1. Alharbi M, Alshammari A, Al Shabanah O, Mufadhe Alanazi M, Altuwaijri A, A FA, Alshammari T. Structure-based discovery of a novel Granzyme A (GZMA) inhibitor for autism spectrum disorder through integrative transcriptomics, virtual screening, and long-timescale molecular dynamics simulations. PLoS One. 2026; 21(10): e0359103.

Granzyme A (GZMA) is a trypsin-like serine protease expressed in cytotoxic lymphocytes that cleaves gasdermin B (GSDMB) to release a pore-forming N-terminal fragment, thereby inducing pyroptosis, a lytic and pro-inflammatory form of programmed cell death. This pathway has been implicated in immune dysregulation reported in a subset of individuals with autism spectrum disorder (ASD). In this study, we reanalyzed the peripheral blood transcriptome dataset GSE26415 using an integrative computational framework comprising outlier-aware quality control, differential expression analysis, functional enrichment profiling, weighted gene co-expression network analysis, and protein-protein interaction network centrality scoring. These orthogonal evidence layers were integrated into a composite prioritization score, in which GZMA ranked first among candidate genes, followed by KLRK1 and KLRB1. Querying the Drug-Gene Interaction Database revealed no approved small-molecule inhibitors targeting GZMA, indicating that it remains pharmacologically undrugged. To explore druggability at the structural level, we performed structure-based virtual screening of a ZINC similarity library against the active site of GZMA (PDB ID: 1ORF). This yielded three drug-like candidates (T1, T2, and T3) with docking scores of -9.3, -9.1, and -8.9 kcal/mol, respectively, compared with -7.4 kcal/mol for the co-crystallized reference ligand (0G6). Each drug-protein complex and apo enzyme was studied in 500 ns molecular dynamics to verify the binding stability and conformational persistence compared to the unliganded protein. Among the screening compounds, T2 was able to occupy the catalytic pocket for the entire simulation, with a stable protein-ligand interaction and one low-energy conformational basin. T1, despite a better docking score, was able to detach from the pocket after around 400 ns, while T3 was able to do so in 50 ns. The overall order of binding persistence was T2 > T1 > T3. Collectively, these results prioritize GZMA as a key ASD-associated immune effector candidate and identify T2 as the most credible lead compound. Importantly, the findings underscore the limitation of docking scores alone and demonstrate that long-timescale molecular dynamics simulations and binding free energy are essential for distinguishing kinetically stable binders from transient docking poses. We note that GZMA was transcriptionally downregulated in peripheral blood; its selection rests on network centrality and on the premise that granzyme pathology is governed by enzymatic activity at tissue sites rather than by circulating transcript abundance, a mechanistic hypothesis to be tested at the activity level.

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2. Bjørklund G. Metallothionein-Related Findings in Autism Spectrum Disorder: A Systematic Review and Targeted Quantitative Synthesis of Human Studies. Mol Neurobiol. 2026; 63(1).

Metallothioneins (MTs) are cysteine-rich proteins that regulate zinc (Zn) and copper (Cu) homeostasis, bind toxic metals, and contribute to redox control. Disturbed trace-element status, oxidative stress, gastrointestinal disease, and immune alterations have been reported in autism spectrum disorder (ASD), raising the question of whether MT biology is altered in this condition. Systematic searches of PubMed, Embase, Web of Science Core Collection, Scopus, Cochrane CENTRAL, and APA PsycINFO were updated on 5 September 2026. Studies directly measuring circulating MT protein, MT isoform mRNA, or anti-MT immunoglobulin G (IgG) antibodies in individuals with ASD, their first-degree relatives, or both were eligible. The review followed PRISMA 2020. Nine reports met the eligibility criteria, comprising eight primary reports and one secondary analysis. Study-level standardized mean differences, risk ratios, and odds ratios were calculated when sufficient published data were available. No pooled meta-analysis was performed because sufficiently comparable datasets were unavailable; otherwise, findings were synthesized narratively. Serum MT protein did not differ significantly between ASD and controls in one study, whereas one small, selected gastrointestinal cohort reported more participants above a study-defined high-MT threshold. In an uncontrolled Zn supplementation study, serum MT-1A increased together with higher serum Zn and lower Cu, but the absence of a concurrent control group precluded causal attribution. Five primary reports assessed MT gene expression, with higher, lower, null, and internally inconsistent findings across different MT isoforms and blood-derived samples; no reproducible ASD-associated transcriptional pattern was identified. Anti-MT antibody findings were also inconsistent across familial, gastrointestinal, and ASD-control comparisons. Across eight primary human reports, MT-related findings in ASD were inconsistent across cohorts, biological matrices, and clinical contexts. Current evidence does not establish a consistent ASD-associated alteration of the MT system, an ASD-specific anti-MT antibody response, or a validated MT biomarker. It also does not determine whether gastrointestinal phenotype, trace-element status, redox biology, immune-related factors, or other variables explain the observed between-study differences. Larger, independently replicated studies using standardized MT measurements and well-characterized populations are required.

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3. Boorom O, Hamrick LR, Estrada K, Seidl A, Kelleher B, Brady N. Influence of Caregiver Input and Dyadic Arrangement on Naturalistic Communication Sampling for Children With Neurogenetic Syndromes. J Speech Lang Hear Res. 2026; 69(10): 5020-30.

PURPOSE: Natural communication samples are a useful tool for measuring social communication and language remotely via telehealth, particularly for children with low-incidence neurogenetic syndromes (NGS). The purpose of this study is to examine how dyadic factors (caregiver language input, dyadic positioning, and dyadic proximity) impact measures of social communication derived from remotely collected caregiver-child communication samples in children with and without NGS. METHOD: Participants included 72 young children and their caregivers (16 Angelman syndrome, 24 Down syndrome, 13 fragile X syndrome, and 19 low-likelihood controls). Participants completed a 10-min video-recorded play interaction with their caregiver in their home, and all video recordings were coded for social communication using the Communication Complexity Scale (CCS), dyadic positioning, and dyadic proximity. Caregiver language input was derived from Language Environment Analysis recordings of the 10-min play interaction. Moderated multiple regression analyses were used to determine whether dyadic interaction variables (positioning, proximity, and caregiver input) predicted CCS scores and whether these effects varied by NGS status. RESULTS: More caregiver language input was associated with higher CCS scores in non-NGS dyads but not in NGS dyads, though there was no relationship between language input and CCS scores when controlling for developmental age. Dyadic positioning and proximity were not associated with CCS scores across the sample, though higher CCS scores were associated with more time spent at right angles or facing the caregiver in children who demonstrated primarily pre-intentional social communication skills. CONCLUSIONS: Results show that measurement of social communication using the CCS via remotely collected natural communication samples is robust to variability in dyadic factors. Developmental age should be considered when interpreting measures from remote communication samples, and procedures for optimal positioning should be considered for children with primarily pre-intentional social communication skills. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33209097.

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4. Cai Y, Maliske L, Kanske P. Equifinal pathways and subtypes: a developmental neuroimaging perspective on social differences in autism. Front Psychiatry. 2026; 17: 1919681.

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5. Esgin Ö, Ari-Arat C, Yilmaz G, Hamitoglu A. Comparison of Eating Behaviours, Anthropometric Measures, and Malnutrition Risk in Children With Autism Spectrum Disorder and Other Developmental Disabilities. J Autism Dev Disord. 2026.

PURPOSE: This study examined differences in eating behaviours, anthropometric indicators, and malnutrition risk among children aged 5-16 years with autism spectrum disorder (ASD) and other developmental disabilities (DD), including Down syndrome, developmental language disorder, and attention-deficit/hyperactivity disorder (ADHD). METHODS: This study was carried out using a cross-sectional design and included 220 children attending special education and rehabilitation centres: 97 autistic children (girls: 26, boys: 71) and 123 children with other developmental disabilities (DD; girls: 44, boys: 79). The DD group comprised children with Down syndrome (n = 52, 42.3%), developmental language disorder (n = 58, 47.2%), and attention-deficit/hyperactivity disorder (ADHD; n = 13, 10.6%). RESULTS: Autistic children differed from children with other developmental disabilities in both growth patterns and eating behaviour profiles. Height-for-age z-scores were higher in children with ASD than in those with Down syndrome (DS) and developmental language disorder (DLD) (p=.01). Autistic children showed higher Food Fussiness scores than children with DS (p<.05). Associations between eating behaviours and BMI-for-age varied according to diagnostic group (all interaction p<.05). In other developmental disability groups, eating behaviours also varied according to BMI-for-age categories and malnutrition risk (p<.05). Among autistic children, malnutrition risk was associated with higher Food Responsiveness and Slowness in Eating scores (p<.05). CONCLUSION: This study showed that eating behaviours, anthropometric measurements, and malnutrition risk vary among children with ASD and diagnostically distinct developmental disability subgroups, underscoring the importance of individualised, diagnosis-informed nutritional assessment and monitoring.

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6. Gatera G, Lanham J, Chellappa SL. Sleep, circadian, and mental health in neurodivergent neurotypes: lived experience perspective on the research landscape and roadmaps. Sleep. 2026; 49(10).

Neurodivergent neurotypes refer to brains that function differently from what is considered the societal standard or « stereotypical » norm, and include autism and attention deficit hyperactivity disorder (ADHD). Currently, global estimates suggest that 15 per cent to 20 per cent of the global population is neurodivergent. Autistic people and those with ADHD often experience mental health problems and a heightened likelihood of anxiety and depression. Epidemiological evidence shows that sleep and circadian rhythm disruption, such as low self-reported sleep quality, insomnia symptoms, and delayed sleep-wake phase disorder, are common in autistic people and those with ADHD. Despite scientific advancements, a comprehensive framework integrating sleep and circadian factors associated with mental health problems in neurodivergent neurotypes remains undeveloped. This perspective, written by people with lived experience of neurodivergent neurotypes, examines mental health problems, particularly anxiety, depression, and suicide risk, in autistic people and those with ADHD; sleep and circadian rhythm disruption in these neurotypes; and the growing epidemiological evidence linking sleep, circadian, and mental health problems in these neurotypes compared to people with neurotypical development. Our perspective advocates for an integrated biopsychosocial model that accounts for the interplay between sleep, circadian rhythms, and mental health in neurodivergent neurotypes. Moreover, it identifies gaps and future research avenues, and the need for personalized behavioral interventions to improve their sleep, circadian, and mental health problems. Co-production of research is advocated as a method to ensure that people with neurodivergent neurotypes are included as equal partners in the entire research process, as a means to best support their sleep, circadian, and mental health.

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7. Ge H, Lee PP, Matthews S. Comprehension of Restrictive Focus With Zing6hai6 (« Only ») in School-Age Cantonese-Speaking Autistic and Neurotypical Children. J Speech Lang Hear Res. 2026; 69(10): 4927-48.

PURPOSE: This study investigated the comprehension of restrictive focus with the focus particle zing6hai6 (« only ») in school-age Cantonese-speaking autistic and neurotypical children. Specifically, it examined whether autistic children differed from neurotypical children in the comprehension of focus with zing6hai6 and explored the effects of age on their performance. METHOD: A total of 75 Cantonese-speaking children (42 autistic and 33 neurotypical) between 5 and 10 years old completed a picture verification task assessing their interpretation of restrictive focus. They were matched on age and working memory. RESULTS: Neurotypical children demonstrated a comprehensive understanding of zing6hai6-focus and showed a preference for preverbal zing6hai6 over presubject zing6hai6, consistent with cross-linguistic findings that children prefer to associate « only » with the verb phrase. Autistic children exhibited partially neurotypical performance: Their interpretation of presubject zing6hai6 aligned with neurotypical peers, whereas their understanding of preverbal zing6hai6 was less accurate. In addition, autistic children were slower than their neurotypical peers in processing speed overall. The findings further reveal a delay in autistic children, as manifested in persistent accuracy differences but gradual convergence in processing speed relative to their neurotypical peers with increasing age. CONCLUSION: These findings suggested a distinct and delayed pattern of interpreting restrictive focus with zing6hai6 (« only ») in Cantonese-speaking autistic children and highlighted the possible influence of cognitive maturation and the inherent complexity of syntax-semantics interface structures on their comprehension.

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8. Han A, Lee N. Racial and Ethnic Disparities in Receipt of Behavioral Treatment Among Children With Autism Spectrum Disorder in the United States. Cureus. 2026; 18(9): e116117.

Background and objective Minority children have delayed diagnosis of autism spectrum disorder (ASD). However, it is unclear whether racial disparities exist in minority children receiving treatment even after a diagnosis, which may further negatively affect their cognitive, social, and behavioral development. We examined caregiver-reported receipt of behavioral treatment across racial and ethnic groups to determine whether minority children younger than five years with ASD were less likely to receive treatment than White children in the United States. Methods From the 2021-2022 National Survey of Children’s Health, we included children with a diagnosis of ASD who were younger than five years of age. We used self-reported responses from parents or caregivers on whether their children had received behavioral treatment for ASD during the previous 12 months. We compared behavioral treatment for ASD by racial and ethnic groups by conducting chi-square tests. We performed multivariable logistic regression models to determine the association between racial and ethnic groups and behavioral treatment after adjustment for age, sex, severity of ASD, parent education, and Medicaid status. Results Among 790 children aged ≤5 years (51 (6.5%) Asian, 143 (18.1%) Hispanic, 78 (9.9%) non-Hispanic (NH) Black, 434 (54.9%) NH White, 84 (10.6%) multi-race; 615 (77.9%) male), 564 (71.4%) received behavioral treatment. Multi-race children had the highest percentage of behavioral treatment (n = 65, 77.4%), followed by Hispanic (n = 106, 74.1%), NH White (n = 314, 72.4%), NH Asian (n = 35, 68.6%), and NH Black (n = 44, 56.4%) children (p = 0.027). Compared to NH White children, NH Black children were less likely to be treated (adjusted OR (95% CI) = 0.47 (0.28, 0.79)). The odds of treatment for Asian, Hispanic, and multiracial children compared to NH White children were not statistically significant. Conclusions NH Black children with ASD were significantly less likely than NH White children to have caregiver-reported receipt of behavioral treatment. These findings underscore the importance of continued efforts to promote equitable receipt of behavioral treatment among children with ASD, particularly for NH Black children.

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9. Han X, Liu Z, Xu H, Weng L. Emerging information technologies across the autism service and prevention continuum: a narrative review of screening, diagnosis, intervention, and health equity. Front Public Health. 2026; 14: 1900591.

Autism spectrum disorder (ASD) is a major global public-health concern, yet timely identification and support remain difficult to access for many families, especially in rural, low-resource, and otherwise underserved settings. Emerging information technologies have been proposed as tools for narrowing this service gap. These include artificial intelligence (AI), wearable sensors, and the Internet of Things, mobile health applications and digital therapeutics, telehealth, immersive virtual and augmented reality, social robotics, and large language models. This narrative review organizes the evidence across an autism service and prevention continuum: upstream risk awareness and health education, early screening and diagnosis, and intervention, management, and long-term support. We use this continuum strictly as a public-health service-organization framework, not to imply preventing the birth or existence of autistic individuals, consistent with a neurodiversity-affirming perspective. Across each stage, we apply a health-equity lens centered on reach, affordability, scalability, health-system integration, and equity of performance. We summarize current applications, appraise recurring limitations, and synthesize cross-cutting issues of equity, data governance, ethics, neurodiversity, and implementation. Recurring limitations include small and heterogeneous studies, dataset bias, weak external validation, short follow-up, and uneven regulatory maturity. Emerging information technologies show genuine promise as complements to conventional autism services, particularly where specialist resources are scarce. Realizing population-level benefit will require equity-centered design, validation in diverse and low-resource settings, larger and longer trials, interoperable standards, and meaningful involvement of autistic people and their families.

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10. Iskenderli HS, Akin EO. Rate and Associates of Early Childhood Care and Education Attendance Among Children With Developmental Difficulties From a Middle-Income Country, Turkey. Child Care Health Dev. 2026; 52(6): e70359.

BACKGROUND: Although the World Health Organisation (WHO) Nurturing Care Framework included early learning opportunities as a main component for optimal child development, important inequalities exist between high-income and low- and middle-income countries (LMICs) regarding early childhood care and education (ECCE) attendance for children with developmental difficulties (DDs). We aimed to determine the rate and associates of ECCE attendance for young children with DDs from a middle-income country, Turkey. METHODS: Using a cross-sectional design, we recruited children aged 12-60 months who were admitted to Ankara University Developmental Paediatrics Division, a tertiary referral clinic, for their first visit due to DDs during the period between 1 January 2022 and 1 January 2023. We used the Expanded Guide for Monitoring Child Development and comprehensive developmental assessment for the rate and associates of ECCE attendance among children with DDs. RESULTS: Of 978 children with DDs admitted to Ankara University Developmental-Behavioural Paediatrics Division in the study period, 482 (49.3%) comprised the sample. Most were boys (64.9%); median age was 32 (min-max: 13-60) months. Of these, 110 (22.8%) children had chronic health conditions, 85 (17.6%) had isolated language delay, 72 (14.9%) had autism spectrum disorder, 60 (12.4%) had global developmental delay, 68 (14.1%) were followed for preterm birth, and 49 (10.2%) were followed for behavioural problems. Of all, 72 (14.9%) children attended ECCE. In the logistic regression model, being ≥ 36 months (OR: 5.84, 95% CI: 3.15-10.81) and having a working mother (OR: 3.63, 95% CI: 1.73-7.59) were independent factors associated with ECCE attendance. CONCLUSIONS: Among children with DDs attending a tertiary developmental-behavioural paediatrics referral clinic in Turkey, a middle-income country, the rate of ECCE attendance was low, particularly for children under 3 years of age and children of homemaker mothers. Urgent interventions are needed for equity in opportunities for learning for young children with DDs in LMICs, especially those with complex developmental and health care needs, for whom early developmental support is essential.

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11. Kim JY, Shawler L, Gilroy S. Application of operant demand in autism and developmental disabilities: An updated review (2017-2025). J Appl Behav Anal. 2026; 59(4): e70090.

Operant demand within behavioral economics provides a quantitative framework for evaluating reinforcer efficacy in applied research involving individuals with autism and those with related developmental disabilities. This systematic review extended the work of Gilroy, Kaplan, and Leader (2018) by examining applied operant demand research published between March 2017 and December 2025. Following PRISMA guidelines, 30 articles (31 experiments; 307 participants) were identified and coded for procedural features and methods, including operant arrangements, demand and work output analyses, open and closed economies, and unit price applications. Results indicated increased use of demand and work output analyses and unit price applications. However, open and closed economies remained rarely evaluated and substantial variability was observed in procedural methods used to manipulate price. Findings indicate growing use of operant demand analyses for treatment durability and schedule thinning but continued underuse for generalization variables.

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12. Lee IO, Wolstencroft J, Housby H, van den Bree MBM, Chawner S, Hall J, Owen MJ, Skuse DH. Association of socioeconomic factors on mental health in children and young people with intellectual developmental disabilities of genetic origin. JCPP Adv. 2026: e70180.

BACKGROUND: Children and young people (CYP) with intellectual developmental disability (IDD) have a high prevalence of mental health and behavioural problems, which might be influenced by socioeconomical status as well as the severity of their disabilities. This is however an understudied topic, and the present study investigated the association between mental health and socioeconomic deprivation as well as severity/type of disability in CYP with IDD of genetic origin. METHODS: Participants comprised a national cohort of 2778 participants with diagnosed genetic disorders associated with IDD, 10.1 ± 4.3 years of age (mean ± SD), 55.7% males. The cohort was linked to routinely collected UK school record data from the National Pupil Database. Socioeconomical status was assessed by free school meals (FSM) eligibility, the index of multiple deprivation (IMD), and parental educational level. IDD severity/type was reported by reviewing statements of primary special educational needs. Participant’s mental health diagnoses were established by parental report using the Development and Well-Being Assessment. Parents also completed the Strengths and Difficulties Questionnaire (SDQ). RESULTS: Socioeconomic factors including lower parental education, greater deprivation (lower IMD decile) and FSM eligibility were associated with the higher prevalence of mental health disorders, as well as greater difficulties in emotional and behavioural adjustment (as measured by the SDQ). In contrast, IDD severity/type was not linked to diagnostic characteristics nor the prevalence of emotional and behavioural difficulties. CONCLUSION: This study revealed that CYP with IDD of genetic origin living in relatively deprived circumstances had a high risk of mental health disorders and poor emotional and behavioural adjustment, irrespective of the severity/type of their learning disabilities. Tackling deprivation (such as FSM as indicator for targeted additional support) and enhancing access to support services (e.g., psychotherapy) could be by implication key strategies to improve the mental health of this vulnerable population with IDD of genetic aetiology.

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13. Lyu B, Ba Y, Ma D, Liu N, Fu L, Xue Y. Correction: Effectiveness of sensory integration-based intervention in autistic children, focusing on Chinese children: a systematic review and meta-analysis. Front Psychiatry. 2026; 17: 1997362.

[This corrects the article DOI: 10.3389/fpsyt.2025.1623149.].

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14. Maljaars J, De Roo L, Van der Paelt S, Roeyers H, Noens I. Supporting incarcerated autistic individuals: evaluation of an autism awareness training for prison staff. Int J Prison Health (2024). 2026; 22(3): 439-50.

PURPOSE: Prison environments are particularly challenging for autistic people experiencing incarceration due to a lack of knowledge and awareness of autism among prison staff. The study aimed to evaluate the level of satisfaction and perceived effectiveness of an autism awareness training for prison staff and to assess whether this training improves autism knowledge and reduces stigma towards autistic individuals in a prison setting. DESIGN/METHODOLOGY/APPROACH: The Autism Experience Circuit (AEC), an interactive autism awareness training, has been offered to prison staff. The training was evaluated through an online survey among 31 prison employees who participated in the AEC compared to a control group of 51 other staff members. FINDINGS: Results showed high satisfaction among AEC participants. They especially appreciated the interactive method. For most participants, the AEC led to increased knowledge and understanding of autism, as indicated by their assessment of goal achievement. A significant improvement in autism knowledge, but not in stigma towards autistic people, was found in the AEC group compared to the control group. ORIGINALITY/VALUE: These findings suggest that an autism awareness training can be a valuable first step in making prisons more accommodating for autistic individuals, but additional strategies are necessary to address stigma effectively.

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15. Nowak AC, Stern A, Esser AL, Razum O. [The significance of « normality » held by Autistic Individuals and Healthcare Professionals for health care: a qualitative analysis]. Psychiatr Prax. 2026.

This qualitative study explores the role of « conceptions of normality » in the healthcare provision for autistic people. Fourteen individuals who identified themselves as autistic were interviewed using a problem-centered approach. The analysis was carried out inductively through thematic coding according to Flick. Our results show that healthcare provision is limited by internalized rules related to care-specific structural conditions, the violation of reciprocal role expectations, and the lack of recognition of otherness. The interview partners employ various strategies to conform to (anticipated) expectations of normality. This may result in care that does not adequately meet individual needs. The results show the role that (societal) assumptions of normality play in healthcare. Different patient groups can benefit from a design of healthcare that is characterized by an acceptance of diversity.

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16. O’Reilly Sparks KC, Pedapati EV. Neural Circuits of Social Behavior in Autism Spectrum Disorder: From Mechanism to Intervention. Biol Psychiatry. 2026.

INTRODUCTION: Difficulties in social communication and interaction are core diagnostic features of autism spectrum disorder (ASD), yet interventions targeting these difficulties have modest and variable effects. Understanding mechanistically distinct contributions to social behaviors may identify new therapeutic opportunities. METHODS: This narrative review integrates human neuroimaging studies, supporting rodent circuit neuroscience, clinical intervention research, and developmental studies. We organize the findings into four overlapping functional-computational domains and relate these domains to the Research Domain Criteria Social Processes framework. RESULTS: The four domains are: (1) Social Reward and Social Interest, encompassing the incentive and hedonic value of social contact and motivation to engage; (2) Social Memory and Social-Affective Value, encompassing recognition of familiar individuals and learned affective or motivational associations; (3) Social Cue Perception, Action Representation, and Social Prediction/Timing, encompassing the processing and forecasting of dynamic social information; and (4) Higher-Order Social Cognition and Model Updating, encompassing mental-state inference and the updating of person-specific social models. Because these domains are not independent, interactions among reward, memory, cue processing, prediction, and higher-order inference create multiple possible developmental entry points, such that early differences in one process may alter experience-dependent learning in others. Evidence for specific causal cascades remains preliminary and requires longitudinal testing. CONCLUSIONS: A circuit-and-development framework may improve hypothesis generation, domain-specific phenotyping, target-engagement assessment, and mechanism-aligned outcomes. Clinical translation, however, requires caution. Biomarkers should be validated as predictors of treatment response, cascade models should be tested longitudinally, and interventions should combine mechanism-informed targets with behavioral support that promotes generalization to daily life.

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17. Rawlinson EC, McCullough MH, Sellami A, Marighetto A, Al-Abed AS, Dehorter N. Reduced dorsal CA1 activity limits retention of the temporal component of declarative memory in the Cntnap2 knockout mouse model of autism. Elife. 2026; 15.

Growing evidence implicates the hippocampus in the pathophysiology of autism spectrum disorder, particularly in the domains of social interactions and cognition. Yet, the mechanisms driving the hippocampal-dependent cognitive atypicalities in autism remain poorly defined. Here, we characterized how dysfunction of the CA1 subfield of the dorsal hippocampus drives abnormalities in critical components of declarative memory. Using trace fear conditioning in the Cntnap2 knockout mouse model of autism, we found that capabilities to retain the association of temporally distant stimuli (i.e. temporal binding) were reduced relative to wildtype mice. Fiber photometry and optogenetic experiments demonstrated that reduced CA1 activity during temporal gaps underlies this impairment, linking CA1 dysfunction to a deficit in long-term memory retention in autism. Using a relational/declarative memory task, we also revealed a deficit in flexible spatial memory, and a preferential use of egocentric learning strategy. This inflexible learning strategy resulted from an imbalance between memory system activity, promoting frontostriatal-dependent procedural learning instead of dorsal CA1/hippocampus-dependent relational/declarative memory. Overall, this study establishes dorsal CA1 dysfunction as a circuit-level mechanism underlying cognitive inflexibility in autism, providing a neurobiological framework for hippocampal-dependent memory deficits in the condition.

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18. Van de Vyver H, Warreyn P, Brys I, Demurie E, Kissine M, Matthys A, Noens I, van Esch L, Weyland M, Roeyers H. Associations Between Types of Imitation and Receptive and Expressive Language Skills in Preschoolers With Autism. J Speech Lang Hear Res. 2026; 69(10): 5001-19.

PURPOSE: Imitation and language are associated in autistic children. However, imitation involves various types. This cross-sectional study examined the associations between different imitation abilities and receptive and expressive language skills in autistic preschoolers while controlling for nonverbal IQ (NVIQ). Additionally, these associations were explored separately in two subgroups based on language level. METHOD: A sample of 176 autistic preschoolers, aged 2-6 years, was assessed using (semi)structured behavioral tasks measuring imitation (elicited object, gestural, and verbal imitation; spontaneous object imitation; and deferred object imitation), nonverbal cognitive, and language abilities. RESULTS: The model with elicited object, verbal, and spontaneous object imitation explained the largest proportion of variance in receptive language after controlling for NVIQ, although a model with elicited gestural, deferred, and spontaneous object imitation showed nearly equivalent explanatory power. Elicited verbal, deferred, and spontaneous object imitation contributed most to explaining expressive language. The interaction effects indicated that differences across subgroups only emerged for spontaneous object imitation. Within-group analyses revealed different imitation abilities contributing to the most predictive model of concurrent language skills, in the minimally speaking/some words group and the speech in sentences/fluent speech group. CONCLUSIONS: Various imitation abilities contribute to receptive and expressive language beyond NVIQ. For autistic children with varying language skills, immediate verbal and object imitation abilities were key contributors to language performance, suggesting that these may be important targets for intervention. In the minimally speaking/some words group, immediate and deferred object imitation contributed to language skills, whereas these abilities were less predictive for verbally more fluent autistic children. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33311877.

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19. Wu QF, Du JQ. Enhancing Attention and Executive Function in Children With Autism Spectrum Disorder: A Randomized Controlled Trial of a 12-Week Multimodal Art Intervention. J Autism Dev Disord. 2026.

PURPOSE: To evaluate the effects of multimodal art interventions on attention and executive function in children with autism spectrum disorder (ASD), thereby adding more evidence-based support to the field of art intervention research. METHOD: Forty-two children with ASD were recruited from a local autism association and randomly assigned to an experimental group (n = 21) and a control group (n = 21). The experimental group received a 12-week multimodal art intervention consisting of three 90-min sessions per week. The control group continued routine physical activities and cognitive therapy without pharmacotherapy or art-related training during the study. Attention and executive function were assessed before and after the intervention. RESULTS: Between-group comparisons of pre-to-post change favored the experimental group for all eight attention and executive-function outcomes (FDR p ≤ 0.01). Within-group analyses showed improved attention and executive-function performance in the experimental group (all p ≤ 0.01). No significant changes were observed in the control group except for poorer performance on the More-Odd Shifting Task (p < 0.001). CONCLUSION: Multimodal art intervention shows potential for improving attention and executive function in ASD children during early developmental stages. However, the underlying mechanisms remain unclear, and future research is needed to explore its efficacy across mild, moderate, and severe ASD severity levels.

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20. Zemantic PK, Shillingsburg MA, Courson C, Harris T, Blank D. Implementation and Assessment of a Tiered Autism Assessment Model. J Dev Behav Pediatr. 2026.

OBJECTIVE: We evaluated a tiered autism assessment model (TAAM) designed to integrate caregiver and provider confidence ratings with an FDA-cleared eye-tracking-based diagnostic device for toddlers (16-30 months) within a specialty autism diagnostic clinic. Despite the availability and purported efficacy of the device, no published research to date has examined its integration into clinical practice. METHOD: We used a type I hybrid effectiveness-implementation design and the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to pilot TAAM. TAAM used caregiver and provider confidence ratings on ASD symptoms alongside device eligibility to triage patients to a shortened appointment (75 minutes or 2 hours) or a standard 4-hour appointment. Low caregiver- and/or provider-rated ASD confidence resulted in a 4-hour appointment. Patients with non-ASD device results received further testing. Caregivers and providers completed acceptability surveys. We describe key phases, including identifying barriers, preparing resources, and implementation. RESULTS: Data from the first 7 months of TAAM indicate that most toddlers were device-eligible (87.80%). Notably, 77.78% of device-eligible toddlers met confidence rating criteria to qualify for a shortened appointment, supporting clinic efficiency. Caregiver and provider acceptability ratings of aspects of TAAM, and of the device specifically, were high. CONCLUSION: Preliminary findings suggest that TAAM and the device were acceptable to caregivers and providers. By optimizing triage decisions through ASD confidence ratings, this approach holds potential to improve clinical efficiency.

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21. Zhou Z, Zhang L, Zhou S, Guo Y, Lin H, Zhang X, Tong M. Functional Near-Infrared Spectroscopy Combined with Machine Learning for Exploratory Classification of Autism Spectrum Disorder in Young Children. J Vis Exp. 2026; (236).

Early identification of autism spectrum disorder (ASD) may facilitate timely intervention, while diagnosis remains clinically based. This exploratory study evaluated fNIRS-derived features using multiple machine-learning algorithms to compare observed classification performance between young children aged 2-6 years with ASD and typically developing (TD) children. β-activation values from eight channels were used as features to differentiate the ASD and TD groups. Two paradigm-specific analytic datasets were analyzed. Paradigm 1 comprised three tasks and included 60 participants (29 children with ASD and 31 TD children), with 24 β features per participant. Paradigm 2 comprised two tasks and included 58 participants (28 children with ASD and 30 TD children), with 16 β features per participant. Leave-one-out cross-validation was used to partition the data, and normalization and principal component analysis were applied for feature extraction. Seven classifiers-K-nearest neighbors (KNN), logistic regression (LR), support vector machine (SVM), decision tree (DT), random forest (RF), gradient boosting decision trees (GBDT), and XGBoost-were evaluated using accuracy, specificity, sensitivity, and area under the curve (AUC), and permutation testing was used to assess whether the observed classification performance exceeded that expected by chance. In Paradigm 1, KNN yielded the highest observed accuracy (0.567), whereas DT yielded the highest observed AUC (0.582). Paradigm 2 yielded numerically higher observed performance for several metrics, but no classifier significantly exceeded chance. These findings demonstrate the procedural feasibility of acquiring and analyzing task-based fNIRS data; however, independent diagnostic value beyond age and sex was not established and requires validation in larger, sex-balanced external cohorts. Overall classification performance was modest; none of the evaluated classifiers demonstrated statistically significant above-chance performance in the permutation tests, and the fNIRS features did not demonstrate statistically significant incremental predictive value beyond age and sex.

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