1. Benjamin LR, Roesch SC, Lau A, Brookman-Frazee L. Characterizing Mental Health Symptoms and Caregiver Priorities for Autistic Children Receiving Publicly-Funded Mental Health Services: A Latent Class Analysis. Evid Based Pract Child Adolesc Ment Health;2025 (Sep 19)

BACKGROUND: Autistic children often receive publicly-funded mental health services to address co-occurring mental health concerns. Increasing research has sought to characterize the mental health profiles of autistic children accessing these services, but there remains a need to integrate caregiver priorities into these profiles. OBJECTIVE: This study seeks to characterize autistic children’s mental health profiles by integrating caregiver priorities and child mental health symptom severity. METHOD: Data from caregivers of 186 school-age autistic children were drawn from baseline assessments conducted in a hybrid type 3 implementation-effectiveness trial testing implementation strategies for An Individualized Mental Health Intervention for Autism in outpatient and school-based mental health services. The Top Problems Assessment was employed to assess caregiver-identified emotional and behavioral intervention priorities, and the Brief Problem Checklist was used to assess the severity of children’s internalizing and externalizing symptoms. An exploratory Latent Class Analysis classified children by caregiver priorities and child mental health symptom severity. Child and family characteristics associated with class membership were examined. RESULTS: A four-class solution emerged: (1) Primarily Externalizing Priority, (2) Mixed Priority, Lower Severity, (3) Mixed Priority, Higher Severity, and (4) Primarily Internalizing Priority. Child gender and caregiver primary language were associated with class membership. CONCLUSION: Findings highlight the heterogeneity of autistic children’s presenting problems and the value of integrating caregiver priorities into child profiles. Results may guide evidence-based intervention selection, implementation planning, and capacity building related to serving autistic children in mental health services.

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2. Bulut A, Haçat SO. AI-Supported Learning Platforms for Students With Developmental Disabilities: A SWOT Analysis Approach. J Intellect Disabil Res;2026 (Apr 23)

BACKGROUND: This study examines the evolving role of Artificial Intelligence (AI) in developmental disability education, focusing on the shift from diagnosis-centred approaches to inclusive, learning-oriented paradigms grounded in STS, UDL and TPACK frameworks. METHOD: A bibliometric and SWOT-based analysis was conducted on 1221 publications (2008-2025) indexed in the Web of Science to explore research trends, conceptual developments and international collaborations. RESULTS: Findings show that AI-supported learning platforms enhance personalisation, accessibility and data-driven pedagogy but are constrained by ethical, pedagogical and infrastructural challenges. The SWOT analysis identifies AI as a transformative yet fragile innovation dependent on teacher competence, ethical governance and global equity. CONCLUSIONS: Achieving a sustainable and human-centred AI ecosystem requires alignment across pedagogical development, transparent governance and inclusive global participation, positioning AI as a catalyst for educational justice in special education.

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3. Burch K, Sahyoun AM, Abutineh S, Munkhsaikhan U, Alipour M, Zahran G, Ait-Aissa K, Wang Q, Samy S, Kassan A, Ishrat T, Abidi AH, Kassan M. From mouth to mind: Investigating oral microbial contributions to autism spectrum disorder. Neurosci Biobehav Rev;2026 (Apr 20);186:106702.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by persistent social communication challenges and restricted, repetitive patterns of behavior. ASD arises from both genetic and environmental influences. Growing evidence also points to microbial dysbiosis, especially in the gut and mouth, as a potential contributor to neurodevelopment and symptom patterns. While gut microbiome alterations have been well documented in ASD, the oral microbiota has received comparatively less attention, despite its established roles in systemic inflammation, immune regulation, and even neurological function. Understanding these microbial shifts may help identify early biomarkers and guide oral health interventions to improve outcomes in ASD populations. This narrative review synthesizes current knowledge on the relationship between oral microbiota dysbiosis and ASD, with three primary objectives: (1) to characterize oral microbiome alterations observed in individuals with ASD compared to neurotypical controls; (2) to explore potential mechanisms linking oral dysbiosis to core and comorbid ASD symptoms; and (3) to evaluate therapeutic strategies targeting the oral microbiome as potential interventions for ASD.

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4. Clark SM, Feldman JI, Magnuson JE, Pulliam G, Santapuram P, Bowman S, Bush CT, Dunham-Carr K, Raj SV, Keçeli-Kaysılı B, Lewkowicz DJ, Woynaroski TG. Relations Between Preferential Looking to Synchronous Audiovisual Speech and Expressive Language in Infants With Autistic and Non-Autistic Siblings. Mind Brain Educ;2026 (Feb);20(1):e70039.

Differences in audiovisual processing may influence language development in autism. We characterized preferential looking to temporally synchronous audiovisual speech in fifty infants (28 elevated-likelihood [54% male]; 22 population-level-likelihood [50% male]) aged 12-18 months. We first tested whether preferential looking to synchronous audiovisual speech differed between groups; population-level-likelihood infants demonstrated greater preferential looking to synchronous audiovisual speech relative to elevated-likelihood infants by 18 months. We then assessed whether preferential looking to synchronous audiovisual speech was related to concurrent expressive language (1) directly, (2) via vocalization complexity, and (3) as moderated by age, sex, and familial likelihood group. Infants completed an eye tracking task and standardized communication and language assessments at 12-18 months. The population-level-likelihood infants demonstrated greater preferential looking to synchronous audiovisual speech relative to elevated-likelihood infants by 18 months. Preferential looking to synchronous audiovisual speech was not directly and unconditionally associated with concurrent expressive language. However, moderation and mediation analyses showed that preferential looking to synchronous audiovisual speech was significantly associated with concurrent expressive language through increased vocalization complexity in male infants. Implications for research, theory, and clinical practice are discussed.

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5. Deng J, Paumier A, Labarta-Bajo L, Brandebura AN, Andrews NA, Kahn SB, Bassil R, Tao T, Pinto AFM, Diedrich JK, Allen NJ. Suppression of astrocyte BMP signaling improves molecular signatures and functional deficits in a fragile X syndrome mouse model. Nat Commun;2026 (Apr 23)

Fragile X syndrome (FXS) is a monogenic neurodevelopmental disorder with molecular, neuroanatomical, and behavioral changes. In FXS, astrocytes express dysregulated gene and protein networks, therefore identifying upstream pathways mediating astrocyte changes may provide a point of intervention. We focus on the bone morphogenetic protein (BMP) pathway, which is upregulated in FXS astrocytes. We generated a conditional KO (cKO) of Smad4 in astrocytes to suppress BMP signaling, finding that this lessens audiogenic seizure severity in male FXS mice. We performed in vivo transcriptomic and proteomic profiling of cortical astrocytes, finding upregulation of metabolic pathways, and downregulation of secretory machinery and secreted and membrane proteins in FXS astrocytes, with these alterations mitigated when BMP signaling is suppressed. Functionally, astrocyte Smad4 cKO restores deficits in inhibitory synapses in the FXS auditory cortex. Our findings show that astrocytes contribute to some FXS mouse molecular and functional phenotypes, and targeting astrocyte BMP signaling improves some FXS symptoms.

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6. Erickson SR, Jean J, Marshall VD. Emergency Department Visits for Adverse Medication Events for Adults With Intellectual or Developmental Disabilities. Ann Pharmacother;2026 (Apr 23):10600280261439952.

BACKGROUND: Persons with intellectual or developmental disabilities (IDD) are at risk of adverse medication events (AMEs). Polypharmacy, complex medication regimens, and reliance on others to manage medications are a few risk factors that are more common in this group of patients than in the general population. OBJECTIVE: To determine the likelihood that an emergency department (ED) visit for an AME is greater for adults with IDD than for the general adult population. METHODS: This exploratory study used the 2018 National (Nationwide) Emergency Department Sample (NEDS) of the Healthcare Cost and Utilization Project (HCUP) databases and applied a multivariable logistic regression analysis for complex surveys to determine the likelihood that an ED visit was for an AME and was different for adults with IDD compared to those without IDD, controlling for patient characteristics. RESULTS: A greater proportion of ED visits for adult patients with IDD were for AMEs (4.4%) compared to patients without IDD (2.6%). The unadjusted odds ratio for IDD when compared with non-IDD was 1.695, with a 95% confidence interval of 1.649 to 1.743. In the multivariable logistic regression model, the odds ratio associated with a patient with IDD was 1.795 (95% confidence interval 1.75, 1.84), indicating that the ED admission was significantly more likely to be due to an AME for patients with IDD compared to patients without IDD. CONCLUSION AND RELEVANCE: Adults with IDD have a higher likelihood that an ED visit is due to an AME compared with the general population. Knowing this, clinicians and researchers can begin to investigate the reasons for this disparity, in an effort to ensure the safe and effective use of medications by persons with IDD.

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7. Facey H, Broderick K, Cichon B, Stephens M. What Gynecologists Need to Know About Intellectual and Developmental Disabilities. Clin Obstet Gynecol;2026 (Apr 23)

Although patients with intellectual and developmental disabilities (IDD) have a right to comprehensive and accessible gynecologic care, they have historically faced discrimination within the health care system, and many providers report limited confidence in their ability to provide high-quality care. To combat this disparity, this article presents a framework for structuring gynecologic visits and reviews practical tools that clinicians can use to support successful clinical encounters and provide equitable care. These recommendations were informed by the expert opinion of health care professionals experienced in caring for patients with IDD, as well as through a review of current literature.

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8. Gao J, Liu W, Zang Y, Liu S. Autism Spectrum Disorder Caused by a Novel De Novo SCN2A Mutation: A Case Report. Int J Dev Neurosci;2026 (Apr);86(2):e70127.

Autism spectrum disorder (ASD) exhibits significant genetic heterogeneity, and a large number of risk genes may eventually converge on a limited number of common pathways. Among them, SCN2A, which encodes the Nav1.2α subunit of the voltage-gated sodium channel, is one of the important risk genes. This article reports a case of ASD caused by a novel mutation in SCN2A. The patient is a 6-year-old female, with the main clinical manifestations being language development delay and social communication disorders, but without epilepsy. Whole-exome sequencing revealed that she carried a heterozygous variant in the SCN2A c.4023_4077del (p.Val1343Alafs*17). This case enriches the ASD phenotype spectrum related to the SCN2A, especially providing a clinical example without comorbid epilepsy.

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9. Hirai T, Umeda N, Ohto-Nakanishi T, Fujioka T, Wakusawa K, Nara T, Tsuchiya KJ, Matsuzaki H. Dihydroxy fatty acids can be used for screening autism traits in toddlers. PCN Rep;2026 (Jun);5(2):e70338.

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10. Jamey K, Laflamme H, Foster NEV, Rigoulot S, Hyde KL, Dalla Bella S. A Randomized Proof-of-Concept Study of Gamified Rhythmic Training in Autistic Children. Ann N Y Acad Sci;2026 (Apr);1558(1):e70270.

Autistic children often experience differences in rhythmic skills and executive functioning, which are associated with rhythm-related challenges and the degree of autistic traits. Training rhythmic skills could support autistic individuals, given the fundamental role of timing skills in various aspects of cognitive, motor, and social functioning. We evaluated the feasibility of rhythmic training to support perceptual, motor, and cognitive functioning by testing Rhythm Workers (RW), a finger-tapping serious game, in autistic children (ages 7-13; n = 26). Participants were randomly assigned to play either RW or a control game with similar auditory-motor demands over 2 weeks. Feasibility results showed high compliance (retention, adherence) and similar engagement (training duration, enjoyment, perceived difficulty) for both games. Compared to the control group, children who played RW showed greater improvement in rhythmic skills as a function of training duration and autistic traits (social awareness). Gains were also observed in composite scores of executive functioning (accuracy), though not all subcomponent tasks showed significant effects. These findings offer preliminary support for the feasibility of implementing digital gamified rhythmic training for autistic children, and suggest potential benefits for motor and cognitive engagement that warrant further investigation.

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11. Kasahara S, Aono S, Takatsuki K, Niwa SI, Yabuki S. Attention-deficit/hyperactivity disorder and autism spectrum disorder in chronic pain: a study in Japanese pain centers. Sci Rep;2026 (Apr 23);16(1)

Chronic pain is influenced by physical and psychosocial factors and associated with symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); however, the specific symptom dimension related to pain severity and the underlying psychosocial pathways remain unclear. This cross-sectional screening study included 958 adult patients with persistent chronic pain despite standard care at their initial visit to multidisciplinary pain centers (Japan). Screening positivity rates were 17.1% for ADHD and 4.4% for ASD. ADHD symptoms, but not ASD symptoms, were considerably associated with higher pain intensity and extremely severe pain [average numerical rating scale score: 9-10]. Among patients with extremely severe pain, 27.4% were screened positive for ADHD. Hierarchical logistic regression analyses revealed that the association between ADHD symptoms and extremely severe pain was attenuated after adjustment for anxiety/depression and pain catastrophizing. Path analyses further indicated that ADHD symptoms were indirectly associated with severe chronic pain through anxiety/depression alone or through anxiety/depression combined with pain catastrophizing. Thus, ADHD symptoms are more strongly associated with pain severity than ASD symptoms in patients with persistent chronic pain, and emotional and cognitive factors may play a key mediating role. Screening for ADHD symptoms is crucial for comprehensive management of severe chronic pain.

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12. Kuriyakose D, M G. Integrating EEG microstate dynamics in a stacked ensemble for neurodiagnostic ASD assessment. Behav Brain Res;2026 (Apr 23);509:116220.

Autism Spectrum Disorder (ASD) remains diagnostically challenging due to its neurobiological heterogeneity and the current reliance on subjective behavioral assessments. To address this, we propose a novel stacked ensemble machine learning framework that enhances EEG-based ASD classification by integrating both spatial and temporal neural features. Spatial features including spectral power, functional connectivity, and signal complexity were extracted alongside temporal features derived from microstate transitions and Hidden Markov Model (HMM)-based dynamics, capturing complementary aspects of resting-state brain activity. Using Random Forest models for both base learners and the meta-classifier, our ensemble achieved a classification accuracy of 96.3% under rigorous GroupKFold cross-validation, significantly outperforming unimodal models based on spatial (88.15%) and temporal (73.6%) features alone. Bootstrapped confidence intervals confirmed the statistical robustness and generalizability of the ensemble approach. Our framework not only improves diagnostic accuracy but also lays the groundwork for translational neurotechnology aimed at early detection, subtype differentiation, and personalized intervention strategies in ASD.

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13. Li J, Liu J, Chen M, Wang Y, Zhou C. Observation of the Therapeutic Effect of Washed Microbiota Transplantation on Childhood Autism Spectrum Disorder. Actas Esp Psiquiatr;2026 (Apr 15);54(2):263-275.

BACKGROUND: This retrospective study evaluated the efficacy and safety of washed microbiota transplantation (WMT) via trans colonic endoscopic administration tube for children with autism spectrum disorder (ASD). METHODS: The clinical data of 19 children with ASD treated between November 2021 and December 2023 were analysed. The data included scores on the Autism Behaviour Checklist (ABC), Childhood Autism Rating Scale (CARS) and PedsQL™ 3.0 Gastrointestinal Symptoms Scales (PedsQL-GI) before treatment and one and six months post-WMT, as well as faecal 16S rRNA sequencing results (vs. healthy controls). RESULTS: ABC, CARS and PedsQL-GI scores improved significantly over time (all p < 0.001, large effect sizes). CARS and PedsQL-GI scores decreased notably at one and six months after treatment. ABC scores reduced significantly only at six months posttreatment. PedsQLGI scores at six months posttreatment further declined relative to those atone month posttreatment, whereas ABC and CARS scores remained stable. Subgroup analysis showed greater score reductions in the high-score ASD and constipation subgroups than in other patients. Faecal microbiota analysis revealed structural differences between ASD and healthy children. WMT altered gut flora structure and increased beneficial bacteria (e.g., Faecalibacterium). CONCLUSIONS: Preliminary findings suggest that WMT may improve gastrointestinal and core symptoms in children with ASD, especially those in high-score subgroups. Caution is needed given this study's small sample size, and large prospective studies are required for validation.

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14. Low ZXB. Serotonergic psychedelics for Autism spectrum disorder: Neurobiological mechanisms and translational prospects. Prog Neuropsychopharmacol Biol Psychiatry;2026 (Apr 23):111717.

Autism Spectrum Disorder (ASD) is characterized by persistent social-communication deficits, cognitive rigidity, and atypical sensory processing. Current pharmacological treatments, including risperidone and aripiprazole, provide only limited symptomatic relief and do not address the underlying neurobiological mechanisms. Converging evidence implicates dysregulated serotonergic signaling, impaired neuroplasticity, and chronic neuroimmune activation as central features of ASD pathophysiology. Serotonergic psychedelics, such as psilocybin and LSD, act as high-affinity 5-HT(2A) receptor agonists and have re-emerged as candidates for modulating these core pathways. In this Review, we synthesize molecular, cellular, and systems-level findings suggesting that psychedelics may transiently relax overly rigid cortical priors, reopen critical periods for social learning, and recalibrate dysfunctional neural circuits in ASD. These compounds enhance synaptic plasticity via BDNF and mTOR signaling, modulate cortical oscillations, and suppress neuroinflammation by shifting microglial phenotypes and suppressing pro-inflammatory cytokines. Systems-level frameworks, including the REBUS and anarchic brain hypotheses, contextualize how psychedelics induce globally integrated, less constrained brain states that may counteract the hyper-segregated connectivity commonly observed in ASD. While preclinical and early human studies report improvements in sociability, sensory responsiveness, and behavioural flexibility, rigorous clinical trials are urgently needed to establish safety, efficacy, and optimal developmental windows for intervention. We conclude by outlining a translational roadmap to guide future research, emphasizing the need for structured integration with behavioural therapies, attention to ASD heterogeneity, ethical considerations, and the potential to shift ASD treatment beyond symptomatic management toward disease-modifying intervention.

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15. Luoni M, Kubacki M, Giannelli SG, Morosi F, Di Berardino C, Iannielli A, Sessa A, Colasante G, Di Patrizio Soldateschi E, Lanzuolo C, Broccoli V. MeCP2 gene dosage-dependent neurodevelopmentally restricted defects arise by aberrant activation of cell fate-determining bivalent genes. Nat Commun;2026 (Apr 23);17(1)

The overexpression of MECP2 leads to severe neurological deficits in MECP2 duplication syndrome, and its dosage is considered a risk factor in gene therapy for Rett syndrome. However, in MECP2 duplication syndrome patients, MECP2 dysregulation arises at the embryonic stage while in Rett syndrome gene therapy, MECP2 is delivered into the mature brain. Here, we show that MeCP2 overexpression induces transcriptional alterations in neural progenitor cells, but has minimal effects in neurons in both mouse and human contexts. Consequently, MeCP2 overexpression in neural progenitor cells, but not mature neurons, leads to functional changes. Mechanistically, we observe that both endogenous and overexpressed Mecp2 bind to the same CpG island repertoire. In neurons, where endogenous Mecp2 is highly expressed, ectopic protein expression leads to reduced CpG island binding and accelerated protein degradation. In contrast, in neural progenitor cells, lower endogenous Mecp2 levels facilitate stronger deposition of the ectopic protein onto CpG islands, driving the transcriptional activation of many developmental bivalent genes. We show that this activation is mediated by the interaction with the SWI/SNF chromatin remodeling complex. Our findings establish that increased gene dosage-dependent effects are highly influenced by cell type, levels of proteins and their mechanisms of action.

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16. Norton A, Boettcher L, Wiench J, Gralton KS. « Let’s Cope Together »: An Evidence-based Approach to Caring for Patients Living With Autism in the Perioperative Setting. J Perianesth Nurs;2026 (Apr 23)

PURPOSE: To determine if an individualized coping plan for pediatric patients with autism, available in the electronic health record, could improve their safety and comfort, and family satisfaction in the perioperative setting. DESIGN: Evidence-based practice project. METHODS: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care was used as a framework for the development and implementation of a program to create individualized perioperative coping plans in the electronic health record for pediatric patients living with autism. Evidence reviews of the literature informed the process, which included environmental and care modifications to achieve an optimal patient experience. Collaboration among nurses, physicians, and child life specialists was integral to project implementation. FINDINGS: During the implementation period of the pilot project, perioperative coping plans were documented for 60% of surgical patients living with autism. Incorporating the creation of the coping plan within the usual nursing preoperative phone call increased the coping plan documentation rate to 90%. Tools and visual reminders built into the electronic health record facilitated the sustainment of the program. The surgical services team was able to make accommodations to perioperative processes and environment when team members had awareness of the child’s individual needs. CONCLUSIONS: Creation of a perioperative coping plan was a feasible intervention when incorporated into the preoperative phone call. In addition to the coping plan, environmental modifications engaged the health care team to provide individualized care and work toward the goal of an optimal perioperative experience for all.

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17. Orell G, Barazanji N, Fernell E, Gillberg C, Lindberg G, Walter S. Traits of autism and attention-deficit/hyperactivity disorder in irritable bowel syndrome with pronounced symptoms. Scand J Gastroenterol;2026 (Apr 23):1-11.

OBJECTIVES: Gastrointestinal symptoms are common in children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, little is known about the relationship between gastrointestinal symptoms with ASD and/or ADHD in adults. Emerging evidence has revealed potential connections between Irritable Bowel Syndrome (IBS) and ASD. Notably, shared genetic architecture has been identified between IBS and ASD. This cross-sectional study aimed at assessing the prevalence of ASD and/or ADHD traits in IBS patients and whether these traits impacted the clinical presentation. MATERIALS AND METHODS: Adult patients with moderate-severe IBS (N = 150) were offered screening questionnaires for ASD and ADHD. The patients also completed questionnaires for symptom severity and underwent a rectal balloon barostat examination. Participants screening positive for ASD and/or ADHD were compared to participants screening negative for both conditions. RESULTS: Screening questionnaires were obtained from 110 patients (86 women). In total, 34/110 participants screened positive for ASD and 45/110 for ADHD, and 26 among those screened positive for both conditions. IBS symptom severity was higher in the group screening positive for ADHD, and somatic symptom burden was higher in both positive screening groups. Barostat thresholds for maximum tolerable pressure were lower in the group screening positive for ASD, and anxiety scores were higher in the group screening positive for ADHD. CONCLUSIONS: We found that positive screening for ASD and ADHD were both highly prevalent in a cohort of patients with moderate-severe IBS. The patients who screened positive for ASD and/or ADHD presented significant clinical differences compared to those who did not.

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18. Parawansa FBP, Sugimoto A, Zain E, Nakazawa Y, Sakuma F, Yoshinaga K, Wahyu MD, Kasahara H, Egawa J, Shirozu H, Iijima A, Boku S. Atypical cortical neural activity in internet gaming disorder comorbid with autism spectrum disorder during a cue reactivity task: A magnetoencephalography study. PCN Rep;2026 (Mar);5(1):e70312.

AIM: Significant, positive correlations between internet gaming disorder (IGD) and autism spectrum disorder (ASD) are known. Individuals with ASD are prone to problematic internet use due to addiction or restricted interests. Here, we examined cortical neural activity in individuals with IGD comorbid with ASD during a gaming-related cue reactivity task, using magnetoencephalography (MEG). METHODS: MEG was used to record neural activity in right-handed male participants aged 11-20 years (11 IGD-ASD, 13 healthy controls; intelligence quotient [IQ] ≥ 80). IGD and ASD were diagnosed per DSM-5-TR criteria. During MEG recording, participants viewed gaming cues and neutral base stimuli in a cue reactivity task. Source-level cortical activity was estimated using minimum norm estimation (MNE), and statistical comparisons were performed using two-tailed nonparametric permutation tests with false discovery rate (FDR) correction. RESULTS: In the IGD-ASD group, neural activity was significantly elevated at 137 ms in the right fusiform gyrus during gaming cues compared with the base condition (p = 0.000039). Between-group comparisons under cue conditions (200-270 ms) showed higher right frontal activation (p = 0.0028) and lower activation in left lateral occipital (p = 0.000092), fusiform (p = 0.00025), lingual (p = 0.0017), and parahippocampal regions (p = 0.000049) in the IGD-ASD group compared with controls. CONCLUSION: The IGD-ASD group showed increased right frontal activity and decreased left occipital, fusiform, lingual, and parahippocampal activity during exposure to the gaming cue, suggesting atypical visual and cognitive processing mechanisms in this comorbid group. Further studies comparing individuals with ASD and those with IGD-ASD, as well as by examining the neurophysiological characteristics of individuals with ASD who develop or recover from IGD, might clarify the pathology of these populations.

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19. Rekik S, Mehmood S, Berriche L. Federated learning for fair autism spectrum disorder screening across age-heterogeneous populations. Front Digit Health;2026;8:1760849.

INTRODUCTION: The detection of Autism Spectrum Disorder (ASD) remains challenging due to the heterogeneity of behavioural manifestations, limited dataset availability, and strict privacy requirements. Conventional centralized machine learning approaches often suffer from overfitting and limited generalizability across different age groups. This study proposes a federated learning (FL) framework to enable collaborative ASD screening across children, adolescents, and adults without sharing sensitive patient data. METHODS: A federated learning framework was implemented and benchmarked using multiple FL algorithms, including FedPer, pFedMe, and q-FedAvg. These were compared with traditional centralized machine learning models such as Support Vector Machine (SVM), Random Forest, K-Nearest Neighbors (KNN), and J48. Data preprocessing involved imputation, encoding, scaling, feature selection, and Synthetic Minority Over-sampling Technique (SMOTE) to address missing values, categorical variables, and class imbalance. Model performance, fairness, robustness under non-IID conditions, computational efficiency, and communication costs were evaluated. RESULTS: Customized federated learning approaches achieved superior global accuracy of 97.2% for children, 89.5% for adolescents, and 86.8% for adults. The proposed framework demonstrated improved fairness and robustness in heterogeneous non-IID environments compared to centralized models, while maintaining computational and communication efficiency. DISCUSSION: The findings indicate that personalized federated learning provides a scalable, accurate, and privacy-preserving solution for ASD screening across diverse age groups. By bridging advanced machine learning techniques with ethical clinical practice, the proposed framework supports responsible and effective ASD detection in real-world healthcare settings.

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20. Tan RR, Nevill R, Intagliata V, Higgins A, White E, Burns A, Herrera J, Davis BE. Predictors of Autism Spectrum Disorder Among Children With Diagnostic Uncertainty After Initial Developmental-Behavioral Pediatric Evaluation. J Dev Behav Pediatr;2026 (Apr 23)

OBJECTIVE: To examine demographic and child/family factors predictive of autism spectrum disorder (ASD) in children with diagnostic uncertainty after initial assessment by experienced Developmental Behavioral Pediatric (DBP) clinicians. METHODS: A retrospective cohort of 87 consecutive children was seen for Interdisciplinary Autism Diagnostic Team (IADT) assessment between January 2022 and March 2023 because of initial DBP clinician diagnostic uncertainty. Sociodemographic and child/family characteristics including IADT results were analyzed using Mann-Whitney U tests, χ2 tests, and logistic regression to determine predictors of ASD diagnosis. RESULTS: Mean age of referred children was 6.9 (SD 3.02) years, 74% were male, and 78% did not exhibit cognitive delays. Demographic factors did not significantly differ between ASD and non-ASD diagnostic groups. The ASD group had lower rates of prenatal substance exposure (p < 0.001), physical aggression (p = 0.033), family history of non-ASD mental health conditions (p = 0.002), and adverse childhood events (p = 0.016). Autism spectrum disorder diagnostic testing best predicted an ASD diagnosis. The ASD group had significantly higher Autism Diagnostic Observation Schedule (ADOS) Total (p < 0.001) and Comparison scores (p < 0.001) than the non-ASD group. CONCLUSION: Children with ASD diagnostic uncertainty often share similar demographic and clinical features. This study found that family history of non-ASD conditions and child experiences of early adversity are significant factors in differentiating ASD and non-ASD. Child and family factors at point-of-referral may help discern need for an ASD team evaluation including structured observational tools (e.g., ADOS-2) and improve efficiency of assessment planning.

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21. Vergara Serpa JJ, Sumalla Cano S. [Curcumin in children with autism spectrum disorder: systemic inflammation, sensory regulation, and gut-brain interaction disorders. A randomized, double-blind, placebo-controlled clinical trial (CURATEA)]. Nutr Hosp;2026 (Apr 15)

INTRODUCTION: low-grade neuroinflammation and gut-brain axis dysfunction are key mechanisms involved in the pathophysiology of autism spectrum disorder (ASD). Curcumin, a polyphenol derived from Curcuma longa, exhibits anti-inflammatory, antioxidant, and neuroimmunomodulatory properties that may offer therapeutic benefits in this population. OBJECTIVES: to evaluate the effects of curcumin supplementation on systemic inflammation, sensory processing regulation, and gut-brain interaction disorders in children with ASD. METHODS: a randomized, double-blind, placebo-controlled clinical trial was conducted in 60 children with ASD over eight weeks. Participants received either curcumin (3,000 mg/day) or placebo. Primary outcomes included high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin. Secondary outcomes included the General Index of Sensory Processing Regulation Dysfunction (IGDRPS) and Rome IV criteria for gut-brain interaction disorders. RESULTS: the curcumin group showed significant reductions in hs-CRP (-83.8 %), ESR (-42.3 %), and fecal calprotectin (-73.7 %), along with a 49 % improvement in IGDRPS and complete resolution of gastrointestinal symptoms in 90 % of participants (p < 0.001). No adverse effects were observed. CONCLUSIONS: curcumin supplementation reduces systemic and intestinal inflammation, improves sensory regulation, and alleviates functional gastrointestinal disorders in children with ASD, supporting its role as a safe, cost-effective adjunctive intervention within an integrative therapeutic approach.

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22. Wang G, Zhu G, Liu H, Wu L, Zhang Z, Pang P, Si S, Yang G. Integrative multi-omics implicates a CTSB/ITIH-ECM axis in autism spectrum disorder. Neurobiol Dis;2026 (Apr 20);224:107402.

BACKGROUND: Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental condition characterized by marked clinical and biological heterogeneity. Despite substantial progress in genetic discovery, the downstream biological mechanisms linking genetic risk to neurodevelopmental pathology remain incompletely understood. METHODS: We conducted an integrative Mendelian randomization (MR) analysis combining large-scale proteomic, transcriptomic, metabolomic, and single-nucleus RNA sequencing (snRNA-seq) data. Proteome-wide MR analyses across plasma, brain tissue, and cerebrospinal fluid were performed to implicate proteins with putative causal associations with ASD. Candidate proteins were prioritized using transcriptome-wide MR and Bayesian colocalization analyses. Cell-type-specific expression patterns were examined in post-mortem human ASD cortex using snRNA-seq. Functional enrichment, metabolite mediation, and protein-protein interaction analyses were used to contextualize the biological pathways implicated, and drug predictions and docking are utilized for drugability assessment. RESULTS: Proteome-wide MR identified 42 proteins with putative causal effects on ASD risk. Integrated transcriptomic and colocalization analyses prioritized eight high-confidence targets, including ITIH3, ITIH4, CTSB, MDH1, MANBA, LRRC37A2, ESAM, and NMB. snRNA-seq analysis demonstrated cell-type-specific dysregulation of these genes in neuronal and glial populations in the ASD cortex. Convergent analyses implicated disruption of extracellular matrix (ECM) homeostasis, mediated in part through sphingolipid metabolism and imbalance between proteolytic activity and protease inhibition. CTSB showed a risk-promoting association with ASD, whereas ITIH3 and ITIH4 exhibited protective effects. Drugability assessment, including molecular docking, identified seocalcitol as a high-affinity ligand for CTSB. CONCLUSIONS: These findings prioritize a genetically supported ECM-related biological axis underlying ASD risk and suggest that dysregulation of proteolytic balance may contribute to neurodevelopmental vulnerability in ASD. This study provides a human genetics-informed framework for understanding ECM involvement in ASD pathophysiology.

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23. Wang K, Wei Q, Yang T, Jia F, Hao Y, Li J, Chen J, Li T, Chen H, Xu X. Latent Profile Analysis of Sleep Patterns in Children With Autism Spectrum Disorder. Pediatr Discov;2026 (Mar);4(1):e70030.

Sleep disturbances significantly impact children with autism spectrum disorder (ASD), yet their heterogeneous manifestations remain poorly understood. This multicenter prospective cohort study employed latent profile analysis to identify distinct sleep phenotypes among 631 children with ASD (aged 3-6 years) and 768 typically developing (TD) controls across three Chinese cities representing Northern, Central, and Western regions. Analysis of Children’s Sleep Habits Questionnaire data revealed three distinct sleep phenotypes based on optimal model fit determined by Bayesian information criterion. Compared to TD children who showed generally better sleep patterns with lower sleep onset delay and fewer disturbances overall, the ASD groups exhibited distinctive profiles: Cluster 1 (9.2%) exhibited severe disturbances across multiple domains (sleep anxiety, parasomnias, night wakings and sleep-disordered breathing) and demonstrated the most severe autism symptoms; Cluster 2 (36.0%) presented a mixed profile with comparable bedtime resistance, sleep duration, and daytime sleepiness to TD children but elevated sleep-disordered breathing; and Cluster 3 (54.8%) showed reduced sleep-disordered breathing but elevated night waking and bedtime resistance. One-year follow-up data indicated that Cluster 3, characterized by mild sleep-disordered breathing, showed significant improvements in core symptoms particularly in social cognition, communication, and motivation domains, whereas Clusters 1 and 2 demonstrated modest changes. These findings suggest that early identification of sleep phenotypes may predict treatment response and inform personalized intervention strategies. Our results underscore the importance of incorporating comprehensive sleep assessment and management into ASD care protocols.

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24. Xiang X, Chen H, Yuan B, Wei Q, Hu B, Zhang D, Ai D, Yang T, Chen J, Li T, Ding Y. Vitamin A status is associated with sleep, clock genes, and symptoms in children with autism spectrum disorder. Front Psychiatry;2026;17:1805599.

BACKGROUND: Vitamin A signals through retinoic acid receptors and may influence neurodevelopment and the expression of clock genes. However, the biological pathway linking vitamin A status to sleep disturbance in ASD remains insufficiently defined. This study aimed to examine associations between vitamin A status and sleep problems, core symptoms, and clock genes in children with ASD, and to explore the mechanistic role of RARβ in regulating core clock genes. METHODS: This observational study included 361 children with ASD. Clinical symptoms were assessed using the Children’s Sleep Habits Questionnaire (CSHQ); the Childhood Autism Rating Scale (CARS) and the Social Responsiveness Scale (SRS). Peripheral blood mononuclear cell (PBMC) mRNA levels of RARβ and clock genes (BMAL1 and CLOCK) were quantified by qPCR. RARβ expression was knocked down in mice by stereotaxic injection of adeno-associated virus. RESULTS: Children with lower vitamin A levels exhibited more severe sleep problems and autistic symptoms. Vitamin A levels showed a weak positive correlation with the expression of RARβ and BMAL1. RARβ knockdown reduced the expression of RARβ and clock genes in mouse brain tissue. Chromatin immunoprecipitation quantitative PCR (ChIP-qPCR) confirmed RARβ occupancy at a predicted CLOCK regulatory region. CONCLUSION: This study provided evidence that vitamin A status was linked to sleep problems, symptom severity, and expression of clock genes in the morning in ASD. We also found that RARβ signaling may regulate the expression of clock genes. This finding provides new insights into the mechanisms underlying sleep disturbances in ASD, but further functional studies are needed to confirm these findings.

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25. Zhang D, Wei Q, Hu B, Ai D, Zhang Y, Xiang X, Yang T, Zhang Q, Chen Q, Guo M, Chen J, Li T, Wei H. A Study on the Peak-to-Valley Characteristics of Intellectual Structure in Low-Functioning Children With Autism Spectrum Disorder. Pediatr Discov;2026 (Mar);4(1):e70041.

Autism Spectrum Disorder (ASD) is marked by a distinctive cognitive profile reflecting neurodiversity, yet whether this profile extends consistently across the functional spectrum remains uncertain. In this study, we examined the intellectual structure of children with low-functioning ASD (LF-ASD) and high-functioning ASD (HF-ASD), comparing their cognitive peak-valley profiles using the Chinese Wechsler Intelligence Scale for Children (C-WISC). Among 314 children aged 6-13 years-including 104 with LF-ASD, 122 with HF-ASD, and control groups with typical development (TD) or intellectual disabilities (ID)-both ASD subgroups displayed significantly greater discrepancies between verbal and performance IQ than controls, with pronounced strengths in visuospatial tasks and weaknesses in arithmetic reasoning. Notably, the Block Design and Object Assembly subtests emerged as cognitive peaks across both ASD groups, whereas the Arithmetic subtest constituted the most frequent trough. Although the mean peak-valley discrepancy was slightly reduced in LF-ASD compared to HF-ASD, both exceeded the 2 standard deviation (SD) threshold for neurodiversity, distinguishing them from the TD and ID groups. These profiles were positively associated with adaptive functioning and inversely related to ASD symptom severity. Our findings suggest that children with LF-ASD exhibit intellectual asymmetries comparable to those of HF-ASD, supporting the universality of neurodiversity within the autism spectrum and offering valuable insights for tailoring cognitive interventions.

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26. Zheng R, Huang S, Feng P, Liu S, Jiang M, Li H, Zheng P, Mi Y, Li E. Correction: Comprehensive analysis of gut microbiota and fecal metabolites in patients with autism spectrum disorder. Front Microbiol;2026;17:1812620.

[This corrects the article DOI: 10.3389/fmicb.2025.1557174.].

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