1. Ábalos Z, Kissine M, Vicente A, Castroviejo E. Conversational Topic Shifts and Topic Maintenance in Autistic and Neurotypical Children. Autism Res;2026 (Feb 18):e70204.

Topic maintenance and topic shifts are crucial components of conversation; however, existing research lacks a clear quantitative operationalization of these topic management skills. Previous studies suggest that autistic children are less likely than their neurotypical peers to maintain and elaborate on the interlocutor’s prior topic, and that they shift topics inappropriately more often. Nevertheless, findings on topic maintenance remain inconclusive, and studies specifically investigating topic shifts are limited. Moreover, little is known about the conversational skills of autistic children from non-English-speaking contexts. We investigated topic maintenance and shifting in 43 autistic and 46 age-matched neurotypical Spanish-speaking children (M = 8.55, SD = 1.91) during a semi-spontaneous conversation task. Given their important role in social interactions, we developed a theoretically grounded protocol for systematically coding topic shifts, supported through a rating task conducted with neurotypical adults. Results showed that although autistic and neurotypical children provided a comparable number of topic-supporting responses, autistic participants produced significantly more topic shifts. Furthermore, autistic children’s topic shifts corresponded to a less natural end of the empirically supported rating scale, indicating such topic shifts interrupted the conversation flow more drastically. These findings suggest that, while autistic children may not have difficulties maintaining a conversation topic, the frequency and nature of their topic shifts could challenge reciprocal conversations. Our study presents a coding scheme that captures relevant distinctions in how different topic shifts are perceived in conversation, serving as a valuable resource for research and clinical practice in assessing and supporting the conversational skills of autistic individuals. This study compared how autistic and neurotypical children maintained and shifted topics during conversation. Autistic and neurotypical children produced a similar number of on‐topic responses, but autistic children made more topic shifts, and their shifts were more drastic. These results suggest that while autistic children are able to maintain a conversation topic, their topic shifts can make their conversations harder to follow. eng

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2. Bamiou DE, Di Bonaventura S, Skuse D. Navigating auditory assessment in autistic individuals: a narrative review. Arch Dis Child;2026 (Feb 19);111(3):229-234.

Abnormal sensory responses have been a diagnostic criterion for autism since 2013, with auditory hypersensitivities representing one of the most frequently reported symptoms. It is not unusual for children with autism, some of whom are as yet undiagnosed, to present clinically to specialists with a history of auditory symptoms in the context of normal hearing. This narrative review paper provides a theoretical background and model to account for autism-associated characteristics that arise within the auditory nervous system. The review highlights the need to assess these symptoms by a multidisciplinary approach. There should be appropriate history taking, followed by psychoacoustic and neurophysiological assessments. We discuss a range of evidence-based management strategies. Affected individuals often present to a range of different clinical settings before their autism is recognised clinically. Nowadays, there is an increasing prevalence of neurodivergence. We emphasise the importance to audiologists and other clinicians that auditory-related symptoms can be the presenting problem in autistic children.

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3. Bergold J, Salisch MV, Voltmer K. Components of Emotion Knowledge in Subtypes of Children with Autism Spectrum Disorders (ASD). Prax Kinderpsychol Kinderpsychiatr;2026 (Feb);75(2):90-108.

Deficits in emotion knowledge can impact children’s social-emotional interactions, which are particularly evident in children with autism spectrum disorders (ASD). However, consistent evidence regarding emotion knowledge and its individual components across ASD subtypes, as defined by ICD-10, remained limited. This study investigates emotion knowledge development – both as a whole and in seven specific components – in children with ASD, categorized by subtype, and compares them with a matched group of children without ASD using nearest neighbor matching based on gender, age, and language background. The sample includes 79 children with ASD (68 boys, 11 girls; ages 5-10): Childhood Autism (n = 33), Atypical Autism (n = 15), and Asperger’s Syndrome (n = 31). Participants completed the Adaptive Test of Emotion Knowledge for Three- to Nine-year-olds (ATEM 3-9). A control group of 152 children without ASD was drawn from the ATEM 3-9 norming sample. Results reveal significant differences in emotion knowledge development across ASD subtypes. Children with Childhood Autism scored significantly lower than children without ASD, whereas children with Asperger’s Syndrome or Atypical Autism showed no significant differences compared to the control group. These findings suggest that emotion knowledge deficits in ASD are subtype specific. Future research should account for these distinctions when examining emotional development in children with ASD.

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4. Binte Mohd Ikhsan SN, Holt R, Ruigrok A, Man J, Parsons T, Gibbs K, Bullock E, Baranger A, Allison C, Doherty M, Ghosh A, Terčon J, Van den Bosch K, Baron-Cohen S. Priorities for change for autistic people across Europe. Mol Autism;2026 (Feb 19);17(1):12.

BACKGROUND: Despite rising rates of autism prevalence, there remains a pressing need to enhance the quality of life for autistic people in Europe and around the world. METHODS: We conducted the 10 Points for Change survey to identify the 10 most important areas that require improvement for autistic people across the region. Data from 1,709 autistic people, parents/carers and members of autism-related organisations residing within the European Union (EU) and the United Kingdom (UK) were analysed, together with autism-related differences (autistic vs. non-autistic; formal vs. no formal autism diagnosis) and gender differences (male vs. female) in results. RESULTS: Across groups, areas that require the most urgent changes are education, public awareness and understanding of autism, employment, and government funding for autism-specific services. Differences in results between groups reflect their specific needs and experiences. Discrimination is a crucial area for change according to autistic people with formal diagnosis of autism, whereas autistic people without formal diagnosis indicate diagnostic services as a priority for change. According to parents/carers and members of autism-related organisations, changes are also needed to improve social inclusion of autistic people. Other areas of priority for change across all groups include mental healthcare (within top 10 for autistic participants and parents/carers), support with daily living, and post-diagnostic services (the latter two within top 10 for parents/carers and members of autism-related organisations). For some areas, their identification and importance as priorities for change significantly varied with whether participants were autistic or formally diagnosed and autistic participants’ gender. Comparisons across countries with the greatest representation in the survey – Germany, the UK, France, Spain and Poland – revealed consistent priorities. LIMITATIONS: Consideration should be given to issues related to methodology and data availability such as how representative the sample is of countries across the EU and the UK. Autistic people with high support needs might have also been unable to participate directly and responses from carers representing them might not fully reflect their views or provide representative data. CONCLUSION: Change through concerted legislative actions within and across countries in Europe is needed to address the priority areas for change for autistic people. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13229-026-00706-3.

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5. Calderai-González G, Aguilera-Rubio Á, Mallo-López A, Carratalá-Tejada M, Alcaide-Márquez M, Cuesta-Gómez A. Relationship between motor skills and receptive language in children with autism spectrum disorder. Hum Mov Sci;2026 (Feb 17);106:103466.

BACKGROUND: Motor impairments are increasingly recognized as a core component of the functional profile in Autism Spectrum Disorder (ASD), with potential associations for communication development. OBJECTIVE: This study aimed to explore the relationship between gross and fine motor skills and receptive communication in children with ASD. METHODS: A cross-sectional observational study was conducted with 21 children aged 3 to 6 years diagnosed with ASD. Motor abilities were assessed using the Peabody Developmental Motor Scales, Second Edition (PDMS-2), and receptive communication was evaluated through the Battelle Developmental Inventory (BDI). RESULTS: Strong, positive, and statistically significant correlations (p < 0.001) were observed between receptive communication and all motor variables, with the strongest association found with gross motor skills (r = 0.85). Although correlations were generally stronger in females, no statistically significant sex differences were detected. Additionally, intercorrelations among the PDMS-2 subtests were consistently high (r ≥ 0,63). CONCLUSIONS: Findings reveal significant associations between motor skills and receptive communication in children with ASD.

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6. Cremone-Caira A, Schnur G, Surmacz M, Faja S. Reduced delay-based executive function in autistic toddlers and preschoolers. Autism;2026 (Feb 18):13623613261418541.

« Hot » or reward-based executive function describes the regulatory skills needed to suppress or delay actions in emotionally salient contexts. These delay-based executive function skills impact social development, mental health, and academic achievement. Accumulating evidence indicates that autistic children (3 years or older) show reduced delay-based executive function relative to neurotypical counterparts. The primary aim of this study was to determine whether these findings extend to younger children (younger than 3 years). Our secondary aim was to determine whether the strategies employed during delay-based executive function tasks differed between autistic and neurotypical toddlers, to understand why autistic children often experience difficulty in this domain. A behavioral battery was administered to measure delay-based executive function in autistic and neurotypical children, aged 2 and 4 years. Consistent with evidence in older children, delay-based executive function was reduced in autistic toddlers. Autistic 2-year-olds waited less during tasks that utilized food rewards, whereas autistic 4-year-olds waited less during tasks using both food- and non-food-based incentives. Autistic children also used significantly less adaptive strategies during tasks. These results are the first to indicate diagnostic differences in delay-based executive function among children as young as 2 years and may inform interventions that target these skills to improve related developmental outcomes.Lay Abstract »Hot » executive function involves the ability to control actions when emotions are involved. For example, a situation when an individual must resist a temptation requires hot executive function. These skills are important for social growth, mental health, and doing well in school. Research shows that autistic children over 3 years of age are less likely to use these skills compared to other children. This study examined whether autistic children under 3 years of age show similar difficulties. We also examined whether autistic children use different strategies than neurotypical children. To find out, we asked both autistic and neurotypical children, ages 2 and 4 years, to complete tasks that required them to delay their responses. The study found that, like older autistic children, younger autistic children also delayed their responses less than neurotypical children. Autistic 2-year-olds waited less for rewards, like food, compared to their neurotypical peers. Similarly, autistic 4-year-olds waited less for both food and other types of rewards, compared to their neurotypical peers. Relative to their neurotypical peers, autistic children also used fewer effective strategies during these tasks. These findings suggest that even very young autistic children have differences in impulse control, which might help in creating better support and interventions for them.

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7. Dayley EE, Durham S, Palumbo MC, Lundell JF, Freeman SM. Oxytocin receptor gene expression in the basal forebrain in autism: association with receptor binding levels and single nucleotide polymorphisms. J Neurodev Disord;2026 (Feb 19)

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8. De Giacomo A, Palmieri R, Russo EF, Pizzolorusso I, Brandi R, Magistro F, Di Cesare MG, Quattrocelli S, Cardone D, Perpetuini D, Merla A. Machine learning and deep learning applied to EEG and fNIRS for early autism spectrum disorder diagnosis: a systematic review. Front Psychiatry;2026;17:1668914.

INTRODUCTION: Autism Spectrum Disorder (ASD) presents considerable diagnostic challenges due to its heterogeneous nature and early developmental onset. In recent years, the convergence of noninvasive neuroimaging modalities such as Electroencephalography (EEG) and Functional Near Infrared Spectroscopy (fNIRS) with machine learning (ML) and deep learning (DL) techniques has opened new avenues for uncovering objective biomarkers of ASD. EEG offers millisecond level resolution of brain electrical activity, while fNIRS tracks hemodynamic responses tied to neuronal function, making the two methods complementary. This review aims to investigate the state of the art of the applications of EEG and fNIRS to ASD patients combined with ML and DL approaches. METHODS: To this goal, Scopus and PubMed databases were searched, and following the PRISMA guidelines, 27 peer reviewed studies published between 2019 and 2024 were included in the survey. RESULTS: The results showed consistent patterns across the studies, including alterations in neural oscillations and disruptions in connectivity within key brain regions related to social communication and cognition. However, a strong heterogeneity was assessed regarding probes montages, preprocessing workflows, and classification models employed, limiting the feasibility of a metanalysis. DISCUSSION: The results demonstrated the potential of DL and ML algorithms applied to EEG and fNIRS signals for early ASD assessment, supporting the development of personalized intervention strategies grounded in robust neurophysiological evidence.

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9. Estrada JAG, Cesare N, Barger K, Sisson EQ, Cole MB, Holmes LG, Parker SE, Higgins A, Ncube CN, Rosenberg SB, Scott A, Rao SR, Werler M, Rubenstein E. Fertility Rates Among Women With Intellectual and Developmental Disability Enrolled in Medicaid and/or Medicare, 2011-2022. Paediatr Perinat Epidemiol;2026 (Feb 19)

BACKGROUND: Women with intellectual and developmental disability (IDD), including those with autism and/or intellectual disability, have historically been sterilised and institutionalised to limit their reproductive rights. As sterilisation laws have been repealed and protections against institutionalisation enacted, stigma persists but may be changing over time. OBJECTIVES: Our objective was to describe fertility rates among women with identified IDD (defined using ICD codes for intellectual disability or autism) using 11 years of data of all women aged 18-45 and enrolled in Medicaid and/or Medicare. METHODS: We identified a cohort of women with IDD enrolled in Medicaid and/or Medicare between January 2011 and December 2022. International Classification of Diseases (ICD) 9 and 10 codes were used to identify pregnancies and IDD diagnoses. We calculated general fertility rate (GFR), age-specific fertility rate (ASFR) and total fertility rate (TFR) and corresponding 95% confidence intervals (CI) for each year. RESULTS: From 2011 to 2022, we observed 50,562 livebirths among 33,457 women. There were 38,983 births to women with intellectual disability, 9360 with autism, and 2219 with autism and co-occurring intellectual disability. There were 1403 pregnancies to women with cerebral palsy and autism or intellectual disability. GFR in women with IDD was relatively stable over the years, from 9.3 per 1000 (95% CI 9.0, 9.6) in 2011 to 9.9 per 1000 (95% CI 9.6, 10.2) in 2022. ASFR for both women with autism-only and women with an intellectual disability-only was highest at 21-25 years. Total fertility rates were slightly higher for those with autism-only (ranging from 0.22 to 0.40 across years) than for women with intellectual disability-only (ranging from 0.25 to 0.27). Data also reveal that fertility rates for women with IDD have increased in most states. CONCLUSION: Trends in fertility rates among women with IDD were consistent over time. Incremental increase in fertility rates were observed among women with autism. Results warrant the need to further examine factors related to access, quality and continuity of care among women with IDD.

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10. Gandam UK, Kumar AK, Annamaneni S. Amino acid disruptions in autism spectrum disorder: from etiology to therapeutic avenues. Nutr Neurosci;2026 (Feb 19):1-13.

Autism Spectrum Disorder (ASD) is a significant health concern in children globally due to its increasing prevalence, complex phenotype manifesting in a range of neuro-developmental disabilities which persist lifelong. As early intervention is linked to improved outcomes and better quality of life in ASD patients, the lack of specific screening and diagnostic criteria is an important concern. Since the discovery of autism in 1943, extensive molecular profiling studies at genomic, transcriptomic, proteomic and metabolomic levels have been conducted but failed to establish or define an ASD signature. Emerging studies emphasizes the implication of metabolic disruption in autism. Hence, the current review focuses on the meta-analysis of metabolome studies to explore and highlight the biochemical intricacies linked to autism specific phenotype. In particular, the review deals with dysregulations in amino acid pathways involved in the complex physiology of ASD. Systemic exploitation of the metabolic profiles in ASD could not only reveal markers with diagnostic significance but also indicate target-oriented treatment avenues.

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11. Hatzell K, Pfingston B, Sneed L. Sleep problems and the occurrence of dangerous behavior within autistic people: A retrospective community-based sample. Autism;2026 (Feb 18):13623613261417525.

Sleep disturbances affect 50%-80% of autistic individuals and are linked to heightened risk for psychiatric comorbidities and dangerous behaviors, including self-injury, suicidal ideation, and aggression. While previous studies have identified correlational relationships, few have examined whether sleep problems predict dangerous behaviors in large, real-world samples. This study used retrospective clinical data from a behavioral health nonprofit to investigate whether sleep problems predict dangerous behaviors among autistic individuals, accounting for age and adaptive functioning. The sample included 8,375 autistic individuals (mean age = 8.35 years). Sleep problems, dangerous behaviors, and adaptive functioning were measured at intake and every 6 months. Binary logistic regressions assessed whether sleep problems predicted current and historical suicidal ideation, self-injury, and aggression. Results showed that sleep problems significantly increased the odds of a history of suicidal ideation and suicidal ideation at intake (odds ratio = 2.29, 2.46, respectively), a history of self-injury and self-injury at intake (odds ratio = 1.95, 2.20, respectively), and aggression at intake (odds ratio = 1.58), even after adjusting for age, sex, and adaptive functioning. Age and adaptive behavior were also independently associated with dangerous behaviors. These findings underscore the importance of routinely assessing and treating sleep problems in autistic individuals as a potential pathway to reducing dangerous behaviors and improving overall wellbeing.Lay AbstractSleep problems are very common among autistic children and adults, affecting between half and three-quarters of individuals. Poor sleep is linked to higher risks for serious behaviors such as self-injury, suicidal thoughts, and aggression, but it is not well understood whether sleep problems actually predict these behaviors. This study looked at real-world clinical data from over 8,000 autistic individuals, ages 2 to 21, who received services from a large behavioral health organization. We examined whether having sleep problems increased the likelihood of dangerous behaviors, even after taking into account a person’s age, daily living skills, and sex. We found that individuals with sleep problems were more than twice as likely to show self-injury or suicidal thoughts and were also more likely to show aggression. These findings highlight how important it is for providers and families to regularly assess and address sleep difficulties as part of autism care. Improving sleep may be an important step toward reducing the risk of dangerous behaviors and supporting overall wellbeing for autistic individuals and their families.

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12. Hedlund Å. The neurodiversity paradigm and the fundamentals of nursing. Br J Nurs;2026 (Feb 19);35(4):200-204.

In this article, the author argues that the neurodiversity paradigm must be integrated into nursing care. Neurodivergent groups, such as autistic and ADHD people (which this article focuses on), are prevalent worldwide, with diagnoses steadily increasing as societal awareness and understanding continue to grow. Neurodivergent patients may have needs that differ from the majority, making it essential for nurses to provide care that accommodates these differences. To achieve this, the neurodiversity paradigm must first be integrated into the theoretical foundation of nursing. This article offers a new perspective on the human being in nursing and emphasises its importance for clinical practice.

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13. Huang YY, Li CY, Li Y, Fang H, Ke XY. Characteristics and functions of the gut microbiome in monozygotic twins with autism spectrum disorders of varying severity. World J Psychiatry;2026 (Feb 19);16(2):111012.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by pronounced behavioral heterogeneity and individual variability. Growing evidence indicates a strong association between gut microbiota and ASD; however, differences in microbial functions across varying levels of ASD severity remain poorly understood. Monozygotic twins (MZs) provide an appropriate model for examining the influence of nonshared environmental factors in ASD. AIM: To investigate the effects of the gut microbiome in MZs with ASD using 16S ribosomal RNA sequencing. METHODS: Participants were recruited from the Chinese MZs with autism spectrum disorder (MZCo-ASD) cohort and stratified into mild MZCo-ASD and severe MZCo-ASD (MZCo-ASD-H) groups based on their Childhood Autism Rating Scale scores. Fecal samples were collected and analyzed using 16S ribosomal RNA sequencing. RESULTS: Although overall microbial diversity did not differ significantly between the groups, gut microbiota composition was notably altered. At the genus level, Por phyromonas was significantly enriched in the MZCo-ASD-H group. Clusters of Orthologous Groups analysis revealed decreased expression of key genes in the MZCo-ASD-H group, including fructose-1,6-bisphosphatase, membrane-bound lytic murein transglycosylase, PasI (part of the RatAB toxin-antitoxin system), HmoA, and a glycoside hydrolase family 25 domain-containing protein. Kyoto Encyclopedia of Genes and Genomes Orthology analysis showed that msmF (K10118) and msmG (K10119), involved in oligosaccharide transport, were significantly downregulated in the MZCo-ASD-H group, suggesting a reduced microbial capacity for prebiotic carbohydrate utilization. CONCLUSION: Despite similar overall diversity, children with severe ASD exhibited distinct gut microbiota structures and functional impairments. The enrichment of Porphyromonas, along with the reduced expression of genes involved in carbohydrate metabolism and stress responses in the high-severity group, suggests an association between gut microbial dysregulation and ASD severity. These findings provide new insights into microbiota-related mechanisms underlying ASD and highlight potential functional targets for intervention.

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14. Kira A, Pontes RG, Pedroso de Lima AK, Araújo LV, Monteiro CBM, Valenzuela EJ, da Silva VYH, Weingartner JP, de Moraes Í AP, Uribe-Quevedo A, Nunes FLS. MazeOut Adaptive Serious Game: Evaluation of Performance and Usability for Motor Rehabilitation in Individuals with Autism Spectrum Disorder. Games Health J;2026 (Feb 19):2161783×251378518.

OBJECTIVE: To evaluate the effectiveness of MazeOut, an adaptive serious game for motor rehabilitation, in individuals with autism spectrum disorder (ASD), by comparing their performance and usability with that of individuals with typical development (TD) and assessing the impact of adaptive (AG) versus nonadaptive gameplay on task performance. MATERIALS AND METHODS: A mixed-design study with 30 participants (15 ASD, 15 TD), aged 8 to 40 years, had each participant experience both adaptive and nonadaptive interventions in randomized order, allowing within- and between-subject comparisons. Performance was measured using overall scores (based on maze navigation speed and coin collection), and usability was assessed with the System Usability Scale (SUS). Data analysis was conducted using R software, with performance trends evaluated through segmented regression and the Kruskal-Wallis test. RESULTS: The TD group outperformed the ASD group across all conditions (TD median score: 27.54; ASD median score: 23.79, P < 0.001). Notably, participants in both groups achieved significantly better performance when AG was introduced first (ASD: 24.04 vs. 19.1, P < 0.001; TD: 30.2 vs. 24.31, P = 0.005), suggesting that the adaptation facilitates initial task learning. ASD participants reported slightly higher usability (mean SUS = 77.2) than TD participants (74.6), with the highest scores among younger users (81.9). CONCLUSIONS: Adaptive serious games can enhance motor performance, particularly for individuals with ASD. The findings suggest that early exposure to AG may improve task performance. Future studies with larger samples and longer interventions are needed to assess long-term benefits.

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15. Li J, Ke Z, Li X, Zhang B, Liao Y, Mou Y. A systematic review and meta-analysis of the proficiency and variability of mathematical ability in populations with autism spectrum disorder. Nat Hum Behav;2026 (Feb 18)

The fundamental characteristics of math ability in individuals with autism spectrum disorder (ASD), specifically proficiency and variability, remain inadequately understood. Here, in this systematic review and meta-analysis, we addressed this gap by synthesizing evidence on math ability in autistic individuals relative to the non-autistic population. Searches in multiple databases yielded 66 studies. Risk of bias was assessed using an adapted Joanna Briggs Institute checklist. Random-effects meta-analyses used Hedges’ g and natural logarithm of variability ratio (lnVR) as effect sizes. Publication bias was adjusted for using the precision-effect test and precision-effect estimate with standard errors, as well as a three-parameter selection model. Results show that, compared with the non-autistic population, as represented by standardized norms (mean 100, s.d. 15; 3,051 participants) and typically developing (TD) control groups (2,351 participants), individuals with ASD exhibit significantly lower math scores (ASD versus norms: Hedges’ g = -0.360, 95% confidence interval (CI) -0.605 to -0.114; ASD versus TD: Hedges’ g = -0.696, 95% CI -0.947 to -0.445) and greater variability (ASD versus norms: lnVR 0.159, 95% CI 0.102 to 0.216; ASD versus TD: lnVR 0.298, 95% CI 0.199 to 0.396). Group discrepancies were moderated by intelligence, age or their interactions. The math-intelligence relationship in ASD provides a theoretical framework for understanding their mathematical development. In addition, the ASD-TD discrepancy has widened over the past four decades. These findings underscore the need for sustained, individualized mathematical education for ASD and investigation of the developmental trajectories of mathematical skills in ASD. Methodological challenges in the field included potential publication bias and insufficient rigour in sample matching.

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16. Miedes LR, Souza ES, Santos T, Fornel MS, Scapini KB, Sanches IC, Uzam CPP, Aparecido JML, Bernardes N. The effects of aromatherapy in children: a systematic review and a call for research in autism. J Complement Integr Med;2026 (Feb 19)

INTRODUCTION: Aromatherapy, the therapeutic use of essential oils, is a growing complementary practice in pediatric care. This systematic review analyzed the scientific evidence on its application and effects in children, with a secondary aim of exploring its use for children with autism spectrum disorder (ASD). CONTENT: Following the PRISMA guidelines, the screening was carried out in Rayyan by two researchers, with studies from the PubMed, Cochrane Library, BVS Library and Web of Science databases, including only clinical trials. The risk of bias assessment used the Cochrane RoB 2 tool. SUMMARY: Out of 1,089 identified studies, seven randomized controlled trials were included. The literature was predominantly focused on neurotypical children, revealing that acute inhalation of essential oils (mainly lavender and orange) was used for managing anxiety in specific settings, particularly dentistry. Findings showed a trend towards reduced anxiety and pain scores, alongside decreased heart rate. However, significant methodological heterogeneity and small sample sizes were noted. The secondary aim highlighted a pronounced evidence gap: only one small-scale study included children with ASD, which reported no significant benefits of aromatherapy. OUTLOOK: Preliminary evidence suggests potential benefits of aromatherapy for anxiety in neurotypical children within controlled contexts. However, the evidence base is limited and insufficient for robust clinical guidance. A critical scarcity of research exists on aromatherapy for children with ASD, underscoring the need for more rigorous and adequately powered future studies.

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17. Naddaf M. How do autistic people age – and what does it mean for their health?. Nature;2026 (Feb);650(8102):538-540.

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18. Osaki T, Wan Z, Haratani K, Jin Y, Campisi M, Barbie DA, Kamm RD, Sur M. miR126-mediated alteration of vascular integrity in Rett syndrome. Mol Psychiatry;2026 (Feb 18)

Rett syndrome (RTT) is a neurodevelopmental disorder caused by mutations in methyl-CpG binding protein 2 (MeCP2). MeCP2 is a non-cell type-specific DNA binding protein, and its mutation influences not only neural cells but also non-neural cells in the brain, including vasculature-associated endothelial cells. Vascular integrity is crucial for maintaining brain homeostasis, and its alteration may be linked to the pathology of neurodegenerative diseases, but a non-neurogenic effect, such as the relationship between vascular alteration and RTT pathogenesis, has not been shown. Here, we developed a microvascular network model using RTT patient-derived induced pluripotent stem (iPS) cells that carry the MeCP2[R306C] or MeCP2[R168X] mutation to investigate early developmental vascular impact. To expedite endothelial cell differentiation, doxycycline-inducible ETV2 expression vectors were inserted into the AAVS1 locus of RTT patient-derived iPS cells and their isogenic controls by CRISPR/Cas9. With these endothelial cells, we established a disease microvascular network and observed higher permeability in RTT microvascular networks than in isogenic controls, indicating that the barrier function is altered by MeCP2 mutation. Furthermore, by microRNA profiling and RNAseq, we found that hyperpermeability is associated with up-regulation of miR126-3p in RTT patient-derived endothelial cells and can be rescued by restoring miR126-3p levels. Overall, our findings point to miR126-3p-mediated vascular impairment in RTT patients and suggest potential therapeutic approaches for restoring function.

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19. Pennewitt D, Borgen A, Warfle M, Fish A, Mohiuddin S, Munzer T. How are School-aged Children With Autism Spectrum Disorder Using Digital Media? A Qualitative Study of Families’ Lived Experiences. J Dev Behav Pediatr;2026 (Feb 19)

OBJECTIVE: Children with autism may be more likely to experience challenges and adverse effects from digital media use; however, prior work has not qualitatively examined children’s and caregivers’ experiences. Among caregivers and school-age children with autism, we aim to qualitatively examine the context, content, and function of digital media use, behavioral strategies, and challenges navigating digital media. METHODS: Caregivers of school-aged children with autism (aged 6-11 years) completed questionnaires on demographic information, child characteristics, and digital media habits. A total of 22 caregivers and 10 children with autism participated in qualitative interviews by Zoom. Questions probed for family experiences, challenges, and digital media strategies. A multidisciplinary team used interview transcripts to conduct an inductive thematic analysis. RESULTS: Children with autism in the study had an average of 4.3 hours of screen media use daily; 68.2% had their own tablet and 27.3% had their own mobile device. We identified 7 themes: Wired World (children are exposed to digital media across settings), Diving Deep and Building Skills (children use media to learn and delve into interests), Retreat/Relief from Reality (digital media is less stressful than other tasks), No Size Fits All (caregivers used diverse strategies), Societal Blame and Parental Shame (caregivers expressed internalized guilt around children’s media use), The Digital Dark Side (concerns about inappropriate content and privacy), and The Double Edged Sword (digital media comes with both benefits and challenges). CONCLUSION: Results from this study emphasize the need for individualized guidance, flexibility, and understanding of digital media’s functional role in families of children with autism.

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20. Salmon F, Letouzey M, Marchand-Martin L, Torchin H, Benhammou V, Monique K, Pierrat V, Foix-L’Helias L, Ancel PY, Lorthe E, Kayem G. Histological chorioamnionitis and neurodevelopment at 5 years of age among infants born very preterm: EPIPAGE-2 cohort study. Arch Dis Child Fetal Neonatal Ed;2026 (Feb 19);111(2):F147-f154.

OBJECTIVE: To assess the association between histological chorioamnionitis without maternal clinical symptoms and neurodevelopmental disabilities at age 5 years in children born very preterm. DESIGN: French national prospective population-based cohort study, EPIPAGE-2 (Etude épidémiologique sur les petits âges gestationnels). SETTING: All births from 22 to 34 weeks of gestational age in France in 2011 were eligible. POPULATION: Infants born alive between 24(+0) and 31(+6) weeks following preterm labour (PTL) or preterm premature rupture of membranes (PPROMs). EXPOSURE: Histological chorioamnionitis without maternal clinical symptoms, also called isolated histological chorioamnionitis, was defined as the presence of neutrophils in the chorionic plate, excluding clinical chorioamnionitis. MAIN OUTCOME MEASURES: Neurodevelopmental disabilities, a composite outcome including cerebral palsy, developmental coordination disorders, sensory impairment, developmental cognitive deficiencies or behavioural difficulties. These assessments were comprehensive, standardised and conducted by trained neuropsychologists and paediatricians at age 5 years. RESULTS: Among 1296 children alive at 5 years of age, 486 (36.3%) were born in a context of isolated histological chorioamnionitis. Overall, 47% vs 33.6% of children exposed and not exposed to isolated histological chorioamnionitis had mild neurodevelopmental disabilities, and 13.8% vs 13.3% had moderate-to-severe neurodevelopmental disabilities. After multiple imputation and multivariable analysis, isolated histological chorioamnionitis was found not to be associated with the occurrence of mild or moderate-to-severe neurodevelopmental disabilities (adjusted OR: 1.0, 95% CI: 0.7 to 1.4 and 0.9, 0.6 to 1.2). CONCLUSION: We did not find any association between isolated histological chorioamnionitis and neurodevelopmental disabilities at age 5 years in children born very preterm after PTL or PPROM.

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21. Simpson K, Allen C, Wheeley E, Pellicano E, Heyworth M, den Houting J, Bowen R, Adams D. Supporting a ‘good life’ for autistic children: Autistic adults’ and parents’ perspectives. Autism;2026 (Feb 18):13623613261418945.

There has been limited research into what helps to promote autistic children’s quality of life. This qualitative study, co-produced with autistic people, aimed to identify, from multiple perspectives, what helps autistic children to live a ‘good life’. We conducted semi-structured interviews with autistic adults (n = 28) and parents of autistic children (n = 29). Using reflexive thematic analysis, we identified four themes: Being accepted by others in a way that allows the child to be themselves; Finding ‘the things that light [the child]’; Having a sense of control over their own life and Physical/sensory environments matter. All themes were common to both autistic adults and parents of autistic children, with the exception of one sub-theme, which was predominantly driven by autistic adults’ responses. These findings highlight potential pathways to support autistic children’s quality of life now and into the future.Lay AbstractThere hasn’t been much research about what helps autistic children to live a ‘good life’ or to have a good quality of life. This makes it difficult to know how to help autistic children to do so. In this study, we asked autistic adults and parents of autistic children what they thought helped autistic children to live a ‘good life’. They mentioned four important areas. These were (a) autistic children being accepted as their real or true self, (b) autistic children finding the things that they enjoy and that energise them, (c) autistic children having a sense of control in their life and (d) physical environments that suit autistic children’s sensory needs. These are things that can be changed in the autistic child’s environment to support the autistic child in living a good life.

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22. Suleman S, Parmar P, Adams DK, Newbube C, Rajamohan S, John C, Juando-Prats C. Feasibility of a co-designed intervention to promote parental empowerment for children with developmental disabilities. Acad Pediatr;2026 (Feb 19):103255.

BACKGROUND: Caregivers of children with developmental disabilities, particularly those socially or economically marginalized, report high stress, decreased empowerment and difficulties navigating resources and programs. OBJECTIVE: This feasibility study co-designed and tested the demand, acceptability and implementation of a pilot intervention to increase social support, promote parental empowerment and increase access to care with families. METHODS: This study utilized principles of community based participatory research and human centered design. In partnership with two community organizations, a caregiver advisory council met for multiple co-creation sessions, and developed the pilot intervention. Participant attendance, pre- and post- surveys to measure satisfaction and knowledge uptake, and semi-structured interviews with participants were used to determine implementation, demand, and acceptability. RESULTS: 11 caregivers joined the advisory council and participated in 7 co-creation sessions. A three-pronged intervention was developed (Figure 2): a phone-based chat group; a toolkit and an accompanying workshop. 55 participants participated in the intervention at both partner sites. Parents and community service workers both reported feeling empowered to navigate services after participating in the workshop and utilizing the toolkit. The group chat was infrequently used but was felt to be a helpful tool to share additional resources and discuss specific topics. CONCLUSION: A three-part intervention co-developed with parents to improve access to services, increase social support and promote empowerment was implemented successfully, with high acceptability and demand. Our study demonstrates the critical importance of working alongside communities to co-create interventions to best serve the specific community needs.

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23. Van der Burg E, Jertberg RM, Geurts HM, Chakrabarti B, Begeer S. Finding the forest in the trees: Using machine learning and online cognitive and perceptual measures to predict adult autism diagnosis. Transl Psychiatry;2026 (Feb 19)

Traditional subjective measures are limited in the insight they provide into underlying behavioral differences associated with autism and, accordingly, their ability to predict diagnosis. Performance-based measures offer an attractive alternative, being designed to capture neuropsychological constructs more directly and objectively. However, due to the heterogeneity of autism, differences in any one specific neuropsychological domain are inconsistently detected. Meanwhile, protracted wait times for diagnostic interviews delay access to care, highlighting the importance of developing better methods for identifying individuals likely to be autistic and understanding the associated behavioral differences. We administered a battery of online tasks measuring multisensory perception, emotion recognition, and executive function to a large group of autistic and non-autistic adults. We then used machine learning to classify participants and reveal which factors from the resulting dataset were most predictive of diagnosis. Not only were these measures able to predict autism in a late-diagnosed population known to be particularly difficult to identify, their combination with the most popular screening questionnaire enhanced its predictive accuracy (reaching 92% together). This indicates that performance-based measures may be a promising means of predicting autism, providing complementary information to existing screening questionnaires. Many variables in which significant group differences were not detected had predictive value in combination, suggesting complex latent relationships associated with autism. Machine learning’s ability to harness these connections and pinpoint the most crucial features for prediction could allow optimization of a screening tool that offers a unique marriage of predictive accuracy and accessibility.

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24. Vlaisavljevic M, Mandic Maravic V, Grujicic R, Lestarevic S, Vasic J, Pejovic-Milovancevic M. Evaluation of the quality of life and stress levels of parents/caregivers of adolescents and young adults with autism spectrum disorder in Serbia. Front Psychiatry;2026;17:1750044.

BACKGROUND: Families of individuals with autism spectrum disorder (ASD) may experience higher levels of stress and lower quality of life (QoL), taking into account their complex needs and daily challenges, especially when faced with discrimination and unavailable support services. This study aimed to examine the QoL and stress levels of parents/caregivers of adolescents and young adults aged 15-30 years and determine the relationship with support systems in Serbia. SUBJECTS AND METHODS: The study included 74 parents/caregivers of adolescents and young adults with ASD. The subjects were recruited from the database of the Institute for Mental Health in Belgrade. We used the following instruments: WHO Quality of Life-BREF, the Parental Stress Scale, and the Caregiver Needs Survey. RESULTS: The obtained results show statistically significant relationships between stress levels and factors such as unavailable services (p=0.036), lack of information (p<0.0005), financial difficulties (p<0.0005), discrimination (p=0.004), and feelings of helplessness (p=0.018) due to the child's ASD diagnosis. A negative correlation is found between all QoL domains and the level of stress, with p<0.0005 for physical health, psychological health, and environment domain and p = 0.001 for the domain of social relationships. CONCLUSION: The obtained data point out to the most significant socio-economic factors and factors within the support system in Serbia that affect the QoL and stress levels of parents/caregivers of youth with ASD. It can be used to create a more specific planning of organizational services, oriented towards the most problematic aspects of care for persons with ASD and their families.

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25. Wu J, Chen X, Zhang J, Wettschurack K, Robinson M, Li W, Zhao Y, Yoo YE, Deming BA, Shu Y, Abeyaratna AD, Que Z, Du D, Tegtmeyer M, Yuan C, Skarnes WC, Zhang ZY, Rochet JC, Wu LJ, Yang Y. Human microglia in brain assembloids display region-specific diversity and respond to hyperexcitable neurons carrying SCN2A mutation. Sci Adv;2026 (Feb 20);12(8):eady2977.

Microglia critically shape neuronal circuit development and function, yet their region-specific properties and roles in distinct circuits of the human brain remain poorly understood. In this study, we generated region-specific brain organoids (cortical, striatal, and midbrain), each integrated with human microglia, to fill this critical gap. Single-cell RNA sequencing uncovered six distinct microglial subtypes exhibiting unique regional signatures, including a subtype highly enriched for the GABA(B) receptor gene within striatal organoids. To investigate the contributions of microglia to neural circuitry, we created microglia-incorporated midbrain-striatal assembloids, modeling a core circuit node for many neuropsychiatric disorders, including autism. Using chemogenetics to activate this midbrain-striatal circuit, we observed increased calcium signaling in microglia involving GABA(B) receptors. Leveraging this model, we examined microglial responses within neural circuits harboring an SCN2A nonsense (C959X) mutation associated with profound autism. Microglia displayed heightened calcium responses to SCN2A mutation-mediated neuronal hyperactivity and engaged in excessive synaptic pruning. These pathological effects were reversed not only by pharmacological inhibition of microglial GABA(B) receptors but also by knockout of the GABBR1 gene in microglia. Collectively, our findings establish an advanced platform that can be used to dissect human neuroimmune interactions in subcortical regions and to evaluate previously undiscovered therapies, highlighting the important role of microglia in shaping critical circuitry related to neuropsychiatric disorders.

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26. Xu Z, Ni Y, Chu M, Yang J, Qin H, Shi L, Wang F. The association between parenting difficulties in children with autism and parental anxiety and the moderating role of parenting stress. Sci Rep;2026 (Feb 19)

This study explores the impact of parenting difficulties in children with autism on parental anxiety, and analyzes the moderating role of parenting stress. A total of 207 primary caregivers of autistic children from 13 rehabilitation institutions in Nantong City were selected as subjects, covering the period from May 2024 to May 2025. Data was collected using the Strengths and Difficulties Questionnaire (SDQ), the Self-Rating Anxiety Scale (SAS), and the Chinese version of the Parenting Stress Index-Short Form (PSI-SF). The hypothesized model was tested through correlation analysis and hierarchical regression analysis. The parenting difficulties of children with autism were significantly positively correlated with the level of parental anxiety (r = 0.56, p < 0.01), and the parental anxiety level increased by 1.08 points for each increase of 1 point (β = 0.56, p < 0.001), which verified the direct predictive effect of parenting difficulties on parental anxiety. Parenting stress had a significant moderating effect on the relationship between the two (interaction term β = 0.13, p < 0.05), and the predictive effect of parenting difficulties on anxiety in the high parenting stress group (β = 1.33) was significantly higher than that in the low stress group (β = 0.77). The parenting stress factors in parenting stress had a significant moderating effect on the relationship between the two (interaction term β = 0.58, p < 0.05), and the predictive effect of parenting difficulties on anxiety in the high parenting stress group (β = 6.58) was significantly higher than that in the low stress group (β = 5.76). Parental anxiety was generally at an upper middle level (M = 51.14), while parenting stress (M = 2.34/5) and parenting difficulties (M = 0.80/2) were at a lower middle level, suggesting that the cumulative effect of stress perception may exacerbate psychological risk. Parenting difficulties in children with autism can positively predict parental anxiety; parenting stress plays a significant moderating role between parenting difficulties and parental anxiety, with greater parenting stress amplifying the impact of parenting difficulties in children with autism on parental anxiety levels.

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27. Zarokanellou V, Gryparis A, Papatheodorou P, Tatsis G, Tafiadis D, Papadopoulos A, Voniati L, Siafaka V. Correction: Societal Attitudes Towards Autism (SATA): Validation of the Greek Version in the General Population. J Autism Dev Disord;2026 (Feb 18)

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28. Zhang Y, Ofori E, Chen K, Harker SA, Velez M, Gallegos S, Grabeel K, Johnson F, Baxter L, Woodruff B, Braden BB. Association of glymphatic dysfunction, free water, white matter integrity and long-term memory performance in aging autistic adults. Mol Autism;2026 (Feb 18);17(1):10.

BACKGROUND: Autistic adults are at elevated risk of accelerated cognitive aging and Alzheimer’s disease and related dementias (ADRD), yet the underlying neurobiological mechanisms remain poorly understood. Dysfunction in the glymphatic system—a brain-wide network responsible for clearing waste via interstitial fluid flow—may contribute to this vulnerability by promoting extracellular free water (FW) accumulation and white matter (WM) degeneration. METHODS: A total of 113 autistic and 90 age- and sex-matched neurotypical (NT) adults (aged 18–71 years) underwent multimodal MRI scanning and episodic memory assessments. Diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, alongside FW maps, and fractional anisotropy (FA) maps were computed for each participant. Group comparisons, correlations, and mediation analyses were performed. RESULTS: Autistic adults showed significantly lower DTI-ALPS values, higher fornix FW, lower fornix FA, and poorer episodic memory scores compared to NT adults. Age-related hippocampal FW accumulation was more pronounced in autistic adults. Mediation analyses revealed that fornix FW mediated the relationship between DTI-ALPS and both fornix FA and hippocampal FW. Long-term episodic memory scores correlated with fornix FA, as well as whole-brain gray matter FW and WM FA in autistic adults. LIMITATIONS: The cross-sectional design precludes causal inference regarding glymphatic function, free water accumulation, WM integrity, and cognition. In addition, our sample was not evenly balanced by sex and excluded individuals with co-occurring intellectual disability, which may limit generalizability to the broader autistic population. CONCLUSIONS: Our results suggest that glymphatic dysfunction and FW accumulation may contribute to aberrant WM microstructure and episodic memory challenges in autistic adults across a broad age range. These findings point to potential biomarkers for identifying and intervening in the cognitive aging process in autism.

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29. Zhang Y, Wang JJ, Xing HY, Yan J. Neurofeedback for autism spectrum disorder: Current evidence, challenges, and future directions. World J Psychiatry;2026 (Feb 19);16(2):114358.

Neurofeedback therapy (NFT) has emerged as a promising noninvasive intervention for autism spectrum disorder (ASD), targeting core symptoms such as social communication deficits and emotional dysregulation. This editorial synthesizes findings from recent studies, including Wang et al’s retrospective analysis (2025), which reported improvements in Social Responsiveness Scale and Aberrant Behavior Checklist scores following NFT combined with conventional therapy. Mechanistically, NFT may modulate prefrontal gamma-band activity, enhances neuroplasticity in social brain networks (e.g., default mode network, a brain network involved in social cognition), and optimizes cognitive processing via event-related potential changes (e.g., shortened P300 latency). Emerging trends include hybrid approaches (e.g., NFT with repetitive transcranial magnetic stimulation and artificial intelligence-driven protocols). However, challenges persist in protocol standardization, long-term efficacy validation, and biomarker identification. Future research must prioritize large-scale randomized trials, neuromarker discovery, and individualized protocols to establish NFT as a viable component of precision psychiatry for ASD.

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