1. Alagal RI, Alshwaiyat NM, Almousa LA, JZ AL, Alsemari MA, AlFaris NA. Eating behaviors and feeding problems among school-aged children with and without intellectual and developmental disabilities in Saudi Arabia: A cross-sectional study. Medicine (Baltimore). 2026; 105(38): e50715.

Children with intellectual and developmental disabilities (IDD) are at increased risk of nutritional challenges due to distinctive eating behaviors and feeding problems. Therefore, this study aimed to assess eating behaviors and feeding problems among school-aged children with and without IDD in Saudi Arabia and explore differences across diagnostic subgroups. This cross-sectional study was conducted in Riyadh, Saudi Arabia, between August and December 2024. A total of 168 school-aged children (68 with IDD and 100 without IDD) were recruited at the Child Development Center, University Hospital. Data on sociodemographic characteristics, eating behaviors, and feeding problems were collected using a structured, caregiver-administered questionnaire. Children with IDD exhibited a higher burden of eating behaviors and feeding problems compared to healthy peers. They were more likely to experience difficulties with sucking, chewing, and swallowing (37% vs 17%, P = .001), gastrointestinal complaints such as nausea/vomiting (37% vs 15%, P = .005) and constipation/diarrhea (43% vs 17%, P = .001), and dental issues that interfered with swallowing (37% vs 18%, P = .024). Overeating (41% vs 18%, P = .002), unhealthy snacking (53% vs 32%, P = .017), and pica (41% vs 15%, P = .001) were also more common in IDD. Fruit and fruit juice intake differed significantly across subgroups (P = .033), with autism spectrum disorder children showing the lowest consumption. School-aged children with IDD in Saudi Arabia face significant nutrition-impacting eating behaviors and feeding difficulties compared to healthy peers. These findings highlight the need for routine, diagnosis-sensitive nutrition care and provide evidence to inform tailored interventions and policy strategies aimed at improving nutritional status and mealtime well-being in this population.

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2. Alexander AE, Padmakumari P, Chatterjee S. Parental Involvement in Intervention for Autism Spectrum Disorder: Experiences of Rehabilitation Professionals. Psychopharmacol Bull. 2026; 56(4 Suppl 1): 57-81.

There has been an increase in the incidence of Autism Spectrum Disorder (ASD) over recent years, which has given rise to an immediate increase in demand for quality intervention and trained professionals. Parental involvement is necessary for a more effective parental training, which will ensure a realistic understanding of their child’s difficulties. Previous studies continuously prove that parental involvement in the lives of their children with ASD is beneficial to improvement in their children with ASD. There are no studies that illustrate the challenges that professionals face when trying to involve parents into the intervention. Based on the literature review, it can be projected that an understanding of these factors will help professionals to improvise on strategies to implement parental involvement methods with efficiency and maximize the gains of the individuals with ASD. This study aims to understand the benefits and challenges of rehabilitation professionals in involving parents for treatment of children with ASD, in the manner in which these issues were overcome. Ten professionals (2 from each domain of rehabilitation) were selected to be part of the study. The participants were interviewed using a semi-structured interview questions and the data collected was thematically analysed under the light of Review of Literature. The results of the study clearly show the inevitability of parental involvement in intervention for autism. The study identified five themes: Dual model of Work, Parenting, Socio-cultural Factors, Professional Expertise of Therapist and Limitations with involvement. The present study implies that is important to take the parents’ personal psychological challenges into consideration before involving them in intervention. A program that can specifically target the needs of the parent and provide them with the kind of support and knowledge that is necessary for their child can do wonders.

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3. Basic D, Begeer S, Ziermans T. Evaluating the Prodromal Questionnaire-16 for Screening and Prediction of Psychosis in Autistic Adults: Cross-Sectional and Longitudinal Findings From a National Cohort. Schizophr Bull. 2026; 52(5).

BACKGROUND AND HYPOTHESIS: Autistic individuals are at elevated risk for psychosis, yet attenuated psychotic symptoms may go undetected due to overlapping features and limited validation of screening tools in autistic populations. This study evaluated the performance of the Prodromal Questionnaire-16 (PQ-16) in autistic adults, including its longitudinal predictive value for schizophrenia-spectrum diagnoses, and examined demographic and clinical correlates of attenuated psychotic symptoms. STUDY DESIGN: Using data from a large longitudinal cohort (the Netherlands Autism Register), we analyzed self-reported PQ-16 symptom and distress scores alongside demographic variables, age at autism diagnosis, autistic traits (AQ-28), and depressive symptoms (PHQ-Dep-4). Descriptive analyses characterized PQ-16 score distributions. Linear regression models examined predictors of PQ-16 symptom severity. Logistic regression and ROC analyses evaluated whether PQ-16 scores predicted self-reported new-onset schizophrenia-spectrum diagnoses at follow-up. STUDY RESULTS: Among 1686 autistic adults (mean age = 46.04), 34.1% exceeded the PQ-16 cutoff (≥6), indicating a substantially higher prevalence of attenuated psychotic symptoms than reported in non-autistic populations. In the fully adjusted model, higher PQ-16 scores were independently associated with greater autistic trait severity and depressive symptoms. New-onset schizophrenia-spectrum diagnoses based on self-report occurred in 1.4% of participants with longitudinal data (5/361) and were observed exclusively among individuals above the PQ-16 cutoff (3.2% vs 0.0%, P = .015). ROC analyses suggested apparent discrimination for PQ-16 total, distress, and combined scores, although estimates should be interpreted cautiously given the very small number of incident cases. CONCLUSIONS: The PQ-16 identifies meaningful patterns of attenuated psychotic symptoms in autistic adults. Findings support brief screening as part of a 2-step assessment approach.

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4. Cepni AB, Tran VT, Yoon C, Johnston CA. Advancing Health Equity in Diabetes Prevention for Individuals With Intellectual and Developmental Disabilities. Am J Lifestyle Med. 2026: 15598276261488036.

Lifestyle interventions and health promotion programs are widely implemented to improve dietary behaviors, physical activity, and other health outcomes associated with diabetes prevention and management. While standard initiatives are effective for the general population, the impact and reach of these interventions remains limited for adults with intellectual and developmental disabilities (IDD). Higher rates of diabetes, lower levels of physical activity, and poorer dietary outcomes highlight the limitations of standard approaches that may not adequately account for the distinct cognitive, behavioral, social, and environmental contexts of adults with IDD. Tailoring lifestyle interventions to the unique needs of these adults offers a promising framework to promote equitable disease prevention for a population historically overlooked in mainstream health promotion initiatives. In this commentary, we discuss how adaptations to diabetes prevention approaches, including tailored communication strategies, community-based care, and caregiver involvement, may improve the accessibility, personalization, and sustainability of health programs for adults with IDD. We also address practical challenges with scaling individualized interventions and propose collaborative models across health care, research, and communities to reduce health disparities and support successful program implementation.

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5. Cho S, Fulop L, Mulqueen A, Faulk C, Bordofsky A, Williams ZJ, Vernon T, Parish-Morris J. Do Autistic Adolescents Talk Differently in Same-Sex Versus Mixed-Sex Conversations?. Autism. 2026: 13623613261485603.

Autistic individuals often struggle with social communication, but the nature of each person’s difficulties varies substantially by context. Recent conversation-based research suggests that males and females (autistic and nonautistic) produce subtle but consistent differences in language during spontaneous conversation. However, the majority of prior studies of conversation in autism include female conversation partners only rather than systematically manipulating whether conversation dyads were same-sex or mixed-sex, thus limiting the generalizability of the findings to everyday life. In this first-of-its-kind study, we examine speech-language behavior in 35 autistic adolescents engaged in two 5-min conversations with nonautistic partners who were sex-matched or -mismatched to the participant. Data were collected at a public research university in the United States as part of a baseline assessment for a randomized control trial that concluded in 2015. Linear mixed effects regression revealed significant effects of sex-match or -mismatch on language, such that participants in same-sex conversations were more talkative, took longer turns, and paused differently than participants in mixed-sex conversations. Results highlight the importance of considering a partner’s demographic characteristics when designing studies involving natural language in autism and suggest that prior research with single-sex conversation partners should be interpreted cautiously as results may not generalize to real-world contexts. Improved understanding of everyday conversational language in autism can be used to inform neurodiversity-affirming supportive interventions while also identifying robust linguistic markers of social phenotype that can be used as outcome measures in future clinical trials.Lay AbstractAutistic individuals often speak and interact differently than nonautistic people, which can lead to challenges when these groups engage in conversation together. Communication can look very different according to the situation, however, including who is in the conversation. For example, prior research found sex differences in autistic language during natural, get-to-know-you conversations, but most existing studies did not consider the potential influence of who a person is talking to. In other words, does it matter whether you are talking to someone that is similar to you versus different from you? This gap in prior research limits our understanding of how natural conversation plays out in real life, when individuals talk to a wide variety of people. In this first-of-its-kind study, we examine whether autistic participants’ language changes depending on whether they talk to a male or a female conversation partner. Thirty-five female and male autistic adolescents participated in two 5-min conversations with nonautistic partners who were sex-matched or -mismatched to the participant. Analyses showed that participants in same-sex conversations were more talkative, took longer turns, and paused differently than participants in mixed-sex conversations. Results highlight the importance of considering partner characteristics when analyzing natural language in autism and suggest that prior research should be interpreted cautiously as results may not generalize to real-world contexts. This study contributes to the goal of better understanding conversational language in autism.

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6. Colville G. Siblings’ reflections on what it is like to have an autistic brother or sister with additional needs. Evid Based Nurs. 2026; 29(4): 217.

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7. Dickinson A, Lewis CR, Geschwind DH, Carroll JE, Lord C. System-Specific Epigenetic Aging Signatures in Autistic Adults. bioRxiv. 2026.

BACKGROUND: Autism is a lifelong neurodevelopmental condition, but the biological processes shaping aging are poorly understood. DNA methylation-based measures index physiological decline and mortality risk independently of chronological age. We tested whether biological aging differs in autistic adults, whether differences are system-specific, and which factors predict within-autism variation. METHODS: Saliva DNA methylation (Illumina EPIC) was assayed in 37 autistic adults (31 male, 6 female; mean age 29.8 years), followed from early childhood, spanning a broad ability range including intellectual disability, and 188 non-autistic adults from four public datasets, processed jointly. Fifteen measures were calculated: four global (Horvath, GrimAge, DunedinPACE, SystemsAge) and 11 system-specific SystemsAge subscores. Models adjusted for age, sex, and epithelial-cell proportion. RESULTS: Global aging measures did not differ between groups (all q > .34). However, autistic adults had higher Brain (β = 0.81), Blood (β = 0.65), and Liver SystemsAge (β = 0.58; all q < .01), with Brain and Blood robust across sensitivity analyses. Within autism, aging measures were unrelated to symptom severity, IQ, co-occurring diagnoses, or medication use. Instead, elevations were associated with psychosocial circumstances, including a lack of structured daytime activity, greater loneliness, and lower quality of life. CONCLUSIONS: Differences in aging biology in autism appeared system-specific rather than global, with no evidence of generalized epigenetic age acceleration. This vulnerability appeared more closely tied to psychosocial factors than core clinical features. System-specific DNAm measures may therefore provide a more sensitive framework for identifying biological heterogeneity and potentially modifiable contributors to healthy aging in autistic adulthood.

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8. Forcelini C, Carregosa AL, Leitzke E, Silva GD, Ampese R, Moura I, Melo H. Prevalence of autism spectrum disorder in children: complete census of a Brazilian municipality. Cad Saude Publica. 2026; 42: e00255925.

The prevalence of autism spectrum disorder (ASD) has been an issue of great concern worldwide, leading to attempts to estimate prevalence based on population samples, including those conducted in Brazil. No epidemiological study in this field has covered an entire population. We aimed to determine the prevalence of ASD in a Brazilian population. This complete census was conducted from March to December 2024 in the municipality of Coxilha, Rio Grande do Sul State, Brazil. All children aged 2.5 to 12 years were screened using the Mini-TEA scale. Children with a score above the 100% sensitivity threshold (> 4 points) were then examined by a neurologist with experience in ASD to establish the diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders. Demographic data were obtained. There was no refusal to participate. Among the 475 children (240 boys and 235 girls), we found 16 ASD cases (15 boys and 1 girl), i.e., 1 in 30 children (1 in 16 boys and 1 in 235 girls), yielding an overall prevalence of 3.36% (6.25% among boys and 0.42% among girls). All ASD cases had also been diagnosed by other professionals. Only one child’s previous diagnosis of ASD was rejected. ASD showed a high prevalence and male predominance in this unprecedented complete census. The overall prevalence is similar to that reported in the United States but higher than previous Brazilian estimates. Further research is necessary to investigate etiological factors.

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9. Freitas MC, Freitas RF, Vasconcelos IKM, Andrade IP, Pitombeira M, Fontenele DR, Alves POF, Diógenes VS, Assreuy AMS, Aragão GF. Metformin Attenuates Behavioral Deficits and Oxidative Stress in a Preclinical Model of Autism. Dev Neurobiol. 2026; 86(4): e70061.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition lacking effective pharmacological treatments. Metformin has emerged as a candidate for drug repurposing in ASD due to its metabolic and neurobiological actions. This study evaluated the in vivo effects of metformin (400 mg/kg, orally) administered from postnatal day 21 to 35 (PND21-35) in male and female offspring of mice prenatally exposed to valproic acid (VPA; 450 mg/kg, i.p.) on gestational day 12.5 (GD12.5). Behavioral tests included the open field, elevated plus maze, Y-maze, three-chamber social interaction, and self-grooming. The prefrontal cortex (PFC) and hippocampus (HPC) were analyzed for oxidative stress markers (malondialdehyde [MDA], reduced glutathione [GSH]), total protein content, and acetylcholinesterase (AChE) activity. In vivo, metformin attenuated several VPA-associated behavioral alterations, including changes in locomotor/exploratory activity and repetitive behavior, with additional effects on anxiety-like behavior, sociability, and spatial working memory that varied according to sex and behavioral parameter. Biochemical analyses showed metformin-associated changes in GSH and MDA that varied across sexes and brain regions. VPA-induced increases in PFC AChE activity were attenuated by metformin in both sexes. Total protein content also varied according to sex and brain region. These findings provide preclinical evidence that metformin can attenuate behavioral alterations associated with prenatal VPA exposure and modulate oxidative stress-related markers, with patterns varying across sexes and brain regions.

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10. Hu J, Wang H, Ren J, Liu T, Jiang Y, Zhang Y, Zhang Y, Zhang H, Sun C, Zou M. Genetic and pharmacological evidence linking CB1R signaling to hippocampal GABAergic dysfunction in ASD mouse model. Neurotherapeutics. 2026; 23(6): e01067.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder increasingly linked to disrupted GABAergic inhibition and altered excitatory-inhibitory balance. Cannabinoid receptor 1 (CB1R), enriched on GABAergic interneurons, modulates inhibitory tone. Whether CB1R dysfunction in GABAergic neurons contributes to ASD-like phenotypes remains unclear. This study investigated the role of CB1R in GABAergic regulation and evaluated whether pharmacological CB1R activation could ameliorate GABAergic abnormalities and behavioral deficits in ASD models. We generated conditional CB1R knockout mice in GABAergic neurons (GABA-CB1(-/-)) and performed behavioral and molecular ultrastructural analyses. GABAergic and neuronal alterations were quantified in hippocampus and striatum by Western blotting, immunofluorescence, and transmission electron microscopy. SA-PEG-DSPE nanomicelles were used to deliver the CB1R agonist ACPA or in combination with the GABAA receptor agonist muscimol to valproic-acid (VPA)-exposed mice to assess pharmacological modulation. GABA-CB1(-/-) mice exhibited social deficits, spatial learning and memory impairments, and repetitive behaviors similar to those of VPA mice. Both models showed increased GAD67 and GABARAP, reduced ABAT, a lower PSD95/gephyrin ratio, a reduced proportion of GAD67+NeuN + neurons, marked dendritic and synaptic disruption in the hippocampus, whereas changes in the striatum were limited. Nanomicelle-mediated ACPA administration ameliorated GABAergic molecular alterations, improved dendritic integrity and ASD-like behaviors, whereas, muscimol co-administration partially attenuated these effects in VPA mice. CB1R deficiency in GABAergic neurons was associated with ASD-like phenotypes accompanied by hippocampal GABAergic dysfunction. Pharmacological CB1R activation ameliorated behavioral and molecular abnormalities, while modulation of GABAAR partially attenuated these effects. These findings support further investigation of CB1R as a potential therapeutic target for ASD.

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11. Khan YS, Khoodoruth MAS, Aati NA. Whose business is autism? Exploring the intersecting roles of developmental paediatrics and child and adolescent mental health services. BJPsych Bull. 2026: 1-5.

This opinion article looks at how autism services for children and young people are organised within child development and child and adolescent mental health services. Although both play vital roles, their responsibilities often overlap, which can lead to delays and uncertainty for families. Rising demand, limited resources and differing pathways have added further pressure, especially since the COVID-19 pandemic. The article highlights key challenges, including age cut-offs, gaps in continuity, the need for a collaborative integrated model, the impact of stigma and the difficulties faced by children whose main needs relate to developmental delay. It argues for clearer pathways and more coordinated care.

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12. Kung FH, Tsou HL, Lin PC, Tsai SJ, Chen TJ, Hsu TW, Chen MH, Liang CS. Major mental disorders in offspring of mothers with polycystic ovary syndrome. Arch Womens Ment Health. 2026; 29(5).

PURPOSE: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder linked to metabolic and psychiatric comorbidities. Emerging evidence suggests maternal PCOS may also impact offspring neurodevelopment. This population-based cohort study investigates the association between maternal PCOS and the risk of major psychiatric disorders in offspring, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), depression, schizophrenia, and bipolar disorder. METHODS: Using data from Taiwan’s National Health Insurance Research Database, 8,930 offspring of mothers with PCOS and 89,300 matched controls were followed from birth to 2011. Psychiatric diagnoses were made by board-certified psychiatrists. Cox regression analyses adjusted for demographics and parental psychiatric history were conducted. RESULTS: Offspring of mothers with PCOS had significantly higher risks of ASD (HR = 1.46), ADHD (HR = 1.39), and depression (HR = 1.36). No significant associations were observed for schizophrenia or bipolar disorder. Findings remained consistent in sensitivity analyses excluding parental psychiatric history. CONCLUSION: Maternal PCOS is associated with increased risks of specific psychiatric disorders in offspring, particularly ASD and ADHD. These findings highlight the need for early identification and integrated care approaches that address both maternal metabolic and mental health to mitigate intergenerational psychiatric risks.

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13. Launay JM, Vodovar N. Miscompartmentalization of microbiota-derived TMAO is a reversible driver in autism spectrum disorder. iScience. 2026; 29(9): 117276.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder. Unlike genetics and gut dysbiosis, ASD appears to be homogeneous when considering tryptophan metabolism. Following these findings, we found that ASD was associated with the miscompartmentalization of the chemical chaperone trimethylamine N-oxide (TMAO). Intracellular TMAO was markedly reduced in ASD, possibly due to altered fluid/electrolyte homeostasis, which appeared to be responsible for most anomalies of tryptophan metabolism described in ASD. Administration of urea in a rat model of ASD that recapitulates the biochemical and behavioral phenotypes observed in humans not only restored biochemical parameters but also broadly improved behaviors. Our results suggest a major role of TMAO miscompartmentalization in the pathophysiology of ASD, although it is not causal for ASD. We anticipate that urea, which is already clinically approved, offers a new therapeutic opportunity for ASD, although careful testing is required to ensure safety and acceptability in this context.

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14. Miller SE, Zant O, Anderson C, Schafer E, Lee D, Lam BPW, Kahnooj HS. Neural Correlates of the Acceptable Noise Level and Self-Reported Listening Skills in Young Adults With Autism Spectrum Disorder. J Speech Lang Hear Res. 2026: 1-13.

PURPOSE: This brain-behavior study investigated the relationship between auditory sensory gating and noise acceptance in listeners with and without autism spectrum disorder (ASD). Relationships between self-reported listening skills and auditory sensory gating were also examined. METHOD: Neural responses to pure-tone stimuli were elicited using a traditional, passive gating paradigm in 12 listeners with ASD and 12 neurotypical control listeners. Noise acceptance was quantified in all listeners using the acceptable noise level (ANL) measure. Self-reported listening abilities were measured using the Speech, Spatial, and Qualities of Hearing Scale (SSQ). Relationships between neural and behavioral measures were analyzed using linear mixed-effects regression. RESULTS: Listeners with ASD accepted less noise when listening to concurrent speech, had higher intensity most comfortable levels for speech, and reported significantly more difficulties on the SSQ compared to the control group. Regression analyses showed that, across groups, weaker P1 gating was associated with poorer noise acceptance. In addition, there were differential effects of P2 gating on self-reported listening deficits on the SSQ between the ASD and control groups. CONCLUSIONS: In listeners with and without ASD, weaker pre-attentive P1 gating was significantly associated with higher ANLs (i.e., poorer noise acceptance). In contrast, weaker later stage cortical inhibition was related to greater reported listening deficits on the SSQ in listeners with ASD only.

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15. Mohtashami T, Aghayan AH, Masoudi A, Atashi A, Garmabi B, Jamalpoor Z, Khaksari M. Therapeutic potential of mesenchymal stem cell-derived extracellular vesicles as a cell-free approach in autism spectrum disorder: A systematic review and meta-analysis of preclinical studies. Behav Brain Res. 2026; 516: 116478.

BACKGROUND: Autism Spectrum Disorder (ASD) is an intricate neurodevelopmental condition distinguished by challenges in social interaction, repetitive behavioral patterns, and neuroinflammation, with limited effective treatments. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) offer a promising cell-free therapy due to their immunomodulatory and regenerative properties. This study evaluates their therapeutic efficacy in preclinical ASD models. METHODS: Following PRISMA guidelines, we conducted a systematic review and meta-analysis, searching PubMed, Embase, Scopus, and Web of Science. The SYRCLE tool assessed risk of bias. Standardized mean difference (SMD) was calculated using a random-effects model to evaluate MSC-EV effects on sociability, repetitive behaviors, and inflammatory cytokines. Subgroup analysis, sensitivity analysis, and publication bias assessment addressed heterogeneity. RESULTS: Five studies (2018-2024) were included. MSC-EV-treated mice showed significant improvements in sociability (SMD =1.34, 95% CI:0.68-2.76), reduced repetitive behaviors (SMD =-1.12, 95% CI:-0.65 to -1.59), and modulated neuroinflammation, with decreased pro-inflammatory cytokines (IL-1, SMD = -2.28, 95% CI:-0.33 to -4.24 and TNF-a, SMD = -1.22, 95% CI:-0.47 to -1.97 and IL-6, SMD = -1.03, 95% CI:-0.38 to -1.68) and increased IL-10 (SMD =0.58, 95% CI:0.03-1.13). Subgroup analysis indicated umbilical cord- and adipose-derived MSC-EVs had superior efficacy. CONCLUSION: MSC-EVs demonstrate significant therapeutic potential in preclinical ASD models by improving core symptoms and modulating inflammation. However, limited studies and heterogeneity highlight the need for standardized protocols and further preclinical research to facilitate clinical translation.

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16. Quevedo-García R, Zaldivar-Colado XP, Zaldivar-Colado U, Gallardo-Zazueta JU, Perez-Aguilar LY. Haptic-enabled virtual reality for fine motor rehabilitation in children with autism spectrum disorder: a multi-session comparative study. Dev Neurorehabil. 2026: 1-12.

BACKGROUND AND OBJECTIVE: Children with Autism Spectrum Disorder (ASD) frequently experience difficulties in fine motor development that may affect daily functioning and participation in structured activities. Virtual reality (VR) has emerged as a promising tool in pediatric rehabilitation; however, comparative evidence from multi-session studies remains limited in children with ASD. This study aimed to compare the effects of a multi-session haptic-enabled VR intervention and a traditional rehabilitation approach on task completion time, figure replication accuracy, attention, and frustration tolerance in children with ASD level 1. METHODS: Eight children diagnosed with ASD level 1 participated in the study and were divided into two groups of four participants each. Group A performed fine motor rehabilitation tasks in a haptic-enabled VR environment using the Phantom Omni device, whereas Group B performed equivalent tasks using physical geometric figures. Repeated-session data were summarized at the session level and analyzed using linear mixed-effects models including group, session, and the group × session interaction as fixed effects, with participant as a random effect. The intervention consisted of 12 sessions delivered over 6 weeks, at a frequency of 2 sessions per week. Each session lasted approximately 15 minutes. No post-intervention follow-up assessment was conducted. RESULTS: The mixed-effects analysis revealed significant effects of group, session, and the group × session interaction for task completion time, indicating different patterns across sessions between interventions. Post hoc comparisons showed that Group A significantly reduced task completion time from session 1 to session 12, whereas Group B did not show a significant change. For figure replication accuracy, a significant effect of session was found, and Group A showed a significant improvement between the first and last session, while Group B did not. For frustration tolerance, the group × session interaction was significant, and only Group A showed a significant increase from session 1 to session 12. No statistically significant effects were found for attention. CONCLUSIONS: These findings provide preliminary evidence that a haptic-enabled VR condition was associated with more favorable within-task performance than a traditional condition in children with ASD level 1, particularly in task completion time, figure replication accuracy, and frustration tolerance. Because outcomes were measured on the same task used during training, the observed effects should be interpreted as task-specific performance improvements rather than as evidence of generalized fine motor rehabilitation. The results support the potential of interactive multisensory environments as a supportive component of pediatric neurorehabilitation programs, while highlighting the need for future studies incorporating independent standardized motor assessments.

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17. Quinlan E, Emery H. ‘Joining the Dots Across Time’: A Temporal Conceptual Model of Self-Concept Reconstruction Following Late Recognition of Autism. Autism. 2026: 13623613261486062.

Late autism recognition can be an interpretive shift, providing language and coherence for long-standing experiences. Using a temporal self-concept lens, we propose a temporal conceptual model of self-concept reconstruction following late recognition and examine how late-recognised autistic adults, many identifying as AuDHD, describe changes in self-understanding across past, present and future selves. Semi-structured online interviews were conducted with 34 Australian adults (autism-only n = 5; AuDHD n = 29; 25-66 years) who reported recognition after age 18 (diagnosed and/or self-identified). Data were analysed using reflexive thematic analysis. Participants described temporal re-authoring through five interconnected themes: The ‘old story’ involving mismatch, masking/camouflaging and self-blame; Recognition as a framework, providing coherence, language and legitimacy while raising disclosure and stigma considerations; Integration work across time marked by oscillation, reprocessing and grief or anger about missed support; Consolidation through belonging, self-understanding and self-compassion or neutrality; and Future redesign towards authenticity, sustainability, revised possible selves and, for some, advocacy. Findings highlight the non-linear nature of post-recognition self-concept reconstruction and point to neuroaffirming supports that normalise oscillation, address internalised self-blame and historical misattribution, and scaffold meaning-making and identity integration.Lay AbstractMany autistic people are not recognised as autistic until adulthood. When this happens, it can feel like ‘joining the dots’, because it provides language and an explanation for experiences that previously felt confusing or were blamed on personal failure. In this study, we interviewed 34 Australian adults who recognised they were autistic after age 18 (through diagnosis and/or self-identification). Most participants also identified as having attention-deficit/hyperactivity disorder (sometimes called AuDHD). We asked about how recognising autism affected the way they understood themselves across time, including their past, their present and their future. Participants described self-understanding as changing through an ongoing process of ‘re-authoring’ their life story. We developed a temporal conceptual model describing five connected parts of this process. First, participants described an ‘old story’ shaped by chronic mismatch, masking or camouflaging, and self-blame. Second, recognition provided a new framework and vocabulary that helped experiences make sense, while also raising questions about disclosure and stigma. Third, many described an extended period of integration, often non-linear, involving repeated rethinking of past experiences and emotions such as grief or anger about missed support. Fourth, participants described consolidation supported by belonging, increased self-understanding, and sometimes self-compassion or a more neutral view of themselves. Finally, many described redesigning the future around authenticity, sustainability and revised expectations, and some described moving towards advocacy. These findings suggest that post-recognition support should normalise non-linearity and ‘ups and downs’, address internalised self-blame and earlier misattributions, and support meaning-making, self-knowledge and connection to supportive communities where this is desired and safe.

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18. Rosen BF, Sumaria K, Miller CE, Arbuckle C, McNamara T, Callaghan T, Mazhani T, Rowley L, Rivalta-Dallal A, English K, Foulkes E, Julies P. ‘See me Autism’: improving the experience and safety of autistic children in the paediatric emergency department. Arch Dis Child Educ Pract Ed. 2026; 111(5): 199-203.

Implementation of co-produced training and resources can improve the experience and safety of autistic children in a paediatric emergency department.

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19. van THP, Moeijes J, Hartman C, van Busschbach J, Hartman E. Aquatic Interventions to Improve Motor and Social Functioning in Children with ASD: A Systematic Review. Rev J Autism Dev Disord. 2026; 13(3): 751-71.

Children with autism spectrum disorder (ASD) often have motor impairments. A promising strategy to improve motor and social functioning in children with ASD may be an aquatic intervention because of the properties of water. This systematic review investigated the characteristics and effects of aquatic interventions on motor and social skills in children with ASD. Searches in six databases on studies conducted between 2000 and 2023 resulted in 19 intervention studies involving 429 children aged 3 to 17 years with ASD. Best evidence syntheses and meta-analyses were used to evaluate the effects. Aquatic interventions guided by a combination of professionals in influencing behavior and in aquatic skills improved motor and social skills and significantly decreased autistic behavior in children with ASD.

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20. Wang T, Dong X, Jia Y, Tian J, Hou X. Dose-response relationship between exercise interventions and motor skills in children with autism spectrum disorder: a systematic review and multilevel meta-analysis. Eur J Pediatr. 2026; 185(10).

Autism spectrum disorder (ASD) is a significant public health concern, with most ASD children suffering from motor skill impairments. This study aimed to explore the dose-response relationship between exercise interventions and motor skill outcomes in children with ASD, thereby identifying the exercise dose associated with the largest intervention effects. Four databases (PubMed, Web of Science, Embase, and the Cochrane Library) were systematically searched from database inception to April 2026. Experimental studies evaluating the effects of exercise interventions on motor skills in children with ASD were included. The outcomes included overall motor skills, gross motor skills, and fine motor skills. Effect sizes were calculated as Hedges’ g, and multilevel random-effect models were fitted using the metafor package. The multilevel meta-analysis and dose-response analysis were used to assess the dose-response relationship between exercise and motor skills. Moderation analyses were conducted to explore significant influencing covariates. A total of 34 studies from 12 countries were included, involving 1,082 children with ASD within the eligible age range of 3-12 years. Results of three-level meta-analysis showed that exercise interventions significantly improved motor skills in children with ASD (Hedges’ g = 0.95, 95% CI [0.67, 1.23]), including gross motor skills (Hedges’ g = 0.99, 95% CI [0.67, 1.30]) and fine motor skills (Hedges’ g = 0.40, 95% CI [0.14, 0.66]). Dose-response analyses indicated an exploratory dose-response pattern, with the estimated effects reaching their highest values at approximately 46 sessions of 45 min each for overall motor skills and 44 sessions of approximately 47 min each for gross motor skills. Moderator analyses indicated that the time point of the test significantly influenced the effect of exercise on overall motor skills, with the immediate test showing a greater effect size than the delayed test (P = 0.044). No significant moderators were identified for gross motor skills or fine motor skills. CONCLUSION: Exercise significantly improved overall, gross, and fine motor skills in children with ASD. Dose-response relationships were identified for overall and gross motor skills. WHAT IS KNOWN: • Motor impairments are prevalent in children with ASD and represent an important barrier to functional independence and participation. WHAT IS NEW: • This is the first multilevel and dose-response meta-analysis evaluating exercise effects on overall, gross, and fine motor skills in children with ASD. • Dose-response analyses identified exploratory dose-response patterns for overall and gross motor skills, with estimated peak effects at approximately 46 sessions (45 min/session) and 44 sessions (47 min/session), respectively. • Assessment time point moderated effects on overall motor skills, with larger effects observed immediately after intervention than at delayed assessment.

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21. Zuo Y, Geng C, Liang C, Wang X, Gao H, Geng M, Wu X, Huang K, Tao F, Tong J. Association between prenatal trace element and toxic metal exposures and autism spectrum disorder symptoms in children: Potential mediating role of cord serum metabolites. Environ Pollut. 2026; 410: 129176.

Prenatal element exposure has been linked to autism spectrum disorder (ASD) symptoms; however, the mediating role of metabolites remains unclear. Based on the Ma’anshan Birth Cohort, 18 elements were quantified in maternal serum during the first, second, and third trimesters, and averaged concentrations of three trimesters represented the whole pregnancy exposure. Untargeted metabolomics characterized the metabolomic profiles in umbilical cord serum. ASD symptoms at ages 3, 5, and 6 years were evaluated by the Chinese version of the Clancy Autism Behavior Scale and analyzed independently across developmental stages. Analytical strategies encompassed exposure-wide associations, quantile-based g-computation, meet-in-the-middle approach, pathway enrichment, and causal mediation model. At age 3, each log(10)-unit increase in cadmium and magnesium concentrations was associated with 1.29-point (95%CI: 0.09, 2.50) and 4.59-point (95%CI: 0.97, 8.22) increases in ASD symptom scores, respectively, whereas selenium was associated with a 3.41-point decrease (95%CI: -6.00, -0.83). Vanadium and copper were inversely associated with ASD symptom scores at age 5; cadmium was positively associated at age 6; and mercury was inversely associated at ages 3 and 6. Overlapping exposure- and outcome-associated metabolites were identified only at age 5. Alpha-Furyl Methyl Diketone mediated an inverse indirect association between cobalt exposure and ASD symptom scores (indirect effect = -0.24, 95%CI: -0.46, -0.08), whereas 3-Methoxypropylamine showed a positive indirect association between barium exposure and ASD symptom scores (indirect effect = 0.13, 95%CI: 0.03, 0.28). Neither cobalt nor barium exhibited a significant total association; thus, these indirect associations were considered exploratory. These findings indicate element- and age-specific patterns rather than a uniform direction of association, while the indirect associations involving cord serum metabolites require confirmation in independent studies.

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