comorbidities. Although multiple publications have reported detailed characterizations for some of them, many gaps of knowledge still remain. Therefore, we characterized the eight most common behavioral comorbidities (i.e., clinician identified behavioral concerns) in children evaluated in specialty FXS clinics. METHODS: We analyzed the pediatric FORWARD clinic-based natural history study database (1,072 males, 338 females), using multiple statistical techniques including chi-square analyses, polychoric and polyserial correlations, and Mann-Whitney tests to determine frequency, co-occurrence, and behavioral scale profiles of children with eight behavioral comorbidities and functional impairment (approximately half of those affected). DSM-5 criteria were only used for autism spectrum disorder (ASD) identification. RESULTS: Attention problems and Anxiety were the two most common and mildest comorbidities, while disruptive behavior (IAAS) . Co-occurrence of impairing behavioral comorbidities were reported for 69% of children, with 39% of them presenting with more than two comorbidities and overall greatest impairment. Comorbidity co-occurrence was influenced by frequency, but strength of association was relatively independent. Strong correlations were found for two distinctive co-occurrences in non-FXS populations: Attention problems-Hyperactivity and Anxiety-Mood disturbances. Although scale scores aligned with other severity parameters, comorbidity-scale correlations reflected relevance of evaluated behaviors. Surprisingly, all behavioral comorbidities were strongly correlated with the Sensory problems scale. CONCLUSION: The reported profiles of impairing behavioral comorbidities could assist clinicians in early identification of behavioral symptoms and in refining their management in children with FXS and, perhaps also, other neurodevelopmental disorders.

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4. Keim SA, Rausch J, Coury DL, Robinette LM, Taylor PL, Sun L, McNally KA, Rogers LK. Inflammatory Cytokines as Biologic Signatures of the Effect of Dietary Supplementation With Omega Fatty Acids on Autism-Related Behaviors and Features Among Young Children: A Randomized Controlled Trial. J Autism Dev Disord. 2026.

PURPOSE: Evidence for the efficacy of dietary omega fatty acid supplementation as a supportive intervention for autism is mixed. Mechanisms by which supplementation may offer benefit are unclear. Inflammation may contribute to autism-related behaviors and features. This double-blind, randomized controlled trial evaluated inflammatory cytokines as biologic signatures of the effect of daily dietary supplementation with omega-3 and omega-6-rich fish and borage oil (« omega 3-6 ») versus placebo in children ages 2 – < 7 years recently diagnosed with autism. METHODS: Children were randomized to omega 3-6 or placebo for 90 days. Cytokines were measured in plasma, and autism-related behaviors and features were assessed by caregiver report and direct assessment. Linear mixed models followed intent-to-treat and evaluated the effect of omega 3-6 supplementation on the change in cytokines. Pearson correlation coefficients estimated associations between change in cytokines and change in autism-related behaviors and features. Exploratory analyses examined moderation by sex, age, gastrointestinal symptoms, and overweight. RESULTS: Of 98 children randomized, 96 were included in this analysis. Omega 3-6 had no overall effect on cytokines or autism-related behaviors and features (e.g., group difference in change for PDDBI autism composite = 0.1, 95% CI= -10.9, 11.1). Changes in cytokines were generally uncorrelated with changes in autism-related behaviors and features. Some sex-specific effects were observed. CONCLUSION: This study offered little support for inflammation serving as a mechanism for the effect of omega 3-6 fatty acids on autism-related behaviors and features among young children. Suggestive sex-specific effects should be replicated in a larger trial. CLINICAL TRIAL REGISTRY: Clinicaltrials.gov NCT04312932 registered March 16, 2020.

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5. Kirton JA, Tod A, Ryan T. Surviving to Thriving: A Grounded Theory of Post-Diagnostic Identity Reconstruction in Midlife and Older Autistic Adults. Autism. 2026: 13623613261483304.

This study explored how midlife and older autistic adults make sense of receiving an autism diagnosis later in life and how this shapes post-diagnostic identity reconstruction. Although rising numbers of adults are diagnosed in later life, little is known about how they interpret this experience or the factors shaping post-diagnostic adjustment. Constructivist grounded theory was used to examine experiences among 14 autistic midlife and older adults aged 50 to 73. Seventeen semi-structured interviews were analysed using iterative coding and constant comparison. An autistic advisory group supported reflexivity and analytic credibility. Diagnosis was valued but had a liminal effect. Two broad patterns of post-diagnostic experience were identified: surviving, characterised by self-blame and deficit-based interpretations; and thriving, characterised by greater self-compassion, personal agency, and living in ways more aligned with their autistic identity. Thriving was delayed and followed years of identity reconstruction. It unfolded through the Thriving Cycle, comprising three interconnected processes experienced as a dynamic and iterative. The Thriving Cycle illustrates how some midlife and older autistic adults moved beyond diagnostic recognition towards a more integrated and affirming autistic identity. These findings suggest that identity-focused support may help individuals move from ‘survival’ towards greater self-understanding, agency, and well-being.Lay AbstractMore adults are being diagnosed as autistic later in life, but little is known about how they make sense of this experience or how it affects their lives afterwards. This study explored how autistic adults diagnosed in midlife and older age understood their diagnosis and how it shaped the way they saw themselves. We interviewed 14 autistic adults aged 50 to 73. We explored their experiences of receiving an autism diagnosis later in life and what happened afterwards. An autistic advisory group helped ensure the findings reflected autistic perspectives. Participants valued receiving a diagnosis, but it also marked a period of uncertainty and adjustment. Two broad patterns of post-diagnostic experience were identified. Some participants remained in a pattern of surviving, marked by self-blame, and seeing themselves in negative ways. Others moved towards thriving, with greater self-compassion, a stronger sense of personal agency, and living in ways that were more consistent with their autistic identity. Thriving did not happen immediately after diagnosis but developed over time through years of making sense of their experiences. The study also identified the Thriving Cycle, a model describing three connected processes that supported thriving. These processes were experienced as ongoing, and people often moved back and forth between them over time. These findings suggest that receiving an autism diagnosis is only the beginning of the journey for many autistic adults. The Thriving Cycle shows how some midlife and older autistic adults moved beyond surviving towards thriving over time. The findings highlight the importance of providing post-diagnostic support to help autistic adults understand themselves and improve their well-being after diagnosis.

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6. Minuk A, Fyie K, Roth C, J DZ. National Trends in Education and Employment Outcomes for Canadians With Developmental Disabilities and Autism: Findings From the 2017 and 2022 Canadian Survey on Disability. J Autism Dev Disord. 2026.

PURPOSE: This study analyzed the demographic characteristics, educational attainment, and employment outcomes of Canadians with developmental disabilities (DD) and autism spectrum disorder (ASD) using the 2017 and 2022 Canadian Survey on Disability (CSD) cycles. METHODS: Data were derived from the 2017 and 2022 CSD datasets and their respective Census linkages. The primary outcomes of interest were employment status and educational attainment. Descriptive statistics were used to summarize demographic, educational, and employment characteristics for individuals with DD and ASD compared to those with any disability and without disabilities. Logistic regression models were employed to estimate the odds of employment among individuals with DD and ASD relative to the comparison groups. RESULTS: While education and employment outcomes improved for Canadians with DD and ASD between 2017 and 2022, disparities remain compared to those with other disabilities and without disabilities. Analysis also revealed notable differences in the education and employment experiences of Canadians with DD and ASD, such as access to accommodations and supports in both environments. Several demographic and contextual variables were identified as significant predictors of employment for individuals with disabilities, including disability type. CONCLUSIONS: Despite progress in education and employment outcomes for Canadians with DD and ASD, structural and systemic barriers continue to limit their full participation in society, highlighting areas for policy action.

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7. Okewole A, Bourque VR, Koko M, Huguet G, Borglum AD, Grove J, Jacquemont S, Baron-Cohen S, Warrier V. Common genetic variants are associated with increased likelihood of latent co-occurring neurodevelopmental and mental health factors among autistic individuals. Mol Psychiatry. 2026.

Autistic individuals show elevated rates of co-occurring neurodevelopmental and mental health conditions, yet the genetic architecture of those comorbidities remains unclear. Using phenotypic (N = 74,204) and genetic (N = 17,582) data from the SPARK study, we investigated the factor structure, heritability, genetic correlation with autism (pleiotropy) and corresponding conditions in the general population (additivity). First, confirmatory factor analysis identified three correlated factors mirroring general population patterns: behavioural (ADHD, disruptive behaviour disorders), cothymic (depression, anxiety), and thought disorder (schizophrenia, bipolar). Second, all three factors had significant SNP heritabilities whilst rare variants were not associated with the tested factors in our sample. Third, polygenic scores and genetic correlations revealed positive shared genetics between the three factors and corresponding conditions in the general population but not with autism, supporting the additivity hypothesis. Fourth, within-family analyses (N = 5236 trios) demonstrated direct but not indirect genetic effects for the behavioural and cothymic factors. In sum, we find evidence for additive effects of other genetic factors in contributing to some latent co-occurring neurodevelopmental and mental health conditions in autism.

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8. Palacios-Muñoz A. Drosophila melanogaster as a Model for Autism Spectrum Disorder: Insights into Lifelong Neuronal Vulnerability. Int J Mol Sci. 2026; 27(18).

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by impaired social communication, restricted interests, and repetitive behaviors. Although traditionally considered a disorder of early brain development, growing evidence indicates that many ASD-associated genes continue to regulate neuronal physiology throughout adulthood. These genes participate in conserved cellular processes involved in synaptic organization, mitochondrial homeostasis, calcium signaling, proteostasis, intracellular trafficking, neuroimmune regulation, and circadian biology, many of which are also implicated in brain aging. This convergence supports the concept that developmental alterations can influence neuronal function long after neural circuits have formed. In this context, the fruit fly Drosophila melanogaster (Drosophila) has emerged as a powerful translational model for investigating the conserved mechanisms linking neurodevelopment and aging. Its high genetic conservation with humans, sophisticated neurogenetic tools, short lifespan, and robust behavioral assays enable longitudinal examination of developmental genetic alterations within a single experimental organism, facilitating mechanistic studies of neuronal function, stress adaptation, and age-dependent behavioral phenotypes. This review examines ASD from the perspective of lifelong neuronal vulnerability, highlighting how genetically diverse ASD-associated genes converge on common biological mechanisms that remain active beyond development. Furthermore, I discuss how Drosophila has advanced our understanding of these conserved pathways and provides a unique experimental platform for investigating how early developmental alterations shape neuronal function across the lifespan.

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9. Safran S, Hurwitz S. Online Dating as a Middleman: Autistic Young Adults’ Pursuit of Romantic Connection. J Autism Dev Disord. 2026.

PURPOSE: Autistic individuals often desire romantic relationships, but face challenges related to social communication. Online dating apps may provide opportunities for connection by reducing immediate social demands; however, less is known about how autistic young adults experience and navigate online dating. This study examined autistic young adults’ experiences of online dating pursuing romantic relationships. METHODS: In this qualitative study, semi-structured interviews were conducted with 20 autistic young adults aged 18-29 in the United States, focusing on their experiences using online dating apps to pursue romantic relationships. Data were analyzed using thematic analysis. RESULTS: Three themes were identified: (1) entering online dating: motivations, expectations, and access; (2) managing interaction: communication, strategy, and masking; (3) emotional consequences: connection, rejection, and vulnerability. While online dating created opportunities to initiate romantic connections, it required actively managing communication, uncertainty, and self-presentation in ways that were not intuitive for autistic participants. Participants described online dating as involving repeated efforts to interpret communication, understand others’ intentions, and decide how to respond. Experiences of connection were often accompanied by rejection, unclear interactions, and limited success. Strategies such as masking supported interaction but were difficult to sustain. CONCLUSION: Online dating functioned as a pathway to connection while also introducing challenges related to communication, uncertainty, and emotional effort. Rather than simplifying communication difficulties, online dating shifted these challenges into interpreting unclear messages, managing self-presentation, coping with rejection, and navigating safety concerns. These findings highlight the need for greater attention to communication support, emotional well-being, and safety for autistic young adults.

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10. Smith JR, Bonnee M, Marler S, Atwood R, Lewis B, Lim S, Baldwin I, Wu H, Liu J, Cascio C, Joshi G, Croarkin PE. Caregiver-Rated Inappropriate Speech and Post-cTBS Motor Cortical Facilitation in Autism: A Pilot Biomarker Study. medRxiv. 2026.

Transcranial magnetic stimulation can provide noninvasive measures of cortical excitability and plasticity, but relationships between these measures and clinically observable features of autism are not fully characterized. Nineteen autistic participants aged 15 to 40 years were included in the analysis of a left primary motor cortex continuous theta-burst stimulation (cTBS) biomarker protocol. Motor evoked potentials were measured at baseline and at seven assessments from 5 to 60 min after stimulation. Linear mixed-effects models evaluated whether clinical measures moderated the post-stimulation motor evoked potential log-response ratio over time. Aberrant Behavior Checklist (ABC) and Attenuated Behavior Questionnaire (ABQ) analyses were restricted to the same 15 participants with caregiver-informant assessments. Catatonia severity, social impairment, ABQ Motor Total, ABQ Total, and cognitive ability did not significantly moderate the post-stimulation response. ABC Inappropriate Speech was associated with progressively greater post-stimulation facilitation (standardized Time × Inappropriate Speech interaction: β = +0.688, SE = 0.210, 95% CI +0.276 to +1.099; Holm-adjusted P = .008 across eight informant-rated models). Two individual speech-related items (« Talks excessively » and « Talks to self loudly ») survived false-discovery-rate correction. An exploratory eight-item ABC phenotype showed a large descriptive in-sample association (β = +0.904, SE = 0.200, P < .001) and directionally positive held-out performance. However, full-pipeline permutation tests were nonsignificant for both Pearson (r = .357, two-sided empirical P = .360) and Spearman correlations (ρ = .446, two-sided empirical P = .261). Caregiver-rated inappropriate speech may be associated with altered post-cTBS motor cortical facilitation in autism. The candidate phenotype remains hypothesis-generating and requires independent validation.

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11. Strobl EV. Unique Behavior Profiles That Specify Mental Distress in Autism. J Autism Dev Disord. 2026.

PURPOSE: Patients with autism spectrum disorder (ASD), particularly those with limited speech, may not communicate internal distress. Clinicians therefore often infer distress from observable aberrant behaviors, whose clinical significance may differ from that in typically developing (TD) individuals. We identified aberrant behavior profiles (ABPs) that differentially track symptom dimensions across ASD and TD groups, and between minimally verbal ASD (MV-ASD) and fluently verbal ASD (FV-ASD). METHODS: We pooled three NIMH Data Archive studies with CASI-5 severities (12 domains) and Aberrant Behavior Checklist (ABC) items (58 behaviors). After adjusting for age and sex, we applied Differentially Supervised Varimax to derive ABPs and tested group differences with permutation testing and false discovery rate control. RESULTS: In ASD, a disruptive/hyperactive ABP related more strongly than in TD to ADHD-hyperactive and oppositional defiant severity and to generalized anxiety, social anxiety, and specific phobia. Emotional reactivity aligned with obsessions, somatization, and depressive severity, whereas withdrawal/self-injury aligned with social and separation anxiety. Preoccupation aligned with schizophrenia-related severity, whereas hypoactivity/depressed mood aligned with post-traumatic stress and specific phobia; in MV-ASD, passive withdrawal/hypoactivity related more strongly to obsessions, somatization, and depressive severity. CONCLUSION: Clinicians can use ABPs to guide next steps: match a patient’s predominant behavior pattern to an ABP, then prioritize targeted history, caregiver probing, and symptom measures in the linked domains. For example, prominent withdrawal with self-injury should trigger focused screening for social and separation anxiety, whereas marked emotional reactivity should trigger assessment for obsessive symptoms, somatic distress, and depression.

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12. Susarla V, George M, Rathinam A, Bhatti D. Genetic Testing Abnormalities in Children with Autism Spectrum Disorder: Prevalence, Patterns, and Clinical Associations. Neurol Int. 2026; 18(9).

BACKGROUND: Genetic testing in autism spectrum disorder (ASD) can reveal a wide range of chromosomal and sequence-level abnormalities, yet large real-world neurology cohorts rarely report the full spectrum of findings alongside clinical correlates and patterns of testing. We characterized genetic findings in an 1884-patient ASD cohort and examined factors associated with both abnormal findings and the use of genetic testing. METHODS: This retrospective cross-sectional study included 1884 patients. Genetic testing was performed in 1011 patients; the primary outcome was an abnormal versus normal genetic result among those tested. All 371 abnormal findings were catalogued in a de-identified supplement. The primary multivariable model included age, sex, seizure history, and EEG abnormality (N = 901); an MRI-inclusive sensitivity model used 422 complete cases, and a separate full-cohort model evaluated factors associated with genetic testing. RESULTS: Abnormal genetic findings were documented in 371/1011 tested patients (36.7%, 95% CI 33.7-39.8%). In the primary model, female sex (aOR 1.483, 95% CI 1.089-2.018; p = 0.012) and seizure history (aOR 1.634, 95% CI 1.136-2.352; p = 0.008) were independently associated with abnormal findings, whereas EEG abnormality was not significant after adjustment (aOR 1.373, p = 0.084). In the MRI-inclusive sensitivity model, female sex and seizure history remained significant, while MRI abnormality was not independently associated (aOR 1.235, p = 0.302). Genetic testing was more common among patients who also underwent EEG or MRI (both p < 0.001). CONCLUSIONS: More than one-third of tested patients had an abnormal genetic finding, spanning a broad range of copy-number, sequence, homozygosity, Fragile X-related, chromosomal, and syndromic findings. Seizure history and female sex were the principal adjusted correlates of abnormal findings. Genetic testing clustered with EEG and MRI use, reflecting observed patterns of neurological work-up within this cohort rather than temporal or causal relationships.

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13. Vukojevic M, Lakicevic G, Bunoza B, Lakicevic S, Jakovcevic A, Frol S, Splavski B. Recognizing genetic association between Lhermitte-Duclos Disease and Autism Spectrum Disorder in PTEN-related patients: a case report and literature comprehension. Neurol Sci. 2026; 47(10).

BACKGROUND: PTEN Hamartoma Tumor Syndrome (PHTS) is a rare autosomal dominant disorder that increases the risk of various tumors and systemic malignancies, including Lhermitte-Duclos disease (LDD), known as dysplastic cerebellar gangliocytoma. Both conditions result from a PTEN gene mutation, which disrupts cellular growth and proliferation. Some children with such a mutation exhibit developmental delay or autism spectrum disorder (ASD), associated with PHTS. Herein, we report on a mother with LDD/PHTS and her child with ASD, discuss screening, genetic counseling, and management of PHTS-affected, PTEN-related, family-connected patients, and provide a narrative literature review. METHODS: Clinical and diagnostic evaluation and genetic analysis were performed on a female patient with LDD/PHTS and on her 14-year-old daughter, diagnosed with ASD. Genomic DNA was extracted from the peripheral blood of both, using a commercial DNA isolation kit to detect a PTEN mutation. RESULTS: Ten-year follow-up of the LDD/PHTS patient showed no evidence of tumor recurrence after partial tumor resection, resulting in full neurological recovery. Genetic testing of both the mother and her child confirmed the same genetic variant-PTEN c.370 T > C p.(Cys124Arg), NM_000314.8, in heterozygous status-classified as pathogenic for PHTS. CONCLUSIONS: This paper highlights the importance of timely diagnosis of PHTS in an ASD-affected child after identifying a parent with LDD/PHTS, a disorder with significant implications linked to a PTEN mutation. Given the risk of malignancy and neurodevelopmental disorders associated with PTEN mutation, patients suspected of having LDD/PHTS and children with ASD should undergo regular screening for PTEN-related diseases and receive appropriate genetic counseling.

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14. Yemineni HSS, Shetty AA, Rai K. An interdisciplinary clinical framework for managing children with autism spectrum disorder in paediatric dentistry. Eur Arch Paediatr Dent. 2026.

PURPOSE: Children with autism spectrum disorder (ASD) frequently present with behavioural, sensory, communicative and nutritional challenges that complicate dental care. Although oral health difficulties in this population are well recognised, clinically relevant evidence is often reported in isolated domains, limiting its translation into paediatric dental practice. METHODS: This integrative review synthesised literature published between 2010 and 2025 from PubMed, Scopus and Google Scholar. Evidence from paediatric dentistry and related disciplines, including psychology, occupational therapy, nutrition and autism-specific interventions, was thematically synthesised to identify clinically relevant strategies. RESULTS: Effective dental management extends beyond conventional behaviour guidance. Key domains include individualised behavioural strategies, structured communication supports, sensory-adapted dental environments, caregiver-centred preparation and consideration of nutritional and systemic factors. Recent evidence, including randomised and controlled studies, supports Sensory Adapted Dental Environments (SADE), video modelling and visual pedagogical approaches as promising strategies to reduce distress and improve treatment tolerance in children with ASD. Nutritional selectivity, gastrointestinal disturbances and micronutrient deficiencies may further influence oral health risk. CONCLUSION: A holistic and interdisciplinary approach can improve treatment tolerance, cooperation and preventive outcomes in children with ASD. PRACTICAL IMPLICATIONS: Paediatric dentists should integrate sensory adaptation, visual supports, caregiver collaboration and dietary and medical assessment into routine care.

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15. Zhao H, Niu H, Jiang Y, Li X, Han W, Yang X, Pang W. Efficacy and neural mechanisms of transcranial direct current stimulation for social function in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis. J Psychiatr Res. 2026; 203: 167-80.

OBJECTIVES: To evaluate the intervention effects of transcranial direct current stimulation (tDCS) on social functioning and neurophysiological indicators in Autism Spectrum Disorder (ASD), and to explore neuro-behavioral consistency at the individual and cross-study levels. METHODS: Following the PRISMA guidelines, we conducted a systematic search of PubMed, Web of Science, Embase, Scopus, and the Cochrane Library from inception until January 7, 2026. We excluded studies involving exclusively adult cohorts and included randomized controlled trials (RCTs) reporting both social behavioral and neurophysiological outcomes. Risk of bias was assessed with Risk of Bias 2 (RoB 2). A random-effects model was employed to calculate the standardized mean difference (SMD), along with tests for heterogeneity and subgroup analyses. A multidimensional matrix was constructed to assess neuro-behavioral consistency. RESULTS: Thirteen RCTs were included (N = 357, ages 4-21 years). tDCS significantly improved social functioning (SMD = -0.51, I(2) = 0%, p = 0.0002) and induced significant overall neurofunctional modulations (SMD = 1.03, I(2) = 71.9%, p = 0.004). Subgroup analyses stratified by measurement modalities revealed distinct profiles across modalities: the functional near-infrared spectroscopy (fNIRS) subgroup showed the largest pooled effect size in neurophysiological responses (SMD = 1.32, 95% CI [0.31, 2.33], I(2) = 63.5%); the electroencephalography (EEG) subgroup also exhibited a large pooled effect (SMD = 1.16, 95% CI [0.07, 2.25], I(2) = 85.8%); whereas the event-related potential (ERP) subgroup demonstrated a modest and non-significant effect (SMD = 0.37, 95% CI [-0.23, 0.97]) with the lowest heterogeneity (I(2) = 0%). Consistency analysis revealed a cross-level dissociation: cross-study regression showed no significant linear correlation between neurobiological and behavioral effect sizes (r = 0.19, p = 0.760), while the multidimensional consistency matrix at the individual-study level showed that, across the four consistency dimensions, two of five studies were fully consistent, two showed partial consistency, and one was inconsistent. CONCLUSION: The left dorsolateral prefrontal tDCS protocol shows potential in improving social functioning in children and adolescents with ASD. Translational research on its neural mechanisms requires standardized measurement paradigms, with ERP showing high cross-study consistency in the limited available data (k = 2), suggesting it may warrant further exploration as a potential biomarker, though this finding remains preliminary. Future large-scale clinical trials should expand sample representativeness, with attention to the potential impact of gender differences and different neurodevelopmental windows on intervention efficacy.

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