1. Abbas AM, Al-Kuraishy HM, Thabat JA, Al-Gareeb AI, Mustafa AM, Alexiou A, Papadakis M, El-Saber Batiha G. Placental dysfunction, inflammation, and impaired autophagy in preeclampsia: A pathophysiological link to autism spectrum disorder. Metab Brain Dis. 2026; 41(1).

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2. Albadry ES, Ibrahim NM, Othman AA, Abd-Elmonem AM, Abbass ME. Effect of Aquatic Training Versus Land Exercises on Motor Function in Children With Autism Spectrum Disorder: A Randomized Controlled Trial. Physiother Res Int. 2026; 31(2): e70220.

BACKGROUND: Autism Spectrum disorder (ASD) is a neurodevelopmental condition characterized by intensely repetitive and limited behaviors as well as deficiencies in perceptuo-motor processing and interpersonal interaction capabilities. OBJECTIVES: The objective of this paper is to evaluate the effectiveness of aquatic training (AT) versus land-based exercises (LBE) on the quality of life (QoL), motor function, and autistic traits in children with ASD. METHODS: Fifty children with ASD diagnoses of both sexes, aged from three to five years, were assigned to two groups at random (n = 25 each). AT was given to the AT group, whereas LBE was given to the LE group for 45 min three times a week for three successive months. Before and after the recommended intervention period, the Childhood Autism Rating Scale (CARS-2), Peabody Developmental Motor Scale (PDMS-2), and Arabic version of the Pediatric QoL generic core scale (PedsQL) were used to measure autistic features, motor skills, and QoL, respectively. RESULTS: Within-group comparison showed significant improvement in PedsQL, PDMS-2 and CARS-2 scores (p < 0.001). Additionally, between-group comparison reveled significant improvement in CARS-2 and PedsQL and PDMS-2 (stationery and locomotion age equivalent and gross motor quotient) of the AT group compared with that of the LE group posttreatment (p < 0.001). CONCLUSION: AT demonstrated higher efficacy than LBE, yielding greater improvements in motor development and QoL, as well as more pronounced enhancements in sensory integration among young children with ASD. Thereupon, it is worthwhile for physical rehabilitation practitioners to include the AT in the intervention plans for children with ASD. TRIAL REGISTRATION: The clinical trial registration number of the current study is as follows: Registry submission date 11/5/2021 URL: https://www. CLINICALTRIALS: gov/study/NCT05123066?tab=table; ID number: NCT05123066.

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3. Alqarawi N, Hamzaa HG, El-Sayed MM, Khedr MA, Hendy A, Amin SM, Klila ZEK. Hidden Shields: How Parental Resilience and Social Intelligence Shape Behavioral Profiles in Children with Autism Spectrum Disorder. Psychol Res Behav Manag. 2026; 19: 598638.

BACKGROUND: Parents of autistic children face significant stress, which can impact their child’s behavioral outcomes. Parental psychological resources, specifically resilience and social intelligence, are theorized to be protective factors, yet their combined influence and interplay require further investigation. OBJECTIVE: This study aimed to examine the relationships between parental resilience, parental social intelligence, and concerning behaviors in autistic children, and to test whether social intelligence mediates the link between parental resilience and child behavior. METHODS: A cross-sectional study was conducted with 300 parents of children diagnosed with ASD at a mental health outpatient clinic. Participants completed the Arabic versions of the Brief Resilience Scale, the Tromsø Social Intelligence Scale, and the Assessment of Concerning Behavior scale. Data were analyzed using descriptive statistics, Pearson’s correlations, multiple linear regression (controlling for child age, level of needs, parental income, and rehabilitation participation), and mediation analysis with the PROCESS macro. RESULTS: Both parental resilience and social intelligence were negatively correlated with children’s internalizing problems (r = -0.38 and -0.33), externalizing problems (r = -0.23 and -0.27), and total concerning behavior (r = -0.36 and -0.36; all p<0.001). After controlling for covariates, regression analysis indicated both factors remained significant predictors, explaining 25.8% of the variance in concerning behavior (R(2) =0.258, p <0.001). Mediation analysis confirmed a significant partial mediation, where social intelligence accounted for 17.1% of the association between resilience and child behavior (Sobel z = -3.08, p =0.002). CONCLUSION: Parental resilience and social intelligence are significant, interrelated protective factors associated with reduced behavioral problems in children with ASD. Interventions that simultaneously enhance both parental resources may be most effective in improving family well-being and child outcomes.

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4. Ayad MN, Ayoub HE. The Efficacy of Treadmill Walking Program on Gait and Body Mass Index of Children With Autism Spectrum Disorder: Randomized Controlled Study. Physiother Res Int. 2026; 31(2): e70222.

BACKGROUND: Children with autism usually have abnormal walking patterns and are at increased risk of being overweight induced by their sedentary lifestyle. Treadmill training has been explored as an intervention to improve gait and support weight management. PURPOSE: This study evaluated the effects of a treadmill walking program on gait and body mass index (BMI) in children with autism spectrum disorder (ASD). METHODS: Thirty (five to nine years old) children diagnosed with ASD according to the DSM-V-Text Revised and the Gilliam Autism Rating Scale participated in the study. They were randomly assigned to a control group (CG), who received conventional physical therapy three times per week for 1 hour, or a treadmill-walking group (TWG), who received the same therapy plus 15 min of treadmill training. BMI, z-scores and gait parameters were measured before and after intervention using the WHO 2007 growth reference and Kinovea motion analysis software, respectively. RESULTS: Both groups showed a small reduction in the percentile BMI, with no significant differences between groups. There was a significant increase in the left hip and both ankle angular displacements in the study group, with no significant differences between the groups for the rest of gait parameters. CONCLUSION: Treadmill training may be effective in reducing percentile BMI and lower limb mobility in children with ASD. These findings support its use for combined weight management and motor improvement. But the findings indicated the need for future research with larger samples and longer follow-up to clarify its clinical significance. TRAIL REGISTRATION: Identifier (PACTR202207804171810).

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5. Ayvaci AS, Cox AD, Mitteer D. Factors Associated With Restraint Application in Children and Adolescents With Intellectual and Developmental Disabilities Displaying Severe Challenging Behavior. Behav Modif. 2026: 1454455261434863.

Emergency physical restraints may still be widely used, with prevalence rates ranging from 11% to 78% across different service sectors (Fitton & Jones, 2020). At times, behavior analysts may recommend restraint when severe challenging behavior poses significant safety risks (e.g., intense aggression causing severe tissue damage; Foxx & Meindl, 2007; Vollmer et al., 2011). Most existing physical restraint literature featuring child and adolescent participants focuses on variables that behavior-analytic interventions do not manipulate (e.g., sex, diagnosis). Additionally, this literature most often features inpatient clinical populations with psychiatric conditions as opposed to those with intellectual and developmental disabilities. The current study applied a multi-level analysis informed by retrospective outpatient data (N = 12) from children and adolescents with intellectual and developmental disability who required emergency physical restraints. The study aimed to (a) examine and report on participant and restraint application characteristics and trends, and (b) determine if challenging behavior severity at intake predicted latency to restraint-application. According to the descriptive analysis, most participants were experiencing polypharmacy (i.e., prescribed at least three concurrent psychotropic medications), had been assigned moderate to high scores on challenging behavior severity, and primarily exhibited behavior maintained by access to tangibles or multiple reinforcers. Regarding restraint characteristics, the average restraint rate was 9.11 per 100 service hours, with most participants described as calm during restraint application. Typically, more than two staff members applied the restraints. Regression results indicated that challenging behavior severity scores significantly predicted latency to the first restraint application. Clinical implications related to these outcomes are discussed.

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6. De Laet A, Whitworth M, Fincham H, Lazar AS, Bedford R, Gliga T. Sound asleep: sensory decoupling during sleep depends on an infant’s sensory profile. Sleep. 2026; 49(4).

Initiating and maintaining sleep requires gating of sensory input. Sensory processing differences, such as elevated sensory reactivity, have emerged as a potential driver of sleep difficulties in autism. Both sensory and sleep difficulties are prevalent in autistic individuals and emerge early in development. Here, we use polysomnography to understand how infant sensory reactivity affects the ability to maintain sleep in a quiet or noisy environment. Forty-four 8- to 11-month-old infants at typical and elevated likelihood for autism participated in a lab-based nap study consisting of two counterbalanced visits, a baseline and an auditory stimulation condition. In the stimulation condition, 60 dB pure tones were played during sleep. We measured slow waves and sleep spindles, electroencephalogram features previously linked to the ability to protect sleep from sensory disturbance. We show that higher caregiver-reported sensory reactivity was significantly associated with lower slow wave activity and density, across both nap conditions. In the stimulation condition, infants with elevated sensory reactivity had even further decreased slow wave density and lower sleep spindle density. Comparisons of pre- and poststimulus windows showed that, rather than triggering immediate event-related disruptions, auditory input and sensory reactivity alter sleep microstructure across the longer timescale of the entire nap. Thus, highly reactive infants experience disruptions in their ability to enter or maintain periods of sensory disconnection, accentuated by the presence of auditory noise.

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7. Dennison CA, Flanagan M, Shakeshaft A, Tilling K, Riglin L, Thapar A. Childhood ADHD and autism spectrum disorder difficulties: exploring the impact of copy number variants on young adult outcomes. BJPsych Open. 2026; 12(3): e108.

Rare copy number variants (CNVs; deleted/duplicated DNA segments) are associated with childhood attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). It is unknown whether carrying a CNV moderates the effect of ADHD/ASD on adult outcomes. In a UK population-based cohort, the Avon Longitudinal Study of Parents and Children, ADHD and ASD difficulties at ages 7-16 years were defined categorically. Outcomes included: General Certificate of Secondary Education non-attainment; depression at ages 18 and 24; functioning at age 25; not in education, employment or training; and receiving state benefits at age 25. Logistic regressions were used to assess associations between ADHD/ASD and outcomes, and to test CNVs as moderators. Multiple imputation was used to account for data missingness. We did not find strong evidence of CNVs moderating the effect of ADHD or ASD on young adult outcomes. However, confidence intervals for the moderating effect were wide, so further research in larger clinical samples is necessary.

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8. Estrada J, Guzmán JA, Aguayo AS, Miglino MA, Del Sol M. Biopsychosocial factors during pregnancy and their implications for autism spectrum disorder: a scoping review. BMC Pediatr. 2026.

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9. Gaspar JA, Dhandapani KM, Hess DC. MAGEB16 as an epigenetic timing regulator linking X-chromosome biology to neurodevelopmental vulnerability in Autism Spectrum Disorder. Excli j. 2026; 25: 377-86.

MAGEB16 (Melanoma-associated antigen B16) is an X-linked cancer-testis antigen belonging to the MAGE-B family, whose expression is tightly regulated by a promoter DNA-methylation switch that restricts transcription primarily to the male germ line under normal physiological conditions. In addition to its established roles in spermatogenesis and oncogenesis, emerging functional, epigenomic, and genetic evidence points to MAGEB16 as an epigenetically sensitive modifier of early developmental programs implicated in neurodevelopmental disorders such as Autism Spectrum Disorder (ASD). In this study, we performed an integrative analysis combining MAGEB16’s chromosomal context, molecular interaction networks, and methylation-dependent regulatory features, alongside experimental depletion datasets from pluripotent stem cells, perinatal cord-blood methylome data from ASD cohorts, peripheral transcriptomics linked to neuropsychiatric risk and recently reported genetic variant associations. Our synthesis identifies underlying evidence indicating that MAGEB16 participates in epigenetically regulated lineage specification processes during early embryonic development. We propose a unified model in which MAGEB16 acts as a dosage- and timing-dependent regulator of early lineage commitment. Disruption of its epigenetic control, particularly during X-chromosome-enriched developmental periods, may influence neurodevelopmental pathways toward ASD-associated phenotypes. These findings position MAGEB16 as a candidate epigenetic-susceptibility factor linking germline-restricted regulatory changes, that could influence early brain development and increase the risk for neurodevelopmental conditions. See also the graphical abstract(Fig. 1).

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10. Getzler I, Malachy A, Fremder A, Stolar O. Chronic Disease Incidence and Onset in Adults With Autism Spectrum Disorder: A 26-Year Matched Cohort Study. J Autism Dev Disord. 2026.

INTRODUCTION: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition, yet long‑term patterns of chronic disease in autistic adults remain poorly characterized. We examined incidence and age at diagnosis of common chronic conditions in adults with ASD compared with matched controls. METHODS: We conducted a retrospective cohort study within Maccabi Health Services, including adults ≥ 18 years with documented ASD and 3:1 controls matched on age, sex, and socioeconomic status, with up to 26 years of follow‑up (1998-2024). Chronic physical and psychiatric conditions were obtained from validated registries. Time-to-event analyses were performed using Kaplan-Meier curves and Cox proportional hazards models. RESULTS: The cohort comprised 6,965 adults with ASD and 20,871 controls; 51% of the ASD group versus 24.5% of controls had ≥ 1 chronic condition. Adults with ASD had higher hazards and earlier diagnosis of type 2 diabetes (HR 1.47, ~ 9 years earlier), hypertension (HR 1.24, ~ 5 years earlier), overweight/obesity (HR 1.49, ~ 7.4 years earlier), inflammatory bowel disease (HR 1.60, ~ 5 years earlier), and schizophrenia (HR 2.10, ~ 4 years earlier). Overweight status amplified diabetes and hypertension risk in ASD but not controls. No significant differences were observed for COPD or cardiovascular disease. CONCLUSIONS: Adults with ASD experience earlier and greater chronic disease burden than matched peers, supporting earlier, tailored preventive care and systematic metabolic and psychiatric screening in this population.

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11. Havusha-Laufer S, Krishnaswamy VR, Krugliak-Shechter N, Shenoy A, Karlinski Zur M, Kuznitsov-Yanovsky L, Solomonov I, Hanna JH, Sagi I, Ben Yosef D. Altered ECM deposition and cell adhesion signaling in a human cortical organoid model of fragile X syndrome. Mol Brain. 2026.

Fragile X Syndrome (FXS) is the most common inherited intellectual disability, and the most common monogenic cause of autism spectrum disorder (ASD). It is caused by epigenetic silencing of the FMR1 gene leading to the loss of FMRP, an RNA-binding protein that regulates local mRNA translation in neuronal dendrites, crucial for synapse development. Three-dimensional (3D) brain organoid models derived through in vitro differentiation of pluripotent stem cells offer a powerful tool to dissect the underlying mechanisms of neurodevelopmental disorders. Here, we generated human FXS and control organoids using isogenic human embryonic stem cell clones with and without the FXS mutation. Our results show that mature FXS cortical brain organoids can be derived by inhibiting the TGFβ and Wnt pathways. Moreover, expression analyses including immunofluorescence, qRT-PCR, proteomics and western blotting reveal altered levels of neuronal markers and ECM deposition along with modulated downstream signaling molecules. Interestingly, in silico analysis of proteomics revealed several altered pathways, such as cell adhesion, regulation of neurogenesis and cell cycle that are implicated in FXS. Collectively, our unique FXS-organoids derived from isogenic hESC lines may serve as a model for studying the pathology of FXS disorder and for developing therapeutical intervention.

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12. Kim M, Lee J, Kim M, Kim J, Park H, Yang S, Yoon H, Chang J, Chung M, Jung YK, Hong SH, Kim HJ, Choi TK. AVATA Cure Digital Therapeutics for Social Communication in Children With Autism Spectrum Disorder: A Pilot Clinical Trial. Psychiatry Investig. 2026; 23(4): 510-9.

OBJECTIVE: Autism spectrum disorder (ASD) is characterized by deficits in social interactions, reciprocal communication, and pragmatic language. Traditional therapeutics are effective but limited by economic, temporal, and spatial constraints. This pilot trial evaluated the effectiveness of AVATA Cure, a mobile-based digital therapeutic application, in improving the social communication skills of children with ASD. METHODS: Thirty-three children with ASD aged 1-7 years were enrolled, of whom 29 completed the study. Participants used AVATA Cure at home on a tablet device for at least 30 minutes per day, 4 days per week, for 8 weeks. The program included modules targeting joint attention, receptive and expressive pragmatics, and non-verbal communication. Social communication skills were assessed at baseline, 4 weeks, and 8 weeks using the Autism Diagnostic Observation Schedule-2 (ADOS-2); Sequenced Language Scale for Infants (SELSI) or Preschool Receptive-Expressive Language Scale (PRES); Social Communication Questionnaire (SCQ); and Korean Vineland Adaptive Behavior Scales 2nd edition (K-Vineland-II). The statistical analyses included complete case analysis with analysis of variance and Bonferroni correction. RESULTS: Significant improvements were observed in all measures. ADOS-2 reciprocal social interaction scores decreased significantly, indicating reduced impairment. SELSI/PRES pragmatic language scores increased significantly. SCQ scores decreased, and the K-Vineland-II subscales improved, reflecting enhanced adaptive functioning. CONCLUSION: AVATA Cure demonstrated preliminary efficacy for enhancing social communication among children with ASD. Notable improvements across multiple assessments suggest its potential as a scalable, accessible, and cost-effective intervention that may complement existing therapies and provide early therapeutic benefits.

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13. Kuy N, Jahromi LB, Basch CE. Parental Perspectives on Oral Health Care for Autistic Children With Medicaid: A Qualitative Study. Health Educ Behav. 2026: 10901981261439001.

Children with special health care needs and disabilities (CSHCND), particularly those with autism, experience disproportionately high rates of oral health problems, yet the underlying factors remain insufficiently explored. This qualitative study investigated the challenges and effective strategies parents use to support the oral health of autistic children enrolled in Medicaid in one large city. Thirty-one parents were recruited through purposive and snowball sampling from the Oral Health Center for People with Disabilities and the pediatric department and participated in semi-structured interviews conducted via Zoom. Interpretative phenomenological and thematic analyses identified eight key themes: (1) Autism-related Barriers to Oral Hygiene Routines, (2) Challenges in Securing Adequate Dental Care, (3) Denial About Autism and Delay in Early Intervention, (4) Electric Toothbrushes May Help, (5) Sensory Adapted Dental Environments, (6) Use of Social Media and Artificial Intelligence, (7) Support from Allied Health Professionals, and (8) Infrastructure in Education. The findings highlight the complex relationship of individual, social, and systemic factors shaping oral health promotion for this population. Insights from this study can inform the development of tailored interventions, educational initiatives, and policy reforms to improve oral health outcomes for autistic children. As the first study of its kind in New York City, this research amplifies the voices of parents and provides a foundation for future efforts to address persistent oral health disparities in an urban setting.

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14. Liu D, Wei Z, Maurer U, Chung KKH, Datu JAD, Fern-Pollak L, Wydell T, Tso WW, Sun F, Luo L, Wang LC, Yum YN, Xu G, Li S. Correction: Profiling Chinese children with symptoms of SpLD, ADHD, or ASD: a transdiagnostic and biopsychosocial study. BMC Psychiatry. 2026; 26(1).

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15. Liu Q, Zhang J, Duan X, Zhang P, Yang Y, Yao G, Jiaerheng B, Shou XJ, He Y, Han K, Jia M, Wang L, Gong W, Xie W, Sun K, Wang D, Wu XD, Cao H, Zhang H, Liu H. Accelerated intermittent theta burst stimulation targeting personalized fronto-parietal control network improves core symptoms of autism spectrum disorder: a double-blind, randomized controlled trial. Mol Psychiatry. 2026.

Autism Spectrum Disorder (ASD) presents a substantial global challenge, yet no pharmacological treatments effectively target its core symptoms, especially in individuals with severe cognitive or adaptive impairments. This double-blind, sham-controlled, randomized clinical trial assessed accelerated intermittent theta burst stimulation (iTBS) targeting the personalized fronto-parietal network (FPN) in ASD. Participants (6-30 years) were randomized in a 2:1 ratio to active or sham iTBS (three daily sessions, 1800 pulses/session) over 12 weeks (324k pulses) alongside behavioral training. The primary outcome was defined as the response rate, charaterized by a ≥ 1-point reduction in ADOS-2 SA at week 12. Of 132 individuals screened, 67 were randomized (mean age 10.04 ± 4.22 years; 88.1% male; all with cognitive/adaptive delays), with 59 completing the study. Active iTBS resulted in a significantly higher response rate (55% vs. 29%) and higher symptom improvement than sham (cohen’s d = -0.53), with mild local pain in only 5% of iTBS group. In the profound autism subgroup, the active group exhibited language improvement alongside amelioration of core symptoms. These findings suggest that prolonged, accelerated FPN-targeted iTBS is a safe and efficacious intervention for severe ASD, offering a promising therapeutic approach.Registration ClinicalTrials.gov Identifier: NCT05890846.

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16. Livingston LA, Leekam SR, Davies G, Shah P, Layinka O, Carrington SJ, Jones CRG. The Signposting Questionnaire for Autism-2 (SQ-A-2): using input from autistic adults to inform questionnaire development. Mol Autism. 2026.

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17. Luo J, Zhou X, Shi Y, Ma D, Li J, Zhou L, Cheng Y, Meng X. Cultural Adaptation and Validation of the Chinese Behavioral Inflexibility Scale: Clinical Interview Version for Children Aged 3-8 Years With Autism Spectrum Disorder in Mainland China. J Autism Dev Disord. 2026.

PURPOSE: This study seeks to sinicise the English version of the BIS-CI and to evaluate its reliability and validity. The aim is to provide clinicians and therapists with assessment tools and intervention guidance for addressing behavioral inflexibility in children with ASD in China, while also establishing a theoretical foundation for the implementation of effective intervention strategies in clinical practice. METHODS: A total of 465 children aged between 3 and 8 years were recruited, comprising 158 with ASD and 307 typically developing (TD) children. Participants were assessed using the BIS-CI. Furthermore, the ASD group completed the Repetitive Stereotyped Behavior Scale – Revised Edition (RBS-R), the Social Response Scale (SRS), and the General Applicable Core Scale 4 for Quality of Life in Children (PedsQL 4) to evaluate reliability and validity, as well as to conduct correlation analyses. RESULTS: The findings indicated that the Cronbach’s α coefficient for the Chinese version of the BIS-CI was 0.822, while the test-retest reliability was 0.956, demonstrating strong reliability. EFA revealed a unidimensional scale, which displayed moderate correlations with the RBS-R, SRS, and PedsQL4. CFA revealed that the model exhibited favourable fit indices. Furthermore, the BIS-CI scores for the ASD group were significantly higher than those of the TD group, with the differences achieving statistical significance. CONCLUSION: It offers clinicians and therapists a valuable assessment tool and a foundation for intervention guidance tailored to the behavioural inflexibility exhibited by children with ASD in China. Furthermore, it provides a theoretical basis for implementing effective intervention strategies in clinical practice.

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18. Marinopoulou M, Mårland C, Gillberg C, Billstedt E. Mortality in Autism: A Longitudinal Register-Based Study. J Autism Dev Disord. 2026.

PURPOSE: To examine mortality and causes of death in a population-based cohort of adults with autism spectrum disorder (ASD), and to compare findings with a sample drawn from the general population. METHODS: A population-based cohort of individuals (N = 113) born 1962-1984 and diagnosed with ASD in childhood during the 1970’s and 1980’s was followed up through register between 2000 and 2023. Most individuals were diagnosed with co-occurring intellectual disability (ID). The group was compared to an age- and sex-matched group (N = 1130) from the general population. Data for both groups were obtained from the National Cause of Death Register in Sweden. Kaplan-Meier survival analysis was used to calculate the survival distributions of the participants with ASD and the comparison group, and Cox proportional hazards regression to estimate Hazard ratios for mortality. RESULTS: During the study period (2000-2023) 9.7% of the ASD group and 2.7% of the comparison group had died, p < .001. The ASD group had a higher risk of mortality than the comparison group (Hazard Ratio = 3.77, 95%CI = 1.89-7.52, p < .001). Mortality did not differ significantly between males and females in the ASD group. Significantly more individuals with severe ID had died compared to the rest of the cohort, X(2) (1, N = 113) = 4.7, p < .05. CONCLUSION: Individuals with ASD and co-occurring ID may be at greater risk of death compared to the general population. Our findings emphasize the importance of monitoring and promoting health in individuals with autism, with special attention to individuals with co-occurring ID.

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19. Meduri A, Marraffa C, Roccaforte G, Failla C, Doria G, Scarcella I, Chilà P, Minutoli R, Pioggia G, Marino F. From chat to change: a neuroinclusive framework for cognitive empowerment and daily living skills in autism. Front Child Adolesc Psychiatry. 2026; 5: 1769862.

Conversational technologies are increasingly investigated as supportive tools for autistic individuals; however, existing approaches remain largely application-driven and conceptually fragmented, with limited integration between conversational design and the cognitive foundations of daily living skills. To date, no unified framework explicitly conceptualizes chatbot-based interaction as a structured environment supporting functional autonomy in autism. This Perspective article introduces the Neuroinclusive Conversational Framework (NCF), a theoretical model that reframes chatbots as cognitive scaffolds designed to support everyday functioning in addition to social simulation. Drawing on cognitive psychology, executive functioning research, mediated learning theory, and neuroinclusive design principles, the NCF conceptualizes conversational interaction as a structured learning environment capable of supporting planning, sequencing, task initiation, and self-monitoring within daily routines. The framework is articulated along three interrelated dimensions-cognitive-functional, structural-adaptive, and contextual-ecological-each addressing mechanisms relevant to cognitive accessibility, adaptability, and ecological transfer. By synthesizing evidence across diverse conversational technologies and identifying recurring design principles such as predictability, low social pressure, and adaptive structure, the NCF provides a coherent lens for interpreting existing systems and guiding future design. The article further discusses emerging directions, including biofeedback-informed adaptivity, perceptually accessible interface design, and context-sensitive interaction, emphasizing the importance of ecological validity and integration with human guidance. Overall, the NCF offers a theoretical foundation to support systematic research and development of conversational technologies aimed at strengthening daily living skills and functional autonomy in autistic individuals.

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20. Oliveira LM, Aslam MS, Ramirez JM, Huff AD. Mecp2 deficiency induces dysphagia in a preclinical model of Rett syndrome. Proc Natl Acad Sci U S A. 2026; 123(16): e2535716123.

Rett syndrome is an x-linked genetic neurological disorder primarily caused by mutations in the methyl-CpG-binding protein 2 (MECP2) gene. This progressive neurodevelopmental condition hinders patients’ ability to breathe and eat normally. It remains unclear how Mecp2 deficiency leads to the high prevalence of dysphagia and aspiration pneumonia observed in individuals with Rett syndrome. This study aims to determine the effects of Mecp2 deficiency on swallow-related neuromuscular mechanisms that contribute to dysphagia in Rett syndrome. Swallow-related submental complex duration and amplitude were significantly decreased in both Mecp2(-/y) and Mecp2(+/-) mice compared to wild-type, likely due to reduced motor unit activation. In Mecp2-deficient mice, cholinergic immunoreactivity in the hypoglossal, facial, and trigeminal motor nuclei was decreased in postsymptomatic, but not presymptomatic mice. We also observed a significant increase in the transition time from inspiration to swallow, swallow to the subsequent inspiration, and impaired post swallow respiratory rhythm resumption in Mecp2(-/y), but not Mecp2(+/-) mice. The combination of decreased ChAT(+) cells in brainstem motor nuclei and reduced submental muscle complex activity suggest impaired swallow-related hyolaryngeal elevation and laryngeal vestibular closure. These results provide insight into a neuromuscular mechanism underlying dysphagia in Rett syndrome and support the use of Mecp2-deficient mice as a viable preclinical model for further investigation of swallow and upper airway dysfunction in Rett syndrome.

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21. Patel R, Rangavajla G, Ananthasubramaniam K, Veldtman G, Lee J, Gandhi D, Jonovich MR, Dawdy J, Villablanca P, Frisoli TM. Percutaneous Balloon Valvuloplasty for Congenital Pulmonary Stenosis With Infundibular Stenosis and ASD. JACC Cardiovasc Interv. 2026; 19(7): 919-22.

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22. Peeples ES, Anzalone AJ, Dai R, Reisher E, Korade Z, Mirnics K. Sterol pathway disruption in pregnancy: a link to autism. Mol Psychiatry. 2026.

Cholesterol is a vital molecule, especially during embryonic development. Disruption of the cholesterol biosynthetic pathway can arise from pathogenic genetic variants or exposure to prescription medications. We investigated the relationship between fifteen sterol biosynthesis inhibiting medications (SBIM) prescribed during pregnancy and the incidence of autism spectrum disorders (ASD) in the resulting offspring. Our study of the Epic Cosmos database queried linked child and maternal health records for births between 2014 and 2023 with follow-up to December 2025. The study included 6,135,213 children with linked maternal health records. We evaluated the incidence of ASD associated with maternal prescription of aripiprazole, atorvastatin, bupropion, buspirone, fluoxetine, haloperidol, metoprolol, nebivolol, pravastatin, propranolol, rosuvastatin, sertraline, simvastatin, and/or trazodone during pregnancy using Cox proportional hazard modeling. We found that exposure to at least one SBIM during pregnancy was associated with a 1.47-fold (95% CI 1.45-1.49) increased risk of an ASD after adjusting for potential confounders. For each additional SBIM co-prescribed, there was a 1.33 (95% CI 1.32-1.34) times increased risk of ASD, reaching 2.33-fold risk when 4 or more SBIMs were prescribed simultaneously. In the ten years of our cohort, we identified 234,971 (3.8%) children with an ASD diagnosis. Of the children with an ASD diagnosis, 35,152 (15.0%) of the mothers were prescribed at least one SBIM during pregnancy. Notably, in our dataset, utilization of SBIM medications by pregnant women increased from 4.6% in 2014 to16.8% in 2023. In conclusion, SBIMs may be potentially harmful to the developing fetus. Given that these drugs account for over 400 million prescriptions annually in the U.S. we recommend these findings be considered before prescribing SBIM medications during pregnancy.

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23. Pollard JS, Hustyi KM, Yan CKY, Hall SS. Caregiver Perspectives on Priorities and Barriers in Applied Behavior Analysis Service Delivery for Autistic Individuals: A Community-Engaged Sequential Mixed-Methods Study. J Autism Dev Disord. 2026.

PURPOSE: We conducted a community-engaged sequential mixed-methods study to identify the treatment and service delivery priorities and barriers that caregivers of autistic individuals experience when receiving applied behavior analysis (ABA) services. METHODS: We first conducted semi-structured interviews with eight caregivers to identify common priorities and barriers. Using the themes derived from the interviews, we collaborated with community partners to co-develop the Caregiver Priorities and Barriers Survey (CPBS) and administered it to a large sample of caregivers (N = 376) who had received ABA services. We analyzed the interviews using thematic analysis (Framework Method) and the surveys were analyzed using standard statistical methods. RESULTS: There was significant concordance between the qualitative and quantitative analyses. Caregivers described prolonged waitlists, limited provider availability, and mixed experiences with telehealth. The most pressing priorities included minimizing delays in diagnostic evaluations, incorporating ABA more effectively in schools, and identifying appropriate telehealth models for their child. Families in rural areas reported greater barriers related to provider communication, medically necessary ABA delivered in the educational setting, disruptions on family life, and increasing their child’s engagement in telehealth sessions. CONCLUSION: The findings reveal persistent inequities in access to ABA services and highlight opportunities to strengthen the behavioral health workforce, policy, and system-level coordination. Further refinement of existing telehealth models could help overcome common access barriers to ABA services for families.

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24. Polzer L, Bast N, Boxhoorn S, Mühlherr A, Mössinger H, Schütz M, Freitag CM, Luckhardt C. Attenuated selective attention during visual perspective taking in autism: A combined behavior, ERP, and pupillometry study. J Child Psychol Psychiatry. 2026.

BACKGROUND: Altered social cognition in autism may be influenced by difficulties in domain-general functions, such as selective attention. Here, we manipulated the requirement for selective attention during a visual perspective taking (VPT) task and used neurophysiological indices to delineate underlying mechanisms. METHODS: 43 autistic and 38 neurotypical children and youth completed a VPT paradigm. Participants’ and an avatar’s perspectives were either congruent or incongruent, manipulating the demand for selective attention to inhibit irrelevant information processing. Group differences in dependence on the attended perspective and congruency were examined for behavioral performance, event-related potentials (ERPs), and in a subsample, stimulus-evoked pupil response (SEPR). RESULTS: Autistic participants showed reduced accuracy when rating an avatar’s perspective and pronounced perspective-related differences in a late-frontal slow wave (LFSW). Incongruency elicited stronger effects on behavioral performance and LFSW in autistic relative to neurotypical participants. Additionally, generally larger and more sustained SEPR was observed for autistic participants, reflecting an alteration that was dissociable from LFSW differences. Across groups, SEPR and ERP measures explained both distinct and partially overlapping variance in response slowing. CONCLUSIONS: Findings support attenuated VPT abilities and difficulties to deploy selective attention in autistic youth. Altered fronto-cortical activation patterns in the LFSW likely reflect an increased top-down involvement in VPT. Concurrently, pupil responses indicate an increased cognitive effort when reporting visual perspectives. Findings emphasize a co-characterization of social cognition difficulties by social and domain-general functions in autism.

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25. Roe K. Immunological Explanations for Autism Initiation From Inflammation and Neurotoxins. Apmis. 2026; 134(4): e70207.

Autism initiation has been associated with genetic vulnerabilities, disruption of gastrointestinal microbes (gut dysbiosis), chemical and neurotoxin damage, maternal infections, allergies or autoimmune diseases. Ingested neurotoxin barriers protecting the central nervous system of a fetus or child include the gastrointestinal wall of the mother or child and the fetus or child’s blood-brain barrier. Inflammation from gut dysbiosis or inflammation from other causes can decrease protections provided by the gastrointestinal wall and the blood-brain barrier, allowing neurotoxins to reach the fetus or child’s brain. Postnatal gut dysbiosis can potentially increase inflammation to facilitate neurotoxin penetration of a child’s brain. Chemical pollutants and neurotoxins continue to increase and include aluminum, mercury, lead, arsenic, cadmium, organophosphates, organochlorines, bacterial toxins and fungal mycotoxins. Gut dysbiosis can increase neurotoxin concentrations within a fetal or child’s brain, potentially initiating neurodevelopmental damage to cause autism. There are three possible scenarios initiating autism. These scenarios include inflammation and neurotoxin access to fetal brains within the prenatal neurodevelopment period, inflammation and neurotoxin access to child brains within the postnatal neurodevelopment period, or a two-stage neurotoxin access to brains within the prenatal and postnatal neurodevelopment periods. In summary, a comprehensive explanation for autism causation by several distinct pathways is discussed.

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26. Ross-Cypcar SM, Zimmerman S, Frame L, Williams T, Pickett A, Haegele JA, Anderson K. Autistic Adolescents’ and their Parents’ Perspectives on a National Flourishing Item Set: A Construct Validation Study. Matern Child Health J. 2026.

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27. Secara MT, Khan Z, Rashidi A, Oliver LD, Yu JC, Foussias G, Dickie EW, Szatmari P, Desarkar P, Lai MC, Baracchini G, Malhotra AK, Buchanan RW, Voineskos AN, Ameis SH, Hawco C. Transdiagnostic Profiles of BOLD Signal Variability in Autism and Schizophrenia Spectrum Disorders: Associations With Cognition and Functioning. Hum Brain Mapp. 2026; 47(5): e70496.

Autism spectrum disorder (autism) and schizophrenia spectrum disorders (schizophrenia) exhibit overlapping social and neurocognitive impairment and considerable neurobiological heterogeneity. Blood-oxygen-level-dependent (BOLD) signal variability captures the brain’s moment-to-moment fluctuations, offering a dynamic marker of neural flexibility that is sensitive to cognitive capacity. This study aimed to examine intra-regional BOLD signal variability during rest and task across schizophrenia, autism, and typically developing controls (TDC) to explore transdiagnostic patterns of brain signal variability and their relationship with cognitive and functional outcomes. Intra-regional BOLD variability, measured by mean squared successive difference (MSSD), was obtained from resting-state and empathic accuracy task fMRI in 176 SSD, 89 autism, and 149 TDC participants. ANCOVAs, controlling for age, sex, and motion, assessed group differences in intra-regional and network-level BOLD variability and dimensional associations with social cognition, neurocognition, social functioning, and symptom severity. Both autism and schizophrenia exhibited lower BOLD signal variability than TDC across rest and task, with reduced variability observed in somatomotor, visual, and auditory networks (pFDR < 0.01). Greater network variability was positively associated with better social cognitive, neurocognitive, and functional scores across the sample. Resting-state variability showed stronger group-based differences and cognitive associations than task-based variability. BOLD signal variability is positively associated with social cognition, neurocognition, and social functioning across groups, suggesting that variability impacts cognitive efficiency and behavior. Reduced variability in autism and schizophrenia may indicate similar patterns of neural rigidity among these related conditions, positioning BOLD variability as a potential biomarker for neural flexibility and a valuable target for future transdiagnostic clinical interventions.

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28. Wang W, Yu D. Impacts of affiliated stigma on depression and anxiety in Chinese parents of children with autism spectrum disorders: roles of parental burnout and spouse support. BMC Public Health. 2026.

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29. Wise J. Autism was used to excuse Southport killer’s violence before murders, inquiry finds. Bmj. 2026; 393: s715.

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30. Zhu J, Yi Y, Ma L, Tao S, Sun J, Zhang D, Sun X, Ding K. Causal effects of single-carbon metabolism and vitamin levels on autism spectrum disorder risk: a bidirectional Mendelian randomized study. Ital J Pediatr. 2026; 52(1).

BACKGROUND: Observational epidemiology studies suggested a relationship between single-carbon metabolism and vitamin levels with autism spectrum disorder (ASD) risk. We aimed to explore the causal relationship between them at the genetic level. METHODS: We performed a two-sample bidirectional Mendelian randomization (MR) analysis using genome-wide association studies summary statistics. The inverse-variance weighted (IVW) method was used as the primary analysis. We applied other complementary methods, including weighted median, weighted mode, and MR Egger regression. MR Egger and MR pleiotropy residual sum and outlier (MR-PRESSO) are used to detect and correct the effects of horizontal pleiotropy. RESULTS: There were no causal associations between genetically predicted single-carbon metabolism and vitamin levels with ASD risk in IVW analysis (Homocysteine: 95% CI: 0.952–1.082, P = 0.652; Folate in Serum or Plasma: 95% CI: 0.968–1.249, P = 0.143; VB12: 95% CI: 0.989–2.133, P = 0.057; VB6: 95% CI: 0.647–1.247, P = 0.522; VC: 95% CI: 0.794–1.881, P = 0.362; VD: 95% CI: 0.825–1.551, P = 0.443; and VE: 95% CI: 0.87–1.711, P = 0.249). Reversely, we did not find significant causal effects of ASD on single-carbon metabolism and vitamin levels in MR analysis (all P > 0.05). Based on sensitivity analyses, heterogeneity and horizontal pleiotropy are unlikely to distort causal estimates. CONCLUSIONS: The MR study suggests that no evidence of a causal association was found between single-carbon metabolism and vitamin levels with ASD risk. Further studies are needed to validate these conclusions. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-026-02254-1.

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