1. de Queiroz SAL, Guimarães DO, Ferreira LA, Martinelli L, Werly RMM, Amorim RF, Holzbach L, Badaró R, Santos AAB, Vasquez EC, Silva RS. Kefir-derived probiotic mixture for children with autism spectrum disorder: a double-blind randomized clinical trial. BMC Pediatr;2026 (Jan 17)

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2. Karaca B, Özyurt G. Social Communication Difficulties in Children with Autism Spectrum Disorder (ASD Level 1): The Mediating Role of Cognitive Disengagement Syndrome. J Autism Dev Disord;2026 (Jan 17)

PURPOSE: This study aimed to examine the mediating role of cognitive disengagement syndrome (CDS) in explaining social communication difficulties in children diagnosed with Autism Spectrum Disorder (ASDLevel 1). METHODS: The sample included 107 children (58 with ASD-Level 1 and 49 typically developing controls). Autism symptom severity (ASSQ), cognitive disengagement (CABI-SCT), social communication (SCQ), and daytime sleepiness (ESS-CHAD) were assessed. Group comparisons, correlation, regression, and mediation analyses were conducted. RESULTS: Compared to controls, the ASD-Level 1 group had significantly higher scores on ASSQ, CABI-SCT, and SCQ (p < .001). Regression analysis showed that both ASSQ (β = 0.382) and CABI-SCT (β = 0.124) significantly predicted SCQ scores, while Epworth had no effect. Mediation analysis indicated that CDS partially mediated the relationship between ASSQ and SCQ (indirect effect = 0.099, 95% CI [0.041, 0.181]). CONCLUSION: Findings suggest that social communication deficits in ASDLevel 1 are not solely explained by core autism symptoms. CDS may independently and transdiagnostically contribute to social dysfunction and should be considered in clinical evaluations and interventions. The study emphasizes the need to move beyond core diagnostic criteria and incorporate cognitive disengagement processes into clinical models of autism. CDS may represent a novel, modifiable target for intervention in ASD-Level 1 populations with preserved cognitive capacity but impaired social functioning.

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3. Lopez-Espejo M, Nuñez A. Medical comorbidities in autistic children: prevalence, sex-specific clustering, and network patterns at diagnosis in a Chilean cohort. Eur J Pediatr;2026 (Jan 16);185(2):85.

Medical comorbidities are common in autistic children, yet patterns of co-occurrence at diagnosis-particularly in under-researched regions-remain poorly characterized. We examined the prevalence, distribution, temporal trends, and sex-specific clustering of medical comorbidities at ASD diagnosis in a large Chilean cohort. We performed a retrospective chart review of 544 children diagnosed with ASD between 2015 and 2023 at a specialized pediatric neurodevelopmental center. Comorbidities were identified through standardized caregiver interviews, clinical examination, anthropometric assessment, and clinician-verified medical record review. Analyses included prevalence estimates, temporal trends, and sex-stratified exploratory network analysis. At least one comorbidity was present in 90% of children. The most frequent were insomnia (61%), overweight (52%), allergic rhinitis/atopic dermatitis (28%), and constipation (27%). Underweight prevalence declined significantly over time (from 11% to 5%; p = 0.028), whereas other conditions remained stable. Exploratory network analysis showed high connectivity in both sexes, with denser clustering in girls. In boys, insomnia, overweight, constipation, and allergic disorders formed the main cluster; in girls, allergic disorders remained central, while underweight showed more limited connectivity within the network. Demographic characteristics did not differ between children with and without additional medical conditions. CONCLUSION: Medical comorbidities are highly prevalent at the time of ASD diagnosis, with distinct sex-specific co-occurrence patterns that may guide early screening priorities. These findings support systematic, multidisciplinary assessment during the diagnostic process and highlight the need for longitudinal, multicenter studies to validate comorbidity clusters and clarify their developmental trajectories. WHAT IS KNOWN: • Autistic children frequently have medical comorbidities such as sleep, nutritional, gastrointestinal, and allergic disorders. • The prevalence of individual comorbidities is documented, but patterns of co-occurrence at diagnosis-particularly in Latin American cohorts-remain understudied. WHAT IS NEW: • In a large Chilean cohort of autistic children, 90% had ≥1 clinician-verified medical comorbidity at ASD diagnosis. • Sex-stratified exploratory network analysis showed a shared central cluster (insomnia, overweight, constipation, and ARAD), with higher overall connectivity in girls; underweight and epilepsy showed more limited connectivity at diagnosis.

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4. Lui M, Lau GKB, So WC, Weiss SM, Wong SWL. Differential Associations of Pitch Discrimination and Rapid Auditory Processing With Emotional Prosody Recognition in Autistic and Non-autistic Children. J Autism Dev Disord;2026 (Jan 17)

PURPOSE: Vocal cues embed speech with crucial emotional expression. Recognizing subtle changes in intonation, pitch and prosody provides rich social information and cues for responding in everyday interactions – cues that may be missed by individuals with differences in sensory processing and social development, such as those with autism. Although atypical auditory processing in autism is well-established in the literature, the contribution of these sensory differences to emotional prosody recognition requires further investigation. This study examined whether the associations of auditory abilities and social cognition with emotional prosody recognition differ between autistic and non-autistic children. METHODS: Twenty-eight autistic children and twenty-eight non-autistic children completed tasks assessing rapid auditory processing (RAP), pitch discrimination, social cognition (SC), and emotional prosody recognition (EPR) of spoken words and sentences. RESULTS: Autistic children demonstrated better RAP but lower SC performances compared to non-autistic children. No group differences were found in pitch discrimination or emotional prosody recognition. Across both groups, better RAP was associated with better emotional prosody recognition. In contrast, pitch discrimination was positively associated with emotional prosody recognition of low-intensity emotional words only in autistic children. CONCLUSION: The findings highlight the important association between RAP and emotional prosody recognition in both autistic and non-autistic children, while indicating a distinct association between pitch discrimination and emotional prosody recognition in autistic children. The results suggest the need for further research into the role of auditory processing in emotional speech perception in autism, and the potential benefits of interventions targeting pitch discrimination and RAP.

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5. Nakamura M, Nakamura T, Nakagami A, Nakagaki K, Kawai N, Ichinohe N. Hyperactivity is linked to elevated cortisol levels: comprehensive behavioral analysis in the prenatal valproic acid-induced marmoset model of autism. Transl Psychiatry;2026 (Jan 16)

Hyperactivity is frequently observed in individuals with autism spectrum disorder (ASD) and significantly affects various aspects of life. This underscores the critical need for effective intervention methods tailored to the needs of individuals with ASD. Non-human primate models offer a promising avenue for elucidating the intricate interplay between ASD characteristics and developing individualized therapeutic strategies. This study examined the activity levels and behavioral dynamics in a prenatal valproic acid-induced (VPA) common marmoset model of ASD using ultraminiature data loggers, employing a more detailed approach to behavioral pattern analysis than is traditionally utilized. Although the overall activity levels showed no significant differences, the VPA group exhibited increased activity during specific hours, which is consistent with human ASD studies. Sample Entropy, a statistical measure used to quantify the regularity and unpredictability of time-series data, was higher during daytime in the VPA group, indicating reduced regularity in activity patterns akin to impulsive behavior in ASD. Subtle patterns that were not discernible through simple group comparisons were identified, highlighting the potential of this method as a valuable tool for the behavioral analysis of human ASD. Associations between erratic activity patterns, brief resting intervals, and elevated cortisol levels were observed, all of which correspond to stress phenotypes in individuals with ASD. The findings revealed variations in activity among the adult VPA groups, potentially linked to stress responses. Additionally, VPA juvenile marmosets showed increased locomotor activity in the social interaction test, complementing the adult behavioral findings and suggesting age-dependent manifestations of hyperactivity in this model. This non-human primate model effectively replicates real-world scenarios encountered by individuals with ASD exhibiting hyperactivity, thus holding significant implications for the advancement of personalized therapeutic strategies.

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6. Sousamli A, Metallinou D, Anagnostopoulos D, Sarantaki A. Parental External Shame and Family Functioning in Households of Children With Autism Spectrum Disorder. J Autism Dev Disord;2026 (Jan 17)

PURPOSE: This study investigates the relationship between maternal external shame and family functioning in families raising a child with autism spectrum disorder (ASD). The objective is to explore the association between parental feelings of shame, perceived inferiority, and the overall functioning of families raising children with ASD. METHODS: A cross-sectional study was conducted with 517 families across Greece. Parents completed validated questionnaires, including the External Shame Scale and subscales measuring family functioning (e.g., communication, problem-solving, personal goals). Statistical analyses included Pearson/Spearman correlations, as well as multivariate linear regressions, to identify predictive relationships. RESULTS: The findings revealed a significant negative association between maternal external shame and key aspects of family functioning, including problem solving, communication, and personal goals. Higher levels of external shame were linked to more dysfunctional family patterns, underscoring the emotional and relational burden experienced by mothers of children with ASD. CONCLUSION: Parental external shame significantly impacts family functioning in ASD contexts. Drawing on family systems theory, these findings underscore the importance of holistic, family-centered interventions that promote parental mental health and resilience, supported by policies ensuring access to tailored mental health services.

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7. Yadav AS, Sravanti L, Chauhan VS, Singh H, Velusamy A, Madegowda RK. CARER program for autism spectrum disorder: a formative qualitative study on developing an early play-based, parent-mediated intervention in the Indian context. Child Adolesc Psychiatry Ment Health;2026 (Jan 16)

BACKGROUND: Families of children with Autism Spectrum Disorder (ASD) often face unmet needs in psychoeducation, skill-building, and coping with behavioral challenges, particularly in low-resource or task-sharing settings. Existing parent-mediated interventions are either intensive, specialist-led, or focus primarily on psychoeducation, leaving gaps in structured caregiver training and support for parental well-being. Therefore, we aimed to develop an early, play-based, parent-mediated intervention program integrating Naturalistic Developmental Behavioral Interventions (NDBI) and structured play-based strategies to enhance caregiver competence and child developmental outcomes, tailored for use in resource-scarce, brief outpatient settings. METHODS: The current study reports the qualitative phase of a broader mixed-methods, proof-of-concept investigation conducted at a premier medical college and its affiliated tertiary hospital within the Armed Forces Medical Services (AFMS), India. Focus group discussions were conducted with purposively selected primary stakeholders (five professionals and five parents of children ASD) supplemented by expert validation to develop a play-based, parent-mediated intervention. Only qualitative findings from the program development phase are presented; quantitative feasibility and outcome data will be reported separately. Thematic analysis of detailed field notes informed program adaptation. The CARER (Communication & social skills, Autism, Restricted and repetitive behaviors management, Empowerment of caregivers, and Responsive play) intervention program was structured into 12 outpatient sessions (45-60 min each), incorporating psychoeducation, modeling, guided parent-child practice, barrier-solving, home tasks, and strategies addressing parental stress. Credibility was ensured through investigator triangulation and member checking, with reporting aligned to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. RESULTS: Thematic analysis to understand stakeholders’ perspectives revealed four core domains: (i) psychoeducation, (ii) caregiver training needs, (iii) educational needs of the child, and (iv) parental stress. The CARER program operationalizes these themes into structured, play-based sessions targeting communication, social interaction, restricted and repetitive behaviors, sensory issues, and caregiver empowerment. The program emphasizes parent-mediated delivery and home generalization of skills, balancing feasibility in outpatient settings with developmental relevance for children with ASD. CONCLUSIONS: The CARER program represents an early, brief, and pragmatically designed outpatient parent-mediated intervention framework to support families of young children with ASD. Further piloting and systematic evaluation in larger samples across similar low-resource settings are needed to assess feasibility, acceptability, fidelity of delivery, and potential clinical impact, and to inform ongoing adaptation. TRIAL REGISTRATION: AFMRC PROJECT NO :5337 /2020.

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8. Zhao Z, Zheng Z, Lin C, Zhang X, Hu X, Zhang X, Peng Q, Qu X. Reduced Gaze-Stimulus Synchrony to a Rhythmic Children’s Song in Young Children With Autism: A Recurrence Quantification Analysis Approach. J Autism Dev Disord;2026 (Jan 17)

OBJECTIVE: To examine the characteristics of gaze behavior, particularly gaze-stimulus synchrony, and their association with developmental levels in young children with autism spectrum disorder (ASD). METHODS: Eye-tracking data were obtained from 52 children with ASD, 58 with global developmental delay (GDD), and 55 typically developing (TD) children, aged 18 to 48 months, while they viewed a video of a girl rhythmically clapping and moving to a song. Area of interest (AOI) analysis was performed to assess visual fixation patterns throughout the task, and recurrence quantification analysis (RQA) was used to evaluate gaze-stimulus synchrony. Correlation analyses were further conducted to examine the associations between AOI, RQA measures and developmental levels. RESULTS: Children with ASD demonstrated significantly reduced visual fixation on the whole face and mouth-and-nose AOIs compared to TD children. RQA revealed that the ASD group exhibited significantly lower [Formula: see text], indicating less sustained gaze-stimulus synchrony. Both RQA and AOI measures were significantly associated with developmental level in the ASD group. CONCLUSION: The findings highlight reduced visual engagement and gaze-stimulus synchrony in young children with ASD compared to their TD peers, and indicate that gaze-based metrics may serve as potential objective markers of developmental functioning. The results underscore the utility of diverse analytic approaches, such as RQA, in uncovering temporal characteristics of gaze behavior. Future research should include nonsocial stimuli to determine whether reduced gaze-stimulus synchrony reflects domain-general atypicalities in visual processing.

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