1. Amaral DG. Why I Invited a Commentary on « Why We Need to Study Assisted Methods to Teach Typing to Nonspeaking Autistic People ». Autism Res;2026 (May 18):e70259.

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2. Ascone F, Giangiacomo D, Trezza V. Classic psychedelics and autism spectrum disorder: preclinical evidence, mechanistic insights and unresolved challenges. Neurosci Biobehav Rev;2026 (May 18):106761.

Classic psychedelics have re-emerged as compelling probes of neural plasticity, raising interest in their potential relevance for behavioral and circuit-level features associated with autism spectrum disorder (ASD). Although only a limited number of studies have examined these compounds in validated animal models of ASD, a growing body of preclinical work has investigated their effects on behavioral and neurobiological processes relevant to ASD. In this context, this review adopts a domain-based perspective, discussing studies that examine the effects of classic psychedelics on behavioral domains overlapping with ASD phenotypes, including social interaction, communication, repetitive behaviors, anxiety-like traits, and cognitive function. We critically evaluate the neurobiological mechanisms underlying these effects, focusing on serotonergic signaling, glutamatergic neurotransmission, neuroinflammatory processes, BDNF/TrkB pathways, oxytocinergic and dopaminergic modulation. Across these domains, we identify points of mechanistic convergence with neurobiological alterations implicated in ASD, and integrate emerging preclinical findings that may guide future hypothesis-driven research. At the same time, we highlight significant gaps that constrain interpretation. We conclude by outlining key conceptual and methodological limitations, including the scarcity of studies in established animal models of ASD, reliance on simplified behavioral assays, and uncertainty regarding how ASD-specific circuit alterations may influence responses to psychedelics. Addressing these issues will be essential to determine whether psychedelic-induced plasticity can provide meaningful insights into ASD pathophysiology or inform future translational efforts.

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3. Beldame Y, Richard R. Conditional Participation and the Limits of Adaptation: Ethnographic Insights from Institutional Adapted Physical Activity Settings With Autistic Youth. Adapt Phys Activ Q;2026 (May 18):1-12.

This article explores the tensions between adaptation and normalization in adapted physical activity (APA) for young autistic people in specialized institutions. Based on participant observations of APA sessions and interviews with educators conducted in two specialized medicosocial settings in southern France, the study examines how participation is negotiated in practice. It highlights how strict behavioral rules and time constraints can hinder participation and lead to disengagement or so-called « challenging behaviors. » Drawing on crip theory and the neurodiversity paradigm, the analysis reveals how normative expectations shape inclusive practices, sometimes reinforcing ableist assumptions. The authors argue that current APA models often misalign with the embodied experiences and rhythms of autistic youth. However, some practices-such as breaks, individualized adaptations, and attention to individual tempos-can foster engagement and well-being. The study calls for a critical rethinking of APA inclusion strategies, advocating for approaches that center on enjoyment and the recognition of diverse ways of being rather than on behavioral compliance or normalization.

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4. Benfica TR, Pondé M, Siquara GM, Souza APR. Labyrinth scale in the differential diagnosis between autism spectrum disorder and language disorder. Codas;2026;38(3):e20250212.

PURPOSE: To analyze the contribution of the Labyrinth Scale in the differential diagnosis of children with Autism Spectrum Disorder (ASD) and Language Disorder (LD) aged between 2 and 4 years. METHODS: The sample consisted of 38 children diagnosed with LD, 48 with ASD, and 28 with Typical Development (TD). The LD group, evaluated in private clinics and school clinics, consisted of children with language delays confirmed by the Dimensional Inventory of Child Development Assessment (IDADI), as well as speech-language pathology evaluation with instruments such as the Language Development Assessment (LDA), ABFW, among others. They were also evaluated using the Labyrinth Scale. Those responsible signed the Free and Informed Consent Term (FICT). Statistical analysis was performed using JASP software, version 0.15, one-way ANOVA test, and Scheffé post hoc tests. RESULTS: Differentiated scores were demonstrated between the LD, ASD, and TD groups both in general terms and in the subscales of the Labyrinth Scale. CONCLUSION: The Labyrinth Scale allowed differentiating the LD, ASD, and TD groups, showing that the instrument has specificity to perform the differential diagnosis.

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5. Colombo RA, Mahmoudi S, Wright WB, Huang YH, Madden GJ. Appetitive Pavlovian conditioning in two inclusive kindergarten classrooms. J Exp Anal Behav;2026 (May);125(3):e70107.

The present study evaluated the efficacy of a classwide appetitive Pavlovian conditioning protocol implemented in two inclusive kindergarten classrooms. Each classroom enrolled similar distributions of typically developing children and children who were either eligible for special education services or diagnosed with autism spectrum disorder. Two Pavlovian conditioning trials (CS+ ➔ US) and two unpaired trials (CS- ➔ no US) per day were superimposed on normal classroom activities at random times. Conditioned responses (i.e., positive emotional responding and attention directed to the CS) were recorded during the CS+ and CS- events. In both classrooms-one in which the teacher verbally specified the Pavlovian contingency and one in which they did not-the CS+ evoked significantly more of both conditioned responses in typically developing children. Children with developmental disabilities showed significantly more CS+-evoked attention, but the effect size was smaller than among typically developing children. The CS+ did not evoke significantly more positive emotional responding in the children with developmental disabilities unless the teacher verbally specified the CS+ ➔ US contingency. Such procedural refinements may be important if a therapeutic appetitive CS is to influence adaptive operant behavior via, for example, conditioned reinforcement or Pavlovian-to-instrumental transfer in children with developmental disabilities.

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6. Ehrenberger KA, Mendoza-Cervantes D, Baldwin JL. Structural Ableism and Healthcare Transition for Adults with Intellectual and/or Developmental Disabilities. J Gen Intern Med;2026 (May 18)

Young adulthood is a period of changes, including transitioning from pediatric to adult healthcare; this is often an informal, disjointed process of securing new insurance and finding adult providers. Children and youth with special healthcare needs (CYSHCN) have more contact with the healthcare system than their peers, thus presenting more opportunities for gaps in care and consequently negative health outcomes during healthcare transition. The discontinuities between pediatric and adult healthcare are particularly consequential for the subset of individuals with intellectual and/or developmental disabilities (I/DD), especially those who will not develop autonomy and the capacity to function on their own. While parents and other caregivers often try to bridge the gaps, transition can be confusing or even dangerous because of ableist assumptions about what it means to be « an adult » patient. When independence is built into policies, procedures, and expectations that paradoxically limit access to and participation in healthcare spaces or services, that is structural ableism. This perspective provides examples of structural ableism in healthcare transition and offers suggestions for how a re-orientation toward radical inclusion for those who need it most can enable better care for all.

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7. Garza Guerra AJ, Mata Cortes EDR, Adame Rocha GH, Montemayor Mancias AC, Fernández Zambrano SM. Underrecognition of Autism and Implications for Adult Psychiatric Practice: A Narrative Review. Cureus;2026 (Apr);18(4):e107164.

Autism in adulthood remains underrecognized across psychiatric settings despite epidemiological evidence supporting its persistence across the lifespan. Recognition is often hindered by heterogeneous presentation, misattribution of autistic traits to co-occurring psychiatric conditions, camouflaging processes, and limited integration of developmental history in adult assessments. This narrative review aims to synthesize current evidence on adult presentation and co-occurring conditions, examine barriers to identification, and propose a developmental, dimensional, and contextual framework for psychiatric assessment and formulation. A narrative review guided by the Scale for the Assessment of Narrative Review Articles was conducted. Peer-reviewed literature published between January 2010 and December 2025 was identified through structured searches of PubMed, Scopus, and Web of Science, with additional sources identified through reference list screening. Studies were selected based on conceptual relevance and applicability to adult psychiatric contexts. The literature indicates that autism in adulthood is characterized by marked heterogeneity, with presentations often shaped by internalized features, compensatory processes, and co-occurring psychiatric conditions. Across studies, these factors contribute to diagnostic overshadowing, delayed identification, and fragmented care trajectories. Developmental, neurobiological, and service-level evidence further highlights the influence of contextual and structural factors on recognition within adult psychiatric settings. Autism in adulthood is best conceptualized within a developmental, dimensional, and contextual framework. Improving identification in psychiatric practice requires systematic attention to developmental history, internal experience, compensatory processes, co-occurring conditions, and structural barriers. Integrating these elements may enhance clinical formulation, reduce diagnostic fragmentation, and improve care for autistic adults within psychiatric services.

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8. Guzick AG, Kaplan-Kahn EA, Cheng JS, Murphy C, Onyeka OC, Riddle D, Dibbs T, Berry LN, Goin-Kochel RP, Storch EA. Development and Pilot Testing of Transdiagnostic Exposure Therapy/Behavioral Activation for Autistic Adolescents With Internalizing Disorders. Cogn Behav Pract;2026 (May);33(2):431-447.

Internalizing disorders disproportionately affect autistic adolescents, though limited research has focused on tailoring therapy for this population. The purposes of this paper were (1) to describe the development of a transdiagnostic exposure therapy/behavioral activation intervention for autistic adolescents with internalizing disorders, and (2) to present a pilot test of feasibility, acceptability, and efficacy of the intervention. The development of this therapy is described in detail, which prioritized the following domains: (1) building on the existing evidence base of exposure-based cognitive behavioral therapy for autistic youth with anxiety disorders, (2) involving caregivers considerably, (3) incorporating autism-specific considerations into case conceptualization and treatment planning, (4) using a neurodiversity-affirming lens, (5) considering changes in therapy delivery for autistic adolescents, and (6) providing a conceptualization-driven, flexible, transdiagnostic framework to therapy. This adapted, exposure-therapy/behavioral activation approach was pilot tested with 14 adolescent-caregiver dyads, and showed strong acceptability and feasibility based on qualitative and quantitative data. The treatment response rate was 78% (11/14; based on the Clinical Global Impression-Improvement scale), and the primary diagnosis remission rate was 57% at the posttreatment assessment (8/14; based on the absence of the primary diagnosis assessed at baseline with a structured diagnostic interview), which benchmarks well on similar treatments that have been published in this literature among nonautistic youth. These pilot data provide a strong justification for a follow-up randomized trial testing efficacy and mechanisms.

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9. Harold R, Kamat R, Neo WS, Novak K, Nossa G, Monsivais H, Durham P, Zhou X, Dydak U, Berry-Kravis E, Foti D, Kelleher BL. Cerebellar GABA and executive function among adult female carriers of the fragile X messenger ribonucleoprotein 1 premutation: a pilot study to examine neural underpinnings of the clinical phenotype. Neurobiol Dis;2026 (May 18):107456.

The FMR1 premutation is associated with a complex clinical phenotype, with increased risk for outcomes across the domains of psychological disorders, motor functioning, and reproductive health. A key gap is understanding intermediate processing that may help to explain how the FMR1 premutation alters brain functioning to confer increased risk across these domains. The current study begins to address this gap by focusing on two candidate, interrelated processes: cerebellar GABA and executive function. Data were collected from a cohort of 15 adult female FMR1 premutation carriers and a comparison group of 15 age-matched unaffected controls. Cerebellar GABA concentration was measured using edited magnetic resonance spectroscopy (MEGA-sLASER) at 3 T. Executive function was measured across two units of analysis: the error-related negativity, an EEG marker of automatic error detection, as well as performance-based measures from validated neuropsychological tests. Premutation carriers exhibited an atypical scalp topography of the error-related negativity. In controls but not in premutation carriers, error-related brain activity was associated with cerebellar GABA concentration and performance-based executive function. This pattern of preliminary findings suggests that the FMR1 premutation may alter the neural network involved in error monitoring. If these findings are confirmed in larger cohorts, they have potential implications for understanding the emergence of the broader clinical phenotype in adult FMR1 premutation carriers.

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10. Howard PL, Martin N, Benson V, Liversedge SP. EXPRESS: Inferential processing in autistic and non-autistic readers: New opportunities for inquiry. Q J Exp Psychol (Hove);2026 (May 18):17470218261454262.

This article discusses inferential processing during reading for autistic and non-autistic readers. We demonstrate the criticality of inferential processing for successful text comprehension, alongside evidence that inferential processing is often less efficient for autistic people relative to non-autistic people. We consider the cognitive mechanisms that may underpin inference generation and highlight the RI-Val theory as a potential framework that will allow for considerable theoretical development in this area. The RI-Val theory specifies how validation processes during comprehension are tied to attention shifts, which is a significant development in the conceptualisation of discourse processing. This creates a testable account which if examined using online methods, provides considerable scope for the development of scientific understanding in relation to the inferential and social-communication differences associated with autism.

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11. Jeong D, Hwang S, Lee Y, Lee J, Kim MJ. Atypical neural synchronization in the temporal gyrus during face processing in children with autism spectrum disorder. Biol Psychol;2026 (May 18):109298.

Autism spectrum disorder (ASD) is characterized by deficits in face processing, which are closely related to difficulties in everyday social interactions. Previous functional magnetic resonance imaging (fMRI) studies have relied on static or simplified dynamic facial stimuli with limited ecological validity, failing to reflect the complex interplay of speech, expressions, and multimodal cues in real-world social contexts. To address these limitations, we used data from the Healthy Brain Network (HBN), which includes two movie-watching runs per participant, and selected homogeneous samples of 18 children with ASD and 18 typically developing (TD) children. Inter-subject correlation (ISC) analysis was applied to compare neural synchronization patterns between groups across the full movie and face-viewing scenes. Results showed that children with ASD exhibited reduced neural synchronization across widespread brain regions compared to TD children. Notably, during face-viewing scenes, children with ASD revealed reduced neural synchrony relative to TD children in the left middle temporal gyrus, right superior temporal gyrus, and right primary auditory cortex. These findings suggest that children with ASD exhibit atypical neural responses in key regions involved in social cognition and multisensory integration when processing face-related information. This underscores the importance of extended regions related to face processing in understanding ASD. Accordingly, the present study contributes to our understanding of neural synchrony patterns associated with face processing in ASD.

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12. Mammarella V, Breda M, De Gennaro L, Bruni O. Sleep disturbances and sensory processing and integration in children and adolescents with autism spectrum disorder: a systematic review. Sleep Med Rev;2026 (Apr 27);88:102302.

Sleep disorders and sensory abnormalities are highly represented in individuals with autism spectrum disorder and represent an important burden for these subjects and their families. Exploring the frequently co-occurring relationship between these two disturbances may be crucial for its therapeutic and rehabilitative implications. Following PRISMA 2020, we systematically reviewed studies examining associations between sleep disturbances and sensory abnormalities in children/adolescents (2-18 years) with autism spectrum disorder based on the following databases searched: MEDLINE, PsycARTICLES, PsycInfo, Psychology and Behavioral Sciences Collection, CINAHL (EBSCOhost), Scopus, and Web of Science. Final search: May 31st, 2025. Eligible designs included observational and interventional human studies reporting quantitative sleep-sensory outcomes. Sixteen studies met inclusion criteria; significant positive associations emerged between sleep problems (especially insomnia symptoms and night wakings) and sensory dysfunctions (notably sensory sensitivity/avoidance; tactile and vestibular domains). Only a minority of these studies have been conducted in older children/adolescents. Two longitudinal non-intervention studies suggested covariation over time. Use of predominantly parent-reported instruments and heterogeneous designs limited quantitative synthesis. Objective measures (e.g., actigraphy, electrodermal activity) were rarely used and showed variable concordance with questionnaires. Sleep issues and sensory dysfunctions appear connected in ASD, but more evidence is needed to determine causality. Future research should use longitudinal intervention trials and both objective and subjective assessments to see if treating sleep or sensory symptoms leads to improvement.

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13. Marino M, Pezone M, Riccio MP, Garotti R, Scapicchio A, Fernandez I, Bravaccio C. Case Report: Integration between eye movement desensitization and reprocessing and cognitive therapy for autism spectrum disorder. Novel intervention protocol based on case formulation and brief review of literature. Front Psychol;2026;17:1812438.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and interaction, alongside restricted, repetitive, and stereotyped patterns of behavior and interests. Individuals on the autism spectrum exhibit increased psychopathological vulnerability, with a high incidence of comorbid conditions, including Post-Traumatic Stress Disorder and trauma-related symptoms. Trauma-related symptoms appear to be highly prevalent in ASD, though they are frequently underestimated. Furthermore, autistic individuals face numerous risk factors that increase their exposure to traumatic experiences and relational trauma. It is also likely that there is an autism-specific vulnerability regarding the perceived traumatic impact of certain events. This paper presents the clinical case of a young autistic woman with no intellectual or language impairment, comorbid social-performance anxiety, and pathogenic schemas associated with relational trauma. The patient was treated with Eye Movement Desensitization and Reprocessing (EMDR) therapy sessions, employing protocol modifications tailored to the ASD condition. Currently, studies on the use of EMDR in ASD are limited; the primary barrier to its application often stems from challenges in adapting the technique to the specific needs of autistic patients. Therefore, further research is essential-not only to evaluate the efficacy of EMDR in ASD but, crucially, to refine and adapt the standard protocol to address the specific requirements and challenges of this condition.

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14. Okai-Nóbrega LA, Santos TRT, Araújo PA, Paz C, Avelar B, Silva LP, Campolina AB, de Rezende A, de Miranda DM, Silva MR, Yehia HC, Vilela Barbosa A, Lage APP, Fonseca ST. Kinematic gait differences in preschool children with autism spectrum disorder. Front Psychol;2025;16:1652594.

BACKGROUND: Autism Spectrum Disorder (ASD) is primarily characterized by differences in communication and social interaction, but motor impairments are also commonly observed, often emerging in early childhood. Understanding these motor characteristics may contribute to earlier identification and intervention. This study aimed to compare walking kinematics between autistic and non-autistic preschool-aged children. METHODS: This observational cross-sectional study included 20 children aged 3 to 4 years (10 autistic and 10 non-autistic). Autism diagnoses were confirmed using DSM-5 criteria and the Childhood Autism Rating Scale (CARS). Gait data were collected using a three-dimensional motion capture system with 41 passive markers as children walked independently over a 6-meter walkway at a self-selected speed. Spatiotemporal and kinematic parameters were analyzed using independent t-tests, Mann-Whitney U tests, and one-dimensional statistical parametric mapping (SPM). Statistical significance was set at p < 0.05. RESULTS: No significant differences were found between groups in spatiotemporal gait parameters. However, autistic children exhibited significantly greater hip abduction compared to non-autistic children at the beginning and end of the gait cycle. CONCLUSION: Differences in frontal plane hip kinematics may reflect a gait motor "signature" associated with autism in early childhood. These findings support the potential use of motion analysis as a quantitative tool to aid early identification and intervention strategies for autistic children.

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15. Pereira AR, Pozo-Rodríguez M, Ribeiro-Carreira A, González-Villar AJ, Zubizarreta SC, Tubío-Fungueiriño M, Carracedo A, Fernández-Prieto M, Sampaio A. Vicarious Perception of Touch in ASD: The Role of Empathy and Touch Experiences. Autism Res;2026 (May 18):e70269.

C-Tactile (CT) targeted affective touch plays a central role in social cognition and emotional development. In autism, atypical sensory processing, particularly in response to tactile stimulation, has frequently been reported. Autistic individuals have been shown to exhibit altered perception and reduced hedonic evaluation of affective touch, as well as increased defensive responses. Despite these differences in direct touch, the perception of vicarious social touch or its connection to social and emotional constructs remains poorly explored. Vicarious touch is theoretically relevant because it recruits social-cognitive and affective mechanisms beyond primary somatosensory processing; however, most prior studies have focused on neural correlates in neurotypical adults, with limited behavioral investigation and scarce evidence in autistic populations. The present study evaluated how autistic and non-autistic adolescents and young adults perceive vicarious social touch. Participants observed videos depicting touch delivered at three different speeds (static, CT-optimal, and fast) and across five skin locations (back, upper arm, ventral forearm, dorsal forearm, and palm). Participants provided subjective ratings of how pleasant they believed the touch was for the person in the video (numeric rating scale (NRS) Other/pleasantness) and how much they would like to be touched in the same way (NRS Self/willingness). We also examined associations with empathy and touch-related attitudes. Results showed no group differences in the pleasantness and willingness ratings. However, a significant three-way interaction between speed, skin location, and group emerged for the NRS Self. Across both groups, ratings indicated that speed and skin location modulated ratings, with CT-optimal stroking and touch in the back rated as most pleasant. For NRS Self, male participants reported higher pleasantness than females, across groups. Pleasantness and willingness ratings were positively correlated with attitudes toward touch from friends and family and toward self-care, but not with other touch-related attitudes or empathy scores, across groups. Finally, autistic individuals reported significantly lower empathy and less positive touch-related experiences than non-autistic participants. Overall, these findings suggest that global vicarious touch perception may be relatively preserved in autistic adolescents and young adults, while individual differences in empathy and touch-related experiences may contribute to broader variability in social touch processing. This study explored how autistic and non‐autistic adolescents and young adults perceive observed social touch, such as seeing someone being gently stroked. Both groups rated the touch as similarly pleasant, but autistic participants reported fewer positive experiences with touch in everyday life and lower empathy. These findings suggest that personal experiences and attitudes toward touch may shape how social touch is understood, which is important for better supporting social and emotional well‐being in autism. eng

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16. Rothman JM, Kwan B, Longhurst CA, Jena AB. Rates of Leucovorin Prescriptions for Children With Autism. JAMA Netw Open;2026 (May 1);9(5):e2613286.

This cohort study evaluates rates of leucovorin prescriptions for children with autism after a White House announcement promoting its use. eng

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17. Savickaite S, Airlie R, McDonnell N, Simmons D. Drawing the inner world: exploring autistic perception through virtual reality art-making. Front Psychol;2026;17:1739991.

First-person accounts of perceptual experience in autism remain underrepresented in psychological research. This exploratory study examined how autistic adults use immersive media to externalize and reflect on perception. Six adults with a formal autism diagnosis (four male, two female; mean age 22.7 years) completed a virtual reality (VR) protocol that combined free drawing in the VR tool Open Brush with the Think Aloud method and a brief interview. To contextualize individual sensory and cognitive profiles, participants completed the Autism Quotient (AQ) and the Glasgow Sensory Questionnaire (GSQ). Reflexive thematic analysis of verbal reports, interviews and digital drawings identified three overarching themes: immersion, artistic expression and individuality, and escapism. Participants described VR as calming, engaging and controllable, with the ability to explore artworks from multiple perspectives and to adjust the environment to reduce sensory demands. Creative approaches were highly individual ranging from detailed figurative drawings to abstract compositions. These often reflected personal interest and preferred sensory qualities. Quantitative scores illustrate the heterogeneity in attention to detail and sensory sensitivity, supporting the qualitative emphasis on variability within autism. The findings demonstrate the feasibility and value of VR drawing as a neurodiversity- affirming participatory method, with potential applications in therapy and in communicating autistic perceptual experience to non-autistic audiences.

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18. Sezgin M, Koyuncu O, Güneş M, Yıldırım Budak B. Comorbid Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder in a Patient with 6q25.1-Q25.3 Microdeletion: A Case Report. Dev Neuropsychol;2026 (May 18):1-8.

6q25 microdeletion is a rare syndrome associated with intellectual disability and dysmorphism. However, comorbid Autism Spectrum Disorder (ASD) and Attention Deficit and Hyperactivity Disorder (ADHD) are poorly documented. We report a 16-year-old male with a 6.7 Mb deletion (6q25.1-q25.3) presenting with hydrocephalus, cerebral palsy, and severe behavioral dysregulation. Psychiatric evaluation confirmed comorbid ASD (CARS: 52) and ADHD. Behavioral symptoms and aggression were successfully stabilized using 5 mg/day olanzapine. Our case is the first report of ASD/ADHD co-occurrence in 6q25 syndrome highlights the potential neurobehavioral role of genes like ARID1B and SYNE1. Our findings emphasize the need for comprehensive psychiatric evaluation in rare chromosomal aberrations.

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19. Silva RAD, Queiroz S, Silva FPD. [Autism spectrum disorder today: critical reflections on hyperdiagnosis]. Cad Saude Publica;2026;42:e00140725.

This study discusses the hyperdiagnosis of autism spectrum disorder (ASD), which occurs when the identification of this disorder exceeds actual clinical relevance, including cases without significant functional impacts. Although the greater recognition of the disorder has included and supported many people, the accelerated increase in diagnoses raises questions about technical criteria, the possible use of diagnoses to obtain benefits, and the influence of social and institutional factors. Recent epidemiological studies have indicated a gradual increase in the global prevalence of ASD. Brazilian data show that about 1.2% of its population has received such a diagnosis, which evinces greater recognition and access to diagnosis. The evolution of the concept of this disorder has broadened diagnostic criteria, including milder and more heterogeneous manifestations of the condition, which has contributed to the significant increase in diagnosis rates worldwide. Factors such as greater social awareness, search for school reports, and institutional pressure for behavioral adequacy also influence increases in diagnosis. Hyperdiagnosis has negative consequences, such as early stigmatization, inadequate treatments, emotional impact on families, and distortion of epidemiological data, harming public policies. The difference between early, desirable, and judicious diagnoses and hasty ones (based on superficial evaluations) is highlighted. To promote more responsible diagnoses, this study proposes the continuous training of professionals, interdisciplinary assessments, longitudinal follow-up, and the appreciation of singularities. It also defends the expansion of public policies with no exclusive dependence on medical reports to guarantee support, prioritizing individuals’ real needs.

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20. Silverman C, Yudell M, Carroll-Scott A. « They Really Save Us From Ourselves » : Autism Researchers’ Insights on Community Engagement and Ethics. J Bioeth Inq;2026 (May 18)

Autism research depends on the participation of autistic children and adults as well as their families, but researchers have not routinely involved autistic people in the planning or execution of research. Community-engaged research practices, standard in other fields such as areas of public health, are gaining acceptance in autism research, although some researchers and other stakeholders remain concerned about their appropriateness, feasibility, or utility. This study, part of a larger project on stakeholder views on the ethics of community engagement practices in autism research, examines researchers’ ethical beliefs about community engagement. We find that the researchers with whom we spoke cite multiple specific ethical and epistemological benefits of these practices and relatively few risks. Barriers to community engagement are, in their view, often institutional and practical, including the longer timelines of community-engaged research, resistance or lack of comprehension on the part of funding organizations and grant reviewers, the need for additional resources to support appropriate compensation, and ensuring that community stakeholders and researchers have a shared understanding of terminology.

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21. Suhumaran S, Aishworiya R, Wong CM. Language Use Preferences in a Culturally Diverse, Multiethnic, and Multilingual Autism Community in Singapore. Autism;2026 (May 18):13623613261441734.

There is an emerging understanding of diverse language preferences in autism among stakeholders, including that for identity-first language (IFL) versus person-first language (PFL). We aimed to understand preferences regarding language use in racially and culturally diverse Singapore. A cross-sectional study was completed by autistic adults, caregivers of autistic individuals, and professionals working in the autism field. The questionnaire comprised commonly used terms in autism, which respondents rated from 1 (uncomfortable/I do not like this term) to 7 (very comfortable/this would be my preference). The sample comprised 320 individuals (82.8% females; Chinese 75.9%, Malay 9.4%, Indian 8.8%). Respondents comprised 38 (11.9%) autistic individuals, 86 (26.9%) caregivers/relatives, and 196 (61.3%) professionals. Differences in language preferences were observed between respondent types. Autistic individuals preferred terms like ‘autistic’ (M ± SD = 5.00 ± 2.25) unlike caregivers/relatives (3.66 ± 2.41) or professionals (3.30 ± 1.94, p < .001). PFL terms like 'person with autism' and 'person with ASD' were preferred by caregivers/relatives (4.47 ± 2.19; 4.33 ± 2.25) and especially professionals (5.32 ± 1.58; 4.89 ± 1.84) but disliked by autistic individuals (3.11 ± 2.09; 2.39 ± 1.99; p < .001). Different language preferences were observed between those with lived experience versus professionals. Sensitivity to the preferences of stakeholders fosters better inclusion and acceptance of neurodiversity.Lay AbstractLanguage shapes how autism is perceived and understood by society. Research on language preferences in the autism community has been mostly from Western sources. The primary consideration has been in identifying the preference between identity-first language (IFL), such as 'autistic person', and person-first language (PFL), such as 'person with autism'. These studies suggest that professionals and caregivers prefer PFL while autistic individuals favor IFL. Little is known about these preferences in a culturally diverse setting like Singapore. This study aimed to explore the language preferences among the stakeholders in the autism community in Singapore. In this study, 320 participants were surveyed anonymously online; participants were asked to rate their comfort level with certain autism-related terms. The survey findings revealed significant differences in preferred language-autistic individuals expressed a strong preference for IFL and for terms that conveyed autism as a part of their identity and did not prefer clinical terms such as 'symptoms of autism' or PFL terms such as 'person with ASD'. In contrast, caregivers and professionals tended to prefer PFL terms and medicalized language. It is likely that societal factors, including Singapore's relatively conservative culture and societal views on autism, influenced these preferences. Awareness of the variations in language preferences among stakeholders in the autism community will help to foster inclusivity, acceptance, and sensitivity toward autistic individuals and their families.

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22. Suresh A, Kourdougli N, Nomura T, Buth JE, Miranda-Rottmann S, Sánchez-León CA, Wu MW, Nelson SM, Wall LT, Tran AT, Araya R, Contractor A, Gandal MJ, Portera-Cailliau C. Translatome profiling reveals opposing alterations in inhibitory and excitatory neurons of fragile X mice and identifies EPAC2 as a therapeutic target. Neuron;2026 (May 18)

Symptoms of fragile X syndrome (FXS), the leading monogenic cause of intellectual disability and autism, are thought to arise from an excitation/inhibition (E/I) imbalance. Here, we leverage cell-type-specific mRNA sequencing to profile molecular alterations in cortical excitatory (Camk2) and inhibitory (Pvalb) neurons in Fmr1 knockout (KO) mice, integrating transcriptomic results with circuit and behavioral readouts to prioritize novel therapeutic targets. We uncovered significant genotype-by-cell type interactions for differential gene expression in Camk2a and Pvalb translatomes, and, strikingly, the underlying signaling pathways were often altered in opposite directions. Among the 184 differentially expressed genes that were concordantly dysregulated across both cell types, only Rapgef4 (a.k.a., exchange protein direftly activated by cAMP 2 [Epac2]; upregulated in Fmr1 KO) was also a fragile X messenger ribonucleoprotein (FMRP) target, brain-enriched, and associated with neurodevelopmental disorders. Treatment of Fmr1 KO mice with a specific EPAC2 antagonist restored cortical circuit function and ameliorated multiple behavioral phenotypes. Thus, EPAC2 should be considered a potential therapeutic target for FXS.

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23. Tachi A, Takahashi Y, Ito Y, Kato S, Sugiura-Ogasawara M, Saitoh S, Kamijima M. Association of intrapartum epidural analgesia and oxytocin exposure with offspring autism and neurodevelopment from the Japan Environment and Children’s Study. Sci Rep;2026 (May 18)

Given the increasing prevalence of neurodevelopmental disorders, this study examined the association between autism and neurodevelopmental delays and exposure to intrapartum labor epidural analgesia (LEA) and synthetic oxytocin (OT) in offspring. The data were obtained from various questionnaires, including the Japanese Ages and Stages Questionnaires, Third Edition. Using data from a large-scale longitudinal birth cohort study in Japan, 72,801 participants were enrolled and follow-up to age 4 years. Exposure during labor was categorized into four groups: no-exposure, OT, LEA, and LEA-OT. Adjusted odds ratios for autism were 2.35 (95% CI 1.44-3.83) in the LEA-OT group and 2.41 (95% CI 1.31-4.45) in the LEA group. The E-values for the point estimates were 4.16 in the LEA-OT group and 4.29 in the LEA group, and those for the lower limits of the 95% confidence intervals were 2.39 and 2.05, respectively, indicating only moderate robustness to unmeasured confounding. Associations with autism were consistent across analyses in the LEA-OT group, but in sex-stratified analyses, only males showed an association. No consistent associations with neurodevelopmental delays were observed in any exposure groups. Since residual confounding cannot be excluded, with limited external validity, these findings warrant replication in independent cohorts to clarify causality.

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24. Wong ML, Milbourn B, Afsharnejad B, Ntoumanis N, Arnell S, Kebble P, Girdler S. Attendance Compulsory, Motivation Conditional. Autistic Youth’s Psychological Need Support and Satisfaction Related to Physical Education: A Qualitative Investigation. Autism;2026 (May 18):13623613261435412.

Autistic students participate less in Physical Education (PE) than their peers. Motivation is a primary driver of participation in PE, yet little is known about factors influencing the motivation of autistic youth in PE. This qualitative study explored the experiences of Australian autistic youth aged 7-18 years (N = 26) in mainstream PE. A deductive content analysis approach, informed by Self-Determination Theory (SDT), directed the development of the interview guide and analysis. Deductive responses (k = 526) were related to the Basic Psychological Needs postulated by SDT: relatedness (k = 165), competence (k = 124), and autonomy (k = 76) and included 33 conceptual categories. Inductive responses capturing autistic differences were mapped to the Conditional Participation Model themes: Adjustment to external demands (k = 52), predictability (k = 41), and affective experiences (k = 68), incorporating 16 conceptual categories. Autistic differences underpin Basic Psychological Needs satisfaction/frustration. Supporting the Basic Psychological Needs of autistic students differs from their neurotypical peers, with PE teachers best positioned to facilitate a need-supportive environment for autistic students.Lay AbstractAutistic youth participate less in Physical Education (PE) than their classmates. We do not know much about the motivation of autistic students to participate in PE. Self-Determination Theory says our motivation is affected by the satisfaction of our Basic Psychological Needs of competence (can I do it), autonomy (is there a choice), and relatedness (do I belong). We investigated what impacts the psychological needs of autistic youth in PE. We also explored how autistic differences affect motivation using the Conditional Model of Participation that considers exercise participation for autistic youth. We interviewed 26 Australian autistic youth, (7-18 years) investigating factors impacting their Basic Psychological Needs in PE. This is a deductive approach, as we considered specific themes and used these to analyse responses. We also recorded patterns relating to autistic differences. This was an inductive approach as themes emerged from the responses. Participants provided 365 responses in relation to competence (124), relatedness (165), and autonomy (76). In addition, 161 responses linked to autistic differences. We mapped responses to the Conditional Participation Model themes of adjustment to external demands (52 responses), predictability (41 responses), and emotions (68 responses). Autistic differences underpinned the Basic Psychological Needs of participants. The PE teacher had the biggest impact on supporting these needs.

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25. Xing L, Ding Z. A contrastive reconstruction vision transformer model for intelligent diagnosis of autism spectrum disorder. NPJ Digit Med;2026 (May 18)

Automated assessment through the analysis of facial expressions in autism can assist in early screening, providing strong support for timely intervention and contributing to the healthy development of patients. However, current deep learning models still face several challenges in the practical application of intelligent diagnosis for Autism Spectrum Disorder (ASD). First, traditional models struggle to fully capture subtle facial expression changes and local fine-grained features. Second, existing models primarily rely on manually annotated facial expression images for supervised training, often overlooking unlabeled facial expression data. Therefore, in this study, supported by the Internet of Medical Things, we propose a Contrastive Reconstruction Vision Transformer (CREViT) model for the intelligent diagnosis of ASD. The design concept of the CREViT model integrates contrastive learning, autoencoder, and Vision Transformer (ViT). Its core advantage lies in the combination of ViT and autoencoders, enabling the model to more accurately capture subtle changes in facial expression images and learn richer and higher-quality image representations. Furthermore, by leveraging contrastive learning, the CREViT model effectively reduces its dependence on labeled data while fully utilizing unlabeled data, thereby improving the model’s generalization capability. We conducted comprehensive experiments on a real-world Autism Spectrum Disorder facial expression dataset. The results reveal that the CREViT model performs exceptionally well in intelligent ASD diagnosis, significantly enhancing prediction accuracy and model generalization ability.

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26. Xing Y, Jomhari N, Zakaria N, Zhou X, Lai S, Liu Y. Design and application of emotion-oriented play-learning tools for children with autism: a cross-cultural qualitative study of parents and teachers in China and Malaysia. Front Psychol;2026;17:1736058.

BACKGROUND: Autistic children experience enduring difficulties with emotion regulation and daily participation. Emotion-oriented play-learning tools (EPLTs, sensory play-learning tools for supporting emotion and self-regulation) are recognized as low-threshold supports across home-school-community settings; however, robust real-world evidence (RWE) on their use, design requirements, and cross-cultural variation remains limited. PURPOSE: The purpose of this study is to examine the meanings, applications, and design requirements of emotion-oriented play-learning tools in China and Malaysia, and to identify system-level enablers and barriers to their development and use from stakeholder perspectives. METHODS: Adopting reflexive thematic analysis, we conducted semi-structured interviews with 30 stakeholders (15 in China; 15 in Malaysia)-parents/primary caregivers and frontline teachers. Data were analyzed inductively in NVivo using three-level coding, and the reporting followed the Standards for Reporting Qualitative Research (SRQR). RESULTS: Five overarching themes were identified: (1) driving factors (heightened emotional difficulties and trend-driven impetus); (2) attitudes to advanced technologies [virtual/augmented reality (VR/AR) and artificial intelligence (AI)]; (3) potentials and applications (multimodal sensory feedback, support for emotional expression, and transition support); (4) design and market requirements (safety, affordability, maintainability, collaboration, and data minimization); and (5) socio-environmental issues (stigma and policy accessibility). Coding frequencies indicated Theme 4 was the most salient, with stronger emphasis among parents than teachers. Attitudes to technology diverged by country-Malaysian participants were generally more open, whereas Chinese participants were more cautious-while socio-environmental constraints were common to both. Overall, Chinese participants offered denser, institution-focused accounts, whereas Malaysian participants emphasized family- and community-based practical coping. CONCLUSIONS: Emotion-oriented play-learning tools may operate as low-threshold, context-adaptable supplement tools in real-world settings. Scalable adoption depends on evidence-informed design; integrated affordability across price, maintenance, and training; and governance frameworks for privacy and explainability. We propose a design paradigm centered on safety, affordability, evidence, and collaboration. This paradigm is intended to guide small-scale RWE pilots, enable home-school data sharing and cross-cultural adaptation, and ultimately enhance quality of life for autistic children-aligning with the Sustainable Development Goals (SDGs) on Good Health and wellbeing, Quality Education, and Reduced Inequality.

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27. Yago X, Astudillo-Skliarova IE, Vinueza-Veloz AF, Guerrero-Vaca DJ, Carrazco-Montalvo A, Piedra-Andrade JS, Svozilík J, Betancourt-Ortiz SL, Abril-Ulloa SV, Boele CP, Sherry S, Gultig KD, Boele HJ, Carpio-Arias TV, Vinueza-Veloz MF. Sensorimotor integration, nutrition and gut microbiota in Ecuadorian autistic children – « Proyecto Wiñay »: a research protocol for a comparative cross-sectional study. Front Psychiatry;2026;17:1721567.

BACKGROUND: Autistic children experience disproportionately high rates of malnutrition compared to non-autistic (NA) peers. Sensorimotor integration differences (SMD), prevalent in 69-95% of autistic individuals, are hypothesized to drive this disparity. SMD contributes to core autistic traits that exacerbate feeding difficulties (e.g., food selectivity), potentially leading to malnutrition and gut dysbiosis. Current caregiver-reported SMD assessments lack validity in autistic populations and are prone to cultural and socioeconomic biases, limiting insight into nutritional outcomes. OBJECTIVE: To investigate relationships between objectively measured SMD, dietary patterns, nutritional status, and gut microbiota composition in autistic children versus NA peers. METHODS: This comparative cross-sectional study will recruit 100 autistic children and adolescents (aged 3-17 years) and 200 age-/sex-matched NA peers (including 100 with developmental disorders other than autism). Autism severity will be assessed using the Childhood Autism Rating Scale; NA peers will be screened with the Autism Spectrum Quotient-10. Dietary intake will be evaluated via three 24-hour dietary recalls, supplemented by questionnaires on socioeconomic status, health, and medications. Nutritional status (anthropometry, bioimpedance) and gut microbiota composition and diversity will be assessed. SMD proxies (sensory gating, sensory adaptation) will be measured using a smartphone application. ANALYSIS: Group comparisons will employ multivariate regression models, adjusting for age, sex, socioeconomic status and medication use. We hypothesize significant between-group differences in dietary patterns, nutritional status, microbiota profiles, and SMD measures. Objectively measured SMD in autistic children and adolescents is expected to correlate with symptom severity, dietary patterns, and differences in microbiota composition and diversity. ETHICS AND DISSEMINATION: The study has been approved by the Escuela Superior Politécnica de Chimborazo Ethics Committee (Ref: IO-01-CEISH-ESPOCH-2025). All participants will receive personalized nutritional counseling. Findings will be disseminated through peer-reviewed open-access publications, scientific conferences, and community workshops.

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