1. Alizée D, Anaïs G, Magali B, Lucie B. Visual Exploration and Construction Strategies Underlying Performance in the Block Design Task in Autism. Autism Res. 2026: e70256.

Visuospatial reasoning in autism is often linked to superior performance on tasks such as the Block Design Task (BDT). While different strategies have been described in the general population, no study has examined how these strategies relate to performance in autistic individuals, even though the task is widely used to characterize their visuospatial profile. To address this gap, the present study examined not only overall scores but also the underlying strategies used by autistic (ASD) and neurotypical (TD) adults during the BDT. Forty-one participants (ASD = 18; TD = 23) completed the standard BDT while eye-tracking and behavioral data captured both visual exploration and construction strategies. Globally, structured strategies-both in visual exploration and construction-were found to be the most effective, as they were associated with higher success rates and faster completion times, consistent with previous findings. At the group level, our results revealed that autistic participants employed these analytic strategies more frequently than neurotypical individuals, along with a stronger alignment between visual and construction approaches. The consistent use of these strategies in the autistic group may help explain the enhanced visuospatial performance observed in our study after controlling for manual dexterity and reported in earlier studies. These findings emphasize the importance of looking beyond traditional performance measures such as accuracy and completion time, highlighting that cognitive strategies are key to understanding visuospatial reasoning. This study explored how autistic and non‐autistic adults approach a clinical problem‐solving task, focusing not only on their performance but also on the visual and motor strategies they use. We found that the most efficient strategy was used more frequently by autistic participants. These findings suggest that differences in thinking styles may help explain the strengths in visuospatial reasoning often observed in autistic individuals. eng.

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2. Castellón FA, Gómez LR, Ramos-Gallardo T. Beyond the bilingualism myth: toward culturally sustaining autism interventions for multilingual families. Front Psychiatry. 2026; 17: 1767278.

Despite robust evidence that bilingualism does not hinder language development in autistic children, service providers continue advising multilingual families to adopt English as their home language. This research-to-practice gap severs intergenerational cultural transmission and compromises parent-child communication. This perspective paper examines how historical misconceptions linking bilingualism with cognitive deficits became embedded in autism intervention practices. We analyze how intersecting ideologies of ableism and racism co-construct deficit-lens perspectives, and how policies rooted in White Mainstream English hegemony, organizational barriers, and assimilationist paradigms undermine multilingual families’ linguistic practices. Research shows autistic children successfully acquire multiple languages, and heritage language maintenance is essential for ethnic identity, family relationships, and well-being. Yet the systematic exclusion of non-English speakers from intervention research has created an evidence base that reinforces monolingual practices. This disconnect represents a fundamental refusal to dismantle structures positioning English monolingualism as the default standard. Culturally sustaining autism interventions must promote additive bilingual environments, recognizing language as the medium through which children access family histories, spiritual practices, and belonging. Adopting a neuroaffirming framework centering well-being over compliance requires cultural humility and self-reflection about how our experiences shape clinical work. We call for research investigating best practices that honors, protects, and sustains heritage language environments-evidence urgently needed to reshape outdated policies restricting home language instruction.

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3. Dawson G. Addressing the Major Challenges Facing the Autism Community. JAMA Pediatr. 2026.

This Viewpoint discusses the need to address proposed diagnostic classifications, competing research and funding priorities, and barriers to screening, services, and supports for the autism community. eng.

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4. Freitag CM, Tebartz van Elst L. [Autism spectrum disorders-Transition from adolescence into adulthood]. Nervenarzt. 2026.

Autism spectrum disorders (ASD) are neurodevelopmental disorders with a prevalence of approximately 0.7%. People with ASD show characteristic social interaction, verbal and nonverbal communication, routine-like and inflexible behavior, special interests and altered perception. ASD manifest in the first decade of life and usually persist throughout life. Like most other neurodevelopmental disorders, they are therefore inevitably not only a topic of child and adolescent psychiatry, psychosomatics and psychotherapy (CAPPP) but also of adult psychiatry, psychosomatics and psychotherapy (APPP); however, the transition from adolescence into adulthood poses a particular challenge for affected individuals, their caregivers, as well as for professionals in the healthcare and social welfare systems. Key aspects of the transition period include the treatment of comorbid mental, cognitive and language disorders as well as social legislation and healthcare aspects. This article depicts these aspects from the perspective of CAPPP and APPP.

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5. Galai T, Goldberg Y, Ziv A, Kalamitzky N, Shemer K, Braiman N, Cohen S, Moran-Lev H. Unique feeding profiles in children with pediatric feeding disorder and comorbid autism spectrum disorder: a retrospective cohort study. Eur J Pediatr. 2026; 185(5).

To compare the clinical characteristics, sociodemographic factors and feeding profiles of children aged 0-60 months diagnosed with pediatric feeding disorder (PFD) with and without comorbid autism spectrum disorder (ASD), in order to characterize features unique to each diagnosis. This retrospective comparative study included all children aged 0-60 months diagnosed with PFD between 2020 and 2023 at a tertiary pediatric center. Participants were categorized into 2 groups: those with comorbid ASD (ASD-PFD group) and those without ASD (PFD-only group), reflecting children diagnosed with ASD by age 5 years within the available follow-up. Clinical, demographic, perinatal and feeding-related data were extracted from medical records and analyzed. Among 141 participants, 47 were in the ASD-PFD group and 94 in the PFD-only group. The ASD-PFD group had a higher proportion of males (52.6% vs. 34.4%, P = 0.03) and cesarean deliveries (38% vs 23%, P = 0.03). These children were born to parents with lower educational attainment (P < 0.05) and presented (10 vs. 5 months) and were diagnosed (14 vs. 9 months) with PFD at older ages (P = 0.05). Nutritional dysfunction was more prevalent (55.6% vs 26.6%), whereas psychosocial dysfunction was less common (8.3% vs. 29.8%) in the ASD-PFD group (P = 0.007). Multivariable analysis identified male sex, cesarean delivery, and lower parental educational status as independent predictors of ASD, whereas psychosocial feeding dysfunction was inversely associated with ASD. CONCLUSIONS: Children with coexisting PFD and ASD exhibit a distinct profile characterized by later diagnosis and a predominance of nutritional over psychosocial feeding dysfunction, highlighting the importance of early recognition and tailored multidisciplinary care. WHAT IS KNOWN: • Pediatric feeding disorder (PFD) is common in children with autism spectrum disorder (ASD). • Most studies focus on older children; data on infants and toddlers are limited. WHAT IS NEW: • Infants and toddlers with ASD and PFD show distinct profiles: later presentation and diagnosis, more nutritional and less psychosocial dysfunction. • In one-third, PFD preceded ASD diagnosis, highlighting feeding issues as early markers. • Lower parental education and higher cesarean rates were more common in ASD-PFD cases.

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6. Hu W, Liu Q, Fu X, Chen Y. Comparative effectiveness of PROMPT-based language training vs. structured home-based training for language and speech delay in children with autism spectrum disorder. Front Pediatr. 2026; 14: 1726236.

OBJECTIVE: To compare the relative effectiveness of PROMPT-based training vs. structured home-based training in facilitating language and speech development in children with autism spectrum disorder (ASD), specifically focusing on how addressing speech motor control impacts overall language stages. METHODS: This retrospective analysis study was conducted at Yongkang Women and Children’s Health Hospital. The data for the research subjects were sourced from ASD children with language and speech delay who received treatment from January 2023 to January 2025. To minimize potential confounding and selection bias, a 1:1 propensity score matching (PSM) was implemented using a nearest neighbor algorithm with a caliper of 0.05. Consequently, 62 patients who received PROMPT-based language training were matched with a cohort of 62 patients receiving structured parent-mediated home training guidance. The Sign-Significant Relation (S-S) and image expression ability were compared before and after the intervention between the two groups. RESULTS: PROMPT-based language training was associated with better outcomes than structured home-based training in children with ASD and language and speech delay, with greater improvement in language developmental stages and image expression ability. CONCLUSIONS: After the 3-month intervention, the distribution of S-S developmental stages for language comprehension and expression differed significantly between the two groups, with the PROMPT group showing a higher proportion of children in more advanced stages than the control group (P< 0.05). In addition, image expression ability improved in both groups after intervention, and the improvement was greater in the PROMPT group than in the control group (P < 0.05).

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7. Jeong SH, Son JW. The Concept of Autism in Autism Spectrum Disorder and Schizophrenia Spectrum Disorder: Historical Divergence and Phenomenological Rapprochement. J Korean Acad Child Adolesc Psychiatry. 2026; 37(2): 82-94.

This study aims to trace the historical origins and conceptual divergence of « autism » as employed in autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD), and to examine their recent rapprochement through the lens of phenomenological psychopathology. A narrative review was conducted to analyze primary historical sources, including works by Bleuler, Kanner, and their predecessors, along with contemporary literature on neurodevelopmental perspectives, social cognition, and phenomenological psychopathology. The analysis focused on comparing the structures of self-experience between patients with ASD and those with SSD using frameworks such as ipseity disturbance and anomalous self-experience. Bleuler’s « Autismus » (1911) denoted active withdrawal from reality and construction of an inner fantasy world in schizophrenia, whereas Kanner’s « infantile autism » (1943) described innate deficits in forming affective bonds. Despite strict diagnostic separation since DSM-III, recent research reveals shared genetic pathways, social cognitive impairments, and clinical presentations. Phenomenological analysis revealed that while both conditions share common predicaments in being-in-the-world, they manifest qualitatively distinct patterns of self-disorder. Patients with SSD exhibit ipseity disturbance characterized by instability of the minimal self, diminished self-affection, and hyperreflexivity, whereas patients with ASD generally show preserved minimal self but deficient intersubjective attunement. Social withdrawal in SSD represents a defensive retreat against ontological anxiety and self-dissolution, whereas in ASD it reflects involuntary isolation arising from impaired intuitive connections with others. ASD and SSD share common predicaments in being-in-the-world, yet manifest qualitatively distinct forms of self-disorder. This phenomenological framework offers a promising transdiagnostic approach for clarifying the relationship between these two conditions and understanding the essence of « autism. ».

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8. Lavi S, Aharony I, Zalsman G. [Borderline Personality Disorder in Patients on the Autism Spectrum: Clinical and Diagnostic Implications]. Harefuah. 2026; 165(4): 247-52.

This review examines the symptomatic overlap, comorbidity, and diagnostic challenges between Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD), particularly among women. The current literature highlights shared difficulties in social functioning, emotional regulation, and tendencies toward impulsive and self-harming behaviors in both disorders. However, there are key distinguishing symptoms: ASD is characterized by repetitive patterns, restricted interests, and unique sensory processing, while BPD is marked by fear of abandonment, unstable self-image, and feelings of emptiness. The gender context underscores the phenomenon of « camouflaging » in autistic women, which can lead to cognitive exhaustion and the misinterpretation of their symptoms as signs of BPD. Such misdiagnosis may result in ineffective or even harmful treatment. The review emphasizes the importance of accurate differential diagnosis through structured clinical interviews, self-report questionnaires, and thorough developmental assessments, with a focus on corroborating childhood difficulties via external informants. Lastly, it advocates for increased awareness of the female autism phenotype and the adoption of gender-sensitive diagnostic and therapeutic approaches to prevent misdiagnosis and improve patient quality of life.

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9. Leblay Y, Felix MS, Roux JC, Panayotis N. From Gene to Hope: Rett Syndrome and the Rise of Molecular Therapies. Mol Diagn Ther. 2026.

Rett syndrome is a rare X-linked neurodevelopmental disorder caused by mutations in MECP2, a gene critical for neuronal function, chromatin organization, and synaptic plasticity. After a period of apparently normal early development, individuals with Rett syndrome experience rapid regression followed by lifelong neurological impairment. Notably, preclinical studies have shown that restoration of MeCP2 expression can reverse established symptoms in adult mice, positioning Rett syndrome as a promising target for molecular therapies. However, MECP2 is extremely dosage sensitive and both insufficient and excessive expression are harmful, creating a narrow therapeutic window and a major challenge for treatment design. This review examines the evolving landscape of gene- and RNA-based therapies for Rett syndrome, with a focus on strategies that enable precise MeCP2 replacement, dosage control, and widespread central nervous system delivery. We discuss clinical-stage adeno-associated virus gene replacement programs, including TSHA-102 and NGN-401, highlighting their vector designs, regulatory elements, delivery approaches, and emerging clinical data. Advances in adeno-associated virus capsid engineering and vector optimization aimed at improving neuronal targeting while minimizing peripheral exposure and immune toxicity are also reviewed. Beyond gene supplementation, we explore approaches that restore endogenous MECP2 regulation, such as reactivation of the inactive X chromosome, as well as DNA and RNA editing strategies. Collectively, these advances reflect a shift toward precision-regulated therapies for Rett syndrome that may provide a model for treating other dosage-sensitive neurodevelopmental disorders.

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10. Liao L, Fombonne E. Autism Overdiagnosis and Its Harmful Effects. JAMA Pediatr. 2026.

This Viewpoint describes the extent and mechanisms of overdiagnosis in autism and reviews its harmful implications. eng.

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11. Linnenbank F, Linnenbank M, Beimdiek S, Bender S, Vöckel J. Co-occurring Psychiatric Symptoms in Verbal, School-Aged Children With Autism Spectrum Disorder and at Least Average IQ. J Autism Dev Disord. 2026.

PURPOSE: Increased levels of co-occurring psychiatric symptoms are observed in children and adolescents with autism spectrum disorder (ASD). Former research often investigated heterogeneous samples of youth with ASD. However, concurrent symptom presentation appears to differ with individual characteristics such as intellectual abilities. METHOD: The present study investigated verbal, school-aged children and adolescents (n = 103) with ASD and at least average intellectual abilities (i.e., full-scale intelligence quotient, FSIQ). Co-occurring psychiatric symptomatology was assessed with the Child Behavior Checklist (CBCL). Path analyses were conducted to investigate whether autistic characteristics or intellectual abilities predicted co-occurring psychiatric symptoms. RESULTS: In the investigated youth with ASD the extent of co-existing symptoms was elevated in all CBCL syndrome domains. Few associations of Autism Diagnostic Observation Schedule (ADOS-2), Autism Diagnostic Interview (ADI-R), and FSIQ scores with concurrent psychiatric symptomatology were found, limited to small effect sizes. CONCLUSION: Within the investigated youth with ASD likelihood of experiencing elevated levels of co-occurring psychiatric symptomatology is increased. However, among individuals above the diagnostic threshold for ASD, variance in ASD symptoms may be of limited influence on concurrent symptom severity. Findings highlight the importance of diagnostics for co-occurring psychiatric symptoms in youth with ASD.

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12. Mimura K, Nakagaki K, Morishita H, Ichinohe N. Altered kinship vocal dynamics in marmosets with valproic acid-induced model of autism. iScience. 2026; 29(4): 115419.

Autism spectrum disorder (ASD) involves social communication impairments and repetitive behaviors. Language abnormalities in ASD, such as echolalia and idiosyncratic speech, heighten caregiver stress and affect communication dynamics within the kinship system. However, the influence of ASD-related traits on family-level interactions remains poorly understood in animal models. Here, we established an ASD model in common marmoset via prenatal valproic acid (VPA) exposure, and analyzed 28,418 kinship vocalizations from VPA-exposed and unexposed (UE) pups with their parents. VPA families exhibited increased isolation calls, decreased affiliative calls, disrupted repetition patterns, and reduced developmental maturations. These alternations intensified after weaning and correlated with parental weight loss, suggesting heightened caregiver stress. VPA pups also displayed premature locomotion independence, indicating broader social disruptions. Our findings highlight VPA marmosets as valuable models for investigating ASD-like traits at both individual and kinship levels, with kinship vocalizations serving as potential non-invasive biomarkers of ASD-related communication impairments and family stress.

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13. Nakamura K, Kubo A, Sanaka S, Kamiya S, Itagaki K, Sasaki T. Cytoskeletal Dynamics and Molecular Motor Dysfunction in Psychiatric Disorders: Insights from Schizophrenia and Autism Spectrum Disorder. Biology (Basel). 2026; 15(7).

Elucidating the pathophysiological mechanisms of mental disorders remains a critical challenge in psychiatric research. Recent studies have highlighted the potential involvement of cytoskeletal and molecular motor abnormalities in the development of mental disorders such as schizophrenia and autism spectrum disorder (ASD). Although schizophrenia and ASD differ clinically, both disorders are increasingly regarded as neurodevelopmental conditions and share vulnerabilities in synapse formation and neural circuit maturation. This review synthesizes the latest findings on the relationship between cytoskeletal and molecular motor abnormalities and mental disorders. The cytoskeleton, composed of microtubules, actin filaments, and intermediate filaments, along with molecular motors such as kinesins, dyneins, and myosins, plays crucial roles in neurodevelopment, synapse formation, and neurotransmission. In schizophrenia, decreased expression of the microtubule-associated protein MAP2 and abnormalities in the DISC1 gene have been reported, potentially leading to dendritic morphological abnormalities and neurodevelopmental disorders. Additionally, abnormalities in molecular motors such as KIF17 and KIF1A have been implicated in schizophrenia pathophysiology. Myosin Id has been identified as a risk gene for ASD. Furthermore, abnormalities in actin-related proteins such as SHANK3 and CYFIP1 have been shown to cause synaptic dysfunction. These findings suggest that mental disorders arise from complex pathologies involving multiple cytoskeletal and molecular motor-related protein abnormalities. Future research should focus on elucidating the functions of individual proteins and adopting a comprehensive approach that includes glial cells. Advances in this field may deepen our understanding of the pathophysiological mechanisms of mental disorders and potentially lead to the development of novel therapeutic strategies.

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14. Pang D, Duan G, Shang Q, Zhang H, Wang B, Ding H, Kang H, Zhao Y, Lu Y, Tian G, Zhang L, Jiang W, Wang G, Liang C, Zhang L, Li B, Li Z, Song C, Yang Y, Wang Y, Yue K, Lang Y, Liu J, Zhang X, Xu Y, Zhu C. Associations Between Comorbidities, Developmental Status, and Disease Severity in Children With Autism Spectrum Disorder: A Multicenter Cross-Sectional Study in China. Autism Res. 2026: e70253.

Children with autism spectrum disorder (ASD) frequently present with co-occurring conditions that can influence autism symptom severity and complicate clinical management. However, studies with clinician-confirmed diagnoses in non-Western populations remain limited. In this multicenter cross-sectional study, 1279 children aged 3-14 years with DSM-5-confirmed ASD were recruited from eight medical centers in China. Autism symptom severity was assessed using the Childhood Autism Rating Scale (CARS). Comorbidities were identified through clinical evaluation and specialized assessments, and developmental status was measured using the Gesell Developmental Schedule (GDS) and Wechsler Intelligence Scales. Associations with CARS scores were analyzed using generalized linear regression. Of participants, 96.6% had at least one comorbidity and 71.2% had multiple comorbidities. Common conditions were intellectual developmental disorders (IDD) (87.3%), food selectivity (45.3%), insomnia disorder (16.9%), developmental regression (15.6%), and behavioral problems (14.6%). Patterns differed by sex and age: gastrointestinal problem and sleep-related interventions were more common in girls, whereas food selectivity was more common in boys. Older children showed higher rates of tic disorders, asthma, epilepsy, and offensive language, although these findings should be interpreted cautiously because the subgroup aged ≥ 6 years was small. In adjusted analyses, IDD, food selectivity, pica, insomnia disorder, and developmental regression were associated with higher CARS scores, whereas higher GDS and Wechsler scores were associated with lower CARS scores. In this Chinese cohort, comorbidities were prevalent and showed distinct sex- and age-related patterns. Several comorbidities were associated with greater autism symptom severity, underscoring the importance of comprehensive developmental and medical assessment in ASD care. This large study found that nearly all children with ASD in this large clinical sample had at least one additional condition, such as intellectual disability (ID), sleep problems, or selective eating. These co‐occurring conditions were associated with more severe autism symptoms, while better cognitive understanding linked to milder symptoms. The findings highlight the clinical importance of comprehensive developmental and medical evaluation in ASD care. eng.

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15. Papageorgopoulou E, Ali JB, Pasco G, Goodwin A, Mason L, Johnson MH, Charman T, Timmer K, Jones EJH. Theta Power at 10 Months of Age Predicts Developmental Change in Language in Infants With and Without an Elevated Likelihood for Autism. Dev Sci. 2026; 29(3): e70194.

Infants with an Elevated Likelihood (EL) for autism are more likely to experience language delays, but their language developmental trajectories are highly heterogeneous. The neurodevelopmental processes driving this variability remain unclear, yet understanding them is important for parsing the heterogeneity in language and informing earlier intervention. However, no studies have examined how developmental changes in brain function are related to changes in language ability across time in this population. In this prospective longitudinal study, we investigated the developmental associations between electroencephalography (EEG) and language measures in a sample of infants enriched for varied language outcomes: Infants with EL and Typical Likelihood (TL) for autism (EL = 99, TL = 60). Measures of EEG power in the relative frontal theta and alpha ranges during natural viewing of social and nonsocial naturalistic videos and observer assessment of language ability were collected at 10, 14, 24 and 36 months. As expected, the EL and TL groups differed in the slope of language ability, with the EL group showing less steep increases in language compared to the TL group. Further, 10-month theta power (but not alpha) was a significant predictor of developmental change in language; autism likelihood group did not moderate this association and theta development was not related to language. Overall, findings suggest slowed language development as an autism trait symptom and that theta power is a predictor of general language ability, not specific to autism. Future research should consider incorporating additional measures to examine the potential environmental or genetic contributions to these associations. SUMMARY: Infants with Elevated Likelihood (EL) for autism vary in their language development, while the neurodevelopmental processes driving this variability are still unclear. The relation between developmental changes in relative electroencephalography (EEG) spectral power and language ability across 10-36 months in infants with and without an EL for autism was examined. The EL group showed less steep increases in language development compared to the TL group, but the groups did not differ in relative EEG power. Theta power was a significant predictor of developmental change in language; this association was not moderated by the autism likelihood group.

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16. Plank IS, Krasniqi K, Pior A, Nowak J, Falter-Wagner CM. No added cost: Emotion recognition in co-occurring ADHD and ASD. Br J Clin Psychol. 2026.

OBJECTIVES: Facial emotion recognition (FER) is fundamental for social interaction, yet this ability is often impaired in attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). While research has documented these difficulties, two key questions remain: Are these deficits specific to recognising emotions or do they reflect broader challenges in face processing? Does the increasingly documented co-occurrence of ADHD and ASD exacerbate these difficulties? METHODS: We compared emotion discrimination thresholds (EDT) in N = 92 participants aged 17-45 years (mean = 28.5, SD = 7.2), including 22 autistic-only, 24 ADHD-only, 22 co-occurring ADHD+ASD and 24 typically-developing individuals. We measured EDT with faces gradually changing from a neutral to an emotional expression (angry, fearful, happy or sad) and designed a non-emotional control task. Using eye tracking, we ruled out potential differences in visual attention to facial features between groups. RESULTS: We showed a specific disadvantage in emotion in the clinical groups, with increased EDT in all three clinical groups, with effect sizes ranging from .43 for co-occurring ADHD+ASD to .77 for autistic-only. Crucially, emotion recognition deficits were not amplified by the co-occurrence of ADHD and ASD, when considering performance in the control task. CONCLUSIONS: Our study possibly suggests equal mechanisms underlying reduced FER in ASD and ADHD. This mechanism should be identified to develop targeted interventions addressing social cognitive challenges in ASD and ADHD, improving social integration and well-being. Clinicians should recognise that FER difficulties are shared across both conditions, since a primary association with ASD may lead to unwarranted assumptions of ASD co-occurrence in ADHD.

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17. Prahm KP, Chen P, Rode L, Ekelund CK, Husby KR, Bergholt T, Lidegaard Ø, Scheller NM, Mikkelsen AP. Acetaminophen Exposure During Pregnancy and the Risk of Autism in Offspring. JAMA Pediatr. 2026.

This cohort study evaluates the potential association between prenatal acetaminophen exposure and risk of autism in Danish national registers. eng Capital Region of Denmark Research Foundation during the conduct of the study. Dr Lidegaard reported receiving grants from Exeltis Institutional grant to conduct European Medicines Agency–requested postmarketing safety study on a new progestin-only contraceptive pill outside the submitted work. No other disclosures were reported.

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18. Rehman AU, Garg A, Khan MA. Efficacy and Safety of Bumetanide in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Rev Recent Clin Trials. 2026.

INTRODUCTION: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition marked by social and behavioural impairments. While behavioural therapies have progressed, pharmacological options for core symptoms remain inadequate. Bumetanide, an NKCC1 antagonist, has shown potential benefits in ASD. This systematic review and meta-analysis evaluated its efficacy and safety in children and adolescents. METHODS: We searched PubMed, ScienceDirect, Scopus, and ClinicalTrials.gov until April 2024 for RCTs and observational studies involving patients with ASD aged ≤18 years. Primary outcome measures the CARS, while secondary measures include the SRS, RBS, CGI-E, and safety profiles. We conducted separate analyses for RCTs and observational studies. Risk of bias was assessed using Cochrane RoB 2.0 for RCTs and ROBINS-I for observational studies. RESULTS: Nine studies (7 RCTs, 2 observational), comprising 952 children and adolescents aged 3-18 years, were included. At 3 months, pooled analysis of randomized trials showed a significant reduction in CARS scores with bumetanide compared with placebo (WMD = -3.11; 95% CI = -6.11 to – 0.11; p = 0.04), though heterogeneity was high (I² = 92%). At 6 months, no significant difference was observed. Bumetanide increased the risks of hypokalaemia, polyuria, diuresis, and dehydration. The overall certainty of evidence was low to very low for most outcomes. DISCUSSION: Although bumetanide shows short-term benefits on core ASD symptoms, high heterogeneity, limited durability, and safety issues constrain its clinical applicability. CONCLUSION: Bumetanide may offer transient symptom improvement in ASD, but further highquality trials are warranted to establish long-term efficacy, safety, and responder profiles.

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19. Steeby CJ, Miller GN, Castro Palacin A, Cohen AL. Naturalistic movie viewing is an effective functional localizer of the fusiform face area in adolescents with and without autism. Imaging Neurosci (Camb). 2026; 4.

Task-based « localizer » neuroimaging protocols are often used to identify specific functional areas in individual participants. Conventionally, these tasks can be unengaging, leading to increased motion and scan fatigue, especially for populations which may struggle with lengthy scans. Dynamic, naturalistic stimuli, like entertaining movies, offer a potential alternative with higher participant engagement and improved data quality. Here, we evaluated whether a short Pixar movie, Partly Cloudy, could serve as a reasonable and useful replacement for a traditional fusiform face area (FFA) localizer in a group of adolescents with and without autism spectrum disorder (ASD). We found that individualized FFA localizations derived from a Pixar movie, Partly Cloudy, were largely consistent with those produced by a traditional localizer. Peak activation locations showed no difference between localizer types; measures of activation pattern and magnitude were also largely the same, except that the occipital face area (OFA) demonstrated more task than movie activation and the parahippocampal place area (PPA) demonstrated more movie than task activation. However, applying these FFA individualized ROIs (iROIs) to independent task data revealed that traditional localizer iROIs still produce more face-selective activations. We also demonstrated that the movie viewing helps to reduce motion levels in both adolescents with and without autism relative to the traditional localizer task. Hence, while they may not localize face-selective regions of the FFA as robustly as traditional task-based localizers, movie localizers may be an appropriate, or even preferable, choice for fMRI studies in populations which struggle to tolerate lengthy scans, such as individuals with autism, and in paradigms that must rapidly localize multiple functional regions.

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20. Woolhouse R, Nicholson SL. Exploring Biases in Autism Diagnostic Pathways. Autism Res. 2026: e70252.

Assessments for autism spectrum disorder are time-consuming and expensive, and demand has increased over recent decades. Despite improved diagnostic criteria and awareness of autism, there still appear to be disparities in diagnostic rates of autism across age, gender, and ethnicity. Research investigating biases in referrals to, and assessments conducted by, autism diagnostic services is limited, especially in adults, making it difficult to understand these disparities. This clinical service evaluation collected data on demographic characteristics of clients referred and accepted for autism assessments (N = 350) and fully assessed for autism (N = 269) by a London-based adult autism team. Demographic characteristics of clients referred to the service were compared to population prevalences using Census data to investigate potential biases in referring clinicians. Demographic characteristics of clients who received diagnoses of autism were compared to the service’s average diagnostic rate to investigate potential biases in assessing clinicians. Participants referred and accepted for autism assessments were significantly more likely to be male, aged 18-34, and from White or « Other » ethnic backgrounds compared to local population prevalences. Of clients assessed, there were no significant differences in diagnostic rates of autism among demographic groups compared to the service’s average diagnostic rate. Clinicians conducting autism assessments appeared to show no diagnostic bias. However, findings suggest there are still disparities in gender, ethnicity, and age of adults who were referred and accepted for autism assessments. Further research is needed to investigate causes of this access disparity to ensure people can access appropriate services and support. This clinical service evaluation explored disparities in age, ethnicity, and gender of adults referred and assessed for autism by a London‐based autism diagnostic service. Participants referred and accepted for autism assessments were significantly more likely to be male, aged 18–34, and from White or “Other” ethnic backgrounds compared to local population prevalences, suggesting potential biases in referring clinicians. Clinicians conducting autism assessments appeared to show no diagnostic bias, as there were no significant differences in diagnostic rates of autism among demographic groups compared to the service’s average diagnostic rate. eng.

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21. Zhao L, Li X, Yang K, Jiang M, Chen Z, Shao Y, Lu T, Zhang D, Wang L, Li J. MELK is Required for G2/M Phase Progression in Cortical Progenitors: Insights from Rare ASD-Associated Variants. Cell Mol Neurobiol. 2026.

Maternal embryonic leucine zipper kinase (MELK) is a cell cycle regulator, yet its role in embryonic cortical development remains unclear. We identified ultra-rare, predicted loss-of-function MELK variants in ASD individuals, prompting this functional investigation. Published human single-cell transcriptomics showed that MELK expression is enriched in neural progenitors and correlates with the G2/M phase. Using in utero electroporation in mouse cortex, we found that Melk knockdown reduced the proportion of progenitors in G2/M phase. Knockdown also caused impaired multipolar-to-bipolar transition and shorter leading processes. Complementing these findings, transcriptomic analysis of FACS-sorted Melk-knockdown cortical cells revealed downregulation of G2/M-related genes and cytoskeletal regulators linked to neuronal morphogenesis. Together, these findings identify MELK as a critical regulator of both G2/M phase progression and neuronal morphogenesis during cortical development, providing a mechanistic link to neurodevelopmental conditions.

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22. Zhong Y, Dang S, Wang X, Chia XY, Zhang J, Li W, Yao C, Li Z, Xiao B. Efficacy and Safety of Massage Therapy for Cognitive Impairment in Patients With Autism Spectrum Disorder: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc. 2026; 15: e88284.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by social communication deficits and cognitive impairment. As pharmacological and behavioral treatments often show inconsistent efficacy, massage therapy-a low-risk complementary approach including tuina and acupressure-is used to improve cognitive symptoms, yet its systematic efficacy and safety remain unevaluated. OBJECTIVE: This systematic review and meta-analysis aims to evaluate the efficacy and safety of massage therapy (categorized into traditional Chinese medicine-based and Western-based approaches) for improving specific cognitive domains (eg, executive function, attention, and memory) in individuals with ASD. METHODS: Randomized controlled trials (RCTs) and cluster RCTs will be identified across 9 English and Chinese databases (including PubMed, Cochrane Library, and China National Knowledge Infrastructure) through September 2025. Two reviewers will independently perform study selection, data extraction, and risk-of-bias assessment using version 2 of the Cochrane risk-of-bias tool. A random-effects model will be primarily applied due to anticipated clinical diversity, with fixed-effects models reserved for sensitivity analyses of homogeneous data (I2=0%). Subgroup analyses will explore age, intervention context, and massage type. Evidence for primary outcomes-including checklist scores and specialized cognitive scales-will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Selection results will be summarized in a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. This review will synthesize evidence on massage therapy’s effects on cognitive outcomes measured using scales such as the Autism Behavior Checklist, Childhood Autism Rating Scale, and Autism Treatment Evaluation Checklist, as well as safety profiles. This study was funded in 2024. Following the September 2025 search, analysis will be completed by June 2026, with final results expected for submission in December 2026. CONCLUSIONS: This study will evaluate massage therapy’s role in managing cognitive impairment in ASD. By synthesizing available evidence from RCTs, the findings will provide an evidence-based foundation for clinical decision-making and clarify whether manual therapies serve as safe, effective nonpharmacological adjuncts to existing ASD interventions.

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