1. Azimpour A, Abbolzadeh N, Mohammadi N. Character Strengths in Parents of Children With Autism, Down Syndrome and Typical Development. J Autism Dev Disord. 2026.

PURPOSE: Concerns about possible over-reporting of posttraumatic growth (PTG) among parents of children with special needs have led researchers to consider alternative indicators of positive adaptation. This study examined whether character strengths differed according to child developmental status and parent gender. METHODS: Participants were 331 parents in Ahvaz, Iran, whose children had typical development, autism, or Down syndrome. They completed a 48-item Persian version of the Values in Action-Inventory of Strengths (VIA-IS) and a 13-item Marlowe-Crowne Social Desirability Scale. Given concerns about the validity of the abbreviated VIA-IS, exploratory factor analysis was conducted, followed by multivariate analysis of covariance (MANCOVA) controlling for social desirability. RESULTS: Exploratory factor analysis yielded five factors: Wisdom, Social Intelligence, Honesty/Persistence, Vitality, and Beauty Appreciation. MANCOVA identified only one significant difference: fathers of typically developing children scored higher on Vitality than mothers of children with autism and mothers of typically developing children. CONCLUSION: Character strengths showed few differences across child developmental status and parent gender, suggesting that parents of children with special needs may demonstrate positive adaptation comparable to that of other parents. However, these findings should be interpreted cautiously because of the limited psychometric properties of the abbreviated VIA-IS and the relatively modest sample size.

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2. Basan S, Arjyal A, Bhandary S. Correction: Quality of life, stress and its coping strategies among the parents of children with autism spectrum disorder in Kathmandu Valley: A mixed method study. PLOS Glob Public Health. 2026; 6(10): e0007504.

[This corrects the article DOI: 10.1371/journal.pgph.0006997.].

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3. Bory P, Fiorentino M, Bérenguier L, Denis A. Autistic burnout: Early insights from a systematic review on characteristics, precipitating factors, and protective mechanisms. Encephale. 2026.

OBJECTIVES: Despite sustained advocacy by autistic individuals over the years, autism research has largely overlooked autistic burnout, a critical but understudied phenomenon. Recently, scientific research has begun to address this gap. This systematic review of literature aims to consolidate scientific knowledge about autistic burnout. The objectives of this study are to provide a comprehensive overview of the known characteristics of autistic burnout, its precipitating factors and strategies for recovery and to clarify how it differs from depression. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines we searched PubMed, PsychINFO, and Web of Science in January 2025 to identify articles that fit our study goals. Some inclusion and exclusion criteria were determined for this review. We appraised the quality of studies with a Critical Appraisal Skills Programme (CASP) checklist. A qualitative analysis was conducted based on the final selected articles. RESULTS: Thirteen articles met inclusion criteria, revealing key characteristics of autistic burnout. Autistic burnout is characterized by a range of symptoms including mental and physical exhaustion, and impairment in cognitive capacities, particularly executive functions. Furthermore, significant impacts on mental health were reported with self-injury and suicidal ideation. Current research conceptualized autistic burnout as a chronic condition with emerging evidence distinguishing it from depression. Key factors precipitating autistic burnout included masking, social interaction and exposure to stressors. Recovery strategies for autistic individuals often emphasized increased self-awareness of personal need and seeking support within an autistic community. However, some studies suggested that not all individuals fully recover from autistic burnout or might benefit from targeted therapeutic interventions. CONCLUSION: This review highlights the lack of knowledge among professionals about autistic burnout and emphasizes the detrimental impact this can have on patient care. Autistic burnout being a new study subject, further research is necessary to deepen conceptual clarity and explore the nuanced dimensions of this phenomenon. Future work should strive to improve representativity in their study.

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4. Chan CCK, Tan BL, Tong HJ, Lam PPY. Navigating professional oral care for autistic children: a qualitative study with parents. Eur Arch Paediatr Dent. 2026.

PURPOSE: Despite growing recognition of inclusion health, autistic children continue to face inequities in accessing dental care. This qualitative study explored how a sample of parents in Hong Kong navigated professional oral care for their autistic children to better understand the perceived barriers and facilitators to dental visits and treatment, as well as strategies and adaptations that support successful dental care. METHODS: Parents or caregivers of autistic children (≤ 18 years) were recruited through purposive and snowball sampling via parent groups, non‑governmental organisations and special schools. Data were collected through one-to-one, semi-structured in-depth interviews. Coding was undertaken by two researchers and refined through iterative team discussions to develop an inductive thematic framework. RESULTS: Twenty-three parents of autistic children aged between 3 and 14 participated. Four themes were identified: (1) accessing dental care-barriers included difficulty finding willing and experienced dentists, high costs, fragmentation between dental and medical services, low prioritisation of oral health and fear of unsuccessful visits; (2) experiences at the dental visit-characterised by sensory overload, need for predictability, and significant emotional burden; (3) what parents value in dental visits-empathetic, flexible staff, sensory‑adapted environments, and partnership‑based communication; and (4) strategies to manage dental visits-pre-visit preparation, graded exposure, and inter-disciplinary collaboration with teachers and parent support groups. CONCLUSION: Findings highlight the need for ASD‑specific training for the dental team, better integration of oral health into mainstream child services, clearer signposting of appropriate providers and schemes, and strengthened collaboration with families and schools.

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5. Chen L, Ji Y. Development of Number Sense in Preschoolers With Autism and its Relation to Approximate Number System Acuity. J Autism Dev Disord. 2026.

BACKGROUND: The approximate number system (ANS) is considered a foundational precursor for the development of formal mathematical abilities, which are often delayed in autistic children. However, the developmental pathways linking this non-symbolic core system to early number sense in autism remain unclear, particularly the role of symbolic number processing. METHODS: Forty-eight preschoolers with autism and 47 typically developing (TD) peers, aged 3-7 years, were assessed on number sense (including counting, number knowledge, and quantity transformation), ANS acuity, symbolic number comparison, verbal ability, and non-verbal reasoning. RESULTS: Autistic children demonstrated significantly lower overall number sense, driven by specific weaknesses in number knowledge and quantity transformation, despite intact counting ability. While ANS acuity showed comparable age-related growth in both groups, its correlation with number knowledge was significantly weaker in autistic children. Crucially, and in contrast to TD children, symbolic number comparison fully mediated the relationship between ANS acuity and number sense in the autism group. CONCLUSIONS: These findings suggest a distinct cognitive pattern for numerical abilities in autism, wherein the translation of non-symbolic numerical representations into formal number sense is strongly associated with symbolic number processing. This underscores the necessity of integrating symbolic scaffolding into mathematical interventions for autistic children.

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6. Cuni E, Cantero-García M. Autistic Masking and Mental Health Outcomes in Autistic Women: A Systematic Review (2015-2025). J Autism Dev Disord. 2026.

PURPOSE: Autistic masking-the behavioral and cognitive strategies through which autistic individuals conceal or compensate for their autistic traits to navigate neurotypical social environments-has been consistently linked to adverse mental health outcomes, with women disproportionately affected. This systematic review examined the association between autistic masking and anxiety, depression, autistic burnout, and suicidality in autistic adult women, and identified which mental health indicators are most consistently predicted by masking. METHODS: A systematic search was conducted across five databases (PubMed, Web of Science Core Collection, Scopus, APA PsycINFO, and ProQuest One Psychology) covering publications from January 2015 to December 2025, following PRISMA 2020 guidelines (PROSPERO: CRD420261342682). Eligibility criteria required autistic adult women (≥ 18 years) with formal diagnosis, explicit measurement of masking, and at least one specified mental health outcome. Methodological quality was assessed using the Newcastle-Ottawa Scale and CASP. RESULTS: Nine studies (2018-2025) were included, with a combined analytic sample exceeding 1,500 women across seven countries. Masking was consistently associated with anxiety (β = 0.21-0.22; d = 0.93) and depression (g = 0.56; Nagelkerke R² = 0.358 via structured lifetime diagnosis), and constituted an independent predictor of suicidality (β = 0.198; OR = 5.04 vs. general population). The CAT-Q assimilation subscale was the specific predictor of suicidal ideation in women, mediated by anxiety. No study assessed autistic burnout with validated instruments. CONCLUSION: Masking constitutes a significant and independent psychosocial risk factor for mental health deterioration in autistic adult women. Systematic assessment using validated instruments such as the CAT-Q should be integrated into clinical mental health and suicide risk evaluation protocols for this population. TRIAL REGISTRATION: This review was prospectively registered in PROSPERO (CRD420261342682; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=420261342682 ).

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7. Feng X, Song Y, Li X, Yang Y, Zhang D, Zhang Y, Zhao S. Past, present, and future of non-pharmacological interventions for autism spectrum disorder: A global bibliometric and thematic analysis (2001-2025). Medicine (Baltimore). 2026; 105(42): e51164.

BACKGROUND: Non-pharmacological interventions (NPIs) have become increasingly important in addressing the complex and heterogeneous needs of individuals with autism spectrum disorder (ASD), particularly in light of the limitations associated with pharmacological treatments. OBJECTIVE: This study aimed to systematically map the global research landscape and thematic evolution of NPIs for ASD from 2001 to 2025 using bibliometric approaches. METHODS: A total of 341 English-language articles were retrieved from the Web of Science Core Collection. Microsoft Excel and Biblioshiny were employed to perform descriptive analysis, co-authorship network mapping, keyword co-occurrence analysis, and thematic evolution analysis based on Keywords Plus. RESULTS: The findings indicate a sustained increase in research output, particularly after 2011, with publication volume peaking in 2024 and citation impact continuing to rise. Music therapy, applied behavior analysis, and repetitive transcranial magnetic stimulation emerged as the most influential intervention approaches. The United States led in both publication volume and academic impact, followed by China and the United Kingdom. Thematic evolution analysis revealed a gradual shift from behavior-oriented frameworks toward mechanism-informed and context-sensitive approaches, with increasing attention to early intervention, population heterogeneity, and family involvement. CONCLUSION: Research on NPIs for ASD is undergoing a transition toward more integrative, individualized, and evidence-based paradigms. Future studies should prioritize longitudinal designs, cross-cultural validation, and the translation of mechanistic insights into scalable, real-world interventions.

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8. Flores J, Montero AE, Barrientos F, Zavaleta R, Dioses A, Noazin S, Powers M, Gilman RH, Roman-Gonzalez A, Zimic M. Analysis of the Pupillary Light Reflex Response Against Light Stimuli for Autism Screening in Children. J Autism Dev Disord. 2026.

PURPOSE: Traditional diagnostic methods for autism spectrum disorder (ASD) predominantly rely on behavioral scales, which can be less effective among young children. This delay in diagnosis impedes timely interventions crucial for improving developmental outcomes. Pupillometry, which measures the pupillary light reflex (PLR), serves as a promising technique to address these challenges. It has the potential to provide biological insights into the central nervous system’s functioning, indirectly revealing potential ASD risk. METHODS: This pilot proof-of-concept study assessed the PLR in 30 children aged 2-5, including 14 diagnosed with ASD (3 females) and 16 typically developing (TD) peers (10 females). The Modified Checklist for Autism in Toddlers (M-CHAT) and the Autism Diagnostic Observation Schedule-2 (ADOS-2) examinations complemented the PLR evaluations to confirm ASD diagnoses. Pupillary responses were recorded through 5 s video captures, emphasizing the measurement of contraction degree, latency, and time to maximum contraction. RESULTS: Quantitative analysis demonstrated a significantly greater degree of pupillary constriction in ASD than TD children, while shorter latency and constriction time showed trend-level differences. An exploratory logistic regression model demonstrated promising in-sample discrimination between ASD and TD children (sensitivity 93%, specificity 86%, AUC 0.93); however, these estimates were obtained without external validation or cross-validation. CONCLUSION: Pupillometry has the potential to become a method for early ASD detection. Its minimal requirement for child cooperation, low operational costs and ease of use, favors this technique as a tool for early screening and intervention in young children, particularly beneficial in resource-limited settings where traditional diagnostic facilities are scarce.

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9. Fuentes-Contreras M, Galindo-Veroiza F, Núñez-Espinosa C, Gómez-Ampuero N, Alcayaga-Palazón C, Correa-Toledo B. Perceived Stress and Subjective Auditory Sensitivity in Autistic and Non-Autistic University Students: A Cross-Sectional Comparative Study. Healthcare (Basel). 2026; 14(19).

Autistic individuals frequently report auditory hypersensitivity, which may affect academic participation, social functioning, and well-being. However, the association between perceived stress and subjective auditory sensitivity remains insufficiently explored in autistic university students, a population exposed to high cognitive, social, and sensory demands. Objective: This study examined the association between perceived stress and subjective auditory sensitivity in autistic and non-autistic university students. Methods: This cross-sectional comparative study included 68 university students: 30 with a formally documented ASD diagnosis and 38 without self-reported ASD, neurological, or auditory disorders. Participants completed the Perceived Stress Scale-14 and the Khalfa Auditory Sensitivity Questionnaire. Between-group comparisons were performed using Mann-Whitney U tests, and associations were examined using Spearman’s rho correlations. Results: The ASD group showed significantly higher scores in perceived stress and total subjective auditory sensitivity than the comparative group (p < 0.001). Likewise, significantly higher scores were observed in all Khalfa questionnaire subscales among participants with ASD (p < 0.001). In the ASD group, moderate positive correlations were identified between perceived stress and total subjective auditory sensitivity (rho = 0.39; p = 0.035), as well as the attentional dimension (rho = 0.39; p = 0.034). In the comparative group, significant positive correlations were observed between perceived stress and total subjective auditory sensitivity (rho = 0.62; p < 0.001), as well as all Khalfa subscales. Although auditory sensitivity scores were markedly higher in the ASD group, the association between perceived stress and auditory sensitivity was stronger and more consistent across subscales in the comparative group. Conclusions: Perceived stress is associated with subjective auditory sensitivity in university students, regardless of diagnostic status. However, the markedly higher auditory sensitivity observed among autistic students may reflect a broader sensory vulnerability not fully explained by perceived stress alone.

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10. Hong CE, Lyu SY. Cord-Derived Stem Cells for Pediatric Autism Spectrum Disorder: Biological Rationale and Source-Specific Trial Design. Int J Mol Sci. 2026; 27(19).

Autism spectrum disorder (ASD) affects approximately 1 in 31 children, yet no pharmacological agent targets its core symptoms, leaving a substantial therapeutic gap. Umbilical cord-derived mesenchymal stem/stromal cells (UC-MSCs) have emerged as a biologically rational candidate, because their immunomodulatory, anti-inflammatory, and neurotrophic properties align with the chronic neuroinflammation, peripheral immune dysregulation, and microglial overactivation that characterize ASD pathophysiology. This review synthesizes the mechanistic rationale, tissue-source biology, manufacturing and characterization standards, preclinical evidence, and clinical trial landscape for cord-derived cell therapy in pediatric ASD, and examines administration routes, post-treatment monitoring, and long-term safety. Across five published clinical trials employing cord blood mononuclear cells, autologous and allogeneic umbilical cord blood, UC-MSCs, bone marrow-derived MSCs, and Wharton’s jelly-derived MSCs, short-term safety is the most consistent finding, whereas efficacy remains unresolved owing to small sample sizes, single-arm designs, and heterogeneous outcome measures; a completed randomized Phase II trial of a cord tissue MSC product, reported to date only in the trial registry, did not meet its primary endpoint. The central argument advanced here is that the proposed active component of cord-derived therapy is the purified MSC population rather than the heterogeneous mononuclear cell fraction; this proposition is supported by the CD14(+) monocyte mechanism and by the one pediatric trial in which purified UC-MSC was added to a mononuclear preparation, but it has not been confirmed in any clinical study and remains a hypothesis. Advancing the field requires dedicated source-specific randomized controlled trials integrating product standardization, patient stratification, and dose-route-timing optimization.

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11. Isralowitz EB, Cermak SA, Sideris J, Baranek GT, Polido JC, Ferrer JMY, Stein Duker LI. Electrodermal Activity as a Metric of Arousal in Autistic Children Prior to Dental Treatment. Sensors (Basel). 2026; 26(19).

Several prominent theories have asserted atypical arousal as a biological feature of autism. However, there is mixed evidence regarding atypical arousal patterns, particularly resting-state arousal, in autistic children, with research increasingly using psychophysiological measures, such as electrodermal activity (EDA), to help elucidate arousal levels in individuals who might not otherwise be able to identify such states. This study analyzed extant EDA data from 135 autistic children (6-12 years) collected during a baseline rest period in a dental environment to determine the relationships between tonic (mean skin conductance level; SCL) and phasic (frequency of non-specific skin conductance responses; NS-SCRs) arousal and participant characteristics, including sensory over-responsiveness, autism traits, expressive language, and general anxiety. EDA data were collected using pre-gelled electrodes placed on the distal phalanges of the participant’s non-dominant hand using the BIOPAC MP150 system. Data preprocessing and epoch analyses were conducted using BIOPAC AcqKnowledge software. Conditional linear and, for the outcome variable anxiety, quadratic growth models were used to assess the temporal (within-participant across observations) relationship between EDA and behavioral variables. The results revealed a significant time-by-autism trait interaction for SCL, as well as linear and quadratic relationships between anxiety and NS-SCRs. No significant relationships were found between EDA arousal parameters and sensory over-responsiveness or expressive language abilities. A significant covariance relationship between SCL and NS-SCR frequency was also observed. Collectively, these results support previous characterizations of unique, within-autism-population arousal profiles related to autism traits, anxiety, and tonic-to-phasic covariance patterns.

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12. Jaffal MA. Exploring Family Quality of Life Among Saudi Families of Children with Autism Spectrum Disorder. Healthcare (Basel). 2026; 14(19).

BACKGROUND/OBJECTIVES: Family quality of life (FQOL) among families of children with autism spectrum disorder (ASD) is influenced by family life, services, and social experiences. Although research in Saudi Arabia has examined caregiver well-being and services, less is known about how families experience FQOL in everyday life. This study explored the experiences and perceptions of Saudi parents and caregivers of children with ASD. METHODS: A qualitative descriptive design was used. Semi-structured interviews were conducted with 12 Saudi parents and caregivers of children with ASD. Data were analyzed using thematic analysis, with the FQOL framework used as a sensitizing conceptual lens. RESULTS: Five themes were identified: (1) Diagnostic Experiences and Family Reorientation; (2) Caregiving and Family Reorganization; (3) Responsive Services and Family Quality of Life; (4) Family Adaptation Through Knowledge and Resilience; and (5) Community Understanding and Social Inclusion. Findings showed that FQOL was influenced by caregiving demands, responsive services, family adaptation, child progress, and opportunities for social participation. CONCLUSIONS: FQOL is shaped by families’ changing experiences and needs over time. Supporting Saudi families requires responsive services, family-centered support, continuity across service systems, and more inclusive communities.

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13. Kaur S, Canals-Sans J, Morales-Hidalgo P, Voltas N. Cluster-derived profiles of parental reports of Autism and ADHD traits and their associations with diagnoses: EPINED study. Eur Child Adolesc Psychiatry. 2026.

Autism and attention-deficit/hyperactivity disorder (ADHD) frequently co-occur and show substantial phenotypic overlap, challenging categorical diagnostic frameworks. Person-centred approaches may better capture heterogeneity, but the consistency and external validity of these profiles across informants remain unclear. Using data from the EPINED population-based study in Tarragona, Spain, we identified symptom-based clusters from parent reports in preschool-aged (n = 1805) and school-aged (n = 1930) children, examined concordance with teacher-derived clusters, and evaluated associations with diagnoses. Parent-reported cluster analyses yielded a four-cluster solution across both age groups: low/no symptoms (Parent-CP-1/Parent-CS-1), sub-autism + sub-ADHD traits (Parent-CP-2/Parent-CS-2), social communication problems (Parent-CP-3/Parent-CS-3), and ADHD-dominant profiles (Parent-CP-4/Parent-CS-4). Although structures were comparable, parent-teacher agreement was low (κ = 0.03-0.05). Across both age groups, clinical diagnoses were primarily concentrated within ADHD-related behavioural clusters, with other clusters showing lower and more variable representation across diagnostic groups. In preschool-aged children, Parent-CP-4 clusters were associated with autism across both parent (ORs: 4.55-7.46) and teacher-CP-4 (ORs: 6.09-6.51). In school-aged children, only teacher-reported Teacher-CS-4 (ORs: 11.96-20.50) predicted autism diagnoses, while parent-reported behavioural features, higher thought problems and lower rule-breaking behaviour were significant contributors. For ADHD, parents (Parent-CP-4; preschool-aged ORs: 19.74-20.58, Parent-CS-4; school-aged ORs: 25.22-27.63) and teachers (Teacher-CP-2; preschool-aged ORs: 20.80-20.94, Teacher-CS-2; school-aged ORs: 2.66-3.10) were significant contributors, although the parent-cluster effect attenuated to non-significance after inclusion of teacher report. Data-driven profiles explained variance in related clinical measures beyond diagnostic categories. Overall, parent-reported clustering identified meaningful behavioural phenotypes, but cross-informant discrepancies highlight context-dependent symptom expression. The findings underscore the clinical importance of multi-informant and multidimensional assessment approaches to better capture heterogeneity within neurodevelopmental conditions.

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14. Li Y, Wang K, Qi A, Liu Q, Shi G, Huang M. Construction of Adverse Outcome Pathway (AOP) for Triphenyl Phosphate (TPHP)-Induced Autism Spectrum Disorder (ASD) and Risk Identification of Neurodevelopmental Toxicity of Aryl Organophosphorus Flame Retardants (OPFRs) Based on Multidimensional Bioinformatic Data. Int J Mol Sci. 2026; 27(19).

Triphenyl phosphate (TPHP) is a widely used plasticizer and organophosphate flame retardant extensively applied in various industrial and consumer products. Due to its pervasive environmental exposure and detection in human samples such as amniotic fluid and breast milk, TPHP has become a pollutant of significant concern in recent years for its potential neurodevelopmental impacts on humans. This study employed a multimethod approach integrating network toxicology, transcriptomics, in silico gene knockout, molecular docking, and molecular dynamic simulations to investigate TPHP’s potential toxic role in autism spectrum disorder (ASD). An adverse outcome pathway (AOP) was constructed, revealing that TPHP exposure may induce and exacerbate ASD by downregulating GAD1-the core gene encoding the GABA synthesis rate-limiting enzyme (glutamate decarboxylase)-leading to an excitation-inhibition imbalance in the brain. The batch molecular docking of 85 organophosphate flame retardants (OPFRs) (widely detected in human and biological matrices) with the GAD1 protein identified aryl-OPFRs as disruptors targeting GAD1 to induce neurodevelopmental toxicity. In summary, this research provides mechanistic insights into how TPHP promotes ASD progression and offers a valuable chemical reference for assessing the neurodevelopmental toxicity of OPFRs.

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15. Lim A, Brewer N. Cyber Dependent Crime May Be Predicted by Autism Diagnosis but Not Autistic Traits. J Autism Dev Disord. 2026.

PURPOSE: Previous research has produced mixed findings on the question of whether autism or the degree of autistic traits influence the prevalence of cybercrime. Our objective was to resolve some of these inconsistencies by investigating the relationships between autism diagnosis, autistic traits, advanced computer skills and different types of cybercrime in adults. METHODS: Autistic (N = 138) and non-autistic (N = 206) adults completed (a) the 50-item Autism Spectrum Quotient to assess degree of autistic traits, (b) the Cyber-Dependent Crime Questionnaire and the Cyber Crime Index to measure the prevalence of cyber-dependent and cyber-enabled crime, and (c) the LiES and the BIDR-16 to permit control for any tendency of participants to lie and provide socially desirable responses. Participants who endorsed any engagement in cybercrime also described the activity to ensure that any disclosure of cybercrime was in fact criminal activity. RESULTS: Autism diagnosis, but not autistic traits, was a significant predictor of cyber-dependent crime. However, this relationship was not mediated by advanced digital skills or theory of mind. Furthermore, neither autism diagnosis nor autistic traits predicted engagement in cybercrime more broadly. CONCLUSION: Contrary to the view that autistic individuals are no more likely to become involved in criminal activity than non-autistic adults, our study indicates that autism may be a risk factor for involvement in cybercrime. However, whether autism diagnosis is the driving factor in this relationship, or there are other individual and socio-environmental factors that might be critical enabling factors, awaits further investigation.

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16. Morgan PL, Hu EH. Intersectional Disparities in School-Based Autism Identification Are Occurring in U.S. Elementary Schools. Autism. 2026: 13623613261489314.

We investigated whether intersections of race or ethnicity, gender, family income, and language use are associated with school-based autism identification (SBAI) in U.S. elementary schools. We estimated logistic and multilevel logistic regression models with interaction terms, adjusting for reading achievement and school contextual factors. We used school record of autism as a student’s primary disability for which special education services were being provided to indicate SBAI. We analyzed a very large, aggregated sample of U.S. fourth graders (typically 9-10 years old; N = 1,419,440) participating in the National Assessment of Educational Progress across 2005 to 2022. The sample included stratified subsamples of Black (n = 246,040), Hispanic (n = 273,620), Asian/Pacific Islander (n = 68,800), and White (n = 759,800) students. Within the racial and ethnic groups, girls (adjusted odds ratio [aOR] range = 0.10-0.27) and those from low-income families (aOR = 0.21-0.60) were less likely to be identified. Among Hispanic and White students, MLs were less likely to be identified (aOR 0.57 and aOR = 0.40, respectively). Attending schools with greater percentages of low-income students was associated with lower odds of SBAI (aOR range = 0.73-0.81). Among Black, Hispanic, and White students, those attending schools with greater percentages of special education students were more likely to be identified (aOR = 1.16-1.23). Overall, Black and Hispanic girls, low-income Black and other race or ethnicity students, and White and Hispanic multilingual learners (MLs) had especially low odds of SBAI. Intersectional disparities are occurring in SBAI in U.S. elementary schools.Lay AbstractWe examined how multiple social positions across race and ethnicity, gender, family income, and language use are associated with whether students were identified with autism in U.S. elementary schools. We analyzed a very large, aggregated sample of U.S. fourth graders (typically 9-10 years old; N = 1,419,440) participating in the National Assessment of Educational Progress across 2005 to 2022. The sample included stratified subsamples of Black (n = 246,040), Hispanic (n = 273,620), Asian/Pacific Islander (n = 68,800), and White (n = 759,800) students. We used school record of autism as a student’s primary disability for which special education services were being provided to indicate school-based autism identification (SBAI). The analyses adjusted for student academic achievement, school contextual factors, and other alternative explanatory factors. We repeatedly observed interactions between race or ethnicity and family income. Girls and those from low-income families were consistently less likely to be identified with autism including within samples of Black, Hispanic, Asian/Pacific Islander (PI), and White students. Black and Hispanic girls, low-income Black and other race or ethnicity students, and White and Hispanic multilingual learners (MLs) had especially low odds of being identified. Students across the racial and ethnic groups were less likely to be identified with autism when attending schools attended by higher percentages of low-income students. Students also were less likely to be identified in schools when their race or ethnicity was the same as those of other attending students. Our findings repeatedly indicate that intersectional disparities in SBAI are occurring in U.S. elementary schools. Referral practices, evaluation and eligibility procedures, and resource allocation and outreach efforts may need to address intersectional disparities to ensure that multiply marginalized student populations have equal access to autism services and supports in U.S. elementary schools.

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17. Özata Değerli MN, Zeynep Uzun B, Abaoğlu H. Understanding Participation in Inclusive Education: Teachers’ Perspectives on Children With Intellectual and Developmental Disabilities. J Appl Res Intellect Disabil. 2026; 39(5): e70321.

BACKGROUND: Understanding teachers’ perspectives is essential for promoting the meaningful participation of children with intellectual and developmental disabilities in inclusive schools. METHOD: This qualitative phenomenological study explored primary school teachers’ perspectives on the participation of children with intellectual and developmental disabilities in inclusive education. Semi-structured interviews were conducted with 28 primary school teachers working in Türkiye. RESULTS: Teachers reported that inclusive education, when it supports children’s active participation, enhances social skills, strengthens a sense of belonging, and promotes inclusion in the wider community. However, they also identified significant barriers, including overcrowded classrooms, long class periods, negative peer attitudes, and self-stigma. Although teachers expressed a commitment to inclusive practises, many reported insufficient experience, training, and confidence in supporting these children. CONCLUSIONS: Strengthening pre-service and in-service teacher training, revising curricula, and creating supportive classroom environments are essential for ensuring the meaningful participation of children with intellectual and developmental disabilities in inclusive education. Primary school teachers considered inclusive education a fundamental right and an essential condition for the social, emotional, and academic development of children with intellectual and developmental disabilities. Teachers reported that structural barriers such as overcrowded classrooms, exam‐oriented curricula, and insufficient institutional support may restrict students’ meaningful participation. Teachers identified self‐stigma as an often‐overlooked but important barrier, as some students may internalize negative attitudes and become socially and academically less visible in the classroom. Teachers’ knowledge, experience, confidence, and willingness to adapt their practises played an important role in inclusion. Insufficient pre‐service and in‐service training may unintentionally limit students’ participation. eng.

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18. Petri S, Franchi S, Bordin A, Abrunzo R, D’Arrigo L, Gatti PI, Santiani G, Pezzullo AM, Broggi F, Purpura G, Coratti G. Research engagement and visibility in a specialized pediatric rehabilitation profession: A bibliometric review of Italian neuro and psychomotor therapists of developmental age, 1993-2025. Medicine (Baltimore). 2026; 105(42): e51106.

INTRODUCTION: In Italy, the neuro and psychomotor therapist of developmental age (Terapista della Neuro e Psicomotricità dell’Età Evolutiva [TNPEE]) is a specialized healthcare rehabilitation professional focusing on neurological and developmental disorders in children from birth through age 18. As this profession exists exclusively in Italy and has no direct international counterpart, its scientific contribution is difficult to identify using conventional bibliographic searches. This bibliometric analysis aimed to map the identifiable TNPEE-authored scientific literature, describe publication patterns and thematic areas, and examine research output according to institutional and academic affiliation. MATERIALS AND METHODS: Major scientific databases and complementary author-, institution-, network-, and citation-based search strategies were used to identify publications involving verified TNPEEs through March 8, 2025. Bibliometric indicators described publication volume and temporal trends, authorship patterns, institutional affiliations, academic appointments, and primary research areas. Temporal trend analyses were restricted to complete calendar years 1993 to 2024. RESULTS: The analysis identified 138 distinct TNPEE authors contributing to 507 publications published between 1993 and March 8, 2025. Temporal analyses of the 497 publications from complete calendar years 1993 to 2024 showed a marked increase in output over time. Research themes predominantly encompassed neurodevelopmental disorders, cerebral palsy, neuromuscular conditions, and early intervention strategies. Publication output was concentrated among the 6 TNPEEs holding university appointments, who contributed to 218 (43%) of identified publications. DISCUSSION AND CONCLUSIONS: This study maps the visible scientific contribution of TNPEEs and highlights challenges in professional identification and bibliographic retrievability. Bibliometric data alone cannot establish the determinants of the observed concentration of research output; dedicated workforce, qualitative, and institutional studies are needed. Standardized professional identification may improve the bibliographic traceability of research contributions from nationally defined healthcare professions.

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19. Pretorius L, Coetzee JA, Dos Santos AP, Smith C. Expanded characterization of the valproic acid zebrafish larval model of autism spectrum disorder: Insights into dysregulation in the gut. Animal Model Exp Med. 2026.

BACKGROUND: Relative lack of data on mechanisms underpinning poor gastrointestinal (GI) health in autism spectrum disorder (ASD) limits patient management strategies. Although the valproic acid (VPA) model of ASD is widely used, a comprehensive profile of the model in zebrafish is still lacking, and almost no data are available on ASD-like GI symptomology or underlying mechanisms. METHODS: ASD-like craniofacial morphology, anxiety-like behavior, GI anatomical and functional dysregulation, and dysregulation of the monoaminergic system in both the brain and the gut were simultaneously assessed in zebrafish larvae at 7 days postfertilization. RESULTS: VPA exposure was associated with increased intraocular distance, neuroligin 3 (NLGN3) dysregulation, decreased muscle tone, and an anxious phenotype (increased thigmotaxis and dark zone preference [light-dark preference test]). In the brain, protein expression levels of tryptophan hydroxylase 2 (TPH2) and serotonin (5-HT), but not serotonin transporter (SERT), were downregulated, as well as tyrosine hydroxylase (TH) and dopamine transporter (DAT), whereas dopamine (DA) was upregulated. In the gut, upregulated serotonergic (increased TPH1 and 5-HT) and downregulated dopaminergic (decreased TH, increased DAT) protein expression was linked to thinner-walled, longer intestinal tracts, and decreased spontaneous peristaltic activity. CONCLUSIONS: Dopaminergic dysregulation aligns with the ASD literature. Novel findings include an association of hyposerotonergic tone with anxiety-like outcomes as core symptomology in ASD. Furthermore, we demonstrate compartment-specific dopaminergic and serotonergic dysregulation in the gut, which provides support for relatively decreased gut motility in ASD.

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20. Ren C, Zhang Q, Liang X, Yun G, Peng K. Establishing Diagnosis Models for Autism Spectrum Disorder With Auditory Brainstem Response Using Machine Learning Methods. Autism Res. 2026: e70381.

This study aimed to develop and validate models built using machine learning methods for the diagnosis of autism spectrum disorder (ASD). A total of 851 children with suspected ASD were enrolled. Related features were acquired using the Autism Behavior Checklist and Auditory Brainstem Response (ABR) outcomes. The Shapley additive explanation (SHAP) values were used to explain the feature impact used in the models with the best performance. In addition, different methods were used to depict group differences. Our study found that significant results in ABR outcomes among children with different phenotypes mainly depend on stimulation intensity. The predominant finding is that signal conduction from the cochlear nerve to the inferior colliculus in children with ASD may be associated with autistic behaviors in a way that displays region-specific (e.g., cochlear nerve, olivary) and intensity-dependent (e.g., 45, 65 dB) complexity. The XGBoost models outperformed the other candidates, with the highest prediction accuracy (85.9%) and AUROC (0.779). Wave III and V were identified as the features with largest impact. These findings highlight atypical ABR patterns in ASD and their association with autistic behaviors, contributing to the growing literature on understanding alterations in bioelectrical performance in children with ASD.

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21. Stefańska M, Smętek W, Kowalska J, Ptak A. Association of Halliwick-Based Aquatic Physical Activity with Health-Related Quality of Life in Children and Adolescents with Autism Spectrum Disorder: A Cross-Sectional Comparative Study. Healthcare (Basel). 2026; 14(19).

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent deficits in social communication and interaction, accompanied by restricted and repetitive patterns of behavior, interests, or activities. Given the considerable heterogeneity in symptom severity and functional abilities, children with ASD require individualized educational and therapeutic interventions. Among the non-pharmacological approaches used to support this population, aquatic physical activity has emerged as a promising intervention. MATERIAL AND METHODS: The study included 45 children with ASD (ICD-11 code 6A02), comprising 19 girls and 26 boys, aged 8-17 years. Two groups were compared: Group G1, consisting of children and adolescents who had participated in Halliwick-based aquatic physical activity for at least 3 months, and Group G2, without aquatic activities. Health-related quality of life was assessed using the validated Polish version of the KIDSCREEN-52 questionnaire. RESULTS: Children with ASD who participated in Halliwick-based aquatic physical activity (G1) had higher mean scores in all KIDSCREEN-52 domains. However, statistically significant differences were only found in the following domains: Psychological Well-Being, Moods and Emotions, Self-Perception, Autonomy, Financial Resources, and School Environment. Overall health-related quality of life, measured by the KIDSCREEN-10, compared with children who did not participate in aquatic activities. CONCLUSIONS: Halliwick-based aquatic physical activity was associated with better quality of life in children and adolescents with ASD, with higher scores observed according to sex, but further research is needed to confirm these findings.

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22. Sukhodolsky DG. Editorial: Sensory Features and Restricted and Repetitive Behaviors in Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry. 2026.

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23. Townsley RE, Andrews JC, Srivastav S, Jangam SV, Hannan SB, Kanca O, Marcogliese PC, Yamamoto S, Wangler MF. NLGN3 autism variants have distinct functional impact on synapses and sleep behavior in Drosophila. PLoS Genet. 2026; 22(10): e1012341.

Neuroligin-3 (NLGN3) was first identified as a X-linked risk gene associated with autism spectrum disorder (ASD). Most reported variants are identified in males who inherited their variants from an unaffected mother, but de novo variants have also been identified in both affected heterozygous females and hemizygous males. The p.R451C variant was the initial variant associating NLGN3 with ASD and has been heavily investigated, yet little is known about the functional consequences of other NLGN3 variants. To determine the functional consequences of other NLGN3 variants in vivo, we generated transgenic Drosophila models corresponding to a de novo variant (p.R175W) identified in a heterozygous female proband with ASD, a maternally inherited variant (p.R451C) identified in a hemizygous male with ASD, and another maternally inherited variant identified in a male (p.R597W) associated with sleep disorder and ASD. In Drosophila, loss of the fly homolog, Nlg3, altered sleep patterns, synaptic architecture, and vesicle dynamics, which were rescued by the expression of the human NLGN3Ref allele. When comparing the variants, the p.R175W variant and the maternally inherited p.R451C variant altered synapse morphology with minimal effects on vesicle dynamics, and the p.R597W variant altered sleep and vesicle dynamics with minimal impact on synapse morphology. Using overexpression models, human NLGN3Ref altered sleep patterns and synaptic morphology. Moreover, the p.R175W variant exacerbated sleep phenotypes, and the p.R175W and p.R451C variants exacerbated synapse morphology phenotypes. Together, our findings suggest that the de novo NLGN3 p.R175W variant identified in a heterozygous female exhibits gain-of-function properties, while maternally inherited variants have context-dependent functional impact. Moreover, some NLGN3 variants disrupt synaptic development, while other variants alter synaptic function, suggesting that NLGN3 variants have differential effects. These functional differences may provide insight into the heterogeneity of individuals with ASD.

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24. Wohofsky L, Küffner C, Fink SH, Sulopuisto O, Orter-Jerney R, Seifert N, Krainer D. Development of Autism-Inclusive Approaches for Everyday Life in a Participatory Process: From Challenges to Resolutions. J Autism Dev Disord. 2026.

PURPOSE: People on the autism spectrum encounter significant challenges in different activities of daily living. This paper presents the findings of a participatory research study that explores the potential of this approach to address the needs of individuals on the autism spectrum and outlines the outcomes emerging from the participatory process. METHODS: This participatory research project was grounded in the Open Innovation in Science framework. In different phases of the project, various participatory research methods were employed: advisor consultations, group discussions, questionnaires, and participatory working groups. As the core part of the participatory process, six working groups were formed, comprising people on the autism spectrum and other experts. These citizen scientists led all decision-making and implementation. RESULTS: A survey on challenges in the daily lives of people on the autism spectrum identified difficulties in social interaction, public transport, education, contact with public authorities, and the healthcare system. Based on these results, six working groups comprising 28 citizen scientists worked over a ten-month period to enhance the daily lives of individuals with autism by fostering greater inclusivity. The groups worked on the domains « Working Life », « Education », « Public Authority Contacts », « Shopping », « Healthcare System », and « Information, Networking, and Exchange ». Among other outcomes, the working groups developed a toolbox of educational materials for schools and a map of autism-inclusive healthcare providers. CONCLUSION: The results of this project demonstrate the potential of community-driven initiatives in addressing the multifaceted needs of individuals on the autism spectrum and contribute to developing autism-inclusive environments across various domains of daily life.

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25. Zhang M, Luo T, Zhao S, Li L, Jiang Y, Duan X, Situ M, Huang Y. Altered glymphatic system measures and functional network connectivity in autism spectrum disorder: A longitudinal study examining associations with prognosis. Psychiatry Clin Neurosci. 2026.

AIM: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social deficits and repetitive behaviors, yet prognostic biomarkers remain elusive. This study investigated the interplay between glymphatic function and functional network connectivity (FNC) in ASD and their longitudinal associations with clinical outcomes. METHOD: This combined cross-sectional and two-year prospective longitudinal study included 50 ASD children and 50 controls. Glymphatic function was assessed using the along the perivascular space (ALPS) index and global blood-oxygen-level-dependent to cerebrospinal fluid (gBOLD-CSF) coupling, alongside FNC analysis. RESULTS: Cross-sectionally, ASD participants showed significantly reduced ALPS index, gBOLD-CSF coupling, and widespread FNC reductions. Longitudinally, among the 40 ASD participants who completed follow-up, glymphatic function increased over time. Greater increases in ALPS were correlated with greater reductions in ADOS-CSS. In the symptom-improved subgroup, four FNC connections (including DMN-DAN) increased over time. In contrast, no consistent pattern was found in the non-improved group. Baseline inter-network connectivity measures were associated with ADOS-CSS reduction in univariate analyses, but the multivariate model was not significant. Mediation analysis showed an indirect association between baseline gBOLD-CSF coupling and long-term ADOS-CSS reduction via DMN-DAN FNC reduction (indirect effect = -0.22, 95% CI [-0.42, -0.07]). CONCLUSION: These findings indicate that glymphatic function and FNC are altered cross-sectionally and improve longitudinally in parallel with symptom changes in ASD and suggest that baseline gBOLD-CSF coupling is indirectly associated with long-term clinical improvement through DMN-DAN connectivity. Together, these results highlight the potential of glymphatic and functional connectivity measures as prognostic imaging markers in ASD.

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