1. [Guideline for intervention and rehabilitation in children with autism spectrum disorder (2026 edition)]. Zhongguo Dang Dai Er Ke Za Zhi. 2026; 28(10): 1175-83.

On September 22, 2026, the National Health Commission released the « Guideline for intervention and rehabilitation in children with autism spectrum disorder (2026 edition) ». The guideline applies to intervention and rehabilitation services for children with autism spectrum disorder (ASD) under 18 years of age. It establishes eight basic principles, namely early intervention, individualized intervention, comprehensive intervention, evidence-based practice, long-term and high-intensity intervention, primary-level care as the mainstay, family participation, and social inclusion and support, and specifies that the optimal treatment window is before 6 years of age and that intervention should be provided for at least 20 hours per week. It covers health education, intervention for developmental deficits, intervention for challenging behaviors, family intervention, digital and intelligent intervention and rehabilitation, and follow-up.

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2. Arutiunian V, Davoudi S, Gaougaou G, Knoth IS, Buckser R, Marcil V, Lippé S. Auditory sustained potential as a biomarker of language functioning in children with autism and its implication in clinical trials. Front Psychiatry. 2026; 17: 1892698.

OBJECTIVE: Most children with autism have language impairment, however, its neural mechanisms are not well understood. A potential biomarker associated with language in autism is a 40Hz Auditory Steady-State Response (ASSR) triggered by periodic click-trains which in electroencephalogram (EEG) evokes two types of responses – 40Hz steady-state gamma response (ASSR) and sustained potential (SP). Although these responses represent low-level auditory processing, they correspond to different stages of sound perception/analysis and are essential in processing of spectrally/temporally complex sounds. However, until now there were no studies focusing on the potentials of these responses in clinical trials. METHODS: The present open-label pilot study evaluated the effects of the probiotic beverage supplement Bio-K+ in children with autism (N = 19). Participants were assessed at three timepoints: T0 (baseline), T14 (14 weeks after intervention), and T22 (8 weeks after intervention, post-supplementation follow-up assessment), including EEG 40Hz ASSR and behavioral phenotyping. RESULTS: First, at T0 we showed a reduction of SP amplitude in children with autism compared to controls, and this reduction was associated with lower speech/language/communication scores. Second, the amplitude of SP became significantly more negative during the probiotic supplementation period and, by T14, was no longer significantly different from the observed in TD controls. Finally, these changes in the amplitude of SP were associated with improvement in speech/language/communication scores. CONCLUSIONS: This study showed that the SP as well as its change was related specifically to speech/language/communication but not to other behavioral measures and has a potential to be used in future clinical trials.

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3. Bernhard FB, Skubik-Peplaski C, Dorich JM. The therapeutic relationship between occupational therapy practitioners, autistic children, and their caregivers is paramount: caregivers’ perspectives and experiences. Disabil Rehabil. 2026: 1-17.

PURPOSE: Caregivers of autistic children are critical to the therapeutic process. However, gaps exist in our understanding of caregivers’ experiences, clinicians’ comfort, and clinicians’ skill sets when involving caregivers in the therapeutic relationship with their autistic child. This study aimed to explore the caregiver experience within the therapeutic relationship. METHOD: Eight caregivers of autistic children aged 3-10 years old engaged in individual, semi-structured interviews sharing their experiences working with occupational therapists and their autistic children. Data was analyzed through thematic analysis following a descriptive qualitative approach. FINDINGS: Three themes were generated. Caregivers emphasized that the therapeutic relationship, including connection and a sense of belonging, is paramount and precedes any work toward therapy goals. The second theme demonstrates the benefits of a positive therapeutic relationship and the caregiver’s active role in the therapeutic process. The final theme outlined the roles and responsibilities of the caregiver and the occupational therapy practitioner within the therapeutic relationship. CONCLUSION: Occupational therapy practitioners must purposefully establish a therapeutic relationship, including connection and a sense of belonging, to support the therapeutic process with autistic children and their caregivers. Further research is needed to investigate the therapeutic relationship from the perspective of the autistic child. Caregivers of autistic children seek out belonging, connection, communication, and collaboration for their child and for themselves within therapeutic relationships with occupational therapy practitionersOccupational therapy practitioners can intentionally build therapeutic relationships by prioritizing the needs of both children and caregivers in real time.Occupational therapy practitioners must focus on developing a therapeutic relationship, in addition to delivering evidence-based, standardized care practices, to ensure the therapy is client-centered and meaningful. eng.

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4. Cola M, Lyons M, Schillinger S, Lee A, Faulk C, Fulop L, Knox A, Howard N, Franke H, Mulqueen A, Cho S, Liberman MY, Flanagan AY, Pandey J, Schultz RT, Armstrong SL, Parish-Morris J. Context Matters: Assessing Sex and Diagnostic Differences in Autistic Children’s Language Across Tasks With Differing Levels of Structure. J Autism Dev Disord. 2026.

PURPOSE: Examine how task structure and participant sex influence social-word production in verbally fluent autistic and non-autistic youth during two ADOS‑2 Module 3 tasks (Picture Description and Telling a Story From a Book). METHODS: One hundred eleven verbally fluent autistic and non-autistic youth (ages 6-15) completed ADOS‑2 Module 3. Groups were matched on age and IQ. Transcripts of Picture Description and Telling a Story From a Book were processed with LIWC‑22 to quantify social words. Generalized linear models predicted social word production in each task using age, IQ, sex, and diagnostic group as predictors, including sex-by-diagnosis interactions. Associations between social-word use in each task and ADOS‑2 Social Affect scores were examined within the autistic group. RESULTS: In the Picture Description task, there was a significant interactive effect of sex and diagnosis. This was driven by non-autistic girls using more social words than any other subgroup. Autistic girls and boys did not differ. In the Telling a Story From a Book task, there were no significant effects of sex or diagnosis. Within the autistic group, participants who used fewer social words during Picture Description task were rated as having greater social difficulties by expert clinicians. CONCLUSION: Task structure impacts detection of diagnostic and sex-related differences in social language: less structured contexts reveal diagnostic group differences, while structured narrative elicitation attenuates them. Social word production in unstructured settings relates to clinician-rated social difficulties, particularly for autistic girls, highlighting the importance of task selection when assessing pragmatic language.

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5. Findling RL, Bozhdaraj D, Duffy W, Strawn JR, Singh MK, Weinberg MS, Rekeda L, Chen C, Parikh M, Lucas M, Smith E. Cariprazine in the Treatment of Pediatric Patients With Irritability Associated With Autism Spectrum Disorder: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry. 2026.

OBJECTIVE: To evaluate the efficacy and safety of cariprazine in youth with irritability associated with autism spectrum disorder (ASD). METHOD: This 8-week, multicenter, randomized, double-blind, controlled trial compared age- and weight-dependent flexibly-dosed cariprazine (0.75-3 mg/day) versus placebo in youth (5-17y) with ASD and irritability. The primary efficacy endpoint was week 8 change from baseline in caregiver-rated Aberrant Behavior Checklist-Irritability subscale (ABC-I) score. The first key secondary endpoint was the week 8 proportion of participants who were responders for clinician-rated Clinical Global Impressions-Change (CGI-C) in irritability (« much improved » or « very much improved »). RESULTS: 155 participants (mean age 10.6y, 70% male participants) received ≥1 study dose; 152 had baseline and ≥1 postbaseline ABC-I or CGI-C scores (n=74 cariprazine, n=78 placebo), with 81% completing the treatment period and 3.9% discontinuing due to treatment-emergent adverse events (TEAEs). The cariprazine group had significantly greater week 8 ABC-I improvement than placebo (least square mean difference [95% CI] = -3.7 [-6.75, -0.57], Cohen’s d effect size = 0.42, p = 0.0205). A significantly greater percentage of cariprazine-treated participants were CGI-C Irritability responders at week 8 than placebo (68.9% vs. 38.0%, odds ratio [95% CI] = 3.6 [1.7, 7.8], p = 0.0012). Overall, 51% of participants had TEAEs (1.3% had severe TEAEs); most commonly, somnolence and headache. TEAEs, laboratory values, and vital signs were consistent with cariprazine’s known adult safety profile. CONCLUSION: Pediatric patients with ASD treated with cariprazine demonstrated significantly greater improvement in irritability than placebo.

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6. Ganji M, Kaki A, Mohammadi MF, Behroozi J, Kahani SM, Rezaei B, Fayazi A, Mohammadi P, Bereshneh AH, Garshasbi M. EEF1D-Associated Neurodevelopmental Disorders: Evidence From Iranian Siblings With a Biallelic Splice Junction Loss Variant. Mol Genet Genomic Med. 2026; 14(10): e70287.

BACKGROUND: Global developmental delay (GDD) and intellectual disability (ID) are neurodevelopmental conditions with significant phenotypic and genetic heterogeneity. EEF1D (OMIM* 130592) has recently been identified as a gene of interest in neurodevelopmental disorders. Neurodevelopmental disorder with thin corpus callosum, hypotonia, and absent language (NEDTCHAL) (OMIM #621150) is caused by homozygous or compound heterozygous disease-causing variants in the EEF1D. METHODS: We performed whole exome sequencing (WES) on an Iranian sibling presenting with global developmental delay, intellectual disability, microcephaly, and failure to thrive. Bioinformatic analysis and Sanger sequencing were used to validate and characterize the identified variant. RESULTS: A novel homozygous splicing variant in EEF1D (c.1489-26_1493del) was identified in both affected individuals. The variant is predicted to disrupt splicing and cause a frameshift deletion. Previous studies have implicated biallelic EEF1D variants in neurodevelopmental disorders, and this report is the first from the Iranian population and the seventh family to be reported worldwide with this rare condition. CONCLUSION: This report provides further evidence for the association between EEF1D variants and neurodevelopmental disorders, expanding the phenotypic spectrum of EEF1D-related conditions. It reinforces the importance of recognizing EEF1D as a key gene involved in developmental delay and intellectual disability.

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7. Hao Y, Banker SM, Schafer M, Zhang E, Barkley S, Trayvick J, Peters AW, Thinakaran AA, McLaughlin C, Gu X, Foss-Feig JH, Schiller D. Autism with social anxiety is associated with acquiescent behaviors and enlarged amygdala volume. Transl Psychiatry. 2026; 16(1).

Social anxiety (SA) frequently co-occurs with autism spectrum disorder (ASD), but it remains unclear whether SA in ASD reflects greater symptom severity or a distinct subtype. Across two complementary studies, we characterized the behavioral and neural correlates of SA in ASD using a naturalistic social navigation task measuring affiliative and power-related behaviors. In Study 1 (ASD = 575; controls = 357), autistic individuals with SA exhibited significantly reduced task-derived power behaviors (e.g., compliance with others’ requests) compared to those without SA-a pattern not observed in non-autistic individuals. In Study 2 (ASD = 72; controls = 72), individuals with both ASD and SA showed enlarged amygdala volumes relative to both ASD without SA and non-autistic individuals. These behavioral and neural differences found in Study 1 and Study 2 were not observed in ASD with co-occurring depression or generalized anxiety disorder. Moreover, in Study 2, larger amygdala volume in the ASD group was associated with reduced task-derived power behaviors, indicating a neural signature linking social-behavioral differences and anxiety-related features. Together, these findings point to a distinct ASD phenotype marked by social anxiety, altered interpersonal dynamics, and amygdala enlargement, with implications for diagnosis and tailored intervention.

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8. Hayden-Evans M, Inkster T, Fimmano I, Smith Z, Leamon J, Girdler S, Milbourn B. Online gaming for autistic youth: Exploring the impact on participation from the perspectives of autistic adolescents and their caregivers. Aust Occup Ther J. 2026; 73(5).

INTRODUCTION: The rise in the number of adolescents diagnosed with autism spectrum disorder has highlighted the need for strength-based approaches to support them. The accessibility of online gaming has made it a popular avenue for autistic adolescents to socialise and connect with others while enhancing skill development. This study aimed to explore online gaming from the perspectives of autistic adolescents and their caregivers, including the impact gaming may have on daily participation and functioning. METHODS: This study employed a mixed methods research design. Both autistic adolescents and their caregivers completed online surveys comprising a combination of Likert-scale and open-ended questions. The survey responses were descriptively and thematically analysed. CONSUMER AND COMMUNITY INVOLVEMENT: Survey questions were reviewed by volunteer staff (including autistic staff members) of a local autistic community coding club to ensure readability and accessibility of the survey. RESULTS: In total, 45 participants (23 caregivers and 22 autistic adolescents) responded to the survey. Themes relating to online gaming were identified, including social communication, emotion regulation, and skill development while also highlighting caregiver concerns of online safety and excessive screen use. Most autistic adolescents reported feeling happy when playing online games and most caregivers agreed online gaming supported their child to build better relationships with others. Over half of autistic adolescents agreed that online gaming helped them feel more confident in social situations with others. CONCLUSION: Allied health professionals, including occupational therapists, may utilise online gaming, incorporating strength-based learning and skill development, when working alongside autistic adolescents and their caregivers to facilitate social participation and promote online safety. Online gaming is becoming more common, giving autistic young people a way to make friends and learn new skills. This study explored how online gaming affects autistic teenagers, from both their own perspective and their caregivers’. The researchers collected information through online surveys from 22 autistic adolescents and 23 caregivers. The study found that online gaming helped many autistic teenagers feel happier, more confident, and better at talking to others. Many caregivers noticed that gaming helped their child build relationships. However, some caregivers were worried about online safety and too much screen time. Occupational therapists could use online gaming to help autistic youths develop social skills. eng.

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9. Ivanov MN, Mladenov A, Tsoneva DK, Napoli A, Mazza T, Tonchev AB, Coppola I, Chiodi V, Tartaglione AM, Vinciguerra M, Domenici MR. Opposing Patterns of the Histone Variant MacroH2A1.1 in Fmr1 Knockout and BTBR T+ Itpr3tf/J Mouse Models of Autism Spectrum Disorder. Mol Neurobiol. 2026; 63(1).

Autism spectrum disorder (ASD) exhibits substantial heterogeneity, wherein genetic and idiopathic forms may converge on shared core phenotypes through divergent molecular pathways. The histone variant macroH2A1.1, implicated in chromatin repression and DNA repair, has been linked to behavioral alterations opposite to core ASD features when depleted systemically. However, its regional and cell-type-specific regulation in genetic versus idiopathic ASD models remains unclear. We investigated macroH2A1.1 expression across the dorsal striatum, hippocampus, and medial prefrontal cortex in Fmr1 knockout (Fragile X syndrome model) and BTBR T+ Itpr3tf/J (idiopathic ASD model) mice. Quantitative PCR and imaging analyses revealed opposing patterns: BTBR mice showed region-specific mRNA downregulation and increased strongly stained macroH2A1.1-positive nuclei, whereas Fmr1 knockout mice exhibited reduced strong staining with increased weak staining, specific to neurons and not astrocytes, independent of significant mRNA changes. Bulk RNA-seq meta-analysis and pseudobulk single-cell transcriptomics further identified pathway-level enrichment of oxidative phosphorylation, chromatin remodeling, and transcriptional repression functional gene sets in unmatched public datasets (BTBR striatum; FXS hippocampus and cortex), with pronounced neuron-astrocyte divergence in Fmr1 knockout cortex. These findings underscore distinct epigenetic regulatory mechanisms in genetic and idiopathic ASD models.

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10. Kawai K, Ishida M, Omura Y. Sequential EMDR and CBT for Small-t Trauma in an Adult With Autism Spectrum Disorder: A Clinical Case Report. Case Rep Psychiatry. 2026; 2026: 4899601.

This clinical case report describes a sequential combination of eye movement desensitization and reprocessing (EMDR) therapy and cognitive behavioral therapy (CBT) for small-t trauma in an adult patient with autism spectrum disorder (ASD). Individuals with ASD could be vulnerable to the accumulation of nonlife-threatening adverse interpersonal experiences, often described as small-t trauma, which can contribute to anxiety, depressive symptoms, and social withdrawal. The patient was a 25-year-old woman with ASD who presented with flashback-like symptoms and social anxiety related to distressing childhood and adolescent experiences with family members and school-related experiences. Treatment consisted of EMDR sessions targeting these traumatic memories, followed by CBT focused on cognitive restructuring and adaptive interpersonal coping. Across treatment, traumatic stress, anxiety, and depressive symptoms decreased, and the patient transitioned from unemployment to employment through a disability employment scheme. This case illustrates how EMDR may reduce trauma-related distress sufficiently to allow subsequent CBT work on current interpersonal difficulties. Although causal conclusions cannot be drawn from a single case, this report suggests that EMDR adapted to the characteristics of ASD, followed by CBT, may be clinically useful for addressing small-t trauma in adults with ASD.

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11. Köksal Z, Selçuk S, Ergen V. Awareness and Clinical Practices of Turkish Anesthesiologists Regarding the Perioperative Management of Children With Autism Spectrum Disorder: A Cross-Sectional Survey. Paediatr Anaesth. 2026.

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12. Lal S, Khan E, Rasheed M, O’Shea M. Anaesthetic Management of a Child with Chromosome 7q32.1 Microdeletion Undergoing Ligation of Patent Processus Vaginalis. Ir Med J. 2026; 119(9): 182.

PRESENTATION: A six-year-old boy with chromosome 7q32.1 microdeletion, autism spectrum disorder, attention deficit hyperactivity disorder, hypotonia and asthma presented for elective ligation of a patent processus vaginalis under general anaesthesia. DIAGNOSIS: Chromosome 7q32.1 microdeletion is a rare genetic disorder with developmental, behavioural and neuromuscular features. Coexisting reactive airway disease and autism spectrum disorder heighten the risk of perioperative respiratory adverse events (PRAEs) and complicate induction and emergence. TREATMENT: A perioperative strategy minimising airway stimulation and preserving spontaneous ventilation was employed. Anaesthesia was induced with sevoflurane in oxygen; a laryngeal mask airway (LMA) was used instead of endotracheal intubation, and neuromuscular blockade was avoided. The perioperative course was uneventful, with no respiratory complications. DISCUSSION: Use of a supraglottic airway with maintenance of spontaneous ventilation, and a calm behaviourally tailored approach, facilitated safe anaesthesia in this child. This case adds to the limited literature on the anaesthetic implications of chromosome 7q32.1 microdeletion.

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13. Latifoğlu F, Alp ZA, Gengeç Benli Ş. Attention load modulates functional brain connectivity reorganization in children with high autistic traits: Evidence from phase and amplitude coupling metrics. Behav Brain Res. 2026; 518: 116545.

Whether emotional processing difficulties in autism spectrum disorder (ASD) stem from deficits in recognizing emotional stimuli or from limitations in flexibly reorganizing brain networks under increasing cognitive demands remains an open question. To our knowledge, this study is among the first to investigate the effects of graded attentional load (low/moderate/high) on EEG-based functional connectivity and brain network organization during task-irrelevant emotional prosody processing in children with high autistic traits (n = 31), by integrating phase-based (iPLV, wPLI) and amplitude-based (AEC) metrics together with graph-theoretic indices within a unified analytic framework. Connectivity matrices from a sliding-window approach were decomposed into edge-level, distributional, and graph-theoretic features and load-dependent changes in connectivity were assessed with statistical analyzes and classification models. The results suggested that attentional load did not uniformly increase or decrease connectivity but rather produced a multi-layered pattern of reorganization that varied as a function of frequency band, connectivity metric, and network topology. Phase-based connectivity in the beta band was decreased with increasing load, while amplitude envelope coupling (AEC) in the theta and alpha bands was increased under high load. This dual-mechanism pattern was most pronounced under the high-load condition, which yielded the greatest number of nominally significant features (uncorrected p < 0.05; none survived FDR correction), the largest theta-AEC effect size (Kendall's W up to 0.22), and the best-performing classification model among those tested (accuracy = 72.6%, F1 = 0.725, AUC = 0.764). In conclusion, this exploratory study suggests that, in children with high autistic traits, increasing cognitive demands may be associated with band-specific network reorganization characterized by attenuated phase-based coordination alongside enhanced amplitude-based coupling; these patterns did not survive correction for multiple comparisons, have not been compared with those of typically developed children, and should be treated as hypothesis-generating rather than confirmatory. If replicated, such findings could eventually inform how environmental stimulation and cognitive load are structured in special education settings.

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14. Li Y, Zhang L, Hou L, Wan L, Zhu G, Yang G, Li R. Multimodal Analysis of Brain Network Abnormalities in Autism Spectrum Disorder: a Graph Neural Network-based Fusion Investigation of EEG and fNIRS. IEEE Trans Biomed Eng. 2026; Pp.

OBJECTIVE: This study aimed to identify brain network abnormalities of children with Autism Spectrum Disorder (ASD) by analyzing multimodal neuroimaging data through graph neural networks (GNNs), laying a technical foundation for future machine learning-based neuroimaging analysis. METHODS: We employed combined electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) to capture brain activity of 58 ASD children and 63 age- and gender-matched typically developing (TD) children. The concurrent EEG and fNIRS data were fused using an enhanced GNN to identify ASD with high accuracy. Key connections and regions of interest (ROIs) were identified for each group, followed by graph theory metrics (e.g., local efficiency) and topological data analysis (TDA) to quantify group differences. RESULTS: The proposed GNN model achieved 84% accuracy, outperforming the single-modality approach. Analysis of subgraph created by the model showed that the two groups exhibited different neural patterns in motor-language integration and lateralization, a key basis for GNN models to distinguish between the two groups. Individuals with ASD may also have topological defects such as lower average local efficiency and a lack of high-order structures. CONCLUSION: The proposed framework effectively captures quantitative insights ranging from specific connection-level variations to network-level differences, identifying candidate discriminative connectivity patterns within this cohort. SIGNIFICANCE: This study establishes a multimodal deep learning framework that identifies candidate discriminative topological signatures from fused EEG-fNIRS data, providing preliminary within-cohort classification evidence and an exploratory topological analysis framework.

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15. Lu JX, Hou CH, Hsiao SJ, Tsai LT. ESCS Reliability in Children with ASD: Exploratory Application in Visual Rehabilitation for Co-Occurring Visual Difficulties. Am J Occup Ther. 2026: 19437676261498879.

ImportanceVisual difficulties are common in children with autism spectrum disorder (ASD) and may limit access to socially informative cues, affecting early social engagement. Reliable observational measures are needed to assess social communication and monitor rehabilitation outcomes.ObjectivesTo examine the inter-rater reliability of the Early Social Communication Scales (ESCS) in children with ASD and explore its clinical applicability for monitoring social-communication change following visual rehabilitation (VR) in children with ASD and co-occurring visual difficulties.DesignMultiphase methodological study with cross-sectional reliability analysis and an exploratory pre-post case series.SettingHealthcare institution.ParticipantsThirty-three children with ASD participated in the reliability analysis; nine children with ASD and co-occurring visual difficulties participated in the VR case series.InterventionIndividualized VR delivered in 10 weekly 1-h sessions using computer-based visual training games and visual perceptual activities.Outcomes and MeasuresThe ESCS was the primary social-communication measure; the Visual Function Battery for Children with Special Needs assessed visual function. Intraclass correlation coefficients (ICCs) and minimal detectable change values were calculated.ResultsESCS inter-rater reliability ranged from poor to excellent (ICC = 0.464-0.951), with lower reliability for advanced initiating behavioral requests. In the VR case series, the ESCS captured changes in responding to behavioral requests, alongside improvements in visual function and visual attention.Conclusions and RelevanceThe ESCS demonstrated acceptable inter-rater reliability for assessing early social communication in children with ASD and showed preliminary clinical applicability for monitoring social-communication change in VR contexts. Larger controlled studies are needed to confirm these findings.What This Article AddsThis study provides evidence that the ESCS can be reliably scored by trained occupational therapists when assessing early social communication in children with ASD. It also illustrates how the ESCS may be used in VR contexts to monitor changes in interaction-based social-communication behaviors among children with co-occurring visual difficulties. Children with autism spectrum disorder may have visual difficulties that affect how they use visual information during social interaction. This study found that the Early Social Communication Scales can be scored reliably by trained occupational therapists and may help practitioners monitor early social-communication behaviors when visual function is addressed in rehabilitation. eng.

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16. Ma L, Li F, Zhang X, Lei F, Liang L, Mao X. Evolutionary Weighted Hodge Laplacian Descriptors for rs-fMRI Brain Networks. J Chem Inf Model. 2026; 66(18): 11778-92.

Complex biological networks often exhibit multiscale organization that is not fully characterized by pairwise edge weights or fixed graph summaries, motivating compact descriptors that retain both topological and spectral information. Here, we present an evolutionary weighted Hodge Laplacian (EWHL) framework for resting-state functional magnetic resonance imaging (rs-fMRI) connectivity, in which the functional connectivity matrix of each subject is represented as a weighted Vietoris-Rips filtration and 0-dimensional and 1-dimensional weighted Hodge Laplacian spectral descriptors are extracted across 13 positive connectivity thresholds. In an autism spectrum disorder (ASD) classification task using 884 participants from the Autism Brain Imaging Data Exchange I (ABIDE I) cohort, EWHL reduced the original 6670-dimensional functional connectivity vector to 130 features and, with eXtreme Gradient Boosting (XGBoost), yielded 87.7% accuracy and an area under the receiver operating characteristic curve (AUC) of 0.946 under 20 repetitions of 10-fold cross validation. Under the same internal protocol, EWHL outperformed a rerun raw functional connectivity baseline and a single threshold ablation, suggesting that multiscale weighted Hodge spectra provide informative descriptors for functional brain networks derived from rs-fMRI, although confound control within each fold and external validation remain necessary before clinical interpretation.

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17. MacNaul H, Cox AD, Thacker I. Attrition in Autism Research for Challenging Behavior: A Preliminary Investigation Into Parental Stress and Other Predictors Related to Project Completion. Behav Modif. 2026: 1454455261495098.

The increasing prevalence of autism spectrum disorder (ASD) in the United States has elevated the need for inclusive and representative intervention research. However, attrition within research initiatives that include autistic individuals who engage in challenging behavior remains understudied. This study examined predictors of study completion across three levels of engagement: consent only (full attrition), treatment only (partial attrition), and full study completion (no attrition). Participants included 182 caregiver-child dyads enrolled in a multi-component study involving a behavior-analytic treatment and a severity tool research portion. Using retrospective data and ordinal logistic regression, we explored whether participant challenging behavior topographies, demographics, and parental stress predicted study completion type. Results indicated that child elopement and higher parental stress scores marginally predicted full study completion after a Bonferroni adjustment, while demographic variables were not significant predictors. These findings may suggest that caregiver urgency regarding specific challenging behaviors and higher perceived stress may increase research engagement. Routine examination of attrition patterns within multi-component intervention studies may support more equitable and representative participation in autism treatment research. Autism affects more and more families each year. Some autistic children engage in behavior that can be difficult or unsafe to manage, such as running away, aggression, or self injury. These behaviors can create stress for caregivers and may also make it harder for families to participate in research studies, especially when studies require time, consistency, or multiple appointments. This project looked at which families completed a research study that offered free behavior treatment and which families dropped out early. We looked at whether completion was related to the child’s behavior, the caregiver’s level of stress, or the family’s background. We found that families of children who showed behaviors like running away (elopement) were more likely to complete the entire study. We also found that caregivers who reported higher levels of stress were more likely to stay involved. In contrast, factors like language, race, or ethnicity did not seem to influence who completed the study. These findings may offer helpful information as it relates to understanding why families drop out. It may also offer ideas on how to conduct future studies that will help families remain engaged for the entire study. This may be important because it can make autism research more fair, useful, and reflective of all families’ experiences. eng.

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18. Milne S, Blake N, Jones E, Ingold C, Cihan B, Bridge L, Robinson JL, Taylor GM. Smoking cessation interventions in adults with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD). Cochrane Database Syst Rev. 2026; 10(10): Cd016400.

This is a protocol for a Cochrane review (intervention). The objectives are as follows: Primary objective To assess the effects of smoking cessation interventions, compared with no intervention, usual care, placebo, or alternative interventions, on sustained abstinence from smoking in adults with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or co-occurring ADHD and ASD. Secondary objectives To assess whether the effects of smoking cessation interventions differ between adults with ADHD, ASD, and co‑occurring ADHD and ASD. To assess whether intervention effects vary according to participant characteristics (e.g. ADHD or ASD symptom profiles, co‑occurring mental health conditions, and alcohol- or substance-use disorders). To assess the safety and acceptability of smoking cessation interventions, including serious and non-serious adverse events and treatment discontinuation.

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19. Nani JV, Duque VJ, Muotri AR, Mecawi AS. Single-Cell Integration of Mouse Models of Autism Reveals Conserved Transcriptomic Signatures of Excitatory-Inhibitory Imbalance and Glial Dysfunction. Glia. 2026; 74(12).

The etiological heterogeneity of autism spectrum disorder (ASD) complicates identifying core molecular mechanisms. We systematically integrated scRNA-seq data from 11 diverse genetic and environmental mouse (Mus musculus) models, encompassing > 300,000 cells across multiple brain regions and developmental stages. Using advanced computational harmonization (RPCA), we identified robust convergent transcriptomic signatures that transcend model-specific variability. Our findings reveal widespread alterations in neuronal communication pathways, specifically increased excitatory-inhibitory signaling involving PTN, SLIT, and PTPR pathways. Furthermore, cell-cell communication analysis via NicheNet prioritized ligand-receptor pairs associated with altered circuit excitability, offering a predictive blueprint of dysregulated intercellular crosstalk. Crucially, we identified significant glial involvement characterized by astrocyte function inhibition, marked by Aqp4 and Kcnj10 downregulation related to impaired water/potassium homeostasis and mature oligodendrocyte metabolic dysregulation through Olig family upregulation and enhanced oxidative phosphorylation. Differentially expressed genes (DEGs) significantly overlapped with SFARI-listed high-confidence risk genes, particularly within excitatory neuronal subtypes. Comparison with human postmortem single-nucleus data from the prefrontal and parietal cortices demonstrated conserved signatures related to impaired synaptic protein synthesis (GRIN2B, CAMK2A) and oligodendrocyte-mediated neurodevelopmental deficits (NRXN, DLGAP). This study confirms that E/I imbalance and glial dysfunction are universal cellular pathologies in ASD, providing a robust, large-scale reference for identifying novel therapeutic targets with single-cell resolution.

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20. Parenteau CI, Nahmias AS, Lerner MD. Feasibility, Acceptability, and Efficacy of an Ecological Momentary Intervention for Autistic Adults. J Autism Dev Disord. 2026.

PURPOSE: Many autistic adults experience limited access to scalable social-emotional supports, underscoring the need for low-intensity interventions that can be integrated into daily life. This study evaluated the feasibility, acceptability, and preliminary efficacy of a one-week ecological momentary intervention (EMI) designed to enhance social attention and social-emotional functioning through in vivo real-time reporting of social interactions. METHODS: Thirty-one autistic adults were randomized to one of three conditions (facial expression, hair color, or passive control) and completed an EMI protocol and pre- and post-intervention measures. RESULTS: Feasibility outcomes were mixed: retention was high, but self-reported adherence fell below the a priori 80% benchmark, and utilization varied considerably. Equivalence tests indicated no condition differences in utilization, adherence, or acceptability. Net acceptability did not meet the a priori threshold of more than 50% of participants reporting neutral or positive net acceptability. Regression analyses revealed no condition-related effects on behavioral, self-report, or neural outcomes. CONCLUSION: Overall, results suggested that the EMI achieved high retention, but did not meet the a priori thresholds of adequacy for adherence and acceptability, and did not produce detectable changes in social-emotional functioning. Refinements to EMI design and dose may be necessary to improve the potential impact of brief EMIs for autistic adults.

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21. Robinette LM, Taylor HG, Boone KM, Rogers LK, Rausch J, Bartlett CW, Klebanoff MA, Keim SA. Fatty Acid Supplementation in Toddlers Born Preterm and Attention and Autism Outcomes at 8-10 Years: Omega Tots Randomized Controlled Trial Long-Term Follow-Up. J Autism Dev Disord. 2026.

PURPOSE: Children born preterm are at increased likelihood of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). We examined whether 6 months of daily dietary docosahexaenoic acid (DHA) + arachidonic acid (AA) supplementation at age 1-year reduced attention problems and likelihood of ADHD and ASD diagnoses in children born preterm. METHODS: In the Omega Tots randomized placebo-controlled trial, children born at <35 weeks' gestation received daily DHA (200 mg) + AA (200 mg) or placebo (400 mg corn oil) at 10-16 months' corrected age. This long-term follow-up assessed outcomes at 8.5-10.5 years. Outcomes included parent- and teacher-rated attention problems, performance on the Flanker Inhibitory Control and Attention Test (continuous performance task), and medical record diagnoses of ASD and ADHD. Mixed linear and log-binomial regression models estimated treatment effects. Subgroup analyses examined effects by sex, birthweight, family income, dietary omega-3 intake, and blood omega-3 status. RESULTS: At least 1 outcome measure was available for all 376 children eligible for follow-up. Flanker scores were higher (better) for the DHA+AA group (difference=3.02; 95% CI=0.01, 6.04), particularly among children with lower dietary omega-3 intake (difference=4.88; 95% CI=0.53, 9.23). DHA+AA was associated with fewer teacher-rated attention problems among children with birthweight>1500g (difference=-2.97; 95% CI=-5.38, -0.55). No group differences were found in likelihood of autism and ADHD diagnoses. CONCLUSIONS: DHA+AA supplementation was associated with modest improvements in attention, particularly among specific subgroups, supporting further investigation of targeted, personalized nutrition approaches. There was no association between supplementation and likelihood of ADHD and autism. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05191823.

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22. Roseby W, Racey C, Ward J. Global organization of structural covariance networks derived from parcellated cortical surface area in atypical populations. Cereb Cortex. 2026; 36(10).

Higher-order features of brain organization are powerful measures for understanding the relationship between brain and experience. In particular, the global arrangement of structural features of the cortex provides insight into neurodevelopmental processes that underlie individual differences in perception and cognition. Structural covariance networks (SCNs), which capture regional coordination of brain morphometry, are an efficient method to derive global cortical properties. However, their interpretation relies on an array of methodological choices that are often inconsistent between studies. Using a hierarchically clustered version of the Human Connectome Project (HCP) atlas, we constructed SCNs of regional cortical surface area for groups with four different conditions-synesthesia, autism, early psychosis, and anxiety or depression-and compared global network properties with those of age- and sex-matched controls. SCNs for synesthesia and autism showed globally stronger connectivity, with specific increases at moderate cortical distances, as well as lower network complexity. Conversely, the SCN for early psychosis showed a globally lower connectivity and a greater complexity, while depression and anxiety showed few differences compared with controls. The results for autism and depression were replicated across two datasets each. These findings support the notion that synesthesia and autism share neurodevelopmental mechanisms, while psychosis may involve a diverging process.

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23. Russell A, Cremen C, Kirby A, Melia R. Experiences of Suicide Prevention Interventions and Supports for Autistic Adults: Perspectives of Autistic Adults, Family Members and Clinicians. J Autism Dev Disord. 2026.

PURPOSE: Autistic adults experience disproportionately high rates of suicidality, yet little research has examined how they experience suicide prevention supports. This study explored perspectives on suicide prevention supports from Autistic adults, family members and clinicians. METHODS: A qualitative study using reflexive thematic analysis was conducted. Semi-structured interviews were completed with 21 participants: 14 Autistic adults with lived experiences of accessing suicide prevention supports in Ireland, 4 family members and 8 clinicians working with Autistic adults experiencing suicidality. Some participants represented more than one role. Analysis was inductive, informed by a neuroaffirmative, constructivist framework and involved community engagement throughout. RESULTS: Five interconnected themes were generated. Three describe a harmful trajectory through suicide prevention supports. (1) « No one can help me », captures confusing and exclusionary help-seeking experiences. (2) « They weren’t listening to me » reflects experiences of being invalidated, misunderstood, and dismissed by supports. (3) « You haven’t done anything, just made it worse » describes withdrawal from future help-seeking. Across themes, systems were experienced as crisis-driven, difficult to access, and poorly attuned to Autistic distress, sometimes escalating rather than reducing distress. Two themes reflect protective buffers. (4) « Having someone who is human with you » describes how feeling understood and supported by others helped to contain suicidal distress. (5) « My whole life makes sense now » captures how developing an Autism-informed understanding of oneself reduced self-blame and fostered self-compassion. CONCLUSION: Autism-informed, relationally attuned suicide prevention approaches that prioritise empathy, accessibility, and individualised support may reduce harm and improve engagement with suicide prevention supports for Autistic adults experiencing suicidal distress.

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24. Sönmezler E, Hız Kurul S, Erez O, Ekinci B, Yaraş T, Binokay L, Karakülah G, Lochmüller H, Horvath R, Yaramış A, Cakan-Akdogan G, Oktay Y. KATNAL2 dysfunction impairs microtubule dynamics and contributes to syndromic neurodevelopmental disease. Hum Mol Genet. 2026; 35(21).

Katanins are microtubule-severing ATPases. Dysfunction of katanin subunits has been implicated in impaired neurogenesis, morphogenesis, and neuronal migration. Although heterozygous variants in KATNAL2 (katanin-like 2), a known autism-spectrum disorder (ASD) risk gene, have been reported in patients with ASD or other neurodevelopmental disorders (NDD), the underlying cellular mechanisms remain incompletely defined. Whole-exome sequencing (WES) identified a homozygous missense variant in KATNAL2 (NM_001387690.1:c.1390T>C; p.(Ser464Pro)) in a pediatric patient presenting with severe global developmental delay, intellectual disability, infantile-onset epilepsy, and autistic features, extending the phenotypic spectrum beyond prior autism-focused associations. To elucidate the cellular mechanisms underlying KATNAL2 dysfunction, we established induced pluripotent stem cells (iPSCs) from patient fibroblasts and differentiated them into neural progenitor cells (NPCs) for quantitative immunofluorescence analyses of microtubule organization, microtubule regulatory proteins, and transcriptome profiling. In parallel, we generated CRISPR/Cas9 katnal2 zebrafish crispants and assessed body patterning and axonal projections using the transgenic nbt:dsRed line. Patient iPSC-derived NPCs showed impaired interphase microtubule network organization with increased angular standard deviation in directionality and mitotic/cytokinetic abnormalities, including abnormal positioning of the microtubule-rich cytokinetic midbody region. In vivo, CRISPR/Cas9 katnal2 zebrafish crispants showed abnormal body patterning together with disorganized motor neuron and posterior lateral line nerve axonal projections. Together, these findings support KATNAL2 as a regulator of microtubule network organization and mitotic progression in human NPCs. Our data from patient-derived NPCs and a zebrafish model provide functional evidence linking the p.(Ser464Pro) variant to an expanded syndromic neurodevelopmental phenotype.

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25. Szabó J, Feješ A, Bačiak L, Fujeríková G, Renczés E, Gogola D, Wadghiri YZ, Ostatníková D, Celec P. Acetaminophen-induced liver injury triggers short- and long-term neuroinflammation, blood-brain barrier disruption, and behavioral deficits in a genetic mouse model of autism. Acta Neuropathol Commun. 2026; 14(1).

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with a strong genetic basis, yet its etiology is not fully understood. Neuroinflammation is emerging as a critical secondary factor. Since peripheral organ injury, such as acute liver failure, can induce neuroinflammation, we aimed to investigate whether liver injury could exacerbate ASD-like phenotypes in a genetically susceptible model. We used adult (12-month-old) Shank3(-/-) mice, a genetic model of ASD, and their wild-type (WT) counterparts. A single high dose of acetaminophen (APAP; 350 mg/kg) was administered intraperitoneally to induce acute liver injury. We assessed acute (24-h) and long-term (1-month) consequences on liver health, neuroinflammation, blood-brain barrier integrity, and brain edema using plasma biomarkers, immunohistochemistry, and in-vivo MRI, as well as behavioral phenotypes, including sociability, repetitive behaviors and exploration. Acutely, APAP induced severe liver damage, cerebral edema, and neuroinflammation in Shank3(-/-) mice. One month later, despite liver recovery, both APAP-treated WT and Shank3(-/-) mice exhibited brain edema, elevated apparent transverse relaxation (R2*) rates, and lasting neuroinflammation, evidenced by microgliosis and reactive astrocytosis. These differences were more extensive in the Shank3(-/-) group. Behaviorally, this was accompanied by increased social deficits in both genotypes. Critically, only the APAP-treated Shank3(-/-) mice displayed significantly increased repetitive behaviors, and reduced exploratory activity. Here, we show that transient liver injury is associated with long-term neuroinflammation, markers of blood-brain barrier disruption, and behavioral deficits. These findings demonstrate that while peripheral organ damage can induce lasting behavioral changes in healthy animals, the severity and spectrum of these deficits are exacerbated by ASD-associated genetic predisposition. These findings support a preclinical gene-environment interaction framework relevant to ASD-associated vulnerability.

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26. Te Hennepe SJ, De Jongh A. Response to ‘Treating trauma, not autism: a critical response to Te Hennepe et al. (2026)’. Eur J Psychotraumatol. 2026; 17(1): 2739784.

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27. Vinurel M, Wang X, Kordon D, Jochaut D, Speranza M, Boeckx C, Giraud AL. Bridging language phenotypes, neural dynamics and gene regulation in autism. Imaging Neurosci (Camb). 2026; 4.

Autism Spectrum Disorders (ASDs) affect approximately 1% of the global population, with prevalence rising over recent decades. Although ASDs are heritable (~70%), translating genetic findings into effective therapeutics remains challenging due to the vast number of implicated risk genes (>700) and the limited influence of individual genes on disease expression. Their collective impact and convergent expression patterns of small-effect genes provide insights into ASD-related neurobiological mechanisms. Current interventions remain symptom-focused and do not address underlying neurodevelopmental mechanisms. Emerging approaches in functional genomics offer new insights into ASD pathogenesis by exploring gene expression diversity, yet clinical applications remain distant. Language deficits are among the most frequent and disabling features of ASD, profoundly affecting individuals’ and families’ quality of life. Recent evidence from neuroimaging and electrophysiology studies suggests disrupted neural oscillatory dynamics are linked to language deficits in ASD. Several ASD-associated genes have been implicated in biological pathways involved in the regulation of brain oscillatory dynamics, suggesting a potential mechanistic link between genetic variation, altered brain rhythms, and language impairment. We propose a neurophysiological imaging genetics framework that leverages neural oscillatory profiles as endophenotypes for targeted investigation and as functional readouts of gene expression. Within this framework, neuromodulation is proposed as an experimental approach to investigate and potentially modulate altered oscillatory dynamics associated with speech communication deficits in ASD, while integrating oscillation-related ASD candidate genes into a symptom-oriented model of functional genomics. This approach shows how integrating genetic variation, non-invasive neuroimaging, and behavioral phenotypes can advance our understanding of ASD and inform targeted, mechanism-based interventions.

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28. Yatsuga S. A Suspected Mosaic 3q29 Deletion in a Patient With Autism Spectrum Disorder and Multiple Micronutrient Deficiencies: A Case Report. Case Rep Genet. 2026; 2026: 9353827.

BACKGROUND: 3q29 deletion syndrome (MIM #609425) is a rare genomic disorder characterized by variable expressivity and incomplete penetrance. Somatic mosaicism for a 3q29 deletion in an affected proband has rarely been documented. Mosaicism inferred from attenuation of the array signal requires confirmation by an independent method. When a chromosomal deletion encompasses an autosomal recessive (AR) disease gene, evaluation of the second allele may be informative. Extreme food selectivity associated with autism spectrum disorder (ASD) poses substantial but underrecognized nutritional risk. CASE PRESENTATION: An 8-year-old Japanese boy with ASD, intellectual disability, absent speech, progressive obesity, hepatosplenomegaly, and congenital toe syndactyly underwent chromosomal microarray analysis (CMA). A 1.27-Mb interval at 3q29 (arr[GRCh37] chr3:195,804,728-197,074,949) was segmented with a mean log2 ratio of -0.252 across 59 informative probes, against an excellent array quality (derivative log ratio spread 0.179). The signal returned to baseline immediately outside the interval. The magnitude of the attenuation is intermediate between a normal diploid state and that expected for a constitutional heterozygous deletion and is compatible with a suspected mosaic deletion; the laboratory’s automated nomenclature nevertheless assigned a copy number of 2, with the explicit caveat that copy number was not verified, and no independent confirmatory method was applied. The interval is atypical and nested within the recurrent 3q29 region and encompasses TFRC, RNF168, PAK2, and DLG1. A targeted 15-gene DNA repair panel identified no pathogenic or likely pathogenic variant on the second RNF168 allele. An incidental heterozygous NBN variant of uncertain significance (c.265A > G, p.Ile89Val; NM_002485.5) was nondiagnostic and did not alter management. Neither exome nor genome sequencing was available as a reimbursed clinical investigation, and parental samples were not obtained. Microcytosis and hypochromia were present at both time points; serum iron was within the reference interval at baseline and low at follow-up, ferritin remained within the reference interval throughout, and no threshold-based criterion for iron deficiency was met. Low 25-hydroxyvitamin D, low vitamin C, and low retinol-binding protein were documented at two time points and considered most likely related to the markedly restricted diet. Plasma amino acids; serum carnitine fractions; zinc; selenium; vitamins B1, B2, and B12; immunoglobulins; and alpha-fetoprotein were unremarkable; serum copper was elevated in the presence of a raised C-reactive protein, and ceruloplasmin was not measured. The cause of the hepatosplenomegaly remained unresolved. CONCLUSION: An attenuated CMA signal at 3q29, compatible with a suspected mosaic deletion but not independently confirmed, was identified in a patient whose phenotype overlaps 3q29 deletion syndrome. Where a deletion encompasses an AR disease gene whose phenotype overlaps the presentation, second-allele evaluation may add diagnostic resolution. This case highlights the importance of considering nutritional assessment in children with ASD and extreme food selectivity; the biochemical abnormalities persisted at follow-up, although no vitamin D had been administered before the follow-up sample and treatment exposure and adherence were not systematically documented.

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29. Yılmaz E, Özer NK, Topal E. Could developmental age explain the apparent screen-time mediation in preschool autism?. Eur Child Adolesc Psychiatry. 2026.

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