1. Ailey SH, Miner DC, Smeltzer SC, Marks B, Sisirak J, Abery B, Tichá R. Using the Collective Impact Model to Organize Evidence-Based Programs to Educate Health Care Professionals About the Care Needs of Individuals with Intellectual and/or Developmental Disabilities. Healthcare (Basel). 2026; 14(15).

Background: Individuals with intellectual and/or developmental disabilities (IDDs) experience persistent health inequities, exacerbated by the systemic lack of education of health care professionals about their care. In response to a 2020 call from the Administration for Community Living in the United States, five institutions formed the IDD Health Equity Consortium to develop a suite of educational materials and practice experiences to improve the education of health care professionals in the health and health care of individuals with IDDs. Methods: The Collective Impact Model, designed to align organizations and stakeholders around a shared agenda for system change, was used to organize IDD Health Equity Consortium programs. Backbone infrastructure included a cross-sector steering committee, an Advocate Advisory Committee, and three Consortium Action Networks focused on communication, measurement, and education, practice, and policy. A scoping review of the literature was conducted, and a Participatory Planning and Decision-Making process engaged individuals with IDDs, family members, students, faculty, and professionals in identifying important themes for developed materials. Results: Learning modules, case studies, service-learning experiences, and simulation experiences were developed across Consortium institutions and were disseminated across multiple other institutions, with beginning alignment with interprofessional and disability competencies. Mixed-methods evaluation strategies assessed learner outcomes, including knowledge checks and pre and post evaluations using established measures of skills, comfort levels, and approach; and interprofessional socialization, valuing, and collaborative practice behaviors. Conclusions: By involving individuals with IDDs in curriculum development and building multi-institution and cross-sector infrastructure, the Consortium developed scalable materials that address longstanding gaps in health care professional education. The developed suite of educational materials and practice experiences and early evaluation findings provided a foundation for further program refinement and future empirical studies examining long-term effects on practice and clinical outcomes.

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2. Cavalier H, Volk H, Afanasyeva Y, Sumner S, McRitchie S, Coble R, Chen Y, Liu M, Trasande L, Ghassabian A. Prenatal targeted maternal pregnancy metabolomic profiles, child emotional and behavioral problems, and autism related traits in the NYU CHES cohort. Mol Psychiatry. 2026.

The prenatal period is a critical window for neurodevelopment, during which maternal metabolic processes are increasingly recognized to shape later behavioral and autism-related traits. We examined associations between targeted maternal urinary metabolomic profiles across pregnancy and preschool emotional, behavioral, and autism-related outcomes in the New York University Children’s Health and Environment Study (NYU CHES), a large prospective birth cohort. Targeted metabolomics was conducted on maternal urine samples collected in early, mid, and late pregnancy. Child outcomes were assessed at a mean age of 2.3 years using the Child Behavior Checklist (CBCL) total and DSM-5-oriented autism spectrum disorder (ASD) subscale scores. We applied two-stage mixed-effects models to assess overall pregnancy metabolite levels and timepoint-specific negative binomial models to evaluate trimester-specific associations, with covariate adjustment, sex-stratification, and false discovery rate (FDR) correction. Few associations were observed two-stage models. In timepoint-specific analyses, a robust sex- and timing-specific association emerged: among males, higher third-trimester urinary lysoPC a C26:1 was associated with lower CBCL total and ASD subscale scores, surviving stringent FDR correction and remaining robust after adjustment for maternal diet quality. Additional associations involving taurine, inflammatory markers, and acylcarnitines were observed primarily in sex-stratified or diet-adjusted models but were less robust to multiple testing correction. These findings suggest that prenatal metabolic profiles, particularly lipid- and mitochondrial energy-related pathways in late gestation, may contribute to early behavioral and autism-related traits in a sex-specific manner, underscoring the importance of exposure timing and maternal metabolism in the etiology of neurodevelopmental outcomes.

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3. Chang CS, Lin CJ. Short Report: Divergent Sleep-Wake Regularity in U.S. Children With Autism Spectrum Disorder: Bedtime vs Wake-up Regularity. Autism. 2026: 13623613261477806.

Sleep-wake regularity is an emerging dimension of sleep health, yet its association with autism spectrum disorder (ASD) remains understudied in nationally representative samples, particularly across distinct components of sleep timing. Using parent-reported data from 11,462 U.S. children aged 5-17 years in the 2022 and 2024 National Health Interview Survey, this study examined associations between ASD diagnosis and irregular bedtime and wake-up timing, including differences by age group. Multivariable logistic regression models were adjusted for sociodemographic characteristics, family context, daytime fatigue, and mental health indicators, with survey weights applied to account for the complex sampling design. In pooled analyses, ASD was associated with lower odds of irregular bedtime (adjusted odds ratio [aOR] = 0.64, 95% CI: 0.43-0.95) but higher odds of irregular wake-up times (aOR = 1.60, 95% CI: 1.01-2.56). Age-stratified analyses showed that the association with irregular wake-up timing remained in children (aOR = 2.27, 95% CI: 1.14-4.51) but not in adolescents, while no association was observed for bedtime in either age group. As one of the first nationally representative analyses distinguishing bedtime and wake-up regularity in ASD, these findings suggest that associations differ by timing component and age group, with wake-up timing representing a potential intervention target.Lay abstractMany children do not go to bed or wake up at the same time every day, which can affect their health and daily functioning. Sleep problems are especially common among autistic children, but most research has focused on how long they sleep or how well they sleep, rather than whether their sleep schedules are consistent. In this study, we used national survey data from the United States to examine whether autistic children differ from other children in how regularly they go to bed and wake up. Using data from the 2022 and 2024 National Health Interview Survey, we analyzed parent-reported information from over 11,000 children aged 5 to 17 years. Our results showed that autistic children were more likely to have consistent bedtimes but also more likely to have irregular wake-up times than children who were not autistic. This pattern remained after accounting for factors such as daytime tiredness and emotional well-being. These findings suggest that sleep challenges in autistic children may vary by time of day and developmental stage. In particular, maintaining consistent wake-up times may be more difficult for younger autistic children. Focusing on wake-up timing may therefore be a useful target for supporting sleep health in this group. Further research is needed to understand the reasons behind these differences and to identify effective ways to promote consistent sleep schedules.

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4. Chen V, Vomvos M, De Sonia A, Rosselot H, Lozano R. Knowledge, attitudes, and perspectives on gene therapy for Fragile X syndrome: results from two community and caregiver surveys. Front Mol Neurosci. 2026; 19: 1912516.

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability and autism spectrum disorder, resulting from CGG trinucleotide repeat expansion in the FMR1 gene and consequent absence of Fragile X Messenger Ribonucleoprotein (FMRP). Current management remains symptomatic, and adeno-associated virus (AAV)-mediated gene therapy represents a promising treatment and perhaps a curative avenue. However, community perspectives on gene therapy in FXS have not been assessed. FXS is a non-lethal neurodevelopmental condition with a normal life expectancy. Caregivers weighing gene therapy for a child with FXS must balance the potential benefits of FMRP restoration against the uncertainties and risks of an investigational gene therapy in the absence of life-threatening urgency. Whether and to what degree FXS caregivers are willing to consider gene therapy under these circumstances is therefore a meaningful and non-trivial question, and one that has not previously been examined. We report findings from two sequential cross-sectional surveys examining community and caregiver knowledge, attitudes, concerns, and information preferences regarding gene therapy for FXS. The initial survey (Survey One) was an 8-item online survey completed by 351 FXS community members. A follow-up survey (Survey Two) was a 26-item online, REDCap-based instrument completed by 56 parents/caregivers recruited through clinics and the National Fragile X International Conference. Both surveys demonstrated strongly positive attitudes toward gene therapy: 94% of Survey One community members indicated they would consider gene therapy for FXS, while 84% of Survey Two caregivers agreed or strongly agreed they were hopeful about gene therapy success, and an equal 84% indicated they would consider gene therapy if available. The primary concern across both surveys was side effects and risks, followed by effectiveness, timeline, and cost. Improving quality of life was the leading motivator (69%), and intellectual and developmental disability was the symptom caregivers most wanted a future therapy to address (57%). Physicians, genetic counselors, and geneticists were identified as the preferred sources for gene therapy education. These findings reveal that surveyed caregivers express high motivation and broadly positive attitudes toward gene therapy, while highlighting specific educational needs that may inform informed consent processes and clinical trial design for future FXS gene therapy development. These results represent the perspectives of surveyed caregivers and may not generalize to the broader FXS community.

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5. Dakopolos A, Vilay N, Chen I, Kaat AJ, Condy E, Coleman J, Berry-Kravis E, Erickson C, Thurm A, Hessl D. Clinical Relevance of NIH Toolbox Cognition Battery Developmental Change in Intellectual and Developmental Disabilities: Associations with Verbal Reasoning. Am J Intellect Dev Disabil. 2026: 1-7.

The NIH Toolbox Cognition Battery (NIHTB-CB) assesses crystallized verbal skills,and shows strong psychometric properties and sensitivity to developmental change in intellectual and developmental disabilities. However, whether gains in NIHTB-CB Crystallized Cognition reflect improvements in broader verbal abilities is unclear, and this has implications for clinical interpretation of the measure in the context of treatment studies. Two-hundred sixty-three participants completed NIHTB-CB Crystalized Cognition subtests (Picture Vocabulary, Oral Reading Recognition) and Stanford-Binet 5th ed. subtests (Verbal Knowledge, Verbal Fluid Reasoning) at baseline and at two-year follow-up. Bivariate latent change score models examined whether changes in Crystalized Cognition were related to changes in broader verbal skills. Changes in Crystalized Cognition were significantly related to changes in Verbal Knowledge (β = 7.92, p = .009) and Verbal Fluid Reasoning (β = 4.91, p = .018). Higher baseline Crystalized Cognition predicted greater improvement in these verbal domains, while higher initial verbal scores also predicted more Crystalized Cognition growth. Change in the NIHTB-CB Crystalized Composite was significantly related to growth in verbal reasoning in children and young adults with IDD. This may indicate that the Crystalized Composite is a useful proxy for broader verbal skills, underscoring its clinical relevance.

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6. De Sales-Millan A, Reyes-Ferreira P, González-Cervantes RM, Luna-Álvarez M, Guillén-López S, Cobo-Díaz JF, Ramos S, Aguirre-Garrido JF, Velázquez-Aragón JA. Clinical Improvement and Taxonomic-Functional Gut Microbiome Remodeling After Six Months of Multi-Strain Synbiotic Supplementation in Mexican Children with Autism Spectrum Disorder. Nutrients. 2026; 18(15).

Background/Objectives: Gut dysbiosis in children with autism spectrum disorder (ASD) has been associated with alterations in microbial ecology and metabolic function that may contribute to gastrointestinal dysfunction and the severity of clinical manifestations. Synbiotic and probiotic supplementation has emerged as a promising microbiome-targeted strategy for ASD; however, its effects on gut microbiome composition, functional potential, and clinical outcomes remain incompletely understood. We conducted a longitudinal study of Mexican children diagnosed with ASD to analyze changes in the composition, diversity, and functional potential of the gut microbiome during six months of multi-strain synbiotic supplementation. Methods: Stool samples were collected from 25 children with ASD at baseline and after 3 and 6 months of multi-strain synbiotic supplementation. Gut microbiome composition and diversity were analyzed by 16S rRNA gene sequencing, whereas whole metagenome sequencing (WMS) was performed in a subset of samples to evaluate the functional potential of the fecal microbiome. Gastrointestinal symptoms were assessed using the Rome IV criteria, and ASD severity was evaluated with the Childhood Autism Rating Scale (CARS). Results: Twenty-five children with ASD completed the 6 months of synbiotic supplementation. Overall, ASD severity decreased, reflected by a reduction in total CARS score, and improvements in several CARS domains. Gastrointestinal symptoms also decreased significantly. Longitudinal microbiome profiling revealed significant taxonomic and diversity changes over the supplementation period, while WMS identified changes in microbial metabolic potential, including enrichment of tryptophan biosynthesis pathways and reduced L-rhamnose degradation. Conclusions: This exploratory research provides proof-of-concept evidence supporting multi-strain synbiotic supplementation in children with ASD. Larger controlled studies are needed to confirm these findings and clarify their relevance to microbiota-gut-brain axis interactions. The observed concordance between clinical improvements and microbiome remodeling supports further investigation of microbiome-targeted interventions according to ASD severity and duration of supplementation.

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7. Doka G, Aliçka Y, Tahiraj D, Elezi B, Gega V, Sula E. The role of telehealth in autism spectrum disorder management: a scoping review. Med Glas (Zenica). 2026; 23(2).

AIM: To map and summarise evidence on the role, benefits and challenges of telehealth in autism spectrum disorder (ASD) management, including assessment and intervention. METHODS: This scoping review searched PubMed and Scopus for English-language studies published from 2015 to 2025; the search was last updated on 14 April 2026. Nine studies met the eligibility criteria, comprising randomised controlled trials and observational, mixed-methods, descriptive, pilot, and qualitative studies. RESULTS: Available findings suggest that telehealth-based assessment may achieve high diagnostic concordance with in-person evaluation, and that telehealth-delivered interventions may yield similar outcomes in selected domains. Several studies reported high caregiver and clinician satisfaction. Key challenges included technological access barriers, variability in caregiver engagement, and concerns regarding reliability and equity in under-resourced settings. CONCLUSION: Telehealth may be a valuable complement to, rather than a replacement for, in-person care. Future primary studies should use rigorous designs and standardised outcome measures and should prioritise linguistically diverse and low-resource populations; future evidence syntheses should include formal risk-of-bias assessment.

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8. Gaouzi Z, Spoto G, Polito F, Festali R, Gasparo I, Licitri L, Mirabello AM, Romano S, Macaione V, Dini N, El Fahime E, Boutayeb S, Kriouile Y, Diawara I, di Rosa G, Aguennouz M. Genetic Heterogeneity in Autism Spectrum Disorder: Diagnostic Yield, Recurrent Genes, and Rare Variant-Phenotype Associations from Whole-Exome Sequencing. Int J Mol Sci. 2026; 27(15).

Autism spectrum disorder (ASD) is genetically heterogeneous, involving rare and common variants that disrupt neurodevelopmental pathways. To explore this complexity, we performed whole-exome sequencing in children with ASD. Clinical phenotypes were systematically recorded, and severity was classified according to DSM-5 criteria. Variants were interpreted using ACMG guidelines, with recurrence analysis to identify genes shared across individuals and cohort enrichment testing against gnomAD. To examine genotype-phenotype relationships, we applied SKAT/SKAT-O across 16 phenotypes after covariate adjustment. Among 25 included individuals, pathogenic or likely pathogenic variants were found in 9, yielding a diagnostic yield of 36%. These involved genes linked to neurodevelopmental, epileptic, metabolic, and syndromic disorders. Recurrence analysis identified 586 genes present in at least two individuals, with PABPC1, GTF2I, PCLO, PKD1, and EP400 being the most frequent. SKAT/SKAT-O revealed the strongest burden associations for motor delay, aggressive behavior, mutism, anxiety, unresponsiveness to spoken voice, digestive disorder, and sleep disturbances, with limited overlap across phenotypes. Several recurrent genes also showed phenotype-specific associations. Overall, this integrative WES study provides clinically actionable diagnoses, highlights recurrent genes, and uncovers phenotype-specific signals, supporting convergent pathways with gene-level heterogeneity.

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9. Griffin JW, Cairney B, Carson WEt, Chetcuti L, Dubois AEE, Dumas G, Jacquemont S, Jeste S, Momsen JP, Naples AJ, McPartland JC. Recent progress of large-scale biomarker consortia and paths forward in biomarker development for autism. Biol Psychiatry. 2026.

Autism presents significant challenges for clinical research and biomarker development due to behavioral heterogeneity and reliance on clinician- and caregiver-report measures that are limited in sensitivity, objectivity, and scalability. Biomarkers offer a complementary approach by providing biologically grounded, standardized, and potentially more sensitive indicators of the autism phenotype. We outline the potential advantages of biomarkers over traditional clinical assessments, operationalize biomarkers using FDA/NIH consensus frameworks, and evaluate recent progress from large-scale biomarker consortia and remaining challenges for two well-developed measurement modalities: electroencephalography (EEG) and eye-tracking (ET). We summarize findings from one of these recent biomarker consortia, the Autism Biomarkers Consortium for Clinical Trials (ABC-CT), that has established the feasibility, stability, and regulatory relevance of several candidate biomarkers. Despite meaningful advances in reproducibility of biological factors associated with autism, clinically actionable biomarkers remain elusive. We describe potential paths forward to overcome this obstacle, including leveraging neurogenetic syndromes and genomic stratification, aligning biomarkers with biologically specified behavioral constructs, expanding measurement into motor and vestibular domains, and applying data-driven, multimodal, and digital phenotyping approaches to advance clinical trial readiness in autism.

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10. Karavuş M, Arısın HB, Bakırkaynak ED, Akkuzugil Z, Tahan SE, Kekeç ME, Akkuş E, Girgin Ş, Lüleci NE, Hıdıroğlu S. Qualitative Evaluation of the Autism Awareness of Pediatric Dentistry Residents of a Public University in Istanbul, Turkiye. Spec Care Dentist. 2026; 46(4): e70234.

AIMS: This study aimed to qualitatively evaluate the awareness, knowledge levels, and clinical approaches of dental residents regarding the dental management and characteristics of individuals with Autism Spectrum Disorder (ASD). METHODS AND RESULTS: Using a phenomenological qualitative design, data were collected through semi-structured, in-depth interviews with dental residents at a public university in Istanbul, Türkiye. Transcripts were analyzed via ATLAS-ti software to identify themes and sub-themes. Residents recognized key ASD traits such as repetitive behaviors, sensory sensitivities, and communication barriers. The theme « Experience During Examination » highlighted significant challenges, including patients’ difficulty following instructions and fear of the clinical setting. Results indicated that residents utilize behavioral management strategies, such as providing isolated, low-stimulus environments and using visual aids or relaxing music. While some managed difficulties through adapted interactions, others reported a need to refer patients for conscious sedation or general anesthesia for invasive procedures. CONCLUSION: Although dental residents demonstrate a foundational awareness of ASD, they face practical challenges in clinical examination and treatment. Enhancing specialized training in behavioral management and providing low-stimulus clinical settings are essential to improve oralhealthcare outcomes for patients with ASD.

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11. Kitthitima Y, Fuengfoo A, Vuttipittayamongkol P, Arunothong W, Liamwanich K, Teekavanich S, Wattanasoontornsakul P, Aroonyadech N, Kangwanthiti IO, Rojmahamongkol P. The Costs of the Diagnostic Process for Autism Spectrum Disorder in Thailand: A Multicenter Study. Value Health Reg Issues. 2026: 101683.

OBJECTIVES: Global information on the costs of the autism spectrum disorder (ASD) diagnostic process is limited. No previous research has been conducted in Thailand. This study aimed to determine the societal costs of the ASD diagnostic process after the patients visited 7 tertiary hospitals in the Northern, Central, Northeast, and Southern regions of Thailand. METHODS: A total of 155 children diagnosed with ASD were included from January to December 2022. The societal costs consisted of the patient costs, and service provider costs. Government reimbursement and labor costs were also evaluated. The patient perspective costs were calculated from direct nonmedical costs plus nonreimbursable direct medical costs. Direct nonmedical costs were collected by parent questionnaires. Nonreimbursable direct medical costs and the government reimbursement were acquired from each hospital’s financial database. Service provider perspective costs were gathered from the Human Resources Unit hospital database. RESULTS: The median of societal, service provider, patient, labor costs, and government reimbursement for the ASD diagnostic process were 3578.6 (2433.7-5412.8), 259.5 (259.5-314.7), 3319.0 (2169.0-5138.1), 559.6 (488.8-795.6), and 200 (0-300) Thai Bahts (THB)/child, respectively. The caregiver productivity loss was the largest proportion among the total patient perspective costs. The median societal costs by region sorted by descending order were Northeast, Central, North, and South, which were 5197.6 (3248.5-6802.3), 3578.6 (2688.8-5412.8), 3028.6 (2286.7-4905.7), and 2198.9 (1686.8-3483.9) THB/child, respectively. CONCLUSION: The societal costs of the ASD diagnostic process were 3578.6 THB/child. The Northeast region demonstrated the highest costs. The caregiver productivity loss was the largest proportion of the total societal costs.

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12. Luo W, Yin Z, Dai J. Early Detection Methods for Autism Spectrum Disorder: From Clinical Screening to Multimodal AI. Diagnostics (Basel). 2026; 16(15).

Early detection of autism spectrum disorder (ASD) in young children is essential for timely referral, developmental monitoring, and access to early intervention. However, conventional screening and diagnostic pathways often depend on parent-report instruments, episodic clinical observation, and specialist-administered assessments, which may delay identification during the first years of life. This scoping review maps the methodological landscape of early ASD detection from traditional clinical screening to multimodal artificial intelligence (AI). A structured literature search was conducted across major biomedical, psychological, and engineering databases for studies published between January 2010 and May 2026. After screening and eligibility assessment, 65 evidence sources were included in the qualitative synthesis, with additional methodological guidelines used to support reporting and appraisal. The reviewed evidence shows that early ASD detection is increasingly shifting from single-session clinical assessment toward multidimensional risk characterization. Clinical and behavioral screening tools remain the foundation of early identification, while eye tracking, video-based motor analysis, acoustic and vocal biomarkers, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and molecular or genomic indicators provide complementary information across different developmental windows. AI-based methods, including machine learning, deep learning, Transformer architectures, multimodal fusion strategies, and foundation-model-based representation learning, may improve the objective quantification of gaze, movement, vocalization, neural activity, and biological risk. Nevertheless, most AI-assisted systems remain limited by small and heterogeneous datasets, insufficient external validation, population bias, privacy concerns, computational burden, and limited interpretability. This review argues that future early ASD detection systems should be developed as clinician-supervised decision-support tools rather than autonomous diagnostic instruments. Clinically meaningful progress will require robust external validation, privacy-preserving deployment, age-appropriate risk stratification, and intrinsically interpretable architectures that align model outputs with developmental and clinical knowledge.

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13. Ma C, Zhao J, Wang C, Meng B, Yao G, Ye H. From autism to obesity and beyond: mapping global trends and gaps in pediatric gut microbiota interventions-a bibliometric analysis. Transl Pediatr. 2026; 15(7): 277.

BACKGROUND: Pediatric gut microbiota interventions are increasingly applied in conditions such as autism spectrum disorder (ASD), obesity, and malnutrition; however, the global research structure and thematic trends remain unclear. This study aimed to map the global research landscape of pediatric gut microbiota interventions from 2010 to 2025, characterizing publication trends, geographic and institutional distribution, collaboration networks, and thematic evolution, in order to identify research hotspots and evidence gaps that should guide future priorities. METHODS: Publications from January 1, 2010, to June 30, 2025, were retrieved from the Web of Science Core Collection (WoSCC) using predefined search terms. Microsoft Excel 2021, VOSviewer 1.6.19, CiteSpace 6.2.4, and the R package bibliometrix 4.0.0 were employed to analyze publication trends, geographic distribution, institutional and author collaborations, highly cited works, and keyword co-occurrence. RESULTS: A total of 1,915 articles involving 12,308 authors across 546 journals were identified, citing 39,956 references and generating 3,510 unique keywords. Global output has increased markedly over 15 years, with China and the United States forming a « dual-core » dominance. Only 27.12% of the studies resulted from multi-country (international) collaborations, indicating limited cross-regional partnerships. Research hotspots have centered on ASD, obesity, and nutritional disorders, while developmental and behavioral outcomes have been underrepresented. Personalized nutrition, microbiota-brain-behavior links, and multi-omics integration have emerged as growing themes. CONCLUSIONS: This bibliometric study maps the global landscape of pediatric gut microbiota interventions, revealing rapid expansion but thematic imbalance. Greater multinational collaboration and broader inclusion of developmental health endpoints emerge as key priorities for the future research agenda.

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14. McQuaid GA, Lee NR, Wallace GL. Characterization of Anticholinergic Medication Use and Its Associations With Everyday Memory Problems and Cognitive Decline in Autistic Adults With Higher Support Needs. Autism Res. 2026: e70342.

Among older adults in the general population, medications with anticholinergic (AC) effects are associated with declines in cognitive functioning and with dementia and Alzheimer’s disease. Autistic people have high rates of co-occurring medical conditions and polypharmacy across the lifespan; thus, they may be at particularly high risk of exposure to AC medications and their negative impacts on cognitive functioning, including earlier in adulthood. Consistent with this, a single study has shown AC medication use is prevalent among autistic adults without co-occurring intellectual disability and is associated with self-reported concurrent memory problems and declines in cognition. No study has examined AC medications and their associations with cognition among autistic adults with higher support needs. We therefore characterized AC medication use and its associations with caregiver-rated memory problems and changes in cognition and behavior that have been linked with cognitive decline. Caregivers of autistic adults (18-68 years; Mean ~31 years) recruited via Simons Powering Autism Research’s (SPARK) Research Match service reported medication use (N = 512), memory complaints (N = 467), and a screener that probes behavior/cognitive changes (N = 466) that are associated with cognitive decline among persons with an intellectual disability. The majority (66.41%) of autistic adults were taking at least one AC medication and 31% were taking clinically-meaningful levels of these medications. After controlling for age and birth sex, greater potency of AC medications was associated with both caregiver-reported memory challenges and behavioral/cognitive changes associated with cognitive decline. Understanding AC medication use and its potential impacts on cognition among autistic adults with higher support needs is crucial. Some medicines are linked to problems with memory and thinking in older people who are not autistic. We looked at these medicines in autistic adults who have higher support needs. This sample included mostly autistic people with likely intellectual disability. Most autistic people in the study were taking these kinds of medicines. Taking these medicines was associated with memory problems. In addition, taking these medicines was associated with responses on a screener the caregiver filled out asking about changes in thinking and behavior that are linked with cognitive decline. eng.

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15. Morton A, Arnold H, Hamrick L, Chase A, Cobb S, Roberts J. Autonomic Nervous System Function and Sensory Sensitivity in 12-Month-Old Infants with the FMR1 Premutation. Int J Mol Sci. 2026; 27(15).

The fragile X premutation (FXpm) is a relatively common condition caused by an expansion of 55-200 cytosine-guanine-guanine (CGG) repeats in the fragile X messenger ribonucleoprotein 1 (FMR1) gene. Previous studies have identified sensory processing challenges in children with the FXpm and reduced autonomic regulation in FXpm infants; no research has examined the relationship between autonomic nervous system (ANS) functioning or molecular variables and sensory responsiveness during infancy. This study examined parent-reported sensory responsiveness and its association with baseline respiratory sinus arrhythmia (RSA), interbeat interval (IBI), and CGG repeat length in 12-month-old infants with the FXpm (n = 35) and neurotypical (NT) controls (n = 55). Results indicated no significant differences in hyporesponsive or hyperresponsive sensory behaviors and no significant associations between baseline RSA or IBI and sensory responsiveness in either group. Within the FXpm group, however, greater CGG repeat length was associated with lower hyperresponsive sensory scores. These findings suggest that sensory processing differences may not be behaviorally evident at 12 months of age despite the presence of biological variability associated with the premutation. The study contributes to the emerging literature on early FXpm development and highlights the importance of examining genetic and physiological factors that may precede later-emerging behavioral phenotypes.

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16. Ogunsola HY, Summers AD, Gonzalez MG, Thompson-Paul AM, Schweizer M, Miller RM, Rosselot H, Tinker SC. Characterizing Populations Based on Proximity to a Fragile X Syndrome Specialty Clinic. Am J Intellect Dev Disabil. 2026: 1-11.

Fragile X syndrome (FXS) is a rare condition that can require lifelong specialized care for optimal management. We describe census-based characteristics of general U.S. populations defined by proximity to FXS specialty clinics to better understand potential barriers to access. We used Geographic Information System software to estimate drive times from U.S. census tract centroids to FXS clinics. Of the contiguous U.S. population, 36.4% lives ≤1 hour from the closest FXS clinic in the same state; 32.4% live >1 to 4 hours, 7.3% live >4 hours, and 23.8% have no FXS clinic in their state. Individuals residing >1 hr from or in a state without an FXS clinic, compared to <1 hr, were more commonly non-Hispanic White, had household income below 150% poverty level, had one or more disabilities, and lived in a household without an internet subscription. Populations living ≤1 hr from an FXS clinic more commonly spoke limited English, lived in multiunit housing, and did not have a vehicle. These results can be used to identify areas of higher need for improving access to specialty care, inform efforts to reduce disparities related to access, and facilitate more optimal healthcare for people with FXS.

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17. Ongun CH, Şandor S, Tanfer MC, Gürkaş S, Bora IE. Comparative analysis of social cognitive performance in autism spectrum disorder and schizophrenia. J Psychiatr Res. 2026; 202: 111-8.

Social cognitive impairments are widely documented in both schizophrenia (SCZ) and autism spectrum disorder (ASD); however, whether these conditions differ in their qualitative mentalizing profiles remains unclear. The present study compared young adults with SCZ (n = 30), ASD (n = 29), and healthy controls (HC; n = 40) using measures of selected domains of social cognition (SC), including the Movie for the Assessment of Social Cognition-Turkish Version (MASC-TR), the Reading the Mind in the Eyes Test (RMET), and the Faux Pas Recognition Test (FPRT). Group differences were examined using multivariate analyses, and the contribution of global neurocognition was statistically controlled. Significant overall group effects emerged across SC measures. Both clinical groups performed significantly worse than HC in overall mentalizing accuracy (MASC-TR total), the ability to infer mental and emotional states (RMET), and faux pas control stories. Although SCZ and ASD did not differ in overall accuracy, distinct error patterns were observed. Individuals with schizophrenia showed a pronounced tendency toward under-mentalizing, reflected in a higher frequency of responses indicating insufficient mental state attribution. In contrast, autism was characterized by a heterogeneous error profile. Group differences remained significant after controlling for global neurocognitive functioning, indicating that social cognitive impairments were not explained by generalized cognitive deficits. These findings support a transdiagnostic framework of impairments in selected social cognitive domains while demonstrating disorder-specific qualitative differences in mentalizing style. Distinguishing between shared impairments and distinct error patterns may contribute to targeted assessment and intervention strategies to improve real-world social functioning.

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18. Ozaydin Y, Canlan Özaydin B. Frozen Instants and Gestalt Words: Toward a Phenomenology of Autistic Language and Temporality. Psychopathology. 2026: 1.

Autistic patterns of language use, including echolalia, gestalt language processing, and formulaic repetition, have been theorized largely within behavioral and developmental frameworks. Such accounts have documented the functional range of these phenomena in valuable detail, yet their experiential structure has received little attention. This paper develops a phenomenological account of autistic language and temporality. We argue that echolalia and gestalt language are best understood not as deficient approximations of normative speech but as expressions of a distinctly structured temporal consciousness. Drawing on Husserl’s analysis of inner time-consciousness and Merleau-Ponty’s account of bodily intentionality, we propose that autistic temporal experience may be marked by a heightened density of the present moment, a configuration in which retention and protention are differently weighted and in which the instant attains a relative closure that canonical phenomenological accounts do not anticipate. Gestalt language, read in this light, appears less as a failure of analytic decomposition than as a mode of meaning-making that preserves semantic wholes rooted in bodily-affective memory. The argument carries implications for both phenomenological theory and clinical practice: it questions the assumption of a universal temporal substrate underlying language acquisition, and it motivates a clinical reorientation from suppressing echolalia toward interpreting it.

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19. Singh J, Chishti S, Ameenpur S, Fiori F, McFadden L, Mirza HA, Vidmar L, Zahavi Z, Santosh P. When Neurodevelopment Meets Autoimmunity: Pemphigus Foliaceus in Rett Syndrome Expands the Clinical Spectrum-A Case Report. Int J Mol Sci. 2026; 27(15).

Rett syndrome (RTT, OMIM 312750) is a complex multisystem neurodevelopmental disorder. Evidence suggests that RTT may have an autoimmune component and inflammatory activation. However, the autoimmune manifestations remain poorly described. Pemphigus foliaceus is a debilitating autoimmune blistering condition caused by IgG autoantibodies that target desmoglein-1 (Dsg1), resulting in widespread skin blistering and lesions. We report a case of pemphigus foliaceus in a 20-year-old female with RTT and discuss its clinical implications. Clinical data obtained from electronic health records were extracted and reviewed. Genetic testing was performed to identify the specific methyl-CpG-binding protein 2 (MECP2) mutation and on an expanded panel of 55 genes associated with pemphigus foliaceus and related blistering disorders. The individual had pemphigus foliaceus, which required immunosuppression, intravenous immunoglobulin (IVIg) therapy, and Rituximab. The disease trajectory was complicated by infections, aspiration pneumonia, and hypoxic cardiac arrest. There was progressive functional decline, and disease control was difficult to achieve, with frequent flares. Genetic testing confirmed a heterozygous pathogenic MECP2 variant (NM_001110792.1:c.952C>T; p.(Arg318Cys)). HLA genotyping identified alleles consistent with the HLA-DRB1*04:02-HLA-DQA1*03:01-HLA-DQB1*03:02 (DR4/DQ8) haplotype. Furthermore, genetic analysis identified a heterozygous DSG1 variant rs12967407. This study reports the first case of pemphigus foliaceus in RTT, expanding the clinical spectrum of RTT beyond its neurodevelopmental phenotype. The DR4/DQ8 haplotype, previously associated with pemphigus susceptibility, supports a background of genetic susceptibility in this individual. No causal association between RTT and pemphigus foliaceus can be inferred from this single case. Rather, this case demonstrates that a rare autoimmune disorder such as pemphigus foliaceus can co-occur with a pathogenic MECP2 mutation. The coexistence of a genetic and autoimmune disease can result in a more complex clinical presentation and treatment course. The case further emphasises the need for increased vigilance in identifying new and emerging systemic pathology alongside RTT.

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20. van Asselt A, Roke Y, Begeer S, Scheeren A. Social Pain Sensitivity in Autistic Adults: Associations With Gender, Self-Esteem, Cognitive Empathy, and Sensory Sensitivity. Autism Res. 2026: e70345.

Social pain sensitivity refers to the tendency to detect and react strongly to cues of social exclusion. Frequent social adversities and specific characteristics may make individuals with autism more sensitive to social pain, yet evidence remains inconsistent. To enhance our understanding, autistic adults aged ≥ 16 years (n = 1425; M(age) = 47.3, SD = 14.2) and allistic adults (n = 187; M(age) = 51.4, SD = 14.6) enrolled in the Netherlands Autism Register (NAR) completed the Social Pain Questionnaire (SPQ). A two-way ANOVA demonstrated that autistic adults reported significantly higher social pain sensitivity than allistic adults, with a small effect size (η(2) (p) = 0.02). Women reported higher social pain sensitivity than men across both groups (η(2) (p) = 0.01), and this gender difference was comparable for autistic and allistic adults. Within the autistic group, in a subset of participants with complete data (n = 234), a hierarchical multiple regression analysis showed that social pain sensitivity was moderately associated with lower self-esteem (β = -0.47), but not with cognitive empathy or sensory sensitivity. Exploratory analyses further indicated that self-esteem fully accounted for the association between autism diagnosis and social pain sensitivity. Consistent with sociometer theory, these results suggest that heightened social pain sensitivity in autistic adults may reflect reduced perceived social acceptance. Our findings highlight the relevance of social adversities for autistic adults and underscore the need for supports that strengthen belonging and reduce socially painful experiences. Autistic adults often face socially painful experiences, such as rejection and exclusion. We found that, on average, they report stronger reactions to these experiences than non‐autistic adults and that these reactions are closely linked to lower self‐esteem. This highlights the importance of support that helps autistic people feel included. eng.

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21. Yang Y, Pan Q, Xin Y, Liu X, Qiu H, Bak MYS, Dueñas AD, Reilly AM, Dumas NG. Creating a caregiver education program with chinese caregivers of autistic children: A community engaged process. PLoS One. 2026; 21(8): e0355749.

Despite a growing body of research highlighting the advantages of caregiver education for both autistic individuals and their caregivers, little is known about what Chinese caregivers of autistic children may want and need within caregiver education. In this qualitative study, we invited 14 Chinese caregivers of autistic children to share their needs and perspectives on the content and delivery of a caregiver education program. Specifically, we conducted two focus groups. The first focus group asked caregivers about the desired content of caregiver education. The second focus group asked for feedback on two prototype videos created based on the first focus group. We used reflexive thematic analysis, revealing three emergent themes regarding content and two themes regarding the delivery method. The study results show that the content and modality of online caregiver education programs should be created by solicitating intended user input throughout the development process.

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22. Yoon CD, Alexander AL, Travers BG, Lainhart JE, Dean DC, 3rd. Widespread alterations in white matter microstructure in autism: A multilevel meta-analysis. Biol Psychiatry Cogn Neurosci Neuroimaging. 2026.

BACKGROUND: Disrupted brain connectivity is central to understanding the neurobiological basis of autism spectrum disorder (ASD). Diffusion tensor imaging (DTI) has been extensively used to study brain microstructure in ASD, often revealing reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in white matter. METHODS: We conducted a multivariate random-effects meta-analysis with a multilevel structure to evaluate the extent to which FA and MD measures of white matter microstructure are altered in individuals with ASD compared to typically developing (TD) individuals, as well as how publication year, participant characteristics (age, sex, IQ), and laterality moderate the magnitude of the estimated differences. Our analysis included 881 effect sizes from 66 studies (N(ASD) = 2231, N(TD) = 1856; M(age) = 2-50 years) across 12 white matter tracts. RESULTS: We found a significant moderate summary effect size for FA in nine tracts (corpus callosum, corticospinal tract, thalamic radiation, arcuate fasciculus, inferior fronto-occipital fasciculus [IFOF], inferior longitudinal fasciculus [ILF], superior longitudinal fasciculus [SLF], uncinate fasciculus, cingulum; Hedges’ g = -0.30 to -0.50), suggesting that individuals with ASD have lower FA compared to TD controls. Additionally, we found a significant moderate-to-large summary effect size for MD in eight tracts (corpus callosum, corona radiata, corticospinal tract, arcuate fasciculus, IFOF, ILF, SLF, uncinate fasciculus; Hedges’ g = 0.29 to 0.97), suggesting that individuals with ASD have higher MD compared to TD controls. Furthermore, moderators demonstrated tract- and metric-specific effects. CONCLUSIONS: Our findings highlight the complex, multidimensional nature of white matter microstructure alterations observed in ASD.

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23. Zhang H, Xiong B, Liu H, Huang Y, Zhang J, Yu R, Jiang W, She T. Intermittent Theta Burst Stimulation Improves Sleep in Autism Spectrum Disorder by Reorganizing Overlapping Brain Networks With Neurochemical and Transcriptomic Signatures: A Randomized Controlled Trial. CNS Neurosci Ther. 2026; 32(8): e71041.

BACKGROUND: Overlapping network architecture supports functional integration and multifunctional regional engagement in the brain, and may serve as a candidate biomarker for interventions in autism spectrum disorder (ASD). However, the biological context underlying intermittent theta-burst stimulation (iTBS)-related changes in overlapping network architecture remains poorly understood. METHODS: Seventy patients with ASD and chronic insomnia were randomly assigned to receive either real or sham iTBS targeting the left orbitofrontal cortex, administered once daily for 8 weeks. The Insomnia Severity Index (ISI) and resting-state functional magnetic resonance imaging (fMRI) data were collected at baseline and after the intervention. The Shannon-entropy diversity coefficient was calculated to characterize overlapping network architecture. The JuSpace toolbox was used to assess spatial correspondence between iTBS-related network changes and neurotransmitter systems. Transcriptomic-neuroimaging association analyses were then performed using gene-expression data from the Allen Human Brain Atlas. RESULTS: Sleep improvement following real iTBS was accompanied by changes in overlapping network architecture across 13 cortical regions. These changes showed spatial correspondence with mGluR5 and GABA_A receptor density maps. Regions showing iTBS-related network changes were associated with glutamatergic synaptic transmission and calcium-dependent signaling, enriched for cortical excitatory neuronal signatures with peak expression during adolescence, and organized into a highly interconnected protein-protein interaction network centered on the Ca(2+)-PKA signaling axis. CONCLUSIONS: This study provides multiscale evidence for the biological context underlying iTBS-related changes in overlapping network architecture in ASD with chronic insomnia.

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