1. Ahmadi A, Baudry J, Tenhundfeld N, Goff K, Adamek D. Using AI to enhance healthcare resource management and allocation: A focus on the autism community in Alabama. PLoS One. 2026; 21(3): e0342700.

This study investigates the potential of artificial intelligence, particularly Natural Language Processing and large-scale language models, to improve resource management and service access for individuals with autism in Alabama. The research aims to explore and evaluate the potential of AI-driven tools to address challenges in navigating complex datasets and supporting social work practices. We designed and tested AI systems, including general language models, domain-specific chatbots powered by advanced language models, and a Retrieval-Augmented Generation framework. A standardized set of queries was used to simulate real-world scenarios encountered by social workers engaged in autism service coordination. System performance was evaluated based on precision, recall, and response accuracy. Results demonstrated that the Retrieval-Augmented Generation (RAG) framework achieved superior performance compared to traditional NLP methods and general-purpose language models, attaining approximately 90-96% precision and recall across evaluated query types. RAG outperformed the domain-specific GPT-4 chatbot by approximately 5-12 percentage points in F1 score, with the largest gains observed for queries requiring geographic specificity, multiple constraints, or complex contextual understanding. The integration of domain-specific retrieval significantly enhanced the accuracy, contextual relevance, and usability of generated responses. The findings highlight the transformative potential of AI-driven tools in improving social work efficiency and enhancing healthcare equity. By streamlining care coordination and delivering accurate, contextually relevant information, these systems offer scalable solutions to improve access to autism-related services. Future research should focus on addressing data quality, minimizing biases, and ensuring ethical deployment to build trust and support widespread adoption of these tools.

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2. Amaral de Almeida Bistafa I, Antonio Ribeiro Filho M, Dos Santos Costa AC, Pimenta Saad AF, Ferreira Franco R, Aparecida de Sales Floriano J, Roberto Dos Santos E, de Souza Menezes JD, Querino da Silva M, Nunes Longhi Aleixo D, Fazuoli Chubaci E, Karina Stefani A, Donegá Martinez W, Belchior da Silveira Junior P, Mirtes Zecchin A, Gonçalves Cristóvão NB, Bertolazzo Quitério A, Mendonça Ribeiro R, Cristina Móz Vaz Oliani D, Hélio Oliani A, Alahmar Bianchin M, Cesar Fava Spessoto L, Helú Mendonça Ribeiro RC, César André J. Strengthening Undergraduate Medical Education for Inclusive Health Care for People With Down Syndrome and Intellectual and Developmental Disabilities in Medical Schools: Protocol for a Scoping Review. JMIR Res Protoc. 2026; 15: e80280.

BACKGROUND: Health inequities represent a persistent and multifaceted challenge, particularly pronounced for individuals with intellectual and developmental disabilities (IDDs), including Down syndrome (DS). This population frequently faces systemic barriers to care and is at higher risk of adverse health outcomes. Despite advances, gaps persist in health care professionals’ training for caring for this population. Undergraduate medical education constitutes a crucial component in addressing these disparities and promoting inclusive care, especially through practical experiences for future physicians. OBJECTIVE: This study aims to map and synthesize evidence regarding undergraduate medical education for the care of individuals with DS and other IDDs in medical schools, identifying gaps and opportunities for enhancement in curricula and educational programs, including pedagogical strategies and experiential learning opportunities. METHODS: A scoping review following the methodological frameworks by Arksey and O’Malley, Levac et al, and the Joanna Briggs Institute will be conducted. The search will be performed in electronic databases and gray literature sources using descriptors in English, Portuguese, and Spanish. Study selection will involve undergraduate medical students as the target population. Two independent reviewers will perform study selection following predefined inclusion and exclusion criteria. Data will be extracted using a standardized form and synthesized narratively, with qualitative (thematic) and descriptive quantitative analyses where appropriate. This protocol has been registered with the Open Science Framework and will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. RESULTS: A comprehensive overview of current undergraduate medical education regarding the care of individuals with DS and other IDDs will be provided, informing the development of more effective and inclusive interventions and yielding insights into existing pedagogical strategies, practical learning opportunities, and medical students’ knowledge and attitudes toward this population, providing a foundation for evidence-based recommendations. CONCLUSIONS: This review will address an important gap in the literature, providing insights for the improvement of undergraduate medical education and clinical practice in caring for individuals with DS and other IDDs, contributing to the development of more capable and empathetic professionals. By systematically mapping the current landscape and identifying specific needs, this protocol lays the groundwork for transformative changes in medical curricula worldwide, ultimately enhancing health outcomes for this vulnerable population.

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3. Bergdolt L, Anding A, Alshaqi O, Arbabi Z, Douchey M, Eldridge E, Hoffman K, Reid A, Sapkota K, Monaghan D, Taraschenko O, Padmashri R, Dunaevsky A. Contribution of astrocytic calcium signaling to auditory hypersensitivity in a mouse model of fragile X syndrome. Neurobiol Dis. 2026: 107355.

Hypersensitivity to sensory stimuli is a common co-morbidity of Fragile X syndrome (FXS), the leading monogenic form of intellectual disability and autism spectrum disorder (ASD). Neuronal impairments associated with auditory and tactile hypersensitivity have been reported in the Fmr1 knockout mouse model of FXS. However, the contribution of astrocytes, in which Fmr1 is also expressed, to sensory hypersensitivity has not been defined. Using mice with astrocyte-specific deletion of Fmr1 (cKO) and mice with astrocyte-specific expression of Fmr1 (cON), we demonstrated that loss of astrocytic FMRP is sufficient but not necessary to confer susceptibility to audiogenic seizures (AGS), an indication of auditory hypersensitivity. Moreover, in vivo multiphoton imaging revealed increased astrocytic calcium signaling in Fmr1 KO mice. To test if enhanced astrocyte calcium signaling contributes to increased AGS, we crossed Fmr1 deletion mice to IP3R2 mutant mice. Reduced expression of IP3R2 rescued the AGS phenotype in the Fmr1 astrocyte cKO but not in the global Fmr1 KO mouse. Our results reveal that astrocytes contribute to AGS in mouse models of FXS through enhanced calcium signaling.

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4. Chen Z, Nie Z, Zhao Y, Song Y. A meta-analytic review of gaze cueing across the autism trait continuum. Psychon Bull Rev. 2026; 33(4).

Social attention is fundamental to social interaction and is experimentally indexed by the gaze-cueing effect (GCE) derived from the gaze-cueing task. Although atypical social attention is often considered a core feature of autism spectrum disorder (ASD), empirical findings regarding the GCE in ASD remain heterogeneous. This inconsistency highlights the need to investigate social attention across the broader autism trait continuum (autism-like traits [ALT]) in the general population to clarify these mechanisms. This meta-analysis synthesized 28 correlational studies (77 effect sizes) and eight group-comparison studies (21 effect sizes) to resolve these inconsistencies. A three-level model integrated the effect sizes, with moderation analyses testing the influence of sample characteristics (proportion of males, sample size), ALT measure type, and experimental parameters (face type, expression, SOA, task type). Results revealed a significant, albeit small, negative correlation: higher ALT levels predicted reduced GCE. Conversely, group comparisons (high ALT vs. low ALT) yielded nonsignificant results. These findings align with the continuum hypothesis, suggesting a gradient relationship rather than a distinct subgroup effect, although statistical power in group comparisons should also be considered. Moderation analyses indicated that the negative association intensified in samples with a higher male proportion but weaker in those with larger sample sizes; no other moderators were significant. Together, these findings indicate that the link between autistic traits and social attention is subtle, continuous, and moderated by sample characteristics, underscoring the necessity for future research using more ecologically valid paradigms to capture the dynamic nature of social processing.

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5. Dong H, Yang C, Dou Y, Chen L. Clinical Effects of Early Intensive Motor Intervention on Gross Motor Development in Infants and Toddlers with Developmental Delay. J Vis Exp. 2026; (228).

Early intensive motor intervention is one of the most important rehabilitation tools to improve gross motor development in infants and toddlers with developmental delay. The combination of conventional rehabilitation training and mesh-intensive suspension training aims to improve core muscle strength, motor control, and balance coordination, and thus improve gross motor function. However, there is no comprehensive clinical evidence on the effects of early intensive exercise intervention combined with conventional rehabilitation on gross motor development and activities of daily living (ADL) in infants and children with developmental delay. The purpose of this study was to investigate the safety and efficacy of early intensive exercise intervention combined with conventional rehabilitation training for gross motor development in infants and toddlers with developmental delay. In the study, the treatment group implemented an early intensive exercise intervention on top of conventional rehabilitation training. The effectiveness of the treatment was evaluated based on the changes in scores on the Alberta Infant Motor Scale (AIMS), Peabody Gross Motor Development Scale (PDMS-GM), and Infant and Toddler Activities of Daily Living score. The results showed that all the indicators improved significantly in both groups after the intervention, and the treatment group showed significantly greater improvement compared to the control group (P<0.05). In the treatment group, the AIMS score increased from (36.80 ± 11.38) to (53.12 ± 7.48), the PDMS-GM standardized total score increased from (18.65 ± 2.33) to (28.03 ± 2.51), and the ADL score increased from (32.89 ± 7.02) to (58.92 ± 6.34). These findings highlight the effectiveness of early intensive motor intervention combined with conventional rehabilitation in improving gross motor function and ADL in infants and children with developmental delay.

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6. Ebert J, Muscatello RA, McGonigle T, Vandekar S, Corbett BA. Adverse Childhood Experiences in Autistic and Neurotypical Girls. Autism Res. 2026: e70221.

Adverse childhood experiences (ACEs) are potentially traumatic, life-altering events that occur in childhood with long-term negative physical and/or mental health outcomes. Previous research, while limited and largely focused on males, suggests children with autism spectrum disorder (ASD) are at higher risk of experiencing ACEs than typically developing (TD) peers. The study aimed to enhance our understanding of ACEs by focusing on female participants comparing diagnostic (ASD, TD), developmental (age, puberty), and mental health (anxiety, depression) factors. Participants included 212 female children with ASD (N = 112) or TD (N = 100) between 6:0 to 12:11 years. Following diagnostic testing, the 10-item ACEs questionnaire was administered. Statistical analyses included Wilcoxon rank-sum tests, negative-binomial models, linear regression, and Spearman correlations. There was a significant group difference in the total number of ACEs such that autistic children had more parent-reported total adverse events (p = 0.024). There were no significant diagnosis by age or puberty stage interactions (p > 0.05). Depressive symptoms were significantly positively associated with autism diagnosis (p < 0.001, RESI = 0.574) and ACE total (p < 0.001, RESI = 0.282), indicating overall higher rates of depressive symptoms in autistic youth, and an increase in depressive symptoms for participants with at least one ACE. There were similar findings for anxiety. Results highlight that having autism along with ACEs may place youth at a higher risk of mental health conditions. Treatments developed to address the unique challenges of adverse events in autism may be warranted to prevent long-term sequelae and poor mental health outcomes. Children with autism spectrum disorder (ASD) may be more likely to experience adverse childhood experiences (ACEs) that can harm physical or emotional health with long‐term consequences. This study, which focused on females with and without ASD, found more reports of adverse experiences and higher depression and anxiety in girls with autism. In both groups, more instances of potentially traumatic life events were related to higher rates of depression and anxiety symptoms. The findings emphasize that autism plus traumatic life experiences may place children at greater risk for mental health conditions. New treatments are needed to help prevent poor long‐term outcomes. eng.

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7. Fayyaz S, Hussain AS, Choudhry M, Bharuchi VNA. Frequency of Acute Stress Disorder (ASD) and Postnatal Depression in Mothers Of Preterm Neonates Hospitalized in a Neonatal Intensive Care Unit (NICU) in Pakistan. Pak J Med Sci. 2026; 42(2): 508-16.

OBJECTIVE: To determine the frequency of Acute Stress Disorder (ASD) and postnatal depression in mothers of preterm neonates hospitalized in the neonatal intensive care unit (NICU) of the Aga Khan University Hospital. METHODOLOGY: It is a cross-sectional study. It was conducted in a 24-bed level-3 NICU at a tertiary care hospital in Karachi. Mothers of preterm newborns under 34 weeks’ gestational age admitted to the NICU were included in the study. RESULTS: Among 123 postpartum women, 43.1% (n=53) met criteria for Acute Stress Disorder (ASD), with significantly lower gestational age in this group: median 29.9 weeks (IQR: 27.6-31.0) vs. 33.0 weeks (IQR: 32.0-33.0) in non-ASD cases (difference in medians: 3.1 weeks, 95% CI: 2.1-4.0). Infants of mothers with ASD had a less mean birth weight (1.3 ± 0.4 kg) compared to those without ASD (1.8 ± 0.5 kg), with a mean difference of 0.5 kg (95% CI: 0.34-0.66). Median NICU stay was significantly prolonged in the ASD group: 20.0 days (IQR: 12.0-28.0) versus 10.0 days (IQR: 7.0-15.0), with an estimated median difference of 10.0 days (95% CI: 6.0-14.0). A higher number of mothers with a miscarriage history (n=23/53, 43.4%) experienced ASD compared to those without (n=17/70, 24.3%), yielding a risk difference of 19.1% (95% CI: 4.3%-33.8%). Mothers with ASD also reported increased Edinburgh Postnatal Depression Scale scores (median 19.0, IQR: 17.0-21.0) than those without ASD (median 11.0, IQR: 9.0-15.0), with a median difference of 8.0 points (95% CI: 6.0-10.0). CONCLUSION: A significant proportion of mothers of preterm infants screened positive for acute stress disorder and postpartum depression hence, Preterm delivery appears to be a traumatic event, increasing the risk of stress-related and depressive disorders in mothers.

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8. Feng M, Hou Y, Zhou S, Song X. Effectiveness of exercise interventions on gross motor skills in children with autism spectrum disorder: a systematic review and meta-analysis. Front Psychiatry. 2026; 17: 1745638.

OBJECTIVE: To systematically evaluate the effectiveness of different exercise interventions on gross motor skills in children with Autism Spectrum Disorder (ASD) and to compare the effects of different exercise types and intervention dosages through subgroup analysis. METHODS: We systematically searched randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) investigating the effects of exercise interventions on gross motor skills in children with ASD across PubMed, Web of Science, EBSCO, ProQuest, CNKI, and Wanfang Data databases from their inception until September 20, 2025. Two researchers independently performed literature screening, data extraction, and quality assessment of the included studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using RevMan 5.4 software with a random-effects model, and effect sizes were expressed as standardized mean difference (SMD) with 95% confidence intervals (CI). RESULTS: A total of 16 studies involving 493 children with ASD were included. Meta-analysis results indicated that exercise interventions significantly improved balance skills (SMD = 0.85, 95% CI [0.54, 1.16]), locomotor skills (SMD = 0.81, 95% CI [0.51, 1.11]), and object control skills (SMD = 0.86, 95% CI [0.65, 1.07]) in children with ASD, with all effect sizes being large (all P < 0.00001). Subgroup analysis showed that Land-based sports significantly improved all three skill domains (all P < 0.00001), whereas Aquatic sports and technically-assisted sports mostly failed to reach statistical significance. Regarding intervention dosage, medium-duration programs (total duration ≤1440 minutes) significantly improved all three skill domains (all P < 0.0001), while high-duration programs (>1440 minutes) only showed a significant effect on object control skills (SMD = 0.75, P = 0.003). CONCLUSION: Exercise interventions, particularly structured Land-based sports, are effective methods for improving gross motor skills in children with ASD. A medium-dosage regimen with a total intervention duration of ≤1440 minutes (approximately 8-12 weeks) appears to be the key window for optimal benefits. Prioritizing this regimen in clinical rehabilitation and educational practice is recommended. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251185572.

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9. Greer H, Williams CA, Ali A, Totsika V. Autistic young people’s psychological well-being in school. Autism. 2026: 13623613261425010.

Autistic students often face unique challenges at school compared to their non-autistic peers. However, there is a lack of robust evidence investigating their well-being at school. This study examined autistic adolescents’ school well-being using data from a UK population-based cohort. Participants self-reported their positive and negative affect towards and within school. Results indicated that autistic adolescents (n = 271; M(age) = 13.73; SD = 0.47; 23.11% female) experienced significantly lower levels of school well-being than non-autistic adolescents (n = 8077; M(age) = 13.78; SD = 0.45; 50.67% female), as evidenced by both lower positive, and higher negative, affect. Differences were attenuated when factors associated with school well-being were controlled for, and levels of well-being no longer differed significantly. Autistic adolescents’ (n = 412; M(age) = 13.76; SD = 0.46; 18.52% female) positive affect towards school was mostly associated with academic self-concept, whereas negative affect was mostly associated with academic self-concept, bullying victimisation and peer problems. The findings suggest that autistic school well-being could be promoted by supporting autistic students to feel good about their academic effort at school, as well as through school-wide anti-bullying programmes.Lay abstractMany autistic young people often experience difficulties at school. However, we know little about how autistic students feel about school compared to their non-autistic peers. Understanding their experiences is important, because school well-being might affect going to school, longer-term learning, as well as friendships and mental health. In this study, we used information from a UK national survey of young people aged 14 years. Students were asked about how happy they felt at school (positive feelings) and how often they felt unhappy at school (negative feelings). We compared answers from autistic and non-autistic students. We also looked at what things were related to autistic students’ feelings about school, including how confident they felt in their schoolwork, experiences of bullying and relationships with friends and family. Autistic students reported feeling less happy and more unhappy at school than non-autistic students. When we considered other things related to well-being, such as being bullying or self-confidence at school, these differences became a lot smaller. For autistic students, positive feelings about school were most strongly related to believing they were good at their schoolwork. Negative feelings about school were related to being bullied, difficult relationships with friends and lower confidence in schoolwork. These findings suggest that differences in school well-being between autistic and non-autistic students may be explained by things that could be changed with support. Supporting autistic students to feel more confident about how well they do academically, and ensuring schools reduce bullying, could help improve autistic young people’s experiences of school.

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10. Gunji A, Takeichi H, Suzuki K, Kobayashi T, Kokubo N, Yasumura A, Yamamoto H, Inoue Y, Kaga M, Inagaki M. Post-stimulus rebound of EEG power in response to vocal and non-vocal sounds in children with and without autism spectrum disorder: An exploratory study. Brain Dev. 2026; 48(3): 104522.

INTRODUCTION: This hypothesis-generating study examined voice perception to find a straightforward measure of communication difficulties associated with autism spectrum disorder (ASD). Whereas face and voice are the most characteristic social stimulus in human visual and auditory perception, studies on the latter are sparse compared with the former. METHODS: The post-stimulus power rebound (PSPR) in response to vocal and non-vocal sounds was characterized in children with ASD. Electroencephalograms were obtained from 11 recording sites in 18 male children with ASD and 18 age-matched typically developing male children. Stimuli included eight degraded human voice sounds, eight degraded non-voice sounds and sixteen control noise sounds. Scores differentiating ASD children from typically developing children were calculated using stepwise regression in each frequency band for both the voice and non-voice stimuli. RESULTS: Between ASD and typically developing children (N = 17 + 17 after artifact rejection), stimulus-dependent PSPR at a right temporal site (T8) in the alpha band was significantly different in response to non-voice sounds, but not in response to voice sounds, showing that PSPR could differentiate the two groups. DISCUSSION: The results show atypical right-lateralized processing of degraded vocal and non-vocal sounds among children with ASD, with less impairment for vocal sounds as indicated by PSPR. This difference may underlie atypical auditory processing and behavior among children with ASD, and suggests the feasibility of PSPR as an index of difficulties in communication during development.

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11. Jamadagni P, Dai Y, Liu Y, Weinschutz Mendes H, Pruitt A, Khan S, Yang L, Huang TC, Huang X, Deans PJM, Balafkan N, Zhao D, Xu G, Liu Y, Li N, Wu W, Fitzpatrick SE, Neelakantan U, Chen T, Szialta C, Jin DS, Lacadie CM, Umlauf S, Papademetris X, Surovtseva YV, Brennand KJ, Wang Z, Hoffman EJ. Pharmaco-behavioral profiling identifies suppressors of autism gene-associated phenotypes in zebrafish. Proc Natl Acad Sci U S A. 2026; 123(12): e2518846123.

Pharmaco-behavioral screens in scalable in vivo systems have critical advantages for drug discovery relevant to large-effect autism spectrum disorder (ASD) genes. Here, we establish a database and open-source website of the behavioral signatures of 520 US Food and Drug Administration (FDA)-approved drugs using high-throughput assays of basic sensory processing and arousal behaviors in larval zebrafish. By leveraging the behavioral profiles of 9 large-effect ASD gene mutants, we identify enrichment of pharmacological mechanisms that anticorrelate with subgroups of ASD genes with shared behavioral phenotypes. Screening of anticorrelating drugs in mutants of two ASD genes, SCN2A and DYRK1A, uncovers compounds that suppress mutant behavioral phenotypes. We identify estropipate, an estrogen receptor agonist, and paclitaxel, a microtubule inhibitor, as the top suppressors in scn1lab and dyrk1a mutants, respectively, and levocarnitine (LEVO), a mitochondrial modulator and carnitine supplement, as a top suppressor of both mutant behavioral phenotypes. Finally, we find that LEVO rescues regional brain activity deficits and dysregulated lipid metabolic pathways in mutants, as well as signaling deficits in human pluripotent stem cell-derived glutamatergic neurons carrying mutations in SCN2A and DYRK1A, demonstrating conservation of drug rescue across systems. Therefore, our study establishes a pharmaco-behavioral resource for precision medicine-based drug discovery, illuminating targets relevant to large-effect ASD genes.

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12. Jeejo M, Mathew M, Mohanakumar KP, Rajamma U. Mitochondrial dysfunction and mitochondrial unfolded protein response (UPR(mt)): unravelling their roles in autism spectrum disorder pathogenesis. Mitochondrion. 2026: 102148.

Autism spectrum disorders (ASD) is a complex neurodevelopmental condition characterized by a gamut of impairments in social interaction, communication, and behaviour. Emerging evidence implicates mitochondrial dysfunction, manifested through disruptions in ATP synthesis, mitochondrial DNA (mtDNA) mutations, and heightened oxidative stress, as a significant contributor to the pathophysiology of ASD. Notably, individuals with ASD demonstrate a higher prevalence of mitochondrial disorders compared to the general population, suggesting a potential pathogenic link. However, the relationship between mitochondrial dysfunction and ASD is heterogeneous and varies among individuals, reflecting the disorder’s intrinsic complexity. Recent interest in the Mitochondrial Unfolded Protein Response (UPR(mt)), which is activated in response to mitochondrial stress and misfolded proteins, underscores its critical role in maintaining mitochondrial integrity. Yet, its specific implications in ASD have been insufficiently investigated. This review aims to consolidate the current literature on UPR(mt)-related biomarkers in the context of ASD, elucidating how disruptions in this pathway may exacerbate mitochondrial dysfunction and contribute to ASD pathogenesis. In this narrative review, based on our literature search from academic databases such as PubMed, Scopus, Web of Science, and Google Scholar, and also grey literature, we present a conceptual framework to enhance our understanding of ASD pathophysiology that integrates mitochondrial stress, UPR(mt) activation, and neurodevelopmental outcomes. This review aims to expand the existing knowledge of mitochondrial contributions to ASD and identify new research dimensions to explore the mechanisms underlying UPR(mt) deregulation in ASD pathophysiology, thereby highlighting the potential therapeutic directions for targeting mitochondria-mediated UPR(mt) dysfunction in ASD.

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13. Lee DH, Suarez-Lopez JR. Maternal Diabetes Mellitus and Child Neurodevelopmental Disorders: Rethinking Causality in Light of Environmental Pollutants. J Korean Med Sci. 2026; 41(10): e110.

Numerous epidemiological studies have linked maternal diabetes mellitus (DM) to neurodevelopmental disorders in offspring, such as autism spectrum disorder and attention-deficit/hyperactivity disorder. However, recent evidence challenges a direct causal relationship: sibling-matched analyses show similar risks regardless of gestational DM status, and glycemic control during pregnancy does not consistently predict neurodevelopmental outcomes. We propose that exposure to environmental pollutants-rather than DM itself-may underlie these associations. Although usually examined separately, many pollutants both increase DM risk and disrupt fetal brain development, providing a biologically plausible basis for the observed epidemiological patterns. Because fetuses encounter these pollutants via placental transfer from maternal blood, understanding what determines maternal circulating pollutant levels is essential. Two major sources contribute: (1) ongoing external exposure through food, air, water, and consumer products, and (2) the release of previously accumulated lipophilic pollutants stored in adipose tissue. Often overlooked, adipose tissue serves as an important reservoir, and lipolysis mobilizes these compounds into circulation. Importantly, key pathophysiological features of DM-insulin resistance and insulin deficiency-accelerate lipolysis, increasing circulating pollutant levels. These pollutant-related mechanisms may also account for associations observed with other maternal conditions, such as obesity, eating disorders, psychological stress, and intrahepatic cholestasis of pregnancy, all of which may also be linked to elevated pollutant levels in maternal circulation. These insights suggest that maternal risk factors should be reconsidered in light of toxicokinetic dynamics, particularly the mobilization of lipophilic pollutants stored in fat. This perspective may offer a unifying explanation for otherwise disparate epidemiological findings and help guide more effective prevention strategies.

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14. Liu CH, Doherty M, Lai MC. Autistic SPACE: clinician advocacy for improving school environments for autistic young people. Lancet Child Adolesc Health. 2026.

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15. Manfredi M, Laulan P, Samson AC. Humour as emotion regulation and resource in autism: a narrative review. Front Psychiatry. 2026; 17: 1770298.

Humour is closely linked to psychological well-being in neurotypical populations, supporting emotion regulation through mechanisms such as cognitive reappraisal, distraction, and positive affect. In autism, emotion regulation presents unique challenges, and humour use shows qualitative differences, including reduced reliance on adaptive strategies and a high prevalence of gelotophobia. This narrative review synthesises current evidence on humour as both a trait and a character strength. Findings suggest that although humour is less frequently employed in individuals with autism, it can act as a selective but valuable resource for resilience and well-being. Intervention studies, particularly those developed within neurodiversity-affirming frameworks, highlight the potential of humour-based approaches to strengthen emotional and social functioning in autism.

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16. Noori T, Hosseini SZ, Alavi SD, Sureda A, Shirooie S. Targeting the mTOR Pathway with Natural Products: A Potential Therapeutic Approach for Autism Spectrum Disorders. Curr Neuropharmacol. 2026.

Autism spectrum disorders (ASD) are complex neurodevelopmental conditions characterized by a diverse range of challenges and strengths in social communication, behavior, and sensory processing, with wide variation in presentation and severity among individuals. Treatment for ASD symptoms typically includes stimulants, modafinil, atomoxetine, antidepressants, antipsychotics, and natural products. The mechanistic target of rapamycin (mTOR), a serine/threonine kinase, is dysregulated in many human diseases, leading to abnormal synapse formation, neuroinflammation, and mitochondrial dysfunction. Natural products, due to their wide range of bioactive compounds and relatively low toxicity, have emerged as promising modulators of this pathway. Several phytochemicals-including curcumin, resveratrol, and epigallocatechin gallate-have demonstrated the ability to modulate mTOR signaling and improve neurobehavioral outcomes in preclinical models of ASD. mTORC1 and mTORC2 are key regulators of cellular processes, with mTORC1 being largely sensitive to nutrient availability and mTORC2 playing a crucial role in cell growth, proliferation, motility, and autophagy, which is modulated by the PI3K/Akt/mTOR pathway. Future research should examine the relationship between autism and the mTOR signaling pathway, as well as the phytochemicals that may contribute to improving the condition through this pathway.

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17. Scaduto G. Family reflections: discovery and justice in autism care. Pediatr Res. 2026.

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18. Singh R, Shah A, Jain N, Shah H, Rawal R. Plasma metabolomic signatures in children with autism spectrum disorder and their modulation following a gluten-free modified ketogenic diet. BMC Psychiatry. 2026.

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19. Tsalkitzi E, Tsalkitzi A, Ntafoulis P. Serving Differently: Pioneering the Inclusion of Autism in the Greek Military. Cureus. 2026; 18(2): e103421.

Autism spectrum disorders are typically considered a disqualifying factor for military service due to their high demands on the environment. This case study describes the implementation of a social skills training program for a military candidate with Asperger’s syndrome. The intervention employed four strategies: Social Stories, which used structured scenarios to teach appropriate social responses; Social Autopsy, which analyzed real-life interactions to identify strengths and areas for improvement; Role-Playing, which provided guided practice of social interactions; and a Cardboard Game, designed to promote empathy and perspective-taking. An individualized plan was created to enhance emotional intelligence and core social communication skills during military service. Following the intervention, the participant demonstrated improvements in social communication and increased self-confidence. Though this is a single-case study, its findings suggest that targeted social skills interventions can enable autistic individuals to participate successfully in structured environments such as the military. The expansion of similar programs can be used to foster integration, personal development, and inclusion in settings that were previously restrictive.

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20. Wang P, Shi Y, Luo Z, Wang J, Zhang Y. Global statistics of attention-deficit/hyperactivity disorder, autism spectrum disorder, and conduct disorder among school-age children from 1990-2021, with forecasts to 2040. Neuroepidemiology. 2026: 1-25.

BACKGROUND: Mental disorders among school-age children represent a significant global health issue and substantially contribute to the global disease burden. This study aims to examine the patterns and trends of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and conduct disorder (CD), which are commonly observed in school-age children, from 1990 to 2021, offering valuable insights for health policy formulation, medical resource allocation, and optimization of patient management strategies. METHODS: We analyzed data from the Global Burden of Disease (GBD) 2021 study for 21 regions and 204 countries, focusing on prevalence, disability-adjusted life years (DALYs), gender, and different time periods to gain a deeper understanding of the health burden. We assessed correlations with the Socio-demographic Index (SDI) and employed autoregressive integrated moving average modeling to forecast developments up to 2040, enabling us to better comprehend the burden and trends of these mental disorders. RESULTS: In 2021, the prevalence rates of ADHD, ASD, and CD per 100,000 population among children aged 5-14 years were 2374.8, 847.13, and 2146.48, respectively; DALYs rates were 29.17, 162.85, and 262.53, respectively. Compared to 1990, prevalence and DALYs rates exhibited changes of -0.06, 0.03, and 0.04, respectively. Australia, Japan, and the United Kingdom exhibited particularly notable burdens, with the United Kingdom continuing to show rapid growth in ASD, while ADHD and CD increased rapidly in China and India, respectively. Gender and age analyses revealed a higher burden among males. Regions with high SDI displayed higher epidemiological indicators. For the 2040 forecast, the indicators for ADHD in terms of prevalence and DALYs are projected to be 3796.65 and 44.33 for males, and 1343.18 and 16.23 for females. For ASD, they are projected to be 1103.04 and 215.23 for males, and 552.01 and 106.40 for females. For CD, they are projected to be 2650.69 and 325.64 for males, and 1593.57 and 200.41 for females. CONCLUSION: This study underscores the complex epidemiological landscape of ADHD, ASD, and CD, revealing variations in burden across gender and geographical regions. It emphasizes the urgent need for healthcare professionals and policymakers to devise innovative prevention and healthcare strategies based on the current and evolving burden of these mental disorders, with the aim of alleviating the global disease burden.

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21. Wang T, Lee JD, Zhang W. Annual Trends in Unmet Health Care Needs Among Children With Autism Spectrum Disorder. JAMA Pediatr. 2026.

This survey study identifies the prevalence of unmet medical, dental, vision, hearing, mental, and general health care needs of autistic children from 2016 to 2023. eng.

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22. Yamamuro K, Kashida N, Ishida R, Toritsuka M, Takeda T, Makinodan M. How parenting shapes the relationship between autistic traits and self-esteem in youth: a comparative study of autism spectrum disorder. Front Psychiatry. 2026; 17: 1747061.

BACKGROUND: Self-esteem is a critical factor in the psychological adjustment of children and adolescents, yet little is known about how autistic traits and parenting styles interact to relate self-worth in individuals with autism spectrum disorder (ASD). Understanding these relationships may provide important insights for family-based interventions. METHODS: We conducted a cross-sectional study of 76 participants (ASD: n = 40; typically developing [TD]: n = 36). Autistic traits were assessed using the Japanese version of the Autism-Spectrum Quotient (AQ-J), parenting attitudes were evaluated with the Parental Nurturance and Parenting Scale (PNPS), and self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES). In the ASD group, clinician-rated autism symptom severity was additionally assessed using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Associations among autistic traits, parenting attitudes, and self-esteem were examined using multiple linear regression and partial correlation analyses. RESULTS: Children and adolescents with ASD exhibited significantly lower self-esteem than their TD peers (RSES: ASD < TD, p < 0.01). In the combined sample, higher AQ-J scores were independently associated with lower self-esteem (β ≈ -0.48, p < 0.01). Within the ASD group, negative parenting attitudes were linked to lower self-esteem (β = -0.36, p = 0.02), whereas positive parenting attitudes showed a non-significant trend toward higher self-esteem (β = 0.20, p = 0.17). Conversely, clinician-rated autism symptom severity assessed by the ADOS-2 was not associated with self-esteem (β = 0.06, p = 0.72). Overall, parenting attitudes were more closely related to self-esteem than clinician-rated symptom severity in the ASD group. CONCLUSION: These findings underscore the relevance of parenting contexts in relation to self-esteem among youth with ASD. Although autistic traits were associated with greater vulnerability in self-esteem, supportive parenting attitudes were associated with more favorable self-esteem outcomes. Together, the results suggest that parenting-related factors may be important considerations when addressing psychological well-being in autistic children and adolescents.

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23. Zhang X, Qiu G, Mou Z, Chen C, Lu J, Tang Z, Zhou Z. Executive Dysfunction in Autism Spectrum Disorder Is Associated With Increased Cerebro-Cerebellar Resting-State Functional Connectivity. Neural Plast. 2026; 2026(1): e7449692.

This study examined the correlation between the cerebellar functional status and the executive function (EF) scores and explored alterations of functional connectivity (FC) among autism spectrum disorder (ASD) individuals compared to typically developing (TD) subjects. Individuals from the Autism Brain Imaging Data Exchange II dataset (ABIDE II) with complete cerebellum scanning coverage and available Behavior Rating Inventory of EF (BRIEF) t-scores were included, yielding a final sample of 71 ASD (age: 11.50 ± 2.77) and 149 TD (age:11.48 ± 1.60) individuals. Four cerebellar ROIs (left Lobule VI, left Crus I, right Crus I, and left VIIB) were defined from a meta-analysis. We quantified cerebellar intrinsic activity using percent amplitude of fluctuation (PerAF) and assessed seed-based FC within cerebro-cerebellar circuits. We found no between-group differences in PerAF across the four ROIs, and PerAF showed no significant association with global executive composite (GEC) scores within the ASD group. In contrast, FC analyses revealed predominantly increased cerebro-cerebellar connectivity in ASD. Notably, stronger FC between left Lobule VI and right inferior frontal gyrus, pars opercularis (IFGoper), as well as between left Crus I and left IFGoper were positively correlated with BRIEF Shift scores, indicating that greater coupling within these loops was associated with poorer cognitive flexibility. These results suggest that EF impairment among ASD individuals might be reflected in part by alterations in functional interconnections within the cerebro-cerebellar system. These findings help to understand the potential role of the cerebellum in EF among ASD individuals and might provide ideas for therapeutic interventions.

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24. Zhu H, Yan HK, Ye J, Li Y, Xiao L, Yu Z, Wang X, Li X. The pathway of early detection, diagnosis, and intervention for autistic children: a multi-center mixed method study. Pediatr Res. 2026.

BACKGROUND AND OBJECTIVES: Timely progression through the early detection-diagnosis-intervention pathway is critical for optimizing outcomes in autistic children but is often impeded by barriers. This multi-center study aimed to describe this care pathway through the experiences of parents to identify key factors influencing its efficiency across diverse settings. METHODS: This multi-center mixed-methods study (July-Oct 2024) integrated survey data collected from 397 primary caregivers and interviews with 17 family caregivers of autistic children across 11 Hainan cities. Survey data on child/family characteristics and clinical timelines were analyzed using regression/comparative tests. Interview data on care-pathway determinants were analyzed thematically. Findings were integrated via triangulation. RESULTS: Findings demonstrated significant delays across all stages of the pathway. Descriptive analysis of survey data indicated that family members initiated detection in 70.3% of cases, with language delay the most common initial concern (88.9%), and that 76.6% of children received 15 or fewer intervention hours weekly. Integrated mixed-methods analysis identified key multilevel determinants: individual (e.g., developmental regression, parental awareness), inner setting (e.g., uneven resource distribution, workforce shortages), and outer setting (e.g., policy, cultural beliefs). CONCLUSIONS: Substantial delays and systemic barriers in the autistic care pathway necessitate coordinated strategies. Recommendations include enhancing parent education, developing integrated regional care networks, expanding telehealth, and implementing targeted public awareness campaigns. This framework offers transferable solutions for under-resourced settings, particularly in low- and middle-income countries facing similar autistic care challenges. IMPACT: This study identifies delays throughout the early detection, diagnosis, and intervention pathway for autistic children, influenced by individual, inner, and outer factors. It presents a comprehensive mixed-methods assessment of the care pathway in resource-limited settings, underscoring the key role of caregivers, cultural belief and structural barriers such as workforce shortages and geographic disparities in resource availability. The findings support the implementation of coordinated evidence-based strategies, including parent education, integrated regional care systems, telehealth services and targeted public awareness campaigns to strengthen early autistic care in comparable settings worldwide.

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