1. Correction to « The Vulnerability Experiences Quotient (VEQ): A Study of Vulnerability, Mental Health and Life Satisfaction in Autistic Adults ». Autism Res. 2026: e70223.

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2. Akbuga E. Preliminary evidence for backward walking to reduce toe walking in autism spectrum disorder: A single-case experimental pilot study. Acta Psychol (Amst). 2026; 265: 106707.

This pilot study investigated whether backward walking (BW) exercises could reduce toe walking behaviors (TWB) in a child with autism spectrum disorder (ASD) and evaluated the utility of pedobarographic measurements to quantify TWB. This prospective single-case pilot study, conducted per SCRIBE guidelines, employed an A-B-A reversal design with 1-week baseline, 9-week intervention, and 1-week monitoring phases. The participant was a 41-month-old girl with ASD who exhibited TWB (pseudonym « Daisy »), and the BTS P-Walk platform was used to measure plantar surface area. Backward walking exercises were implemented on a treadmill five days per week, adapted to developmental characteristics. Data analysis included visual analysis, internal and social validity, and effect size calculations. Results showed gradual increases in plantar surface area bilaterally, suggesting a potential reduction in TWB. Preliminary findings indicated improvements for the right foot during weeks 8-9 (x̄ =42.78-42.82 cm(2) vs. baseline x̄ =33.58 cm(2); p = 0.009, Tau = 1, IRD = 1) the left foot (x̄ =45.22-47.28 cm(2); p ≤ 0.016, Tau≥0.92, IRD ≥ 0.80), with these statistics providing supportive evidence for the observed changes. The monitoring phase indicated that improvements were maintained, albeit attenuated. Pedobarographic measurements may provide a quantitative assessment of TWB. BW exercises appeared to reduce TWB and may benefit motor development in this case. The preliminary findings derived from the single-case design limit generalizability; therefore, larger samples should be tested before making clinical recommendations. Future research should include controlled studies and examine the biomechanical analyses and muscle properties underlying the mechanisms of BW.

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3. Almughyiri S. Perceptions of Saudi parents of students with autism toward the responsibilities of transition plan members in implementing transition plans. PLoS One. 2026; 21(3): e0345501.

OBJECTIVE: This study investigates how Saudi parents of children with autism perceive the roles and responsibilities of school staff and families in implementing transition plans. It looks at how these duties are shared between home and school during the planning phase. METHODS: A cross-sectional, quantitative approach was employed. A total of 469 parents of students with autism from the Riyadh (n = 243) and Makkah (n = 226) regions completed a structured survey. The instrument, developed from validated measures and based on the National Technical Assistance Center on Transition (NTACT) practices, used a 5-point Likert scale. Descriptive and inferential statistics (t-tests and cross-tabulations) were applied to compare perceptions across demographic variables such as gender, education level, and region. RESULTS: Parents viewed schools as more responsible than homes for most transitional skills, especially in areas like self-advocacy, vocational preparation, and study skills. Conversely, daily living and independent living skills were more often considered the family’s responsibility. Perceptions did not significantly differ based on gender, education, or location. CONCLUSION: The results indicate a collaborative responsibility between families and schools, with schools being considered the primary partner in most skill areas. To support smooth transitions for individuals with autism, increased collaboration between educators and families and parent-led training are essential.

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4. Cooper S, Doherty M, Shaw SCK. The experiences of autistic medical students in relation to seeking and receiving online support: A phenomenological study. PLoS One. 2026; 21(3): e0345156.

BACKGROUND: Previous studies have reported that autistic medical students experienced specific challenges throughout their medical studies, including isolation, bullying, and discrimination from their institutions – alongside receiving minimal support. Despite this, it has been argued that many autistic characteristics are well aligned with practising medicine, bringing key benefits to patient care. ‘Autistic Medical Students’ (AMS) is an online international support group, containing over 200 members – a sub-group of Autistic Doctors International. This study aims to explore the experiences of AMS membership and if membership has any wider impacts on medical studies or wellbeing. Within this, it aims to explore the experiences that led to seeking this support. METHODS: This was a qualitative study. Five participants from AMS were recruited. Semi-structured, 1:1 interviews were conducted via Zoom. These were audio recorded, transcribed verbatim, and analysed using interpretive phenomenological analysis. RESULTS: Group experiential themes included: medical culture, belonging, safety, ability to thrive, internalised optimism for the future, and real modelling. Participants experienced systemic ableism and weaponised professionalism, which led to a sense of helplessness for their futures. AMS had a positive impact on participants. They experienced a sense of belonging, alongside an improved ability to both recognise their own needs and implement accommodations. They also felt better able to advocate for support. ‘Real modelling’ from peers and autistic doctors motivated participants in their wider medical studies. Of particular benefit was that AMS uniquely encompassed both being autistic and a medical student, making its specific support invaluable. DISCUSSION: Findings were in keeping with previous research. Autistic peer-to-peer communication enabled development of social relationships and self-identity. Autistic medical students and doctors exhibit traits that make them assets to medicine. This study highlights the need for knowledge, acceptance and representation of autism within medical education – to enable autistic medical students to thrive.

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5. Endo A, Nakamura A, Nakagawa M, Suzuki M, Shimizu T. Patient- and Family-Centered Care for the Emergency Admission of a Child with Autism Spectrum Disorder. Juntendo Med J. 2026; 72(1): 142-6.

Patient- and Family-Centered Care (PFCC), an evolving healthcare model, places patients and their families at the center of care, promoting collaboration between healthcare providers and families. We report the case of a 5-year-old boy with autism spectrum disorder (ASD) who required emergency hospitalization for nephrotic syndrome. Severe anxiety and behavioral difficulties hindered routine medical procedures. Applying the PFCC approach, a multidisciplinary team-including a child psychiatrist and child life specialist-collaborated closely with the family to develop a personalized care plan based on detailed developmental history and behavioral assessment. Strategies included positive language, visual schedules, and stuffed animals to demonstrate procedures, thereby reducing anxiety and improving cooperation. These interventions enabled the patient to adapt to the hospital environment, comply with treatment, and achieve remission after one month. Post-discharge follow-up revealed continued medication adherence. The family’s involvement was crucial, enhancing communication and ensuring consistent care. The PFCC approach not only improved the boy’s medical outcomes but also fostered trust and collaboration. The case emphasizes the importance of adopting PFCC, especially for children with developmental disabilities like ASD, to provide compassionate and effective care, ensuring long-term success. As the prevalence of developmental disabilities rises, the PFCC model will become increasingly essential in healthcare, being of significance not only in pediatric care but also for all medical professionals.

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6. Fonseca LD, Carnes S, Kumar G. From a caregiver perspective: Quality of life of children with epilepsy and autism spectrum disorder – a single site case-control study. Brain Dev. 2026; 48(3): 104526.

BACKGROUND: We aim to investigate the quality of life (QoL) in children with idiopathic generalized epilepsy (IGE) compared to children with epilepsy and autism spectrum disorder (ASD) and their respective caregiver’s QOL. METHODS: We conducted a case-control study from a single pediatric hospital in Ohio. Inclusion criteria for the epilepsy group included children with a diagnosis of IGE; the ASD group included diagnosis of epilepsy and ASD. Both groups included children aged 2-18 years. To capture patient QoL, adult caregivers completed the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55), and to capture caregiver QoL, adult caregivers completed the Health-Related Social Needs (HRSN) and the CarerQoL-7D instrument. RESULTS: A total of 43 caregivers completed the surveys. There was a greater distribution of female patients in the IGE group (57.1%) versus the ASD group which had higher distribution of males (86.4%). Cognitive functioning (M = 33.0), emotional functioning (M = 57.4), physical functioning (M = 33.6) and overall QOLCE-55 mean score (M = 45.2) revealed a statistically significant lower QoL in the ASD group (n = 22), compared to the IGE group (n = 21) (M = 76.8, M = 75.4, M = 61.8, M = 75.3 respectively). The overall CarerQol-7D score mirrored these results with a lower score in the ASD group (M = 68.8) compared to the IGE group (M = 80.3). The individual dimensions in the CarerQol and HRSN revealed no differences. CONCLUSIONS: The QoL as assessed by caregivers for the patients and the caregivers themselves was lower in the ASD group compared to the IGE group. QoL assessment should be integrated in clinical care for comprehensive health management.

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7. Ghoshal R, Vinayagamoorthy G, Ghosh S. Eye Movements and Visual Perception in Children With Autism Spectrum Disorder. J Pediatr Ophthalmol Strabismus. 2026: 1-9.

PURPOSE: To quantify eye movements and visual perception of children with autism spectrum disorder (ASD) and to compare the same parameters with children with typical development (TD). The association between eye movements and visual perception among study children was also evaluated. METHODS: Children with ASD who were verbal and children with TD as age-matched controls were recruited. All children underwent a developmental eye movement (DEM) test and Motor-Free Visual Perception Test-4 (MVPT-4) following standard protocol. RESULTS: Ninety-one children (ASD group = 54, TD group = 37) were evaluated. In the DEM test, mean scores of horizontal and vertical saccades (HT, VT) were significantly (P < .001) extended in children with ASD (mean HT = 262.22 ± 101.152 seconds, mean VT = 121.66 ± 39.72 seconds) compared to children with TD (mean HT = 80.316 ± 32.73 seconds, mean VT = 55.08 ± 16.95 seconds). The majority (88.84%) of children with ASD showed type IV error, indicating both oculomotor and automaticity disorders. Average MVPT-4 scores along with MVPT-4 domain scores were significantly lower (P < .05) in the ASD group. Although a multiple regression model with age, HT, VT, and DEM ratio could explain 71% of the variation in the visual perception score of the TD group, 42% of the variation in the same was explained in the ASD group. CONCLUSIONS: This study reports a significantly increased duration of saccades and impaired visual perception scores among children with ASD compared to those with TD. Although a strong association between MVPT-4 and DEM scores was observed in the TD group, DEM scores failed to associate strongly with visual perception scores in the ASD group.

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8. Huang Y, Liang Q, Shen Y, Chen J, Xu W. Oral microbiome dysbiosis in autism spectrum disorder: the oral-gut-brain axis and future perspectives: a narrative review. Front Microbiol. 2026; 17: 1783810.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with a steadily increasing global prevalence, yet its etiology remains largely unclear. Emerging evidence suggests that oral microbiome dysbiosis may contribute to the pathogenesis of ASD, potentially through the oral-gut-brain axis, although the exact role and causality remain to be fully established. In this narrative review, we synthesize recent clinical and metagenomic evidence on oral microbiome alterations in ASD and critically evaluate the potential pathways through which these microbial imbalances may impact neurodevelopmental outcomes. We summarize the key host-microbe interactions, including inflammatory signaling, epithelial barrier disruption, and immune-neural crosstalk, while emphasizing that direct causal evidence is still limited. Dysbiosis in individuals with ASD is characterized by altered microbial communities, including increased Streptococcus and decreased Prevotella, which correlate with clinical symptom severity. Moreover, metagenomic profiling has indicated the presence of potential biomarkers in the oral microbiome, which may serve as promising noninvasive diagnostic tools for ASD. While the clinical applications of oral microbiome diagnostics are still in the early stages, we explore the challenges and opportunities for developing these biomarkers for risk stratification. Finally, we outline future research directions that could enhance the understanding of the oral microbiome’s role in ASD and facilitate the development of personalized intervention strategies.

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9. Jang J, Yeo S, Kim JP, Baek S, Jung HJ, Hwang SK, Choe Y. Integrated proteomic and single-cell transcriptomic profiling elucidates immunomodulatory effects of L-serine in autism spectrum disorder. Sci Rep. 2026.

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10. Kim S, Kim H, Pelayo JP, Alvarez S, Jang G, Kim J, Kim B, Hoelscher VM, Calleja-Pérez B, Jung H, Yang Y, Lee HJ, Lee J, Kim S, de la Peña MJ, Lee Y, Kim S, Han AR, Lee DS, Ji S, Yu W, Kim HM, An JY, Oh WC, Kwon SK, Kim JY, Um JW, Fernández-Jaén A, Ko J. Bazedoxifene reverses sexually dimorphic autistic-like abnormalities in biallelic MDGA1-mutant mice. EMBO Mol Med. 2026.

MDGA1 reportedly suppresses GABAergic synaptic inhibition and may be associated with schizophrenia. However, it has been unclear whether and how MDGA1 dysfunction causes neurodevelopmental disorders. Here, we describe two patients with autism spectrum disorder (ASD) carrying missense mutations in MDGA1: p.Val116Met/p.Ala688Val and p.Tyr635Cys/p.Glu756Gln. Murine in utero overexpression of MDGA1 p.Val116Met/p.Ala688Val alters normal cortical neuron migration and impairs ultrasonic vocalizations (USVs). The p.Tyr635Cys/p.Glu756Gln substitution disrupts the triangular extracellular structure of MDGA1 and renders it unable to impact GABAergic synapses in hippocampal CA1 neurons. Male Mdga1 knock-in (KI) mouse pups and adults harboring the p.Tyr636Cys/p.Glu751Gln mutation exhibit impaired USVs and sensorimotor gating, similar to male Mdga1 conditional knockout (cKO) mice. No behavioral deficits were seen in female counterparts. Bazedoxifene (a selective estrogen receptor modulator) treatment of male Mdga1(Y636C/E751Q) KI mice rescues the changes in the expression and phosphorylation of a subset of GABAergic synaptic proteins, as well as behavioral performance and GABAergic synaptic strength. Thus, different MDGA1 mutations manifest as distinct MDGA1 dysfunctions and are likely to cause ASD via sexually dimorphic loss-of-function and/or gain-of-function mechanisms.

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11. Li X, Qureshi MNI, Laplante DP, Elgbeili G, Jones SL, King S, Rosa-Neto P. Amygdala and hippocampal contributions to broad autism phenotype: Project Ice Storm. Transl Psychiatry. 2026.

Prenatal maternal stress (PNMS) increases the risk for autism, and individuals with autism inconsistently exhibit increased or decreased volumes and functional connectivity of the whole amygdala and the whole hippocampus. Given heterogeneous structures of the amygdala and hippocampus and the heterogeneity of autism symptoms, it is worth examining how their subregions contribute to different autism phenotypes. T1-weighted and resting-state functional MRI data were acquired from 32 young adults of mothers who were pregnant during, or within 3 months of, the 1998 Quebec ice storm. Their broad autism phenotype (BAP) was self-reported, including aloof personality, pragmatic language impairment and rigid personality. This sample has a wide range of scores on the BAP Questionnaire. Volumes of the amygdala nuclei and hippocampal subfields were calculated. Seed-to-voxel analysis was applied to examine functional connectivity of the amygdala nuclei and hippocampal subfields with the rest of the brain, and linear regressions were implemented to examine associations of volume and functional connectivity with the three autism phenotypes. Primarily, we found that 1) rigid personality was associated with decreased left hippocampal cornu ammonis (CA)1 volume; 2) pragmatic language impairment was associated with decreased left hippocampal CA1 connectivity with the supplementary motor area, and increased right hippocampal CA4 connectivity with the left putamen; and 3) rigid personality was associated with increased right central amygdala connectivity with the left inferior lateral occipital cortex (LOC); and increased left hippocampal CA3 connectivity with the right superior parietal lobule, increased right hippocampal CA4 connectivity with the left superior LOC, and increased right hippocampal dentate gyrus connectivity with the left superior LOC. In contrast, we found no associations with aloof personality. Our results suggest that, within a sample exposed to PNMS, amygdala and hippocampal structure and function contribute differently to two different autistic-like characteristics, with hippocampus-motor connectivity explaining variance in communication impairment, and with hippocampal volume, amygdala- and hippocampus- sensory connectivity sharing the common mechanism in rigid behaviors. Given these links between brain and autistic-like traits, future research should examine whether brain volumes and connectivity mediate associations between PNMS and autistic-like traits in young adulthood.

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12. Li Y, Zhong J, Shen Y, Gong J, Feng Y, Lan W, Hou X. Voluntary wheel running exercise attenuates VPA-induced ASD-like behaviors in male rats: implication of the vagal pathway of the gut-brain axis. NPJ Biofilms Microbiomes. 2026.

Autism spectrum disorder (ASD) is a prevalent neurodevelopmental disorder with elusive pathogenesis and lack of targeted therapies. While exercise can ameliorate ASD-like behaviors, its underlying mechanisms remain unclear. Recent studies have identified dysbiosis of gut microbiota and altered levels of short-chain fatty acids (SCFAs), as critical contributors to ASD-associated behavioral abnormalities. This study investigated the potential role of the gut-brain axis, specifically the vagal pathway, in mediating the therapeutic effects of voluntary wheel running exercise in a valproic acid (VPA)-induced ASD-like rat models. We demonstrated that six weeks of voluntary wheel running exercise attenuated ASD-like behavioral deficits. Exercise restructured gut microbial communities and elevated SCFA levels, notably butyrate, in feces and plasma. Concurrently, exercise normalized imbalances of neuroactive substances in the hippocampus and prefrontal cortex and suppressed neuroinflammation, evidenced by reduced microglial/astrocytic reactivity and a shift in microglial polarization toward an anti-inflammatory phenotype. Critically, subdiaphragmatic vagotomy attenuated these exercise-induced improvements, including the restoration of neuroactive substance homeostasis, resolution of neuroinflammation, and the amelioration of behavioral deficits. Our findings suggest that intact vagal signaling plays a critical role in coordinating gut-derived microbial and metabolic signals with central neuroadaptations to mediate the benefits of voluntary exercise on ASD-like behaviors.

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13. Lu H, Zhang H, Yi L. Autistic children sample costly information with increased variability due to inflexible updating. Commun Psychol. 2026.

Efficient information sampling is crucial for human inference and decision-making even for young children. It is also closely associated with the core symptoms of autism spectrum disorder (ASD), since both the social interaction difficulties and repetitive behaviors suggest that autistic people may sample information from the environment distinctively. However, the specific ways in which autistic children sample information, especially when facing explicit costs and adapting to environmental changes, remain unclear. Thirty-two autistic and 41 IQ-matched neurotypical children aged five to eight participated in a computerized bead task, where children decided to gather samples sequentially from an unknown target to infer which of the two options was the target. Autistic children showed lower sampling efficiency under costly conditions compared to neurotypical peers, resulting from increased variability in sample numbers across trials, rather than solely systematic sampling bias. Computational models indicated that while both groups shared a similar decision process, autistic children’s sampling decisions were less influenced by dynamic changes and more by recently gathered evidence. This led to higher sampling variation and lowered the efficiency of autistic children. These findings offer valuable insights into the cognitive mechanisms underlying fundamental behaviors in autistic children.

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14. Manav Yigit Z, Erarslan SB, Tosun A, Bozkurt G, Bolat H, Unsel Bolat G. Biallelic TTBK1 variant causes a severe syndromic neurodevelopmental disorder: clinical and genetic insights from two siblings. J Med Genet. 2026; 63(4): 244-9.

BACKGROUND: Tau-tubulin kinase 1 (TTBK1) is a neuron-enriched kinase implicated in τ phosphorylation and neurodegeneration. Human phenotypes associated with constitutional TTBK1 variants remain undefined. METHODS: Two siblings with a severe neurodevelopmental phenotype were assessed using quartet exome sequencing, segregation analysis and standardised clinical and neuroimaging evaluations. RESULTS: Both children exhibited profound global developmental delay, non-ambulation, axial hypotonia with lower-limb spasticity and proportionate postnatal growth failure with microcephaly. Epilepsy was present in the older sibling. Brain MRI showed a thin brainstem and corpus callosum, periventricular T2 hyperintensities and mild cerebellar atrophy in the older sibling and external hydrocephalus in the younger. Exome sequencing identified a homozygous frameshift variant in TTBK1 (NM_032538.3:c.1899del; p.Thr634Argfs*39) that segregated with the disease. The variant was absent from population databases and predicted to cause loss-of-function. According to the American College of Medical Genetics and Genomics criteria, it fulfils PVS1 and PM2_P. CONCLUSION: We report the two siblings with a neurodevelopmental disorder due to a biallelic TTBK1 loss-of-function variant, establishing TTBK1 as critical for human neurodevelopment. Together with preclinical data, these findings underscore its role in motor and cognitive circuits. Additional cases and functional studies will be essential to delineate the clinical spectrum and mechanistic basis of TTBK1 deficiency.

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15. Monnier M, Peyre H, Peries M, Simoncic V, Nicolet G, Michelon C, Seetahul Y, Baghdadli A. Reciprocal Associations Between Parental Anxiety/Depression and Emotional/Behavioral Difficulties in Autistic Children Following Their Diagnosis. Autism Res. 2026: e70220.

Emotional and behavioral difficulties (EBD) are common in autistic children, while anxiety and depressive symptoms (ADS) are prevalent in their parents. However, the bidirectional relationship between the parents’ and children’s symptoms remains unclear, especially in the years following the child’s autism diagnosis. Addressing this gap, our study investigates the bidirectional association between parental ADS and two subdomains of EBD (internalizing and externalizing difficulties) in autistic children from diagnosis (T0) to 3 years later (T1). Data from the French ELENA cohort were analyzed using two-wave cross-lagged panel models (CLPM). At the time of diagnosis, 55.2% of mothers and 42.7% of fathers among 315 parents exhibited clinically significant ADS, while 61.3% of children experienced clinical EBD. The CLPMs did not reveal any directional association between parental ADS and children’s EBD. However, we observed significant autoregressive effects for parental ADS and children’s EBD, with a moderate positive correlation between the two at the time of diagnosis. Our findings highlight significant psychological distress in both parents and children at the time of diagnosis and therefore recommend suitable interventions for families requiring social, financial, or psychological support. Future longitudinal studies with greater representation of girls, using continuous-time models could clarify whether parent-child associations are time-lag dependent (including identifying potential peak lags) and whether they differ across parent-child sex dyads. Parents of autistic children often experience significant anxiety and depressive symptoms, while these children frequently face emotional and behavioral difficulties (EBD). Our French study shows that parental distress and children’s EBD are moderately correlated at diagnosis, but these factors do not appear to influence each other 3 years later. These findings underscore the need for early support during the diagnostic period to address the psychological well‐being of both parents and children. However, because we did not find evidence that these difficulties influence one another 3 years after diagnosis, interventions should prioritize immediate coping strategies and adaptive resources rather than targeting long‐term reciprocal effects. eng.

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16. Neto FR, Andreis LM, Gazola E, Fernandes S, Germano AMC. Impact of Autism Spectrum Disorder on Motor Development of Brazilian Preschool and School-Age Children. Autism Res. 2026: e70200.

Autism spectrum disorder (ASD) can be identified in early childhood, often manifesting through motor delays, stereotyped behaviors, and atypical developmental profiles, with motor impairments frequently being among the earliest observable indicators. This study aimed to assess the motor development in preschool and school-age children, comparing those with ASD to neurotypical peers. The research focuses on evaluating the overall impact of ASD on motor development and examining specific motor domains. The study included 292 children (73% boys and 27% girls), aged 3 to 10 years. The sample was divided into two groups: the ASD and the neurotypical (NT) groups, with a ratio of 3:1, with three neurotypical children selected for every child with ASD. Motor development was assessed using the Motor Development Scale III (MDS III), which evaluates six specific domains: fine motor skills (FM), gross motor skills (GM), balance (BL), body schema (BS), spatial organization (SO), and temporal organization (TO). Children with ASD, both in the preschool and school-age groups, exhibited a significantly higher incidence of motor impairments across all evaluated motor domains compared to their neurotypical peers. Motor impairments in children with ASD are not only prominent during the preschool years but also tend to intensify as children transition into school age. These findings highlight the need for early identification and targeted interventions to address motor challenges in children with ASD. This study investigates the impact of autism spectrum disorder (ASD) on the motor skills of Brazilian children aged 3 to 10. The findings show that children with ASD experience significant delays in motor development compared to their neurotypical peers, particularly in areas like coordination, balance, and spatial awareness. These motor challenges worsen as children grow older, highlighting the need for early intervention to support their overall development. eng.

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17. Oyungu E, Keehn B, McHenry MS, Monahan PO, Joseph RM, Yoon SY, Carlucci JG, Saina C, Khaitan A, Baliddawa J, McNally Keehn R. Autism outcomes and neurobehavioural markers in young children born to mothers with HIV in Kenya: a protocol for the Alama project. BMJ Open. 2026; 16(3): e109958.

INTRODUCTION: The over 14 million African children who are HIV-exposed but uninfected (CHEU) are at risk for poor health outcomes, including neurodevelopmental conditions such as autism; however, no study to date has examined autism in CHEU in Africa, where the vast majority of these children live. Scalable diagnostic and neurobehavioural tools, including powerful, low-cost approaches such as eye-tracking, for detection and study of mechanistic neural processes are necessary to advance autism research in these settings. The objective of this study is to examine autism diagnostic outcomes and eye-tracking biomarkers in relation to CHEU while at the same time building capacity for neuro-health research in Kenya. METHODS AND ANALYSIS: This study will leverage a longitudinally assessed cohort of CHEU and children who are HIV-unexposed and uninfected (CHUU) with well characterised HIV-related and contextual exposures. We will first determine and compare autism diagnostic outcomes between young CHEU and CHUU across a large cohort (n=850) of Kenyan children using research-grade autism assessment tools, and, second, determine whether neurobehavioural eye-tracking markers predict autism outcomes across this cohort. ETHICS AND DISSEMINATION: Human subjects approvals have been obtained from Moi University Institutional Review and Ethics Committee (IREC; IREC/909/2024; Approval #0004835), Kenya’s National Commission for Science, Technology and Innovation (NACOSTI; Reference #NACOSTI/P/25/415028), the Institutional Review Board of the Indiana University School of Medicine (Protocol #23171), with reliance agreements executed with Purdue University and Boston University. Dissemination of findings will occur through multiple channels within the research and clinical community, including peer-reviewed journal publications and conference abstracts and presentations. As part of capacity building efforts, the research team will also communicate study results to policy makers, the lay public and other health systems involved in the care of young children with disabilities via study-hosted workshops and conferences.

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18. Paone A, Logrieco MG, Guerrera S, Fucà E, Casula L, Minutolo A, Vicari S, Valeri G. Sleep problems in autistic children and adolescents: an age-stratified approach. Front Psychol. 2026; 17: 1715093.

Sleep disorders are common in autistic children and adolescents. However, the associations between children’s age and clinical features remain underexplored. This study investigates age-specific relationships between sleep difficulties and autism symptomatology, behavioral/emotional problems, cognitive development, and parenting stress. A total of 218 autistic participants were divided into three age groups: 6-36 months, 3-6 years, and 6-18 years. Sleep was assessed using the Sleep Disturbance Scale for Children (SDSC); behavioral and emotional difficulties were measured using the Child Behavior Checklist (CBCL); autism severity was assessed using the Autism Diagnostic Observation Schedule – Second Edition (ADOS2), cognitive development was assessed using the Intelligence Quotient (IQ)/Developmental Quotient (DQ) scores, and parenting stress was assessed using the Parenting Stress Index (PSI). Results demonstrate age-specific variations in the relationship between sleep disturbances and clinical features in autistic children. In the 6-36 months group, sleep difficulties were influenced by autism severity, cognitive level, and emotional-behavioral factors. In the 3-6-year-old group, behavioral and emotional regulation issues were associated with sleep problems. In children aged 6-18 years, autism severity, adaptive functioning, and parenting stress emerged as key factors contributing to sleep disturbances. These findings underscore the dynamic and evolving nature of sleep problems in autism, highlighting the need for age-tailored interventions.

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19. Roddick KM, Habib EB, Brown RE, Balcı F. Interval Timing Is Altered in Male Nrxn1(+/-) Mice: A Model of Autism Spectrum Disorder. Autism Res. 2026: e70226.

Autism spectrum disorder (ASD) is characterized by impaired social interactions and communication, and increased repetitive and stereotypical behavior. Neuroimaging shows functional abnormalities in brain areas involved in temporal processing in autistic individuals, and they also show deficits in interval timing. Neurexin (NRXN) mutations have been identified in a wide variety of neuropsychiatric disorders, including ASD, and Nrxn1(+/-) mice possess a mutation that disrupts the α, β, and γ isoforms of Nrxn1, a gene involved in synapse structure. We investigated the interval timing abilities of the Nrxn1(+/-) mouse model of ASD in the peak interval procedure using a 15-s target interval and compared their performance with that of Nrxn1(+/+) and Nrxn1(ΔS5/-) rescue mice. Two-month-old male Nrxn1(+/+) (C57BL/6 J), Nrxn1(+/-), and Nrxn1(ΔS5/-) mice were trained to obtain sucrose liquid rewards 15 s after the onset of a discriminative stimulus (discrete fixed-interval training), and their timing responses were tested in non-reinforced probe trials. Our analysis of responses across individual trials revealed that Nrxn1(+/-) mice had earlier timing responses overall. This difference was manifested as earlier termination of responding in terms of the response curves. These findings are consistent with leftward shifts observed with experimental animal models of ASD. In conclusion, we believe these results indicate a bias in long-term memory in the Nrxn1(+/-) mouse model of ASD and may capture the timing deficit observed in autistic individuals. Neurexins help nerve cells connect and communicate with each other, and changes in these genes are often seen in people with autism. Mice with a mutation in the neurexin1 gene, called Nrxn1(+/−) mice, exhibit autism‐like behaviors. In a time‐judging test, these mice respond early, similar to some people with autism. This study helps develop our understanding of how interval timing is affected in ASD. eng.

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20. Scherer N, Nemerimana M, Nanyunja C, Kitema GF, Sadoo S, Iradukunda F, Munyuzangabo M, Lassman R, Rotenberg S, Bagahirwa I, Greenland K, Chen S, Carew M, Davey C, Greco G, Banks LM, Musendo DJ, Uwinkindi F, Kuper H, Webb EL, Baganizi E, Tann CJ. Early childhood intervention for children at risk of developmental disabilities and their caregivers in Rwanda: study protocol for the PDC/Baby Ubuntu cluster randomised trial. Trials. 2026.

BACKGROUND: Early childhood intervention strategies have the potential to promote health, participation and quality of life for young children at risk of developmental disabilities and their caregivers, however evidence on the impact of integrated care strategies in sub-Saharan Africa is lacking. Access to early intervention is crucial for affected children and families, particularly in resource-constrained settings with limited access to specialised services. This trial aims to evaluate the effectiveness and implementation of a bundle of early identification, care and support, integrated into government health systems in Rwanda: the Pediatric Development Clinic (PDC)/Baby Ubuntu programme. METHODS: The study is a single-blind, effectiveness implementation-hybrid (type II) cluster randomised controlled trial with two arms (1:1 ratio). At cluster level, all community health centres in the three trial districts will be eligible for inclusion. At the participant level, at risk children aged ≤ 59 months will be eligible where ‘at risk’ is defined as being a survivor of a newborn condition that is a recognised risk factor for developmental disability (neonatal encephalopathy, prematurity, meningitis, severe jaundice, cerebral malaria, suspected genetic and chromosomal conditions and seizures), and/or not meeting age-specific developmental milestones. Those receiving inpatient hospital treatment or in institutional care will not be eligible. Primary outcomes will be family health-related quality of life (PedsQL) and child participation (Young Child Participation & Environment Measure) assessed 12 months after enrolment and randomisation. Secondary outcomes include caregiver knowledge and confidence (scored structured assessments), psychological distress (Self-Report Questionnaire), experience of disability-affiliated stigma (Affiliate Stigma Scale), and economic activity (time-use survey), in addition to child mortality, illness and hospitalisation, child development/function (Global Scales of Early Development, Malawi Developmental Assessment Tool, PEDI-CAT), and nutritional status (weight-for-age, height-for-age). Analysis will be by intention-to-treat, consisting of all randomised subjects analysed according to assigned study arm. Cluster-level analyses will assess intervention effect. DISCUSSION: The trial utilises best practice methodology and frameworks to conduct rigorous and comprehensive impact, process and economic evaluation of the intervention implemented and is guided by a multi-disciplinary team and steering committee. TRIAL REGISTRATION: ISRCTN, ISRCTN17523514. Retrospectively registered 24 July 2024, https://doi.org/10.1186/ISRCTN17523514.

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21. Sertié AL, Josino R, Goll VR, Nunes Goussain Filippo AL, Campos GDS, do Rego F, Siqueira ES, Farias de Alcântara N, Zachi EC, Passos-Bueno MR. Catatonia and regression in an autism spectrum disorder patient harbouring a BRSK2 frameshift mutation. J Med Genet. 2026; 63(4): 269-74.

Deleterious variants in the BRSK2 gene, which encodes a serine/threonine kinase crucial for neuronal polarisation and brain development, have recently been linked to the pathogenesis of autism spectrum disorder (ASD). However, comprehensive clinical descriptions of individuals with pathogenic BRSK2 variants remain limited, and the molecular and cellular consequences of these mutations are poorly understood. This case report provides a detailed clinical, cognitive and molecular characterisation of a male patient with ASD harbouring a de novo BRSK2 frameshift variant, who developed catatonia, developmental regression and cognitive decline during early adolescence. To assess the functional impact of the variant, induced pluripotent stem cells (iPSCs) and iPSC-derived neural organoids were generated from the patient. Molecular analyses revealed a significant reduction in BRSK2 transcript and protein levels. Sequencing of BRSK2 mRNA showed exclusive expression from the wild-type allele, consistent with degradation of the mutant transcript via nonsense-mediated decay. These findings broaden the mutational and phenotypic spectrum associated with BRSK2-related neurodevelopmental disorders and provide functional evidence supporting the pathogenicity of the identified variant. Furthermore, this report demonstrates the role of BRSK2 in complex neuropsychiatric features-such as catatonia and cognitive deterioration, which remain underreported in the existing literature-and emphasises the importance of longitudinal cognitive and behavioural monitoring in individuals with BRSK2 mutations.

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22. Singh M, Adnan M, Husain K, Trivedi C, Jain S. Role of Transcranial Direct Current Stimulation in the Management of Autism Spectrum Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis. Prim Care Companion CNS Disord. 2026; 28(2).

Objective: To evaluate the efficacy and safety of transcranial direct current stimulation (tDCS) in reducing autism spectrum disorder (ASD) symptoms in children and adolescents. Data sources: A systematic search of multiple databases including PubMed, Ovid MEDLINE, Embase, Web of Science, Scopus, Cochrane CENTRAL, and Google Scholar was conducted through March 2025 using keywords and MeSH terms related to ASD and tDCS. Study selection: Eligible studies included randomized controlled trials (RCTs), nonrandomized controlled trials (non-RCTs), and case reports that examined the effects of tDCS in individuals with ASD aged ≤18 years. Data extraction: Two reviewers independently extracted data and assessed bias using Cochrane tools. Meta-analyses were performed with RevMan Web, and the certainty of evidence was rated with Grading of Recommendations Assessment, Development, and Evaluation profiler. Results: Of the 266 studies screened, thirty studies (22 RCTs, 6 non-RCTs, and 2 case reports; N = 963) were analyzed. Significant improvements were observed in Social Responsiveness Scale scores (mean difference = -14.95; 95% CI, -26.07 to -3.83; P = .007; d = -0.42) after tDCS. Autism Treatment Evaluation Checklist scores showed moderate-to-large effect (d = -0.75), increasing to d = -0.95 after sensitivity analysis. Dorsolateral prefrontal cortex stimulation was most effective for behavioral improvements, while ventromedial prefrontal cortex stimulation improved emotional regulation. No major adverse effects were reported. Conclusion: tDCS appears to be a safe and potentially effective adjunctive therapy for ASD. However, further large-scale, long-term RCTs are needed to confirm efficacy and optimize stimulation parameters. Prim Care Companion CNS Disord 2026;28(2):25r04049. Author affiliations are listed at the end of this article.

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23. Sundberg-Alley M, O’Donnell DE. Critical Incidents: Analysis of Missing Children With Reported Autism Spectrum Disorder. J Autism Dev Disord. 2026.

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24. Xu M, Zhang X, Liu Y, Yang Y, Zhou Z, Ma J, Shen S. Mesenchymal stem/stromal cell-based therapies for autism spectrum disorder: emerging evidence and clinical prospects. J Transl Med. 2026.

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25. Zhang F, Xu Y, Liu L, Xing Y, You C, Lv S, Huang H, Zou Y, Liang F, Ye Q, Li Y, Wang S, Chen K, Deng H. Trajectories of Autism Symptoms and Overlapping Patterns in a Chinese Cohort From 18 to 36 Months. Autism Res. 2026: e70219.

Several studies have examined trajectories of autism symptoms in autistic children and their siblings. However, less is known about developmental patterns across different neurodevelopmental conditions, as well as the clinical characteristics and early predictors among children with distinct diagnoses but overlapping trajectories. This study investigated trajectories of autism symptoms [ADOS-2 Calibrated Severity Score; Total CSS, social affect (SA) CSS, and restricted and repetitive behaviors (RRB) CSS] and their overlap across symptom domains in a Chinese cohort of 163 children aged 18-36 months, including autism, broader autism phenotype (BAP), developmental delay (DD), and typical development (TD). Latent class growth modeling identified three trajectories for Total CSS and SA CSS, and two for RRB CSS. Cross-domain analyses revealed overlapping CSS trajectories between 51 autistic children (Overlap-Autism) and 36 children with BAP (Overlap-BAP). Clinical comparisons between these two groups revealed distinct temporal profiles in CSS and ADI-R scores. Hierarchical logistic regression analyses indicated that female sex was a protective factor for Overlap-Autism (OR = 0.20, p = 0.009) relative to the Overlap-BAP group, whereas higher SA CSS at 18 months independently predicted Overlap-Autism (OR = 1.61, p = 0.003). These findings highlight the challenges of early diagnostic differentiation among children with autism-related traits and underscore the importance of comprehensive and longitudinal assessment. Early childhood is a crucial period for understanding how autism‐related behaviors develop, yet limited research has examined how these behaviors change over time in very young children with different developmental outcomes. In this study, we followed 163 Chinese children aged 18 to 36 months, including children later identified as autistic, showing broader autism‐related traits, having developmental delays, or developing typically. We found that children showed distinct patterns of change over time in overall autism‐related behaviors, social communication, and repetitive behaviors. Importantly, many children who were later classified as autistic or as having broader autism‐related traits followed very similar developmental patterns during early childhood. This overlap helps explain why it can be challenging to clearly distinguish between these outcomes at a very young age. In addition, we found that girls were less likely than boys to follow an autism‐related developmental pathway. Children who showed greater difficulties in social interaction at 18 months were more likely to develop autism‐related patterns over time. Overall, these findings highlight the complexity of early neurodevelopment and emphasize the importance of using comprehensive assessments and conducting repeated follow‐up evaluations in early life, rather than relying on a single assessment at one point in time. eng.

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26. Zhang Z, Zhang L, Zhu G, Liang Y, Pang P, Yan H, Cao X, Wang J, Shi X, Hu L, Yang G. Efficacy and Safety of Intravenous Immunoglobulin in Children with Autism Spectrum Disorder with Immune Dysregulation: A Prospective, Open-Label, Single-Arm Study. Neurol Ther. 2026.

INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder. Accumulating evidence indicates that immune inflammation and oxidative stress may be involved in the pathogenesis of ASD. Intravenous immunoglobulin (IVIG), a well-established immunomodulatory agent, has demonstrated potential in ameliorating neuroinflammatory and behavioral symptoms in neuroimmune disorders. This prospective, open-label, single-arm study aimed to evaluate the short-term efficacy and safety of IVIG in children with ASD who have peripheral blood immune dysregulation. METHODS: A total of 41 children with ASD (aged 3-8 years) were enrolled. Participants received IVIG at a dose of 1 g/kg per infusion 1 month apart, resulting in a cumulative dose of 2 g/kg. The Social Responsiveness Scale-2 (SRS-2) was used to assess symptom changes at baseline, 1 month, and 2 months, and adverse events were recorded. RESULTS: The SRS-2 total score and the scores of the Social Cognition, Social Communication and Social Motivation domains were significantly reduced at 2 months after IVIG intervention (P < 0.05). In terms of safety, two participants presented with a transient low-grade fever, two participants experienced vomiting, and one participant exhibited abdominal distension and poor appetite. All adverse events (AEs) were classified as Common Terminology Criteria for Adverse Events (CTCAE) grade 1 and resolved spontaneously without medical intervention. CONCLUSION: This exploratory single-arm open-label study demonstrated that IVIG is well tolerated and may be associated with improvements in social behavior among children with ASD with immune dysregulation. However, since the primary outcome measure (SRS-2) was caregiver-reported, response bias should be taken into consideration. As an exploratory and hypothesis-generating study, no definitive conclusions regarding therapeutic efficacy or causal relationships can be drawn from these findings. Therefore, its therapeutic efficacy remains inconclusive, and the results should be interpreted with caution. Further multicenter, double-blind controlled trials are warranted to confirm the efficacy of IVIG and explore the underlying mechanisms involved. TRIAL REGISTRATION: chictr.org.cn (registration number ChiCTR2500111846).

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27. Zhao Y, Zhang Y, Li T. Causal relationships between ADHD, ASD and brain structure: A mendelian randomization study. Prog Neuropsychopharmacol Biol Psychiatry. 2026; 145: 111631.

Neurodevelopmental disorders (NDDs) are debilitating conditions that impose significant burdens on individuals, families, and society. Despite evidence demonstrated altered brain structure in NDDs, definitive conclusions remain elusive. Using two-sample mendelian randomization (MR) and the latest GWAS findings, the current study aimed to elucidate the causal relationships between grey matter (GM), white matter (WM), subcortical regions, and two prevalent NDDs: attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Our findings identified two frontal regions as key neural substrates in NDDs. Specifically, an increased surface area (SA) of the superior frontal gyrus (SFG) was significantly associated with an enhanced risk of ADHD (P = 2.04E-13, β = 4.28E-02, SE = 5.82E-03), while a larger SA of the orbital frontal gyrus (OFG) was associated with a reduced risk of ASD (P = 1.98E-42, β = -9.8E-02; SE = 0.007). Regarding WM tracts, the mode of anisotropy (MO) in the inferior fronto-occipital fasciculus (IFO) emerged as a causal factor for ADHD (P = 3.36E-70, β = -18.35; SE = 1.04), whereas the MO in the retro-lenticular part of the internal capsule (RLIC) was implicated in ASD (P = 1.37E-04, β = -12.73, SE = 3.34). No reverse causal link, i.e., brain alteration caused by NDDs was identified. Further mediation analyses using functional MRI (fMRI) GWAS data revealed that brain functional activities mediated the relationship between structural brain changes and NDDs risk. In conclusion, our findings underscored the critical role of the frontal lobe and association and projection fibers in the pathophysiology of NDDs, provide novel insights into the neural mechanisms underlying ADHD and ASD.

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28. Zhu H, Ho KY, Wu VX, Ye J, Xiao L, Li Y, Yu Z, Wang X, Li X. Facilitators, barriers, and strategies in implementing early intervention for children with autism spectrum disorder aged 0-6 years: A multicenter qualitative study using the consolidated framework for implementation research. Autism. 2026; 30(4): 1028-46.

Autism spectrum disorder poses a growing global health challenge due to rising prevalence and significant disability burdens. Early intervention during the 0- to 6-year developmental window is critical to reduce individual, familial, and societal impacts. However, implementation gaps persist in China, particularly in resource-limited settings, where context-specific barriers and facilitators remain understudied. This multicenter qualitative study (July 12 to October 28, 2024.) across 11 cities in Hainan Province involved 47 stakeholders (4 policymakers, 13 managers, 13 practitioners, and 17 family caregivers of children with autism spectrum disorder aged 0-6 years). Semi-structured interviews guided by the Consolidated Framework for Implementation Research were complemented by document review and field observations, with data analyzed via template analysis. Key facilitators included government funding, stratified training, caregivers’ positive attitudes, and clear implementation standards. Barriers mainly included low social acceptance, regional resource disparities, workforce shortages, caregiver challenges, and limited evidence-based practice adoption. Four key strategies were identified: strengthening external support, optimizing internal resources, empowering stakeholders, and refining implementation through technology and evidence-based practices. This first China-based study uses a stakeholder-driven approach to co-design contextualized strategies, offering a model for improving autism spectrum disorder care delivery in similar resource settings globally.Lay abstractThis study explored how to improve early support services for young children aged 0 to 6 years with autism spectrum disorder in resource-limited areas. We interviewed 47 stakeholders, including policymakers, service managers, healthcare professionals, and parents of autistic children across 11 cities to identify factors that support or limit effective early support services. Key helpful factors were government funding, practical staff training, and parents’ proactive attitudes. Major challenges included low public understanding of autism, unequal resources between regions, too few trained professionals, and difficulties families face accessing care. To address these, we suggest four solutions: increasing funding and community awareness, sharing resources more fairly, training more staff and supporting parents, and using technology and proven therapies. As the first study in China to design solutions with families and professionals, these strategies could help similar communities globally deliver better early autism care.

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