1. Aguado-Gracia J, Borràs R, Calvo Escalona R. Correction to: Differential Associations of Adversity and Victimisation With Psychotic Experiences in Autistic Adolescents. J Autism Dev Disord. 2026.

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2. Babalola TT, Moss R, Dipper L, Botting N. Understanding Healthcare Access for Autistic Children in the UK: Perspectives From Parents and Healthcare Professionals. J Autism Dev Disord. 2026.

PURPOSE: Access to healthcare for autistic children remains challenging, with previous qualitative and quantitative research identifying barriers across individual, provider, and system levels. This study used qualitative interviews to explore parents’/carers’ and healthcare professionals’ perspectives on healthcare accessibility for autistic children in the UK, with particular attention to barriers, facilitators, and areas of convergence and divergence between the two groups. METHODS: A phenomenologically informed qualitative approach was employed. Semi-structured interviews were conducted online with 12 parents/carers of autistic children and eight healthcare professionals, including general practitioners, nurses, and speech and language therapists. Participants were recruited through survey follow-up, social media, and snowball sampling. Data were analysed using inductive, phenomenologically informed reflexive thematic analysis, with NVivo 14 used to manage the data. RESULTS: Four themes were identified across the parent/carer and healthcare professional datasets: knowledge and training, reasonable adjustments, communication, and system-level barriers. Both groups recognised barriers associated with inconsistent autism-specific knowledge, communication, service pressures, and fragmented care, but differed in emphasis. Parents/carers more often described the consequences of unmet needs and inconsistent adjustments, whereas healthcare professionals emphasised workload pressures, variable training, and the need to adapt care within existing service constraints. CONCLUSIONS: This study highlights the urgent need for addressing systemic inefficiencies, flexibility in healthcare services, and individualised approaches to meet the needs of autistic children and their families to ensure equitable access to healthcare for autistic children in the UK.

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3. Bakul F, Krafick KI, Kana RK. The spectrum within the spectrum: Neural heterogeneity in autism. Behav Brain Res. 2026; 518: 116546.

Autism Spectrum Disorder (ASD) encompasses diverse behavioral, cognitive, and neural profiles that vary widely across individuals. Because diagnosis remains predominantly behavior-based, clinically meaningful within-spectrum differences are often missed. Recent advances in neuroimaging analysis have created opportunities for the identification of distinct neural profiles within ASD. These new avenues provide ways to examine intra-ASD heterogeneity directly, identifying person-specific brain-behavior patterns that group-level comparisons fail to capture. The present systematic review focused on neuroimaging methods (i.e., resting-state fMRI; rs-fMRI, cortical morphology) that emphasized heterogeneity-informed outcomes based on normative modeling, data-driven subtyping, clustering analysis and similar analytic choices. For rs-fMRI, findings showed that differences in connectivity within the default mode and salience networks were linked to social-communication and language impairments, with subtype-specific patterns emerging across samples. In cortical thickness and surface area, studies identified distinct developmental trajectories and individual deviation profiles, with prefrontal and temporal regions often tied to repetitive behaviors and social-communication difficulties. Voxel-based analyses revealed subgroup-specific gray matter alterations, including cerebellar and cortical differences, that aligned with variation in repetitive behaviors and social difficulties. Collectively, this emerging evidence supports the notion that neural heterogeneity in autism is a core feature rather than a limitation. Embracing individual variability can provide crucial insight into the inconsistencies and contradictions of earlier case-control and group-level findings. Moving forward, autism research must prioritize heterogeneity-based methods to establish reproducible subtypes and individualized brain-behavior links.

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4. Barbalat G, Guilbert A, Davidovic L, Charles MA, Hough I, Launay L, Kloog I, Lepeule J. Association of Heat, Cold, and Ambient Pollution in the First 1000 Days of Life with Autism Spectrum Disorder Risk Indicators in Two-Year-Olds. Findings from the ELFE National Birth Cohort. Environ Sci Technol. 2026; 60(36): 25206-20.

Early life is a vulnerable period to environmental exposures that may be associated with autism spectrum disorder (ASD). We investigated associations between prenatal and postnatal exposure to weekly averages of temperature and air pollutants (PM2.5, PM10, NO2) with autism screening scores (based on the Modified Checklist for Autism in Toddlers, Revised version) in 12,139 2-year-olds from the French ELFE birth cohort. Exposures were based on daily outdoor predictions at 1 km resolution (200 m in large urban areas for temperature and NO2). Relationships were modeled with confounder-adjusted distributed lag nonlinear models and generalized linear models. Autism screening scores significantly increased following exposure to night-time heat throughout the beginning of the third trimester and possibly toward the end of pregnancy, even after adjusting for PM2.5 and PM10. During the postnatal period, night-time heat (months 2-7.5) and increased PM2.5 and PM10 exposures (months 7-11.5) led to higher scores in males compared to females. Conversely, night-time heat (months 17-20) led to higher scores in females. Our findings suggest that prenatal exposure to heat, but not air pollution, may be associated with early ASD risk indicators, while sex-specific effects of heat and PM exposure were observed in the postnatal period.

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5. Clifton H, Kamarova H. Fifteen-minute consultation: managing sleep problems in children and young people with autism spectrum disorder. Arch Dis Child Educ Pract Ed. 2026.

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6. Córdova VV, Espinosa F, Álvarez-Aguado I, Figueroa Figueroa JA, Nejaz Rodríguez VB, Archiles Donoso SR. Late autism diagnosis in adulthood: experiences of invisibility and reinterpretation in Chile. Int J Dev Disabil. 2025; 72(Suppl 1): S69-s79.

In recent decades, significant advances in early autism diagnosis have improved developmental outcomes and quality of life in childhood. However, this progress contrasts with a persistent gap in adulthood, where many individuals receive a diagnosis only after years of unrecognized differences shaped by gender bias, social camouflaging, and psychiatric comorbidities. OBJECTIVES: This study aimed to understand the experiences and life trajectories of autistic adults in Chile who received a diagnosis in adulthood. METHODS: Semi-structured interviews were conducted with autistic adults (n = 22, aged 23-47). Data were coded using AtlasTi using a reflexive thematic analysis to explore how participants interpreted and experienced late diagnosis. RESULTS: Four interrelated themes were identified: prolonged misdiagnosis and lack of information, normalization of autistic traits and masking, grief and biographical reinterpretation, and workplace challenges linked to self-care. CONCLUSIONS: Findings suggest that late diagnosis is not merely a clinical event but a relational and identity-transforming process. While diagnosis often entails grief, exhaustion, and recognition of past exclusion, it also enables self-understanding, redefinition of personal history, and engagement in supportive and activist communities. These results underscore the need for adult-oriented diagnostic pathways and policies that integrate social, cultural, and occupational dimensions across the life course.

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7. DuBay M, Lazarte I, Dorado S, Sanz H, Sarmiento P, Yoder M. Enhancing autism diagnostic capacity in Bolivia using an Extension for Community Healthcare Outcomes model. Int J Dev Disabil. 2025; 72(Suppl 1): S56-s68.

OBJECTIVES: In low- and middle-income countries like Bolivia, the pathway from recognizing early symptoms of autism spectrum disorder (ASD) to receiving a diagnosis is often hindered by limited public awareness, financial constraints, and a shortage of trained professionals. This study explores the impact of the ECHO (Extension for Community Healthcare Outcomes) framework as a virtual professional development strategy to enhance diagnostic capacity for ASD in Bolivia. METHODS: The project involved 9 credentialed diagnosticians who participated in a 3-day preparatory workshop and 10 monthly ECHO sessions, which included community building, didactic presentations, and case discussions. Additionally, individuals who can serve to refer families for evaluations attended live webinars to learn ASD screening strategies. RESULTS: Pre- and post-surveys indicated significant increases in diagnosticians’ competence and confidence in ASD evaluations, as well as a reduction in perceived barriers and an expansion of professional networks. Diagnosticians reported increased use of ASD screening tools and more frequent referrals for intervention supports. Qualitative interviews suggested improvements in evaluation procedures and referral rates, though systemic and financial barriers remain. CONCLUSIONS: The findings suggest that the ECHO methodology holds promise for enhancing ASD diagnostic capacity in low- and middle-income countries.

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8. Figueroa Saavedra C, Retamal Aranda M, Rodríguez Elgueta P, Guillén Cañas V, Huenupán Quinán F, Sáez CG, Sandoval Fox Y, Hernández González O. Social competence, bullying, and suicidal risk in autistic adolescents: evidence from Chile. Int J Dev Disabil. 2025; 72(Suppl 1): S80-s8.

Adolescents with Autism Spectrum Disorder (ASD) frequently present difficulties in social communication and interaction and are disproportionately exposed to bullying experiences, both of which have been associated with adverse mental health outcomes. The present study aimed to (1) examine differences in social competence and bullying experiences according to suicidal risk, and (2) analyze the associations between social competence, bullying, self-esteem, and suicidal risk in children and adolescents with ASD. It was hypothesized that greater exposure to bullying and lower levels of social competence would be associated with higher suicidal risk. A cross-sectional design was employed, including a sample of 103 adolescents with ASD, Level 1 support needs (DSM-5 criteria), selected using a non-probabilistic purposive sampling method. Social competence, bullying experiences, and suicidal risk were assessed using validated self-report instruments. Significant associations were observed between bullying experiences and suicidal risk (p < 0.05), with higher exposure to peer aggression linked to increased suicidal vulnerability. Additionally, lower levels of specific social competence domains were associated with a greater likelihood of suicidal ideation. These findings highlight the central role of social vulnerability in adolescents with ASD and underscore the importance of early identification and targeted, school-based interventions aimed at reducing bullying and strengthening social competence to mitigate suicidal risk in this population.

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9. Fucà E, Parisi M, Guerrera S, Vicari S. Sleep, executive functions, and repetitive behaviors in autism spectrum disorder: different patterns of association with lower- and higher-level repetitive behaviors. Front Psychol. 2026; 17: 1903369.

BACKGROUND: Restricted and repetitive behaviors (RBs) are a core feature of autism spectrum disorder (ASD), although the mechanisms underlying different RB subtypes remain poorly understood. The present study investigated the differential contribution of executive functions (EFs) to lower- and higher-level RBs in autistic children and explored whether specific EF domains mediated the relationship between sleep disturbances and RBs. METHODS: Fifty-seven autistic children aged 6-14 years underwent neuropsychological and behavioral assessment. RBs were assessed using the Repetitive Behavior Scale-Revised, executive functions using the Behavior Rating Inventory of Executive Function-2, sleep disturbances through the Sleep Disturbance Scale for Children, and behavioral difficulties through the Child Behavior Checklist. RESULTS: Partial correlations, regression analyses, and mediation models were performed. Distinct association patterns emerged across RB subtypes. Lower-level RBs were significantly associated only with emotional control difficulties, whereas higher-level RBs were associated with several EF domains, including inhibition, shifting, emotional control, planning, and initiation. Regression analyses showed that higher-level RBs were independently predicted by shifting difficulties, whereas lower-level RBs were significantly associated with IQ and behavioral problems. Mediation analyses indicated that emotional control difficulties significantly explained the association between sleep disturbances and lower-level RBs. In contrast, cognitive flexibility did not mediate the relationship between sleep disturbances and higher-level RBs. CONCLUSION: These findings provide preliminary evidence of different patterns of association across lower- and higher-level RBs in autistic children. Emotional regulation processes may be particularly relevant for lower-level RBs, whereas cognitive flexibility appears more strongly related to higher-level RBs. Findings also suggest that sleep disturbances may contribute to specific RB manifestations through different mechanisms.

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10. Goryunova AV, Shevchenko YS, Goryunov AV. [Russian early childhood psychiatry: challenges and prospects]. Zh Nevrol Psikhiatr Im S S Korsakova. 2026; 126(9. Vyp. 2): 5-11.

This article examines the main challenges In Russian early childhood psychiatry. It outlines the developmental stages of Russian « micropsychiatry, » which addresses children from the first year of life to age four, and notes its close relationship with pediatrics, neurology, and early childhood psychology. The increasing prevalence of mental disorders among children and adolescents in recent decades underscores the need for early diagnosis, rehabilitation, comprehensive treatment, and prevention within national policies aimed at strengthening the mental health of the younger generation. Establishing a system for early detection and comprehensive intervention for developmental disorders in children within primary healthcare settings has therefore become a priority. Early childhood psychiatry currently faces clinical-diagnostic, classification, terminological, interdepartmental, therapeutic-corrective, and organizational-methodological challenges, which this article examines along with proposed solutions.

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11. Hall DA, González DA, Klusek J, Todd PK, O’Keefe JA, Maltman N, Montanaro FAM, Protic D, Scorr L, Malik R, Turcano P, Meyers MS, Seritan A. Management of fragile X-associated tremor ataxia syndrome: a review for clinicians. Front Neurol. 2026; 17: 1870779.

Fragile X-associated tremor ataxia syndrome (FXTAS) is a multi-faceted and progressive neurodegenerative disorder that manifests clinically with action tremor, gait ataxia, parkinsonism, peripheral neuropathy, and cognitive and psychiatric features. The disease is highly heterogeneous and there are no FDA approved medications for FXTAS as a specific indication. As such, treatment is symptomatic and must be tailored to the specific needs of a given patient. This review provides expert opinion-based treatment recommendations for the core and ancillary clinical features of FXTAS. Movement disorders, such as tremor, ataxia and parkinsonism may respond to symptomatic medications and therapies, but caution is required when considering surgical interventions such as deep brain stimulation. Cognitive decline can be responsive to medications developed for other cognitive disorders, but these medications work best when combined with non-medication based approaches and all patients should be screened for other reversible causes of memory decline. Psychiatric symptoms, including anxiety, depression, and psychosis, can be treated with psychotherapy and medications; but caution is required to avoid exacerbating clinical and subclinical movement disorder features with psychotropic medications. Rehabilitative therapies, such as speech therapy, occupational, and physical therapy, often enhance patient function and quality of life. Exercise and good nutrition are recommendations that are common to other cerebellar ataxias and adult neurodegenerative disorders and may have a positive impact on general health. A multi-disciplinary approach is recommended to address all components of FXTAS.

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12. He Y, Lin F, Huang H, Chen Q. Mapping and visualizing global research trends in gut microbiota and autism spectrum disorder: A bibliometric analysis (2015-2024). Medicine (Baltimore). 2026; 105(43): e51247.

BACKGROUND: Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder with increasing research interest in its association with the gut microbiota. However, the knowledge structure and development of this field have not been systematically analyzed. METHODS: We conducted a comprehensive bibliometric analysis of English-language publications related to ASD and gut microbiota from 2015 to 2024 using the Web of Science Core Collection. We used the bibliometrix package in R, VOSviewer, and CiteSpace for analysis, focusing on publication trends, geographic and institutional contributions, prominent authors and journals, citation patterns, keyword dynamics, and thematic clusters. RESULTS: A total of 1309 publications were included, involving corresponding authors from 64 countries or regions. The annual number of publications steadily increased from 2015 to 2022, followed by a slight decline in 2023 and a partial rebound in 2024, with the US and China contributing the most. Leading authors and teams were primarily based in North America and Europe. Thematic evolution revealed a shift from early mechanistic research to intervention-focused topics, such as short-chain fatty acids, fecal microbiota transplantation, and probiotics. CONCLUSION: Research on ASD and gut microbiota is progressing from theoretical exploration toward early-stage translational research, with increasing investigation of potential clinical applications. Future studies should emphasize multi-omics integration, mechanistic validation, and international collaboration. This bibliometric analysis offers a comprehensive overview to inform and guide future research in this rapidly evolving field.

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13. House A. Making up autism: can reading philosopher Ian Hacking help us with the neurodiversity and overdiagnosis debate?. BJPsych Bull. 2026: 1-3.

Philosopher Ian Hacking noted that people respond to being placed in categories – setting up an iterative process that leads to (sometimes radical) changes in the features used to diagnose group membership. Hacking called this process making up people, and the interactions that were its underlying mechanism he called looping effects, which he saw as an important means both to advocacy and overdiagnosis. Hacking was sceptical of the idea of an autistic spectrum, not least because it carried a risk of overdiagnosing people with few symptoms. These are important messages for the current debate about diagnosis in autism.

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14. Hübner Junqueira Franco G, Montiel-Nava C, Bertti Cruz B, Rosoli Murillo A, Valdez D, Garrido G, Sepúlveda R, Teixeira MC, Perez Liz G, Rattazzi A, Silvestre Paula C. Cultural adaptation and validation of the Suicidal Behaviours Questionnaire – Autism Spectrum Conditions (SBQ-ASC) for use in Brazil. Int J Dev Disabil. 2025; 72(Suppl 1): S89-s103.

BACKGROUND: Suicide risk among autistic individuals is a growing global concern, yet culturally adapted and validated assessment tools are scarce in most low- and middle-income countries, including South America. OBJECTIVES: To translate, culturally adapt, and evaluate the psychometric properties of the Suicidal Behaviors Questionnaire – Autism Spectrum Conditions (SBQ-ASC) for Brazilian Portuguese, focusing on young autistic adults. METHODS: The adaptation process followed five stages: (1) independent translation by two bilingual experts; (2) synthesis of a unified version by a panel of evaluators; (3) expert validation to ensure conceptual and cultural alignment; (4) cognitive debriefing with autistic individuals (n = 10, aged 20-30) to assess clarity and relevance; and (5) back-translation by a bilingual expert to confirm equivalence. RESULTS: The Brazilian SBQ-ASC showed strong semantic equivalence to the original version, requiring only minor linguistic adjustments. Participant feedback confirmed its clarity, cultural appropriateness, and ease of understanding. The final version was reviewed and approved by the original SBQ-ASC author. CONCLUSION: The adaptation process highlights the importance of culturally tailored tools for suicide risk assessment. The Brazilian SBQ-ASC provides a reliable, valid, and contextually appropriate measure for evaluating suicidality among young autistic adults in Brazil.

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15. Jang H, Bennett DH, Tancredi DJ, Schmidt RJ, Shin HM. Associations between Prenatal Exposure to Perchlorate, Thiocyanate, and Nitrate and Child Neurodevelopment in the MARBLES Study. Environ Sci Technol. 2026; 60(38): 26961-73.

Associations between prenatal exposure to perchlorate, thiocyanate, and nitrate and autism spectrum disorder (ASD) remain largely unexplored. We investigated these associations in the MARBLES cohort, a prospective cohort with an elevated familial likelihood of ASD. A total of 310 mothers provided 1916 urine samples during pregnancy, and their children were classified at age 3 years as typically developing (TD), ASD, or non-TD (developmental concerns not meeting ASD diagnostic criteria). We estimated relative risks for ASD and non-TD compared with TD using Poisson regression and assessed mixture effects using quantile G-computation and Bayesian kernel machine regression. Overall and mixture analyses showed no significant associations between prenatal exposure to these NIS inhibitors and the child neurodevelopmental outcomes. However, stratified analyses identified several context-specific associations according to child sex, trimester of exposure, maternal urinary iodine concentration, and passive smoking status, some of which remained significant after false-discovery-rate correction. These findings suggest that susceptibility to prenatal exposure to perchlorate, thiocyanate, and nitrate may vary across population subgroups and exposure windows. Although these subgroup-specific associations should be considered hypothesis generating, they highlight the need for future studies integrating thyroid biomarkers and mechanistic approaches to better understand thyroid-related pathways underlying child neurodevelopment.

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16. Kashanian M, Manoochehri Z, Davarinejad O, Nakhaee S, Mansouri B. Blood zinc and copper levels in children with autism spectrum disorder: a systematic review and meta-analysis. Rev Environ Health. 2026.

BACKGROUND AND AIMS: Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition shaped by genetic, environmental, and biochemical influences. Among these, trace elements such as zinc (Zn) and copper (Cu) have attracted considerable interest due to their involvement in synaptic transmission, antioxidant defense mechanisms, and neuroinflammatory processes. This systematic review and meta-analysis aimed to assess whole blood, serum and plasma levels of Zn and Cu in children diagnosed with ASD compared to neurotypical controls. METHODS: A comprehensive literature search was conducted in accordance with PRISMA guidelines across PubMed, Embase, Web of Science, and Scopus databases up to July 2025. Eligible studies included observational studies, including cross-sectional and case-control studies reporting whole blood, serum, or plasma concentrations of Zn and Cu in children with ASD. Two independent reviewers performed study selection and data extraction, and quality assessment using the modified Newcastle-Ottawa Scale (NOS). Meta-analyses were conducted using STATA version 17.0. Pooled effect sizes were calculated using Hedges’s g. Heterogeneity was evaluated using the I(2) statistic, and publication bias was assessed via funnel plots and Egger’s test. RESULTS: In total 15 studies comprising 2,537 participants (849 children with ASD and 1,688 controls) met the inclusion criteria. The meta-analysis revealed non-significant pooled differences between children with ASD and controls for Zn (SMD=-0.48, 95 % CI: -1.08 to 0.13; p=0.13) and Cu (SMD=-0.59, 95 % CI: -1.30 to 0.11; p=0.10). Substantial heterogeneity (I(2)>97 %) was observed for both analyses. CONCLUSIONS: The children with ASD and the control groups did not significantly differ in blood Zn or Cu levels. Due to the possibility of publication bias and heterogeneity that existed between included studies, the results should be interpreted cautiously. Thus, existing evidence should be treated as an attempt to generate the hypothesis, and higher-quality studies are needed to uncover the role of trace elements homeostasis in ASD.

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17. Khusenova N, Madjidova Y, Mizamov F, Abidova M, Karimova G, Irfan, Mohammad T, Abramyan A. Clinical, immunological and metabolic features and gut-brain axis markers in children with autism spectrum disorder and TORCH-associated central nervous system involvement. Brain Dev. 2026; 48(6): 104611.

BACKGROUND: Autism spectrum disorders (ASD) have heterogeneous etiologies, with TORCH infections potentially contributing to neurodevelopmental disruption through central nervous system injury and gut-brain axis dysfunction. METHODS: A prospective comparative study enrolled 280 children aged 3-10 years with ASD: 112 with TORCH-associated central nervous system (CNS) involvement (main group) and 168 with idiopathic ASD (comparison group), alongside 25 healthy controls. Assessments included clinical/neurological features, autism severity, gastrointestinal symptoms, pro-inflammatory cytokines, metabolic markers, neuron-specific enolase (NSE), fecal zonulin, and brain MRI. TORCH pathogens were detected by PCR from saliva samples. RESULTS: TORCH-associated ASD exhibited a more severe phenotype with greater frequencies of delayed speech, cognitive impairment, sleep disturbance, hyperactivity, emotional-behavioral dysregulation, epileptiform manifestations, and gastrointestinal symptoms. Severe ASD was significantly more common in the TORCH group. Laboratory analyses revealed significantly elevated interleukin-1β, interleukin-8, tumor necrosis factor alpha, homocysteine, ammonia, uric acid, NSE, and fecal zonulin, with reduced folate. Fecal zonulin was positively correlated with inflammatory markers and neuron-specific enolase. MRI more frequently demonstrated periventricular gliosis, ventriculomegaly, subependymal abnormalities, and diffuse residual organic changes. CONCLUSIONS: In this cohort, ASD with clinical evidence of TORCH-associated CNS involvement was associated with greater clinical severity and higher serum inflammatory, metabolic, neuronal-injury, fecal-zonulin, and structural MRI measures than ASD without such evidence. The cross-sectional design and limitations of salivary PCR preclude causal attribution to TORCH infection.

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18. Langa A, Salmons B. Rights, recognition, and research: the situation of adults with intellectual and developmental disabilities in Latin America. Int J Dev Disabil. 2025; 72(Suppl 1): S1-s4.

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19. Liu G, Qiu J. Digital twin control framework uncovers individualized cross-scale links between functional connectivity deviations, communication impairment, and molecular mechanisms in autism. Neuroimage. 2026; 342: 122311.

BACKGROUND: Autism spectrum disorder (ASD) is hallmarked by pronounced inter-individual heterogeneity in brain function and clinical manifestations. Conventional neuroimaging studies yield highly inconsistent findings, as extrinsic confounding factors and intrinsic disease heterogeneity mask ASD-specific functional connectivity (FC) signatures, hampering the identification of individualized neural mechanisms linked to symptom severity. METHODS: We developed a digital twin control analytical framework based on deep contrastive learning. By comparing each ASD participant with their matched digital twin control, we quantified individual-specific FC deviations. Principal component analysis was applied to extract the core aberrant pattern, followed by multi-dimensional analyzes and validation including clinical correlation, transcriptomic decoding, neurotransmitter and mitochondrial co-localization, as well as disease and cognitive enrichment. RESULTS: The model effectively disentangled disease‑related from non‑disease‑related variations. The identified dominant aberrant FC pattern was significantly associated with Autism Diagnostic Observation Schedule (ADOS) communication scores, suggesting it is associated with to communication impairment. This pattern showed convergent associations with synaptic pathways, excitatory/inhibitory neuronal signatures, critical developmental windows and subcortical structures, and exhibited negative spatial association with multiple neurotransmitter systems and mitochondrial respiratory complexes. Biological validation further supported its ASD specificity and communication‑related cognitive relevance. CONCLUSIONS: Leveraging the twin control analytical framework, this study provides an exploratory cross-scale framework linking individualized FC deviations with clinical, transcriptomic, neurochemical, and mitochondrial maps. The findings indicate that communication difficulties in ASD may partly arise from multi-scale disturbances in neural integration, social-perceptual processing and activity-dependent cellular energy regulation.

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20. Lyu S, Chen Y, Wei L, Ning C. « This Home Still Stands »: Systemic Reorganization of Family Communication Through Orchestra Participation Among Adolescents with Autism Spectrum Disorder. Health Commun. 2026: 1-15.

Autism spectrum disorder (ASD) can place sustained strain on family communication and relational equilibrium. Existing interventions have often emphasized symptom management or parent-mediated strategies, leaving less clear how disrupted family communication is reorganized over time. Guided by family systems theory, this qualitative case study examines communicative change in relation to long-term orchestra participation among families of adolescents with ASD in Shanghai, China. Data include in-depth interviews, prolonged participant observation, and supplementary digital and documentary materials from the Shanghai Angel Autism Salon. Findings indicate that families often described a post-diagnosis communicative deadlock characterized by boundary contraction, role polarization, ambiguous loss, and stigma-related withdrawal. Orchestra participation was associated with a socio-musical environment that reduced exclusive reliance on verbal communication, supported competence-oriented communication, and enabled adolescents to be recognized as contributors to collective activity. Public performance further reframed social evaluation as recognition and reconstructed mianzi (, social reputation and standing), with some families reporting more open external boundaries and greater paternal involvement. Over time, these patterns were associated with more resilient forms of family adaptation. The study conceptualizes collective arts participation as a relational health communication intervention shaped by stigma and family reputation.

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21. McKenna P, Yildirim B. Formal Thought Disorders. Psychiatr Clin North Am. 2026; 49(4): 641-53.

Formal thought disorder (FTD), changes in the form (as opposed to the content) of thinking, has a largely unknown pathophysiological basis or bases, although language, frontal/executive, and semantic memory mechanisms have been implicated. FTD is a major symptom of schizophrenia and is also common in mania, with there being a marked overlap of clinical features between the 2 disorders. Changes in thought form are also seen in major depression, autistic spectrum disorder, and the frontal lobe syndrome; the presentations in these latter disorders differ from those seen in schizophrenia and mania, notwithstanding some points of overlap.

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22. Montenegro M, Garrido G, Alliey N, Solis S, Villalobos BT, Montiel-Nava C. Unfulfilled promises: educational and policy barriers for autistic children in Uruguay. Int J Dev Disabil. 2025; 72(Suppl 1): S19-s33.

OBJECTIVES: As our understanding of autism spectrum disorde continues to improve, concerns remain that the existing literature is not inclusive, since autism research is primarily conducted in wealthy nations with abundant resources. In this study, we examined the experiences of autistic individuals in Uruguay when attempting to access educational services, particularly the barriers they face, against the backdrop of what local legislation indicates should be available. METHODS: To gain a deeper understanding of the experiences of autistic individuals seeking to access education in Uruguay, we conducted semi-structured interviews with 12 parents and four key informants, selected to represent a variety of settings. Data analysis consisted of a reflexive thematic analysis using a theory-of-change framework specifically drafted for low- and middle-income countries, which served as guidance for coding and theme identification. RESULTS: Themes that emerged identified parents’ concerns about barriers to education for children with autism, despite laws designed to protect them. Additionally, participants reported an overall lack of resources to provide autistic children with opportunities to succeed in school adequately, and the perception of poorly coordinated services. CONCLUSIONS: Our study’s findings indicate that, despite Uruguay having a strong legal foundation in its legislation and decrees, its implementation is hindered by factors such as limited finances, poor coordination, and shifts in political interests.

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23. Montiel C, Rattazzi A, Sepulveda RG, Valdez D, Garrido G, Rosoli Murillo A, Alzugaray F, Perez Liz G, Montenegro M, Teixeira MC, Silvestre Paula C, Lachman I, Hovey J. Suicidal ideation and behavior among autistic, self-reported autistic, and non-autistic adults in Latin America. Int J Dev Disabil. 2025; 72(Suppl 1): S104-s18.

OBJECTIVE: Suicidal ideation and behavior are recognized as major public-health concerns among autistic adults, yet almost all existing evidence comes from high-income, English-speaking countries. This study is the first multi-country investigation of lifetime suicidal ideation and behavior in confirmed autistic, adults who suspect they are autistic, and non-autistic adults across seven Latin American countries. METHODS: Using the culturally adapted Suicide Behaviors Questionnaire-Autism Spectrum Conditions (SBQ-ASC), a cross-sectional online survey was conducted through the Red Espectro Autista Latinoamérica(REAL) network. The final analytic sample comprised 1,083 adults classified as confirmed autistic (n = 387), adults who suspect they are autistic (n = 188), or non-autistic (n = 508). RESULTS: Lifetime suicidality differed markedly across groups (all χ(2) p < 0.001): lifetime suicide attempt was reported by 22.5%, 14.0%, and 5.7% respectively. Confirmed autistic adults had 3.96- to 5.32-fold higher odds and adults who suspect they are autistic adults 3.44- to 4.93-fold higher odds of every lifetime outcome compared to non-autistic adults (all p < 0.001) in models adjusted for country of residence only. Past-12-month intense suicidal ideation was reported by 70.0%, 65.4%, and 33.1% respectively; adjusted odds ratios ranged from 2.72 to 5.08 (all p ≤ 0.01). CONCLUSIONS: In this non-probability online sample recruited across several Latin American countries, both diagnosed autistic adults and adults who suspect they are autistic reported elevated, graded levels of suicidal ideation and behavior relative to non-autistic adults after adjusting for country of residence. These preliminary findings highlight the potential value of autism-informed suicide prevention and of expanding diagnostic and mental-health services in the region, and underscore the need for confirmatory research using representative samples and multivariable adjustment.

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24. Muñoz-Martínez Y, Barrios Á, Simón C, González de Rivera Romero T. Support networks required in the transition of students with autism spectrum disorder from compulsory to post-compulsory education. Int J Dev Disabil. 2025; 72(Suppl 1): S34-s44.

This study explores the support networks required to facilitate the transition of students with autism spectrum disorder (ASD) from compulsory education to post-compulsory education in Spain. An instrumental case study was employed, focusing on students, families and teachers of ordinary schools with ASD students. The selection of participants was purposeful and strategic, and exhaustive semi-structured interviews were carried out with four students, their families and eight teachers. The data were analysed through inductive thematic analysis using NVivo 12. The findings highlight the importance of coordination among educational institutions and anticipated planning for a successful transition. The constant involvement of the families and the presence of professional supports are crucial. However, the participants identified the removal of supports in post-compulsory education as a significant barrier. Effective strategies include preparation for autonomy, competence and interpersonal relationships. The results are discussed in relation to studies conducted in the Spanish, international, and Ibero-American contexts.

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25. Munsaka T, Tshababa M, Mpofu P, Maepa MP. Prenatal exposure to maternal stress hormones and the risk of autism: a neuroendocrine-epigenetic scoping review. BMC Psychiatry. 2026; 26(1).

Maternal psychosocial stress during pregnancy is increasingly recognized as a factor capable of shaping fetal neurodevelopment through alterations in the hypothalamic-pituitary-adrenal (HPA) axis and placental regulatory systems. When maternal stress hormones, particularly cortisol, rise persistently during gestation, they may exceed the buffering capacity of the placenta, influencing fetal brain pathways implicated in social communication, sensory processing, and emotional regulation. Empirical evidence from prospective cohorts has shown that elevated maternal cortisol, altered diurnal HPA rhythms, and increased placental corticotropin-releasing hormone (CRH) trajectories are associated with neurodevelopmental outcomes relevant to autism spectrum disorder (ASD), although results remain heterogeneous across populations and methods [1-3]. This scoping review examines confirmed studies on prenatal stress hormones, placental enzymatic processes, epigenetic changes and their relation to stress, and the diagnosis of ASD and ASD-related traits on a continuum. Per the guidance of the Joanna Briggs Institute and the Scoping Reviews and Mapping Approaches (PRISMA-ScR) framework, we cataloged the eligible studies on their research design, biomarkers, gestational periods, and outcomes by neurobiological processes, and of the children in question. Across studies with multiple methodologies, there is a consensus that disruptions in maternal HPA axis functioning and placental signaling contribute to early changes in the trajectory of ASD development, with the moderating variables of fetal sex, maternal mental health and environmental adversity. While there is no compelling evidence of a causal relationship, the strength and consistency of the proposed mechanisms support the idea that prenatal HPA and epigenetic processes play an important role in shaping the development of ASD. The review highlights the importance of cross study harmonization of biomarkers, expanded longitudinal study designs with varied and several gestational samplings, and the need to pinpoint the timing, magnitude, and detail of the relationships between the stress biology of pregnancy and ASD with outcomes. Collectively, the findings present a framework and strengthened the linkage of the maternal stress physiology to the neurodevelopment of the fetus. This provides a pathway for future mechanistic research and further applied research [10].

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26. Nardi B, Palego L, Bonelli C, Tognini V, Pronestì C, Pioltino M, Massimetti G, Pini S, Saba A, Betti L, Giannaccini G, Dell’Osso L, Carpita B. Biochemical correlates of social anxiety in subjects with autism spectrum conditions. CNS Spectr. 2026; 31(1): e46.

BACKGROUND: Social anxiety disorder (SAD) is a common and debilitating condition marked by intense fear of negative evaluation in social situations. It often co-occurs with other psychiatric disorders, and in particular Autism Spectrum Disorder (ASD). The exact cause of SAD is unclear, though biological, environmental, and genetic factors are believed to contribute. Recent research highlights the involvement of neuropeptides, neurohormones, and immune system components in SAD development, suggesting complex interactions between psychological and biological factors, with a growing focus on inflammation’s role. This study aimed to investigate potential biochemical correlates of SAD in individuals with ASD, their first-degree relatives (BAP group), and healthy controls (HCs), focusing on inflammatory markers, neuropeptides, and growth factors. METHODS: Twenty-four adults with ASD, their relatives, and HCs, for a total of 72 participants, were assessed. Biochemical parameters were analyzed using enzyme-linked immunosorbent assays (ELISA), and social anxiety symptoms were evaluated via the Social Phobia Spectrum-Self Report (SHY-SR) questionnaire. RESULTS: Individuals with ASD exhibited significantly higher SHY-SR scores compared to the BAP and HCs. Subjects in the ASD group tended to make greater use of anxiolytics in order to improve their social interaction skills. Additionally, a specific pattern of correlation and association was found between biochemical variables and specific SAD symptoms, suggesting a potential role of inflammatory pathways in SAD pathophysiology. CONCLUSIONS: Our results confirm the presence of greater social phobic symptoms in subjects with ASD, and support the hypothesis of a role of the inflammatory cascade in the maintenance of the disorder.

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27. Rusadze KZ, Burjanadze MA, Beselia GV, Chkhikvishvili NC, Chighladze MR, Nozadze BG, Naneishvili TL, Dashniani MG. Deep brain stimulation of the nucleus basalis magnocellularis ameliorates autistic behavior in a rat model of autism via cholinergic modulation in the prefrontal cortex. Neuroreport. 2026.

OBJECTIVE: In the present study, we investigated whether deep brain stimulation (DBS) of the nucleus basalis magnocellularis (NBM) improves autism spectrum disorder (ASD)-related behavioral abnormalities in a valproic acid (VPA)-induced rat model of autism, consistent with changes in cholinergic markers in the medial prefrontal cortex (mPFC). METHODS: On the 12.5th day of gestation, pregnant rats (n = 16) received a single intraperitoneal injection of 500 mg/kg sodium valproate dissolved in 0.9% saline, while others (n = 5) received saline alone. Male offspring were allowed to reach 3 months of age and then were randomly assigned to one of four experimental groups: Contr – prenatally saline injected, VPA – prenatally VPA-injected, VPA/I – VPA-injected with electrode implantation in the NBM, and VPA/S – VPA-injected with electrical stimulation. DBS was initiated in rats of the VPA/S group 10 days after surgery (two consecutive hours per day, every day for 2 weeks; DBS parameters: 60 Hz, 120 µs, and 50 µA). RESULTS: The prenatally VPA-exposed rats demonstrate deficits in social behavior, increased locomotor activity, and reduced anxiety levels. Immunohistochemical evaluation shows a decrease in the number of acetylcholinesterase-immunoreactive neurons in the mPFC and choline acetyltransferase-immunoreactive neurons in the NBM. NBM-DBS improves VPA-induced autistic behavior and increases the number of acetylcholinesterase-immunoreactive neurons in the PFC. CONCLUSION: The correlation between ASD-like behavior and cholinergic markers in the mPFC supports our hypothesis that NBM-DBS improves behavioral deficits by modulating cholinergic neurotransmission in the PFC in a rat model of autism.

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28. Salahat MH, Sarsak HI, Al Adam HA. Experiences of telehealth-delivered occupational performance coaching among Palestinian mothers of autistic children: a qualitative study. Front Pediatr. 2026; 14: 1974022.

BACKGROUND: Families of autistic children in Palestine face substantial barriers to sustained, family-centred rehabilitation, including travel demands, fragmented services, financial pressures, digital inequalities, and recurrent movement restrictions. Occupational Performance Coaching (OPC) is a collaborative, occupation-focused approach that supports caregivers to analyse everyday participation challenges, identify priorities, generate contextually relevant strategies, and evaluate change. This study explored how Palestinian mothers experienced an eight-session OPC telecoaching intervention and how they perceived its acceptability, benefits, challenges, and contextual fit. METHODS: A qualitative descriptive study was embedded within an explanatory sequential mixed-methods external pilot trial. All 12 mothers who completed OPC participated in a post-intervention semi-structured interview in Arabic via Zoom. The interview guide was informed by the Theoretical Framework of Acceptability (TFA) and included broader questions about intervention processes, perceived change, and contextual experience. Analysis of the complete Arabic interview dataset used reflexive thematic analysis. TFA provided deductive sensitizing concepts, while coding and theme development remained open to meanings arising from participants’ accounts. Reflexive notes, cross-case comparison, attention to divergent accounts, peer debriefing, and an audit trail supported analytic reflexivity and transparency. COREQ guided reporting. RESULTS: Five interrelated themes were developed: (1) from receiving advice to becoming a reflective problem-solver; (2) coaching in the context of everyday life; (3) taking responsibility: empowering, but demanding; (4) context-responsive access with conditional digital and cultural fit; and (5) meaningful progress as partial, variable, and still unfolding. Mothers valued collaborative reasoning, individualized goals, and the ability to work within real family routines. Remote delivery reduced some travel, scheduling, cost, and safety burdens, but connectivity, time, caregiving demands, and wider structural conditions remained important constraints. Increased parental responsibility could be experienced as both meaningful and demanding, and perceived changes were not uniform across goals or families. CONCLUSION: Mothers valued OPC telecoaching not only as a means of remote access, but as a way of working collaboratively on occupational challenges within everyday family life. Telehealth reduced selected access burdens in the Palestinian context but did not remove digital, caregiving, or structural constraints. The findings support further evaluation of culturally and contextually responsive, participation-focused telecoaching within pediatric occupational therapy.

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29. San Martín C, Contreras-Fernández V, Ramírez-Vega C. Employment alternatives and labor market access for adults with intellectual and developmental disabilities in Latin America: a scoping review. Int J Dev Disabil. 2025; 72(Suppl 1): S171-s84.

OBJECTIVES: This scoping review maps and synthesizes evidence regarding employment models and labor market access for adults with intellectual and developmental disabilities (IDD) in Latin America. It identifies key barriers, facilitators, and knowledge gaps in regional research and policy. METHODS: Following JBI guidance and PRISMA-ScR standards, a systematic search identified 22 studies published between 2006 and 2026. Data extraction utilized the population, concept, and context framework, followed by descriptive numerical analysis and reflexive thematic synthesis. RESULTS: A critical implementation gap persists between advanced legal frameworks and effective workplace inclusion. While Supported Employment is recognized as the most effective methodology, it is not yet formally institutionalized in several countries. Dominant barriers include symbolic adherence, family overprotection, employer stigma, and a benefit trap in which formal employment risks the loss of social subsidies. Potent facilitators include assistive technology and the attainment of higher education, which significantly reduce wage gaps. CONCLUSIONS: Regional progress requires transitioning from welfare-based to rights-based strategies, prioritizing worker autonomy and institutional oversight. Future research must adopt participatory designs to incorporate the direct voices of individuals with IDD.

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30. Sanabria F. Beyond Observable Behavior: A Narrative Review of Integrated Clinical, Biological, and Functional Assessment in Children With Autism Spectrum Disorder. Cureus. 2026; 18(10): e118440.

Assessment of children with autism spectrum disorder must characterize everyday functioning, co-occurring conditions, and individual support needs alongside diagnostic classification. This narrative review examines the evidence and clinical rationale for integrated clinical, biological, and functional assessment in pediatric autism and presents SMART-NB as a proposed framework for organizing these dimensions. The review combines selected clinical guidelines and research publications with conceptual analysis and a targeted literature update, distinguishing established assessment principles from the author-developed framework. Three findings emerge. First, standardized observational instruments contribute to diagnosis but require interpretation alongside developmental history, caregiver information, differential diagnosis, and clinical judgment. Second, co-occurring sleep disturbances, gastrointestinal symptoms, nutritional problems, sensory impairments, and pain can influence behavior and participation and warrant clinically directed evaluation; their association with autism does not establish causation. Third, symptom severity does not fully describe adaptive functioning, supporting assessment across functional domains and everyday contexts. SMART-NB proposes connecting clinical, medical and biological, and demand-related profiles with seven functional domains, individualized goals, and longitudinal reassessment. The demand dimension examines available capacity, physiological and emotional burden, environmental requirements, and supports. Its proposed contribution is to document how assessment findings inform care priorities. Existing multidimensional approaches already address overlapping aspects of this task; the incremental value of this particular organization remains untested. The reviewed evidence supports multidimensional assessment but does not establish the validity, reliability, or clinical utility of SMART-NB. This review is not systematic, and extension beyond autism remains a hypothesis requiring condition-specific evaluation. Development should proceed from operational specification, independent content assessment, and feasibility studies to the evaluation of measurement properties and comparative clinical outcomes.

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31. Sokolov PL, Chebanenko NV, Tulupova SA, Mednaya DM, Krapivkin AI. [Clinical heterogeneity and prediction complexity associated with nucleotide sequence abnormalities in the SCN2A gene]. Zh Nevrol Psikhiatr Im S S Korsakova. 2026; 126(9. Vyp. 2): 101-15.

Numerous variants of the SCN2A gene have been identified, including missense mutations, deletions, insertions, frameshifting, nonsense mutations, and splice site mutations. The emergence of severe phenotypes is generally associated with de novo and missense variants. The clinical manifestations linked to SCN2A abnormalities exhibit considerable diversity, including varying severities of epileptic episodes with onset in neonatal or subsequent periods, autism spectrum disorders, schizophrenia (including catatonic manifestations), and episodic ataxia. With rare exceptions, all identified phenotypes are associated with developmental delay or regression. The phenotypic diversity associated with SCN2A genetic variants is influenced by the extensive expression of the gene in neuronal populations across various brain regions, its impact on numerous processes critical for the development and functionality of the central nervous system, the distinct localization of mutations within the gene, and the type of mutations (missense, nonsense, frameshift). Variants in nucleotide sequences may increase or decrease gene function (gain-of-function and loss-of-function, respectively) and are associated with ion channel activity influenced by neuroglial effects. An analysis of four cases of SCN2A genetic variants (one case shown to be associated with DENND5A) demonstrated a high efficacy in predicting phenotypes based on existing descriptions of nucleotide sequence abnormalities. However, predictions proved ineffective for similar mutations and for de novo mutations. It is concluded that advances in predicting the phenotypic outcomes of genomic abnormalities depend on the accumulation of clinical data and a thorough investigation of the molecular mechanisms governing gene function.

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32. Wilson N, Minnis H. Mental health, ADHD, and autism: two reports, one call to act. Lancet Child Adolesc Health. 2026.

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33. Yang Y, Wang L, Ma D. Association between allergic diseases and autism spectrum disorder: protocol for a systematic review and meta-analysis. BMJ Open. 2026; 16(10): e114099.

INTRODUCTION: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition increasingly linked to immune dysregulation and chronic low-grade inflammation. Allergic diseases, including asthma, atopic dermatitis, allergic rhinitis and food allergy, are generally associated with immune dysregulation and type 2 inflammatory responses predominantly involving T helper 2-related pathways. Epidemiological evidence also suggests a possible association between ASD and allergic diseases. However, existing studies differ in population characteristics, allergic phenotypes, diagnostic definitions, case ascertainment methods and strategies for confounding control. As a result, the available evidence remains fragmented and the findings are not fully consistent. Therefore, an updated and comprehensive synthesis is needed to integrate observational evidence and examine the associations between multiple allergic diseases and ASD. METHODS AND ANALYSIS: This protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines. We will systematically search PubMed/MEDLINE, Embase, Web of Science, Scopus, the Cochrane Library, CINAHL and APA PsycINFO, supplemented by searches of grey literature sources. We will search for studies published from 1 January 2011 to the date of the final search. Only English-language publications will be eligible for inclusion. Observational studies (cohort, case-control and cross-sectional) evaluating associations between ASD and allergic diseases will be included. Study selection, data extraction, risk-of-bias assessment and certainty-of-evidence assessment will be performed independently by two reviewers. Disagreements will be resolved by discussion, with persisting discrepancies adjudicated by a third senior reviewer. For effect estimates, the most fully adjusted estimates will be prioritised. ORs, risk ratios, HRs and prevalence ratios will be log-transformed. Analyses will be conducted in Review Manager (RevMan, V.5.4). A fixed-effect model or a random-effects model will be selected according to the degree of heterogeneity. Subgroup analyses, sensitivity analyses and publication bias assessment will also be performed. When meta-analysis is not appropriate, the findings will be summarised using a narrative synthesis approach. ETHICS AND DISSEMINATION: No ethical approval is required as this study is based on published literature only. This protocol has been registered with Prospective Register of Systematic Reviews (CRD420251119984). Findings will be disseminated through peer-reviewed publication and conference presentations.

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34. Yu B, Li B, Deng X, Tang J, Chen R, Guo T. The association of anxiety, depression, developmental disabilities, and congenital heart disease in US children and adolescents. BMC Psychiatry. 2026; 26(1).

BACKGROUND: Congenital heart disease (CHD) has been linked to the risk of mental health or some developmental disabilities, but there is limited research on the effect of CHD on children and adolescents’ mental health and developmental disabilities (varying severity) in the general children and adolescents’ population. METHODS: This nationally representative study included 52,846 children and adolescents aged 6-17 years who participated in the 2022-2023 National Survey of Children’s Health (NSCH) in the US from July 2022 to January 2024. Weighted adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable logistic regression models to investigate the association of CHD with anxiety, depression, and multiple developmental disabilities. RESULTS: Finally, 52,846 children and adolescents representing 38 million US youth aged 6-17 years (mean age 11.47 years, 95% CI: 11.41-11.52) were included. Children and adolescents with CHD was associated with a higher presence of of anxiety (OR, 1.80 [95% CI, 1.37-2.37]), depression (OR, 1.52 [95% CI, 1.02-2.27]), Down syndrome (OR, 25.59 [95% CI, 14.27-61.36]), behavior problems (OR, 2.39 [95% CI, 1.77-3.24]), developmental delay (OR, 3.16 [95% CI, 2.39-4.18]), intellectual disability (OR, 3.81 [95% CI, 2.29-6.33]), speech disorder (OR, 2.61 [95% CI, 1.99-3.43]), learning disability (OR, 2.39 [95% CI, 1.80-3.17]), autism spectrum disorder (ASD) (OR, 2.11 [95% CI, 1.35-3.28]) and attention deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD) (OR, 2.04 [95% CI, 1.52-2.72]), respectively. In stratified analyses, the ORs for depression, Tourette syndrome, behavior problems, developmental delay, speech disorder, learning disability, ASD, and ADD/ADHD were higher in moderate or severe status than in mild status. The results were similar in the sensitivity analyses. CONCLUSION: In conclusion, this is the first nationally representative, population-based study to demonstrate that children and adolescents with CHD are associated with increased presence of anxiety, depression, and developmental disabilities in US children and adolescents. The presence of depression and developmental disabilities was higher in moderate or severe status than in mild status. Our findings suggested that early prevention, risk assessment, and support of mental health conditions and developmental disorders in high-risk children and adolescents, such as those with CHD. CLINICAL TRIAL NUMBER: Not applicable.

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35. Zhang H, Zhao J, Wu S, Szigeti K, Miklós K, Sun J, Qiao J. Dynamic multi-scale topology learning and cross-modal graph fusion for autism spectrum disorder diagnosis. Neuroscience. 2026; 619: 85-96.

Multi-modal fusion methods have demonstrated potential in integrating complementary information from different data modalities. However, existing methods often rely on static fusion strategies, failing to capture the heterogeneous interactions across modalities. To address this challenge, we propose the dynamic multi-scale topology learning and cross-modal interaction graph fusion network (DMTL-Net) for autism spectrum disorder (ASD) diagnosis. The model is designed to extract distinctive and complementary features from brain functional and structural networks while capturing their dynamic topological organization. Specifically, the structural radiomics similarity network (RSN) and functional connectivity network (FCN) are constructed from structural magnetic resonance imaging (sMRI) and functional magnetic resonance imaging (fMRI), respectively. Multi-modal graph initialization is performed by the cross-modal inclusive integration and consensus filtering to balance sensitivity and specificity. Then we propose the dynamic topology learning mechanism that integrates multi-scale feature extraction with adaptive channel-wise and spatial-wise fusion, effectively capturing complex inter-modal interactions. Additionally, focal loss is used to reduce the contribution of easy-to-classify samples and emphasize hard examples during optimization. Evaluated on the Autism Brain Imaging Data Exchange dataset, the proposed DMTL-Net demonstrates superior performance and consistently outperforms the state-of-the-art methods.

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