1. Correction to « Effects of Cannabidiol on Social Relating, Anxiety, and Parental Stress in Autistic Children: A Randomized Controlled Crossover Trial ». Autism Res. 2026: e70380.

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2. Ajanya A, Malhotra S, Arya AK, Deb D. Sleep Disturbances in Children and Adolescents with Autism Spectrum Disorder: A Scoping Review of Clinical Features, Impact and Interventions. Indian J Psychol Med. 2026: 02537176261491880.

PURPOSE OF THE REVIEW: Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by social-communication deficits, restricted-repetitive behaviors, and sensory anomalies. Sleep disturbances are reported to significantly worsen behavioral, cognitive, and family functioning in ASD. This scoping review aims to map existing evidence on the clinical features, impact, and interventions for sleep disturbances in children with ASD. COLLECTION AND ANALYSIS OF DATA: A comprehensive literature review was conducted in accordance with PRISM-ScR guidelines, and searches were performed in PubMed, Directory of Open Access Journals (DOAJ), Cochrane, Scopus, and Embase. Studies published from 2015 to August 31, 2025, were identified using combinations of the terms « Sleep disturbances, » « ASD, » « Prevalence, » « Etiology, » « Types, » and « Intervention. » Eligible studies included systematic reviews, meta-analyses, narrative reviews, randomized controlled trials, observational studies, and case series published in peer-reviewed English-language journals involving children and adolescents with ASD. RESULTS: The reviewed literature indicates multifactorial causes for sleep disturbances in ASD, including medical/psychiatric comorbidities and behavioral factors like sensory sensitivities and bedtime resistance. Common sleep problems include insomnia, circadian rhythm disorders, parasomnias, sleep-disordered breathing, and sleep-related movement disorders (SRMDs). These disturbances exacerbate core ASD symptoms, impair adaptive functioning, contribute to aggression, and increase parental stress. Reported interventions include caregiver education, behavioral strategies, pharmacological approaches, and management of comorbid sleep-related conditions. CONCLUSIONS: Sleep disturbances in children with ASD are highly prevalent, multifaceted, and clinically significant. Early identification and evidence-based, integrative interventions may improve sleep quality, behavioral outcomes, and overall family well-being. Future research should focus on longitudinal designs and objective sleep assessment methods to strengthen the evidence base.

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3. Alsolami AS. Predicting multidimensional quality of life among autistic people and people with intellectual disability in Saudi Arabia: An explainable machine-learning study. Res Dev Disabil. 2026; 178: 105402.

BACKGROUND: Quality of life (QoL) among autistic people with or without co-occurring intellectual disability (ID) and people with ID without autism is multidimensional and shaped by interacting individual and contextual factors. METHODS: A multi-region cross-sectional study included 275 adults aged 18-65 years with autism, ID, or co-occurring autism and ID recruited through disability-service, vocational rehabilitation, adult support, and community networks across Riyadh, Jeddah, and Dammam, Saudi Arabia. Eligibility required a documented diagnosis established by a qualified healthcare professional. QoL was assessed using the Arabic WHOQOL-BREF across four domains. Multivariable regression examined adjusted associations with 18 prespecified predictors. Random Forest, XGBoost, and support vector regression were evaluated using five-fold cross-validation within the training set and an untouched 20% held-out test set. SHAP was used to interpret the best-performing tree-based model for each domain, and K-means clustering explored multidimensional QoL profiles. RESULTS: Adjusted associations varied across QoL domains, with disability severity and family support showing the most consistent relationships. Machine-learning models provided stronger held-out prediction than linear regression, with performance differing by domain: Random Forest performed best for Physical Health (R² =.62) and Social Relationships (R² =.50), whereas XGBoost performed best for Psychological Health (R² =.68) and Environment (R² =.58). SHAP analyses revealed distinct domain-specific predictive patterns, with disability severity ranking highest for Physical Health, family support for Psychological Health and Social Relationships, and household income for Environment. Exploratory clustering further identified four multidimensional QoL profiles: High Well-Being (26.2%), Environmental Challenges (32.0%), Psychological Strain (24.0%), and Social Isolation (17.8%). CONCLUSIONS: QoL heterogeneity extended beyond diagnostic status and differed across physical, psychological, social, and environmental dimensions. Integrating regression, explainable machine learning, and person-centered profiling revealed complementary patterns, highlighting disability severity, family support, socioeconomic resources, and geographic context as salient to multidimensional QoL and service planning.

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4. Bekele MW, Zhou M, Li W, Lv Z, Wei Y, Ran R, Pan Y, Xi W. Facial data for autism spectrum disorder detection using machine learning, deep learning, and emerging large language and vision-language models: A systematic review. Artif Intell Med. 2026; 183: 103546.

Autism spectrum disorder (ASD) is a neurodevelopmental condition whose timely identification can support earlier intervention. Conventional assessment relies on specialist observation and caregiver reports, motivating research into computer-aided screening using facial and behavioral data. This systematic review examines 171 studies published between 2016 and May 2026. It synthesizes machine learning and deep learning approaches to ASD assessment using static facial images, facial video, eye tracking, and multimodal data containing a facial signal. It also covers large language models, vision-language models, and multimodal large language models applied to ASD assessment, which were not addressed by the previous reviews included in the structured comparison, together with facial-data foundation-model studies in other clinical conditions that offer transferable methods. The review compares datasets, modeling strategies, and evaluation practices, and assesses methodological quality and risk of bias. Reported performance was often promising, but the strength of evidence varied with dataset provenance, diagnostic confirmation, participant independence, and validation design. Static-image studies relied heavily on reused public datasets and image-level partitions, whereas facial-video, eye-tracking, and multimodal studies more often used participant-level cohorts but still provided limited external and prospective validation. Differences in populations, acquisition protocols, prediction targets, and evaluation units prevent direct ranking of reported metrics across studies. Foundation models broaden the field toward behavioral description, diagnostic reasoning, and clinician-readable reporting, although their evidence remains preliminary. Facial-related data therefore show potential for computer-aided ASD screening, but clinical translation depends on clinically verified datasets, participant-independent evaluation, and testing in independent cohorts.

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5. Burhan ZM, Hoidy WH. Genetic variants in NEF2L2 rs35652124 and GABRB3 rs2081648 genes: association with autism spectrum disorder in Iraqi children. Neuroscience. 2026.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder of complex etiology with substantial genetic contribution. Oxidative stress and GABAergic dysregulation are implicated in the pathophysiology of ASD. Both genetic variations in NEF2L2 (Nuclear factor (erythroid-derived 2)-like 2, an antioxidant regulator) and GABRB3 (GABRB3 encodes the GABA-A receptor β3 subunit) may increase susceptibility to ASD. This is the first study of the two genes in this field in the context of the Iraqi children. Because the NEF2L2 control genotype distribution deviated significantly from Hardy-Weinberg equilibrium (χ(2) = 50.05, P < 0.0001), the NEF2L2 CT-genotype association below is reported as provisional pending independent genotyping verification; stratified subgroup findings are reported after Benjamini-Hochberg false-discovery-rate correction.This case-control study engaged 90 Iraqi children. Both GABRB3 rs2081648 and NEF2L2 rs35652124 polymorphisms were genotyped using Tetra-ARMS-PCR. GABA and NRF2 were also evaluated both using serum and protein, involved in elements of the oxidative stress, and biomarkers were analyzed. This study also conducted both a haplotype and an epistatic analysis. In exploratory analysis, the NEF2L2 rs35652124 CT genotype showed an apparent association with increased ASD risk; however, because the NEF2L2 control genotype distribution deviated severely from Hardy-Weinberg equilibrium, this association is provisional and is not treated as a confirmed finding of this study. The GABRB3 rs2081648 CT genotype presented robust evidence of protection. The ASD group was found to have a significant decrease in both GABRB3 (43.8%) and NRF2 (43.7%) proteins. The combined biomarker panel for the ASD population was AUC = 0.834. The T-C haplotype presented the most pronounced risk (OR = 2.84, P = 0.003; FDR q = 0.012). The two-locus epistatic interaction (P = 0.028, based on 1,000 permutations) is preliminary pending a confirmatory 10,000-permutation analysis. The GABRB3 polymorphism and serum GABRB3/NRF2 biomarkers are associated with GABA-mediated impairments in ASD in Iraqi children; the NEF2L2 CT-genotype association remains exploratory pending independent genotyping verification.

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6. Caruthers C, Hochheimer S, Pellecchia M, Gulsrud A, Hassrick EM, Mandell D, Stahmer A, Kasari C, Iadarola S. Comparison of Natural Language Processing and Traditional Qualitative Analyses of Caregiver Feedback From a Community-Based Intervention for Children With Autism. J Eval Clin Pract. 2026; 32(7): e70667.

BACKGROUND: Satisfaction data is a commonly used construct to evaluate programs, products, and experiences. This data is collected through forced choice (scales, surveys) and/or open-ended measures. While open-ended questions have the greatest potential for more useful and candid feedback, analysis of this data can be time-consuming. OBJECTIVE: This paper compares two evaluation methods, traditional qualitative analysis (TQA) and Natural Language Processing (NLP), to analyze themes from open-ended satisfaction data of a caregiver-mediated intervention for families of autistic children, called ‘Mind the Gap (MTG)’. METHODS: This secondary analysis utilized existing survey data from 73 caregivers that participated in the MTG trial. To identify themes, TQA was performed using latent coding, and R statistical software was used for NLP, with strategies including term frequency and sentiment analysis. Methods were evaluated independently and in combination. RESULTS AND CONCLUSION: Both methods are comparable in thoroughly analysing this type of data, with each method contributing both unique and overlapping themes. TQA and NLP showed parent satisfaction with materials and organization, as well as peer coach support. NLP may provide more thorough results while also reducing the time burden associated with TQA, although this strategy may also overlook important nuance in data. This clinical trial is registered as ‘Mind the Gap (AIRB-3) (MTG)’ at clinicaltrials.gov, registration number NCT03711799.

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7. Chen L, Neo B, Fleming GE, Kaouar S, McDonogh C, Henery J, Gu H, Le B, Gardiner S, Kimonis ER. The Empathy Hierarchy: Unique Associations of Childhood Callous Unemotional Traits and Autism Spectrum Disorder Symptoms. Child Psychiatry Hum Dev. 2026.

Child conduct problems commonly co-occur with callous-unemotional (CU) traits and autism spectrum disorder (ASD), which are both associated with empathy deficits; however, their unique associations are poorly understood because few studies consider the high overlap between CU traits and ASD. This study addressed this knowledge gap by investigating the unique associations between CU traits and ASD symptoms, and components of empathy (attention to others’ distress, emotion recognition, understanding emotional states, empathic responding), and differences between children classified into clinical groups (conduct problems with and without CU traits and ASD) and typically developing children. Parents reported on their child’s psychopathology symptoms and empathy, and children completed laboratory tasks measuring empathy components. Results indicated that ASD symptoms, but not CU traits, were uniquely associated with emotion recognition deficits. Meanwhile, CU traits were uniquely associated with reduced empathic responding, and this relationship was exacerbated with ASD symptoms. Theoretical and clinical implications are discussed.

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8. Crehan E, Whaling K, Jones H, Shinall J, Loftin R. Diagnostic Agreement of a Structured Telehealth Adult Autism Assessment. J Autism Dev Disord. 2026.

PURPOSE: This preregistered retrospective study evaluated diagnostic agreement under shared-information conditions for a structured, neurodiversity-affirming telehealth adult autism assessment protocol mapped to DSM-5-TR criteria. METHODS: The sample included 100 adults who primarily communicated through spoken language and was intentionally stratified to include at least 50% Black, Indigenous, and people of color (BIPOC; 51% achieved). Evaluations generally included two 90-min structured interviews across ten DSM-5-TR-mapped domains, criterion-level decision rules, behavioral observation, questionnaires, and collateral information when available. A blinded expert reviewed de-identified assessment materials and independently classified cases as ASD or non-ASD. RESULTS: Overall agreement was 86.0% (95% CI [77.9%, 91.5%]), with Cohen’s κ = 0.684 (95% CI [0.531, 0.836]). The point estimate exceeded the preregistered 0.66 benchmark, although the confidence interval included lower values. ASD classification rates were 68% for original clinicians and 66% for expert review. Positive and negative percent agreement were 90.9% and 76.5%, respectively. Exploratory subgroup analyses suggested lower agreement among BIPOC participants, although estimates were imprecise. CONCLUSION: Findings provide preliminary evidence that a structured, neurodiversity-affirming telehealth framework can yield concordant ASD/non-ASD classifications under shared-information conditions. Neurodiversity-affirming practice can coexist with structured, criterion-based diagnostic decision-making: affirming clients’ experiences and reducing deficit-based assumptions does not require presuming an autism diagnosis. Because reviewers relied on substantially overlapping information, findings do not establish diagnostic accuracy or criterion validity. Independent prospective validation using separate evaluations and multiple blinded reviewers is needed.

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9. Dallman AR, Santucci G, Lai D, Welch C, Jimenez ME. Lifestyle Documentation in Therapy Evaluations for Autistic Children: A Lexicon-Based Analysis of Electronic Health Records. Am J Occup Ther. 2026: 19437676261493019.

BackgroundWhole person health (WPH) is a multidimensional construct encompassing, physical, and mental health along with relational constructs such as social health that are deeply tied to well-being. Autistic individuals report an overall lower quality of life, but the extent to which these issues are addressed during therapy evaluations has not been examined systematically.MethodologyIn this retrospective, cross-sectional study, we employ a rule-based NLP/lexicon-based approach to examine the areas of focus of therapy evaluations documented by occupational therapy, physical therapy (PT), and speech-language pathology (SLP) professionals. Using electronic health records for children aged 2 to 18 diagnosed with autism spectrum disorder (ASD) (n = 5619 evaluation reports of n = 2021 unique patients), we classified health records based on the domains addressed.ResultsAcross notes, nutrition had the highest average degree of documentation (M = 2.14), compared to activity (M = 0.91), followed by wellness (M = 0.66), and sleep (M = 0.39). In occupational therapy, wellness was the most common (77.62% of notes), followed by physical activity (76.49% of notes), nutrition management (73.33% of notes), and sleep (34.97% of notes). The overall area under the curve (AUC) from the receiver operating characteristic analysis is 0.89.ConclusionsWhile it is encouraging that most evaluations addressed nutrition or physical activity, the near absence of attention to sleep represents a critical gap in care. Given sleep’s foundational role in overall health and daily functioning, its omission is particularly concerning. Occupational therapists and interdisciplinary rehabilitation teams should more deliberately integrate WPH frameworks into their evaluations. Many Autistic people face challenges that can affect their overall well-being and quality of life. In this study, we reviewed evaluation reports from Autistic children in a large health system. We looked at how these reports addressed key areas of whole-person health, including physical activity, sleep, nutrition, and overall wellness. We found that nutrition was the most addressed area, followed by physical activity, sleep, and wellness. While it is encouraging that many evaluations included nutrition and physical activity, very few addressed sleep. This is an important gap, given how essential sleep is for health and daily functioning. We believe rehabilitation clinicians should routinely ask about sleep as part of their evaluations. We also suggest that evaluation reports can be a valuable tool for identifying gaps in care and should be used more often to improve health system practices. eng.

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10. Dunham-Carr K, Feldman JI, Simon DM, Wallace MT, Murray MM, Woynaroski TG. Scalp Topography of Event-Related Potentials Reveals Differences in Audiovisual Speech Processing in Autistic and Non-Autistic Children. J Autism Dev Disord. 2026.

PURPOSE: In our prior work, conventional event-related potential (ERP) responses to audiovisual versus auditory-only speech were found to explain variance in language abilities in autistic and non-autistic children but failed to differentiate autistic children from non-autistic children. This study extends previous ERP analyses of responses to audiovisual versus auditory-only speech in autistic and non-autistic school-aged children to investigate group and condition differences in the strength and topography of the ERP based on data-driven, reference-independent metrics that overcome limitations of conventional ERP analyses. METHODS: Extant ERP data from 50 5-12-year-old children (25 per group, matched at the group level on age and sex assigned at birth) recorded during a passive task of listening and watching videos of auditory-only and audiovisual speech syllables were analyzed for differences in ERP strength and topography, quantified via global field power (GFP) and global map dissimilarity (GMD), respectively. RESULTS: GFP was significantly reduced for audiovisual compared to auditory-only speech at 245-275 ms post-stimulus. Groups differed in GMD of the ERPs reflecting the difference in response to audiovisual versus auditory-only speech at 139-170 ms post-stimulus, wherein microstates suggested predominantly differential occipital electrode responses. CONCLUSIONS: The benefits of audiovisual integration manifest as a facilitation effect (reduced signal strength of the ERP response to audiovisual versus auditory-only speech) across autistic and non-autistic children. Autistic children also display different patterns of activation underlying ERPs in response to audiovisual versus auditory-only speech relative to non-autistic children. Topographic ERP analyses show promise for advancing our understanding of audiovisual speech processing in autism.

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11. Gloanec C, Bonazzi G, Boughanmi ME, Demily C, Peyroux E. Assessment of Autism Spectrum Disorder in Gender-Diverse Populations: A Systematic Review and Meta-Analysis. LGBT Health. 2026: 23258292261495121.

PURPOSE: This review aimed to determine how autism spectrum disorder (ASD) and autistic traits are assessed in gender-diverse populations. METHODS: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines, we conducted a systematic review and meta-analysis of studies published from January 2013 in English or French that focused on gender-diverse individuals and reported diagnostic procedures and/or tools used to assess ASD. Only studies involving human participants were included. Reviews, meta-analyses, case reports, editorials, posters, and conference abstracts were excluded. Two independent reviewers screened records and extracted data using a standardized form, including study design, sample characteristics, diagnostic instruments, and assessment procedures. Data were synthesized qualitatively, and pooled prevalence estimates were calculated using random-effects meta-analysis when appropriate. Methodological quality and risk of bias were assessed using the Joanna Briggs Institute tools for analytical cross-sectional studies and for case-control studies. RESULTS: Twenty-eight studies met the inclusion criteria. Eighteen assessed ASD diagnoses; only six (33%) used robust diagnostic criteria, identifying 100 participants with a confirmed ASD diagnosis (5.4%) among 1855 participants. Other studies relied mainly on self-report or screening instruments. Twenty-three studies examined the broader autism phenotype using 13 different tools. The pooled prevalence of robust ASD diagnosis was 12% (95% confidence interval [CI] = 7%-19%), and broader autism phenotype prevalence was 24% (95% CI = 17%-33%). CONCLUSIONS: Few studies met clinical gold standards. Elevated prevalence estimates may reflect methodological variability and barriers to appropriate evaluation. Training in both ASD and gender diversity is essential for inclusive and accurate diagnostic practices.

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12. Granovsky Y, Weissman-Fogel I, Hoffman T, Kalingel Levi M, Gal E, Sprecher E, Shor M, Bar-Shalita T. How the Brain Interprets Pain in Autistic People: Does Sex Matter?. Eur J Pain. 2026; 30(9): e70411.

BACKGROUND: While psychophysical studies suggest heightened pain sensitivity in individuals with autism spectrum disorder (ASD), the relationship between subjective pain experience and cortical neurophysiological responses and whether this relationship is sex-dependent, remains poorly understood. METHODS: This cross-sectional two-group comparison study included 50 adults with Level 1 ASD and 52 age-, sex- and IQ-matched typically developing controls (TDC). Pain ratings and cortical contact heat-evoked potentials (CHEPs) were recorded in response to 52°C phasic heat stimuli. ANOVA and regression models assessed the effects of group, sex and pain ratings on CHEP amplitudes. RESULTS: Compared to TDC, autistic participants reported higher pain scores (p = 0.004) and had lower N(2) amplitudes (p = 0.02). A significant Group × Sex interaction (p < 0.001) was associated with the lowest N(2) amplitudes in autistic females (p < 0.05). Regardless of group, in females, higher N(2) amplitudes were associated with higher pain scores (p = 0.042; model p = 0.032), whereas this association was not significant in males (p > 0.05). Within-group correlation analyses in females showed a significant pain-N(2) amplitude relationship in TDC (r = 0.734; p = 0.004) but not in autistic participants (r = 0.371; p = 0.192). Across groups and sexes, higher N(2) amplitude values were associated with greater attention-to-detail autistic traits (p = 0.009). CONCLUSIONS: Our findings suggest a dissociation between subjective pain experience and cortical responses to nociceptive stimulation in autism, particularly among females, consistent with different salience-related or attentional pain processing. These results underscore the importance of considering sex and autism when interpreting pain-evoked cortical responses and challenge the assumption that pain-evoked potentials provide universally objective measures of pain. SIGNIFICANCE: This study identifies sex-related differences in the relationship between subjective pain ratings and cortical responses to nociceptive stimulation in autistic and typically developing individuals. Autistic females showed particularly attenuated N(2) amplitudes and a weaker correspondence between pain ratings and cortical responses, suggesting different salience-related or attentional processing of nociceptive stimuli. These findings highlight the importance of considering sex and autistic traits when interpreting pain-evoked cortical responses in autism.

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13. M YIB. Associations between executive function and core symptoms of attention-deficit/hyperactivity disorder in adults with autism spectrum disorder: Controlling for theory of mind, and age. Appl Neuropsychol Adult. 2026: 1-6.

This study aims to use the Executive Function Indicators (EFI) with ecological dimensions to reflect the actual daily executive function of adults with ASD, while controlling for cognitive influencing factors (ToM, and age), to further explore the association between EFI and ADHD symptoms and core symptoms in adults with ASD. 120 participants were selected as the planned sample size. Age, and Happé Strange Stories score were controlled for to analyze the association between EF and ADHD symptoms and ASD symptoms (Social, Communication, and Repetitive Behaviors/Restricted Interests). These results indicate that daily executive function deficits in children with ASD are generally associated with ADHD symptoms and the severity of ASD symptoms, especially with a stronger association with ADHD symptoms. Daily EF deficits can explain more variation in the severity of ADHD symptoms. In addition to daily executive function, theory of mind ability and age are also important factors influencing the social functioning of adults with ASD. In the multiple linear regression analysis, deficits in EF were significantly associated with the severity of ASD and ADHD symptoms, especially with ADHD symptoms. No moderating effect was found on the association between The Happé Strange Stories score and age on daily EF.

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14. Mintál K, Hormay E, László K, Kocsis B, Kulcsár G, Vörös D, Vizvári Z, Czifra L, Petykó Z, Cserjési R, Rook CJ, Lénárd L, Karádi Z, Tóth A. The impact of probiotic treatment on sex-specific behavioral differences in valproic acid-induced autism animal model. Brain Behav Immun Health. 2026; 57: 101378.

Autism spectrum disorder (ASD) is defined by social impairments and disturbances of repetitive, stereotypical behaviors. However, its presentation shows sex-specific traits that may have shaped underlying mechanisms and treatment outcomes. The purpose of this study was to investigate the effects of a specific probiotic on behavioral outcomes and serotonin levels in adult rats prenatally exposed to valproic acid (VPA), an established experimental model of ASD. Wistar rats received either 500 mg/kg VPA or physiological saline on gestational day 12.5. Offspring of both sexes were assigned to 8 groups, with designated groups receiving a specific probiotic mixture. Animals were tested at postnatal day 111 in social, anxiety-related and locomotor tasks and platelet serotonin levels were measured after sacrifice. Our results suggest that VPA exposure and probiotic administration elicit distinct sex-specific behavioral responses and differences in platelet serotonin levels. ASD-related social symptoms persist only in male animals, while females generally exhibit higher activity levels and lower anxiety. The probiotic mixture appeared to alleviate social deficits in male VPA-exposed rats. However, the mixture showed no measurable effects on other ASD-related behavioral parameters and caused no adverse outcomes in either sex. Notably, female animals displayed distinct behavioral patterns and did not exhibit VPA-induced alterations, suggesting potential sex-specific protective mechanisms that may modulate both VPA effects and microbiota-related interventions. These findings highlight the importance of sex-specific analysis and timing in evaluating therapies. Therefore, sex differences should be carefully considered, given their impact on both the understanding and treatment of ASD.

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15. Mishra A, Wang J, Scott L. Enhancing Peer-Directed Social Communication in Autistic Children Using Video Visual Scene Displays. J Autism Dev Disord. 2026.

PURPOSE: Minimally speaking autistic children often experience significant challenges engaging in reciprocal social communication with peers. Although augmentative and alternative communication (AAC) interventions using video-based visual scene displays (VSDs) have shown promise for supporting contextualized communication, limited research has examined their effects within reciprocal, peer-directed play contexts. This study evaluated the effects of a video-based VSD AAC intervention on peer-directed symbolic communication during. METHODS: A single-case, multiple-probe design across dyads was used to examine intervention effects. Fifteen autistic children and 15 age-matched peers with neurotypical development participated in peer play sessions organized into three cohorts, with five dyads per cohort, to facilitate staggered intervention introduction. Following baseline probes using static printed VSDs, autistic children received a video-based VSD AAC intervention incorporating dynamic visual supports and speech-generating communication. The primary dependent variable was the frequency of peer-directed symbolic communication turns. RESULTS: Across all cohorts, intervention implementation was associated with immediate increases in peer-directed symbolic communication. Visual analysis demonstrated consistent changes in level and immediacy of effect with minimal overlap between baseline and intervention phases. Tau-U analyses indicated large intervention effects across dyads, and maintenance probes suggested that gains were sustained following intervention completion. CONCLUSION: Findings provide evidence that video-based VSD AAC interventions may support peer-directed symbolic communication among minimally speaking autistic children. Embedding AAC within reciprocal, play-based interactions may enhance opportunities for social participation and meaningful communication with peers.

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16. Mutlucan Köseoğlu G, Ceylan AC, Çavdarlı B, Ömercioğlu E, Çöp E, Kılıç E. Phenotypic spectrum of 1q21.1 copy number variants in 42 children: genotype-phenotype correlations and clinical implications. Eur J Pediatr. 2026; 185(11).

Chromosome 1q21.1 copy number variants (CNVs) are associated with a broad and variable clinical spectrum encompassing neurodevelopmental, anthropometric, and systemic anomalies. The incomplete penetrance and variable expressivity of these rearrangements pose significant challenges for clinical interpretation and genotype-phenotype correlation. We retrospectively analyzed 42 pediatric patients with 1q21.1 CNVs, identified by chromosomal microarray analysis (CMA), evaluated at a single tertiary center between 2019 and 2025. Patients were classified according to CNV type and localization: distal deletions (n = 30), distal duplications (n = 7), proximal deletions (n = 3), and proximal duplications (n = 2). Clinical findings were compared according to CNV type, sex, inheritance pattern, parental origin, and deletion size. The median age at presentation was 27 months. Among distal deletion carriers, microcephaly (60.0%), short stature (40.0%), and developmental delay (39.3%) were the most frequently observed findings. Cardiac anomalies were present in 34.5% of deletion patients, with two patients dying due to severe cardiac complications during follow-up. Macrocephaly was identified exclusively in duplication carriers (28.6%), corroborating the mirror phenotype of reciprocal 1q21.1 rearrangements. Developmental delay was significantly more frequent in duplication compared with deletion carriers (85.7% vs. 39.3%; p = 0.041). Cardiac anomalies were significantly more common in female patients (p < 0.05). No significant differences were identified according to inheritance status, parental origin, or deletion size, reflecting the variable expressivity of this locus. One proximal deletion patient was diagnosed with TAR syndrome through combined microarray and exome sequencing, confirming the two-hit molecular mechanism involving a 1q21.1 deletion and a pathogenic RBM8A variant. CONCLUSION: This study delineates the broad phenotypic spectrum of 1q21.1 CNVs in a pediatric cohort, highlighting microcephaly and cardiac anomalies as clinically significant findings and reinforcing the mirror phenotype of reciprocal rearrangements. The absence of consistent genotype-phenotype correlations underscores the contribution of modifier factors beyond the CNV itself. Routine cardiac evaluation and multidisciplinary follow-up are recommended for all carriers. WHAT IS KNOWN: • Distal 1q21.1 CNVs cause microcephaly, developmental delay, and cardiac anomalies with incomplete penetrance and variable expressivity. • Reciprocal rearrangements show a mirror phenotype: microcephaly in deletion and macrocephaly in duplication carriers. WHAT IS NEW: • This is among the few single-center cohorts characterizing all four 1q21.1 CNV subtypes in a pediatric series. • Cardiac anomalies were more frequent in female carriers, a sex-specific observation warranting further investigation. • Inheritance status, parental origin, and deletion size did not appear to significantly influence clinical phenotype.

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17. Rodrigues de Sousa Junior R, de Carvalho Silva AC, Azevedo de Castro J, Assis Lourenzo G, Eloah Mesquita D, Palhares Scalzo Matter L, Fernandes AC, Borges Ferreira LF, Clutterbuck GL, Nogueira de Carvalho C, de Andrade Nascimento F, Ribeiro Ferreira WV, Ribeiro Leite H. State of the Evidence and Strength of Recommendations for Interventions Used by Physical Therapists in Children and Adolescents with Autism: An Overview of Systematic Reviews. Phys Occup Ther Pediatr. 2026: 1-40.

AIMS: To evaluate the evidence and strength of recommendations for interventions used by physical therapists for children and adolescents with autism spectrum disorder (ASD). METHOD: An overview of systematic reviews was conducted following the Preferred Reporting Items for Overviews of Reviews of Healthcare Interventions statement. Systematic reviews evaluating interventions used by physical therapists for this population were included. Outcomes were categorized according to the ICF framework. Risk of bias was assessed using the Risk of Bias in Systematic Reviews tool. Quality of evidence and strength of recommendations were evaluated using GRADE and translated into a traffic-light system (green, yellow, or red). A patient and public involvement group, including parents and individuals with ASD, contributed to recommendation evaluation. RESULTS: Nine reviews, including 53 studies and 1016 participants, identified 11 interventions used by physical therapists. Most studies reported positive effects, mainly on body functions and activities, although evidence quality ranged from very low to low. Most interventions received conditional « yellow light » recommendations, whereas task-specific motor training for gross motor function received a strong « green light » recommendation. CONCLUSION: Interventions used by physical therapists may benefit children and adolescents with ASD, but evidence remains overall limited and is of low or very low quality.

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18. Wu Z, To CKS. Challenges in Accommodating Talker Variability in Lexical Tone Perception Among Autistic Adults: Implications for Talker Adaptation. J Autism Dev Disord. 2026.

PURPOSE: Successful speech perception requires listeners to accommodate acoustic variability arising both across talkers and within a single talker. This challenge is especially pronounced in tone languages, where fundamental frequency (F0) simultaneously encodes lexical meaning and talker identity. The present study investigated how between-talker and within-talker variability affects lexical tone perception in Cantonese-speaking adults with and without autism spectrum disorder (ASD). METHODS: Twenty-five adults with ASD and 25 neurotypical (NT) controls completed a speeded word identification task involving minimal word pairs differentiated by level tones. Between-talker variability was manipulated by presenting words produced by either a single talker or multiple talkers, and within-talker variability was manipulated by using either a single exemplar or multiple exemplars from each talker. Performance was assessed using identification accuracy, response time (RT), and a composite efficiency measure. RESULTS: Both groups demonstrated reliable processing costs associated with between-talker variability, reflected in lower accuracy, longer RTs, and reduced efficiency, with no group difference in the magnitude of this effect. In contrast, only the ASD group exhibited reduced efficiency under within-talker variability. Furthermore, within-talker and between-talker processing costs were not significantly correlated in either group. CONCLUSION: These findings suggest that autistic adults may experience greater difficulty accommodating subtle within-talker acoustic variability during lexical tone perception, consistent with a more detail-focused processing style. Such difficulty may have implications for everyday speech understanding in socially diverse listening environments while highlighting the importance of distinguishing between-talker normalization from within-talker stabilization in models of speech perception.

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19. Zant OM, Anderson C, Howell A, Schafer E, Miller S, Mathews L. Functional Listening Experiences of Autistic College Students: A Qualitative Study of Real-World Listening Demands. Am J Audiol. 2026: 1-15.

PURPOSE: Autistic individuals frequently report auditory processing differences, including difficulty perceiving speech in noise and heightened sound sensitivity. Although increased listening effort has been documented in autistic children, little is known about how autistic college students experience listening demands in higher education. This qualitative study explored the lived listening experiences of autistic college students across academic and everyday contexts. METHOD: Eighteen autistic adults (ages 18-39 years) enrolled in or recently graduated from university programs participated in semistructured interviews via Zoom. Interviews explored listening experiences across classroom environments and everyday contexts. Reflexive thematic analysis following Braun and Clarke’s six-phase framework identified patterns and themes within the participant narratives. RESULTS: Five themes were generated through analysis: (1) affective cycle of listening, (2) strategic cognitive management of listening, (3) environmental contexts shape listening experiences, (4) social risk and stigma, and (5) inherent and developed listening strengths. CONCLUSIONS: Listening effort may represent an underrecognized barrier to educational participation for autistic college students. The present findings extend the existing frameworks of effortful listening by illustrating how cognitive, emotional, sensory, and social factors interact to shape listening experiences in real-world contexts. Importantly, these findings illustrate the value of incorporating lived experiences to better reflect the variability and subjective nature of listening, which traditional assessments may not fully reflect. For clinicians and educators, considering the contexts in which listening occurs alongside patient-reported experiences may support a more comprehensive understanding of listening-related demands and extend considerations beyond traditional auditory accommodations to improve education and communication participation.

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