1. Dahake U, Deotale S, Mandavgane S, Sharma S, Bang A, Solanki R, Kumar A. Feasibility of millet-based gluten free and casein free diet in children with autism spectrum disorders: A 12-week pilot study in India. Nutr Health. 2026: 2601060261489302.

BackgroundAutism spectrum disorder (ASD) is often associated with selective eating, nutritional deficiencies, and gastrointestinal (GI) disturbances. Gluten-free, casein-free (GFCF) diets are popular but inconsistently supported by evidence. Millets, naturally gluten and casein-free, are nutrient-dense traditional grains that may offer a culturally relevant alternative.AimTo assess the feasibility, acceptability, adherence, and nutritional impact of a millet-based GFCF dietary intervention in children with ASD.MethodsA 12-week single-arm pilot study enrolled children aged 4 to 6 years with confirmed ASD. A millet flour blend (foxtail, little, pearl millet) was developed into three recipes: Foxtail Millet Upma, Little Millet Biscuits, and Pearl Millet Nachos. Pre and postintervention dietary intake was measured using 3-day recalls. Sensory acceptability was rated on a nine-point hedonic scale; adherence was tracked through caregiver logs; and structured interviews explored feasibility.SummaryAll millet-based recipes were well accepted, with Foxtail Millet Upma receiving the highest acceptability scores. Significant improvements were observed in cereal and pulse intake, along with a reduction in fat consumption. Caregivers reported improvements in GI comfort (70%), sleep quality (60%), and reductions in hyperactivity (55%). Adherence to the dietary intervention was high (80%), although challenges related to ingredient availability and preparation time were reported. Millet-based GFCF diets are feasible, acceptable, and nutritionally balanced at the food-group level in children with ASD. Findings highlight their potential as culturally appropriate dietary interventions, warranting larger controlled studies to evaluate long-term outcomes.

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2. Grot-Nigowska M, Kowalski O, Białek-Dratwa A. Dietary Diversity in Children with Autism Spectrum Disorders, Feeding Difficulties, and Sensory Issues Related to Eating-A Case-Control Study. Nutrients. 2026; 18(18).

Background/Objectives: Pediatric feeding disorders are common in children with autism spectrum disorder (ASD) and may result from sensory processing differences, contributing to reduced dietary diversity and increasing the risk of nutritional deficiencies or excessive body weight. This study assessed whether children with ASD exhibit lower dietary diversity than typically developing children. Methods: A clinical case-control study included 181 children aged 2-10 years (ASD: n = 85; controls: n = 96). Children with ASD had a confirmed diagnosis, while controls had no neurodevelopmental disorders. Dietary diversity was assessed using the Dietary Diversity Score (DDS), based on a 24 h dietary recall completed by parents or legal guardians. Foods were classified into nine food groups. DDS was categorized as low (≤4 groups), moderate (5-6), or high (≥7). Results: Mean total DDS was comparable between groups (ASD: 6; controls: 5). Children with ASD consumed legumes and oilseeds more frequently, whereas controls consumed dark green leafy vegetables more often. Low DDS was more prevalent in the ASD group (32.9% vs. 15.6%), while moderate DDS predominated in controls (64.6% vs. 32.9%). High DDS was also more common in children with ASD (34.1% vs. 19.8%), indicating substantial heterogeneity in dietary patterns. Dietary diversity was significantly associated with sensory characteristics, particularly acceptance of food texture and temperature. Conclusions: The study results indicate a heterogeneous nature of dietary diversity among children with ASD, without confirming a generally reduced level. After adjusting for age, sex, and BMI, ASD group membership was associated with DDS scores. Individual and sensory-related dietary factors should be taken into account when addressing nutritional needs.

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3. Hao D, Mansi H, Elkefi S. Extended reality (XR) interventions in supporting children with autism: A systematic review. Int J Med Inform. 2026; 222: 106719.

OBJECTIVE: This study aims to synthesize the evidence on the role of extended reality (XR) in supporting children with autism. METHODS: We followed PRISMA guidelines. We searched PubMed, IEEE Xplore, Web of Science, and ProQuest Central for studies published between 2005 and March 2026. A total of 21,979 records were retrieved from the literature search, and 115 studies met the inclusion criteria. RESULTS: There was a significant increase in XR autism research after 2020, with virtual reality (VR) as the largest modality (n = 61, 53.0%), followed by augmented reality (AR) (n = 36, 31.3%). Hybrid systems were the most common functional category (n = 49, 42.6%), followed by training and educational systems (n = 29, 25.2%), therapy and rehabilitation systems (n = 20, 17.4%), assessment systems (n = 13, 11.3%), and. Mobile or tablet-based delivery, avatar-based interaction, motion tracking, AI integration, and physiological sensing were most frequently reported technical characteristics. Most studies reported positive outcomes related to engagement, social communication, emotional recognition, adaptive functioning, and rehabilitation participation. CONCLUSIONS: Overall, this review suggests that although large-scale longitudinal studies are needed to demonstrate longer-term efficacy, scalability, and real-world implementation, XR technologies have significant potential to benefit autistic children in educational, therapeutic/rehabilitative, and assessment.

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4. Ito Y, Akiyama M, Maejima R, Nakayama KI, Furuichi T, Motoyama J. Distinct developmental trajectories of pup ultrasonic vocalizations across ASD mouse models without increased variability. Behav Brain Res. 2026; 516: 116486.

Autism spectrum disorder (ASD) is characterized by impairments in social communication. Pup ultrasonic vocalizations (USVs), a widely used measure of early social communication in mouse models, have yielded inconsistent findings across studies, hindering cross-model comparisons. Here, we systematically compared isolation-induced pup USVs across three ASD mouse models with distinct etiologies: valproic acid (VPA)-treated, Caps2(-/-), and Chd8(+/-) mice. Alterations in call rate were most pronounced at postnatal day 9, corresponding to the developmental peak of USV production, but both the direction and magnitude of these changes differed across models. VPA-treated and Caps2(-/-) mice exhibited shortened call duration and simplified frequency structure, whereas Chd8(+/-) mice showed minimal acoustic alterations. Notably, despite clear differences in mean USV features, within-group variability in call rate and acoustic properties was comparable across all models, including controls. These findings indicate that ASD-related alterations in pup USVs reflect model-specific shifts in developmental trajectories rather than increased inter-individual variability.

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5. Khot A, Lumsden DE. The utility of the term ‘Rett-like’ in relation to Rett syndrome: A systematic review. Dev Med Child Neurol. 2026.

AIM: To determine clinical features and evaluate the clinical utility of the term ‘Rett-like’, which is commonly used to describe individuals who do not meet the clinical criteria for a Rett syndrome (RTT) diagnosis, but exhibit some features in keeping with the diagnosis. METHOD: A systematic review was conducted. Literature searches of Medline, CINAHL, and Embase (January 2010-December 2025) were performed, identifying individuals described as Rett-like, examining the extent to which they met major and minor RTT criteria, clinical features defined, and the linked genetic landscape. RESULTS: In total, 166 individuals were described as Rett-like; these were predominantly female, most with no period of typical development, and a minority experienced regression. Gait abnormalities and hand stereotypies were common; loss of hand skills and speech were not. Minor RTT criteria were uncommon. A wide genetic landscape emerged, encompassing 47 different genes. INTERPRETATION: The term ‘Rett-like’ commonly describes female individuals with developmental disability, typically with no period of regression, with stereotypies, abnormal gait, and seizures. The genetic landscape encompassing this disorder is broad. Clinical utility of this term is limited, with little to no evidence of diagnostic or prognostic use of ‘Rett-like’.

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6. Kim Y, Choe I, Kim Y, Tabrizi M, Kim YS, Ioanitoaia-Chaudhry I, Chong MT, Namkung H, Kwak I, Yoo JW. Rural Obesity Counseling for Adults Living With Intellectual and Developmental Disabilities Under the Medicaid Program. AJPM Focus. 2026; 5(6): 100530.

INTRODUCTION: This study aims to compare the efficiency and outcomes in adults with obesity and intellectual and developmental disabilities in rural areas. METHODS: Utilizing the administrative database of the rural health system and Nevada Medicaid (January 1, 2022 and December 31, 2024), 257 adults with obesity and with or without intellectual and developmental disabilities were identified. A propensity score was applied to match demographics and comorbidity conditions between subjects with and without intellectual and developmental disabilities. Logistic regression analysis was used to identify the factors associated with behavioral counseling for obesity. RESULTS: Those with intellectual and developmental disabilities were less likely to have behavioral counseling for obesity than the non-intellectual and developmental disability cohort (16.9% vs 30.7%; OR=0.55; 95% CI=0.24, 0.89; p=0.03). Being aged 45-64 years, being female, having mental health conditions, and being telehealth users were associated with higher probabilities of receiving behavioral counseling for obesity. CONCLUSIONS: Primary care workforce training is warranted to reduce health disparities by integrating behavioral counseling for obesity among those with special care needs as well as those with limited access to care.

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7. Mudawarima L, Santos N, Chimhini GL, Mujuru HA, Magonya R, Ghosh R, Martin-Herz SP. Validation of neurodevelopmental assessments for early detection of high-risk infants in Zimbabwe: protocol for the Child Development Observation study (ChiDO study). BMJ Paediatr Open. 2026; 10(1).

INTRODUCTION: Appropriate neurodevelopmental assessment tools are often unavailable in low- and middle-income countries (LMICs) due to lack of validation, cost and cultural-linguistic challenges. This reduces the availability of high-quality developmental evaluation, resulting in clinical gaps that impact individual child outcomes and modifiable risk detection for prevention. The objective of this study is to validate three neurodevelopmental assessment tools for early detection in low-resource settings through recruitment of infants across the neurodevelopmental impairment (NDI) risk spectrum related to perinatal asphyxia and neonatal encephalopathy (NE). METHODS: This prospective, longitudinal cohort study in Harare, Zimbabwe will collect data at 3 months, 6 months, 12 months, 18 months and 24 months. The sample of approximately 600 caregiver-infant dyads will include: (1) infants without clinical concern for perinatal asphyxia or other complications (low risk); (2) infants who do not cry at birth and require resuscitation but do not have NE (moderate risk) and (3) infants who experience NE (high risk). In addition to demographic, antenatal and perinatal data collected at enrolment, neurodevelopmental assessments to be conducted include the Prechtl General Movement Assessment (GMA); Hammersmith Infant Neurological Examination (HINE); Global Scales for Early Development (GSED); Mullen Scales of Early Learning (MSEL) and caregiver-reported Ages and Stages Questionnaire. At the 24-month visit, a comprehensive diagnostic evaluation for NDI will be conducted adhering to international guidance. Predictive ability of all tools will be assessed by receiver operating characteristic (ROC) analyses, including area under the ROC curve. Construct validity of the GSED will be assessed by comparing to the MSEL. The GSED’s ability to differentiate subgroups defined by correlates of NDI risk will be assessed using generalised estimating equations. ETHICS AND DISSEMINATION: Ethical approvals have been obtained. If shown to be valid, the GMA and HINE could provide earlier, feasible and low-cost detection of children at elevated risk for NDI.

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8. Pandina G, Martin WJ, Chatham C, Murphy D, Myles J, Ring RH, Kalali A. Lessons Learned from Drug Development Programs in Autism: Implications for Future Programs. Innov Clin Neurosci. 2026; 23(4-6): 10-7.

There are no approved drugs for autism core features; the heterogeneous biology, symptom presentation, and clinical outcomes complicate drug trials design, and have hampered therapeutic drug development. We synthesized expert viewpoints from industry and academia on recent diagnostics and biomarker advances as well as pharmacotherapy evidence, aligned to patient-focused drug development outcomes and key concepts. Key learnings include: (i) measure what matters to patients and caregivers; (ii) enrich populations where they can be rationally matched to mechanism; (iii) do not use diagnostic tools as efficacy endpoints; (iv) align biomarker science with a potential qualification pathway associated with relevant behavior and biology; (v) design trials that reduce placebo response, burden, and attrition; (vi) assess co-occurring conditions and treatments explicitly. Observations and recommendations serve as a practical roadmap for sponsors and clinicians to increase trial informativeness and chance of success.

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9. Pelizza L, Picone TF, Leuci E, Quattrone E, Palmisano D, Pupo S, Paulillo G, Pellegrini C, Pellegrini P, Menchetti M. Psychometric properties of the PANSS autism severity score (PAUSS) in young peoples at clinical high risk for psychosis: does it really measure autistic features?. Eur Arch Psychiatry Clin Neurosci. 2026.

The PANSS Autism Severity Score (PAUSS) is a commonly used measure for autistic features in early psychosis, including in adolescents at Clinical High Risk (CHR). However, no research examining its psychometric properties in this at-risk population has been published to date. Therefore, we explored reliability, validity, and longitudinal course of PAUSS scores in a sample of young CHR individuals treated in an early intervention service in Italy during 2 years of follow-up. Participants completed the Autism-spectrum Quotient (AQ) and the Positive And Negative Syndrome Scale (PANSS) at baseline and annually during the follow-up. Cronbach’s α statistics were used for internal consistency, while Cohen’s k statistics and Spearman’s correlation coefficients (ρ) were used for convergent validity with AQ scores and longitudinal stability. In the 214 recruited CHR participants, Cronbach’s value was 0.849, but the PANSS G5 item showed unacceptable inter-item and item-total correlations. Furthermore, Cohen’s k value in relation to AQ scores was unacceptable (0.022), as were ρ (< 0.750) and k (< 0.600) values for longitudinal stability. The results of this research suggest that the PAUSS may not be a valid tool for assessing autistic characteristics in CHR individuals. In fact, it may detect attenuated psychotic symptoms and their transient psychopathological severity, rather than being a reliable indicator of autistic features. Alternatively, its poor discriminatory ability could also reflect contamination of autism measurement by concurrent psychopathology. Therefore, it should never replace careful clinical judgment and the use of appropriate instruments for the diagnosis of ASD.

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10. Russell LA, Williams S, Shaw KA, Dirienzo M, Pas ET, Bakian AV, Howerton EM, Bilder DA, Esler A, Hallas L, Ladd-Acosta CM, Maenner MJ, Tinker SC, Fitzgerald RT, Olivarez AJ, 3rd, Solis A, DaWalt L, Durkin MS, Lopez M, Hall-Lande J, Zahorodny W, Wu YC, Shenouda J, Schwenk YD, McArthur D, Washington A, Hudson AE, Bustamante LG, Mitamura M, Skowyra C, Patrick ME. Co-occurring Conditions and Education Services Among Transition-Age Adolescents With Autism. Pediatr Open Sci. 2026; 2(2).

OBJECTIVES: This study describes sociodemographic characteristics, co-occurring mental and behavioral health conditions, services provided in individualized education programs (IEPs), and transition planning goals for adolescents with autism spectrum disorder (ASD) in a population-based sample. METHODS: The study included 4311 adolescents aged 16 years in 2022 from the Autism and Developmental Disabilities Monitoring Network. All lived within defined catchment areas in 9 states and had an ASD diagnostic code or special education exceptionality. Health and education records from when the adolescents were aged 12 to 16 years were reviewed. RESULTS: Adolescents with ASD had high prevalence of language delay (51.6%), attention-deficit hyperactivity disorder (51.1%), and anxiety (42.7%). Few adolescents had an IQ or adaptive test in their records (25.5% and 19.1%, respectively). Most adolescents with an IEP had a transition plan in their records (94.8%), and most had the federally-required postsecondary education (95.7%) and employment goals (95.5%), whereas fewer had the optional postsecondary living goal (43.3%). The prevalence of many elements on the IEP and transition plans varied widely by site. The prevalence of some co-occurring mental and behavioral health conditions and use of school services differed by median household income. CONCLUSIONS: Adolescents with ASD have high prevalence of co-occurring mental and behavioral conditions, with limited information on recent IQ and adaptive testing, potentially impacting service needs and receipt. The variability in the prevalence of IEP elements and service provision across different sites highlights the complexities in addressing the diverse transition needs and health outcomes for adolescents with ASD.

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11. Snijder MIJ, Grieve C, Pieters S, Petersen E, Andel M, Ruiter EL, Buitelaar JK, Dietz C, Oosterling IJ. Short-term outcomes and six-month follow-up of BEAR: a blended, pre-emptive intervention for infants and toddlers at elevated likelihood for autism. Eur Child Adolesc Psychiatry. 2026.

To improve access to early interventions for infants and toddlers with a neurodevelopmental vulnerability, the BEAR (Blended E-health for children at eArly Risk) intervention was developed. BEAR is a parent-mediated, blended e-health intervention with the aim to promote parental sensitivity to their child’s needs and to motivate the child to socially engage. The primary hypothesis was that the BEAR intervention would lead to improved joint engagement in parent-child interactions. Secondary hypothesis included improved social-communicative development of the child, enhanced parental skills (e.g., scaffolding, highlighting symbols, following the child’s interest, caregiver affect), lower parental stress, improve parental well-being and overall improvement of parent-child interactions. A cluster randomized controlled trial (cRCT) was conducted to assess short-term and six-month effects. Fifty-five toddlers and their parents were randomized to either the BEAR group (n = 40) or the care-as-usual (CAU) group (n = 15). Results showed no significant treatment effects on the child, a positive treatment effect on the parental skills (scaffolding and affect), and a possible treatment effect on dyadic level (i.e. improved fluency and connectedness in parent-child interaction). The current study provides some support for BEAR as a promising pre-emptive intervention for young children with a neurodevelopmental vulnerability and their parents. Parents seem to benefit primarily from the intervention through the enhancement of their parental skills while direct effects on the child’s behaviors were lacking. Longitudinal assessments are essential to evaluate the long-term impacts of the BEAR intervention and to assess its sustainability over time.

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12. Zhang Y, Chen Y, Sun H, Yan J, Zheng Y, Fu G, Zhang R, Kendrick KM, Jiang X. FL-SEHGT: Federated Learning-Based Heterogeneous Graph Transformer with Squeeze-and-Excitation for ASD Identification. Neural Netw. 2026; 205(Pt C): 109663.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with widespread functional brain changes. Although deep learning has advanced computer-aided diagnosis of ASD using neuroimaging data, three key challenges remain: limited classification accuracy due to inadequate feature extraction, underexplored model interpretability that impedes understanding of the underlying neural mechanisms, and privacy concerns over multi-site data sharing that constrain practical deployment of collaborative diagnostic models. To address these challenges, we propose a federated learning-based squeeze-and-excitation heterogeneous graph transformer (FL-SEHGT) that utilizes resting-state functional MRI (rsfMRI) data to improve diagnostic accuracy relative to the evaluated federated baselines, enhance interpretability, and enable collaborative multi-site training without centralizing raw neuroimaging data. Experimental results on 871 subjects from 17 ABIDE I sites show that FL-SEHGT achieves a mean site accuracy of 63.45% across all 17 sites and 70.54% across the 10 sites with more than 40 subjects each, outperforming graph-augmentation-guided federated knowledge distillation (GAFD) (60.11%, 58.63%) and local-global federated learning (LG-FedAvg) (52.61%, 57.11%) on the corresponding site groups. The 10-site result also surpasses traditional models trained independently at each site (which achieved accuracies of 63.4%, 55.7%, and 60.2%). In a pooled five-fold evaluation, the proposed SEHGT attains an AUC of 71.7%. Altered functional connectivity patterns predominantly involving the default mode, cerebellar, and executive-control networks are identified as candidate neuroimaging features associated with ASD diagnosis. In summary, FL-SEHGT offers an effective, interpretable, and privacy-preserving framework for neuroimaging-based computer-aided diagnosis of ASD.

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