1. Alsayouf HA, Al-Ghawanmeh R, Alhawawsha LS, Alsarhan O, Hamada HA. Clinical-Radiological Discordance in the Detection of Chronic Constipation in Children Newly Diagnosed with Autism Spectrum Disorder: A Retrospective Study. Reports (MDPI). 2026; 9(4).

Background/Objectives: Chronic constipation in patients with autism spectrum disorder (ASD) may be undetected during routine care and can exacerbate ASD symptoms such as irritability and hyperactivity. This retrospective study evaluated the prevalence of radiographic findings suggestive of chronic constipation in children newly diagnosed with ASD, and it compared these findings with those based on routine clinical history and examination alone. Methods: A retrospective chart review of pediatric patients diagnosed with ASD at neurology clinics in Jordan between 2022 and 2025 was conducted. Informed consent was required for an abdominal radiographic examination at screening to initiate the standard treatment protocol at participating clinics. A more stringent version of the Leech criteria, equivalent to a total Leech score of ≥10, was applied to the radiographic images to identify patients with findings suggestive of chronic constipation. Data were extracted via retrospective chart review using a standardized data collection form. Results: Among the 455 patients who met the study eligibility criteria, the mean ± SD age was 6.7 ± 3.3 years (median, 6 years; range, 2-18 years) and 80.2% were male. Most patients had radiographic findings suggestive of chronic constipation at baseline (81.5%, n = 371/455), whereas 5.3% (24/455) had findings suggestive of constipation based on their medical history and clinical examination alone. Conclusions: Radiographic findings suggestive of chronic constipation were common in children newly diagnosed with ASD and were identified substantially more frequently than constipation identified through routine history-taking and clinical examination in the same patients. Prospective studies are warranted to determine whether the use of alternative, standardized methods as adjunct diagnostic tools can improve clinical outcomes in this population.

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2. Amorim MMR, Delgado A, Brilhante AVM, Souza ASR. Comments on: Prenatal acetaminophen and autism: a meta-analytic signal driven by a single, mis-extracted estimate. Rev Bras Ginecol Obstet. 2026; 48.

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3. Balabanovska M, He JL, Powell HJ, Edden RAE, Mostofsky SH, Puts NA. Paired-pulse tactile stimulation enhances tactile perception in neurotypical but not autistic children. Res Sq. 2026.

Tactile sensory differences are common in autism. Sensory gating, a mechanism by which perception is filtered, is of relevance, yet it is unknown if atypical sensory filtering in autistic people directly impacts the perception of sensory stimuli. In this study we used a novel psychophysical protocol to examine the effect of pre-pulse sub-threshold stimulation on tactile detection thresholds in 8-12 year old autistic (n = 24) and neurotypical (n = 51) children. We used two pre-pulse conditions with either a 30 ms or 100 ms interval. We hypothesised, based on prior work, that sub-threshold stimulation would worsen detection threshold in neurotypical controls whereas the effect of sub-threshold stimulation would be absent in autism. We further hypothesised that the absence of gating would correlate with autism outcomes. Contrary to these expectations, we observed that both pre-pulse stimulation conditions significantly improved detection thresholds in neurotypical children but not autistic children. The improvement is consistent with recent work examining the impact of different pulse types and intervals and reflects the importance of sensory filtering mechanisms on tactile perception. These findings reinforce prior findings that sensory filtering may underlie poorer perceptual capacity in autism. We did not find associations with clinical measures suggesting that the relationship between perceptual and behavioural sensory differences and their relation to autistic traits is complex. This work shows that atypical sensory gating is directly related to differences in perception in autistic children. This work has strong implications for understanding how different brain mechanisms give rise to altered sensory processing, core to autism.

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4. Chen B, Boxberger A, Mahmalji J, Do T, Herrera M, Tuy S, De Oliveira Campos GA, Sereno MI, Fishman I, Linke AC. Tonotopic mapping in children shows an overrepresentation of high frequencies in autism. bioRxiv. 2026.

Altered sensitivity to sounds despite normal peripheral hearing is common in neurodevelopmental disorders but the underlying mechanisms remain poorly understood. Here we investigate tonotopic organization in 86 children (6-11 years) with autism spectrum and related neurodevelopmental disorders as well as typically developing (TD) peers, using a child-friendly, passive listening, functional magnetic resonance imaging design. In TD children, tonotopic maps in primary auditory cortex resembled the typical high-low-high frequency gradients previously reported in adults, while children with autism showed an overrepresentation of high frequencies consistent with what has been observed in animal models of autism. Higher frequency tuning further correlated with greater caregiver-reported sound but not touch sensitivities. Importantly, tonotopy is a core organizational feature of auditory cortex that develops early in life and remains relatively stable after the critical period of heightened plasticity ends. Thus, these results suggest that atypical auditory processing in autism may result from early disruption to tonotopic map formation. Longitudinal neuroimaging studies are needed to understand the genetic and environmental causes of altered auditory cortex topology and its long-term consequences for higher-level auditory, language, and social communication development.

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5. Chen XN, Zhang Y, Zhang XJ, Yim C, Kam KW, Ng MPH, Ip P, Wong ICK, Zhang W, Young AL, Tham CC, Pang CP, Chen LJ, Yam JC. Anisometropia, Strabismus, and Amblyopia in Children with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and Their Comorbidity. Ophthalmol Sci. 2026; 6(11): 101406.

PURPOSE: To explore the association of anisometropia, strabismus, and amblyopia with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and their comorbidity. DESIGN: Population-based cross-sectional study. SUBJECTS: Children aged 6-10 years in Hong Kong. METHODS: Participants underwent comprehensive ocular examinations. Attention-deficit/hyperactivity disorder and ASD diagnoses were made by qualified physicians using International Classification of Diseases 10 criteria. MAIN OUTCOME MEASURES: The prevalence of anisometropia, strabismus and amblyopia. RESULTS: A total of 10 936 children were included, comprising 153 (1.4%) with ASD only, 413 (3.8%) with ADHD only, 276 (2.5%) with comorbid ASD-ADHD, and 10 094 (92.3%) healthy controls. The prevalence of anisometropia was 9.8%, 8.7%, 15.2%, and 6.0% across the respective groups (P < 0.001). The corresponding prevalence of strabismus was 4.6%, 2.9%, 4.0%, and 1.7% (P < 0.001), and for amblyopia, it was 7.2%, 2.7%, 4.0%, and 2.9% (P = 0.03). Autism spectrum disorder (ASD only plus comorbidity) was associated with higher risks of anisometropia (odds ratio [OR] = 1.51, P = 0.04), strabismus (OR = 2.30, P = 0.01), and amblyopia (OR = 1.91, P = 0.02), whereas ADHD (ADHD only plus comorbidity) was associated with anisometropia (OR = 1.58, P = 0.008) after adjusting for covariates. In subgroup analyses, the ASD-only group showed associations with strabismus (OR = 2.47, P = 0.04) and amblyopia (OR = 2.46, P = 0.02). The comorbid ASD-ADHD group exhibited a higher risk of anisometropia (OR = 2.17, P < 0.001), whereas children with ADHD only showed no association with the aforementioned ocular disorders. CONCLUSIONS: Children with ASD only and ASD-ADHD comorbidity were associated with increased and distinct patterns of anisometropia, strabismus, and amblyopia, while children with ADHD only showed no such association. FINANCIAL DISCLOSURES: The author has no/the authors have no proprietary or commercial interest in any materials discussed in this article.

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6. Kelly B, MacRae C, Prigge R, Hemingway H, Fitzpatrick N, Torralbo A, Guthrie B. Variation in Primary Care Diagnostic Codes Used to Define Health Conditions for Research: Comparison of 45 Health Data Research UK Phenotype Library Codelists for Eight Health Conditions. Int J Popul Data Sci. 2026; 11(1): 3418.

INTRODUCTION: The use of electronic healthcare records (EHRs) has become standard practice in most healthcare settings in many countries. These can be utilised for research purposes by developing codelists to define cohorts and health conditions of interest. In the UK the Health Data Research UK (HDR UK) Phenotype Library is a resource where researchers can access multiple codelists deposited by other researchers for a range of medical conditions. OBJECTIVES: This paper examines variation in the published codelists in the HDR UK Phenotype Library for a number of conditions. METHODS: We extracted codelists held within the HDR UK Phenotype Library for eight common conditions (asthma, autism, coronary heart disease, chronic obstructive pulmonary disease, depression, hypertension, obesity, and type 2 diabetes). We categorised included codes as diagnostic, disease related, administrative, and unrelated to the condition. We explored the degree of agreement between codelists by estimating kappa statistics for codelists for each condition and category. RESULTS: There were 48 published codelists for the eight conditions, with wide variation in the number of codes used to define each condition (for example from 39 to 247 codes in eight asthma codelists). Only codelists for chronic obstructive pulmonary disease and depression consistently achieved fair (kappa 0.21-0.40) moderate agreement (kappa 0.41-0.60), with other conditions consistently achieving fair agreement at best. Agreement was higher for diagnostic codes, and lowest for administrative codes. CONCLUSIONS: The HDR UK Phenotype Library publishes researchers’ codelists to facilitate greater transparency and replicability of studies. This study finds that agreement between codelists in terms of the codes included was low. Further research is needed to determine how such variation alters identification of which individuals have conditions of interest.

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7. Lu M, Chen Y, Zhou H, Lin Y. Gut microbiota-mediated tryptophan metabolic dysregulation in the comorbidity of inflammatory bowel disease and autism spectrum disorder: mechanisms and research progress. Front Immunol. 2026; 17: 1950055.

The « microbiota-gut-brain axis » represents a critical link connecting various aspects of intestinal physiology, brain function, and behavioral performance. Among these, tryptophan metabolism abnormalities mediated by gut microbes through the gut-brain axis (GBA) have garnered widespread attention in the study of IBD-ASD comorbidity. This article reviews the current state of research on tryptophan metabolism abnormalities in IBD-ASD comorbidity, with a particular focus on the connection between peripheral and central tryptophan metabolic derangements mediated by gut microbes via the GBA. Furthermore, we summarize and analyze potential therapeutic targets and intervention strategies in this comorbid condition, integrating recent mechanistic studies and clinical evidence to provide a conceptual framework for understanding the potential mechanisms underlying IBD-ASD comorbidity. However, direct evidence from patients with confirmed IBD-ASD comorbidity remains limited at present, and further clinical studies are still needed to test this hypothesis.

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8. Makhlouf M, Calderwood S. Missed Perforated Appendicitis in a Nonverbal Patient with Autism and Duchenne Muscular Dystrophy: A Case Report. Reports (MDPI). 2026; 9(4).

Background and Clinical Significance: A 4-year-old nonverbal boy with level 3 autism spectrum disorder and Duchenne muscular dystrophy (DMD) who was receiving chronic prednisone therapy presented to the emergency room with acute appendicitis. The diagnosis was significantly delayed due to atypical pain presentation, a potentially blunted inflammatory response from chronic steroid use, and an uncertain contribution from DMD-related muscle weakness. Case Presentation: The patient presented with five days of fever, poor oral intake, decreased stool output and behavioral changes. Initial physical examination and evaluation over two emergency department visits failed to establish the diagnosis. By the third visit, the patient exhibited abdominal distension, hypoactive bowel sounds, and bandemia. Computed tomography demonstrated perforated appendicitis with a walled-off abscess. Nonoperative management was unsuccessful, resulting in the development of multiple intra-abdominal abscesses that required percutaneous drainage. Following a 10-day hospitalization, the patient improved and was discharged. He subsequently underwent a scheduled laparoscopic appendectomy two months later, with pathology demonstrating persistent inflammation. Conclusions: This case raises awareness of the atypical presentation of pain in children with autism and the potential for DMD and chronic steroid therapy to complicate clinical assessment. These factors should prompt clinicians to maintain a low threshold for advanced imaging when clinical concern is present. It also illustrates the importance of close monitoring during nonoperative management of perforated appendicitis in medically complex or immunosuppressed children.

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9. Moore Z, Tasnim N, Frank R, Jones C, Tripathi V, Nobriga G, Dhaveji S, Gahagan M, Purevtugs J, Newpol J, Basso JC. The Choreography of Coupled Brains: Coordinated Movement and Multi-Scale Neural Synchrony in Musical Theater for Individuals with Developmental Disabilities. bioRxiv. 2026.

Performing together, which demands moving, singing, and coordinating in real time, is among the most social things people do, yet whether such coordination synchronizes not only behavior but brain activity, within and between performers, has rarely been examined during genuine performance. In this pilot study, we used mobile electroencephalography, including dual-brain hyperscanning of co-performing partners, to resolve neural change over a 16-week musical-theater program in adolescents and adults with developmental disabilities, the majority autistic. We examined four levels: behavior, spectral power, within-brain (source-space) connectivity, and between-brain synchrony, framing all estimates as effect sizes. Anxiety decreased from pre- to post-intervention, consistently across participant and parent reports. During performance, high-beta and gamma power and within-brain amplitude connectivity rose broadly across the cortex, with maximal effects seen in parieto-occipital regions. Between-brain coupling was similarly carried by amplitude co-fluctuation rather than phase; however, it was graded by the degree of interpersonal movement coordination (strongest when partners mirrored one another) and scaled with movement vigor. Local and within-brain changes were thus broad and state-like, whereas coupling between brains was specific to interpersonal coordination. Coordinated movement may organize neural synchrony across scales, positioning musical theater as a tractable model for studying the social brain in motion.

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10. Naples AJ, Cayir S, Cukar-Capizzi C, Wolf JM, McClelland JE, Robertson EC, Sawant SS, Matuskey D, McPartland JC. Synaptic density imaging associates with performance but not self-report in autism. bioRxiv. 2026.

Autism is a common neurodevelopmental condition with considerable between-person variability and unknown biological etiology. Diagnosis of autism in adults relies on measurement of performance (e.g., clinician rating of social behavior, standardized assessment of cognition) and self-report of autism features. Our prior work revealed a strong relationship between clinician ratings of social function in autism and in vivo measures of synaptic density as measured by [ (11) C]UCB-J PET (Matuskey et al., 2025). However, it is not understood how the measured aspects of the autism phenotype index underlying biology. Here, in a sample of 12 autistic adults, we address this question by relating synaptic density imaging to a range of performance measures, such as cognition and face recognition, in contrast to self-report measures. Our results identify a dissociation between these measurement types in that synaptic density correlates strongly with measures of performance but shows virtually no relationship with self-report. These findings suggest that, while self-report and performance measures share variance in characterizing phenotypes in autism, they diverge when mapping onto the underlying biology. Results suggest that higher synaptic density may index a general mechanism that facilitates social and cognitive performance across a range of tasks. These data also indicate that performance and self-report measures are not interchangeable in capturing brain-behavior correspondences in autism, a finding that can guide measure selection in future biomarker studies and clinical research.

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11. Oliveira JA, Lemos MJ, Queiroz LF, Sciorilli JV, Tran T, Ortiz IO, Armstrong BBS, de Oliveira FR. Author´s reply to comment on: Prenatal exposure to paracetamol and risk of autism spectrum disorder: systematic review and meta-analysis of observational studies. Rev Bras Ginecol Obstet. 2026; 48.

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12. Özbaran NB, Şener Z, Sarı S, Korkmaz Şahin G. Clinical characteristics and camouflaging behaviors in children and adolescents with late-diagnosed autism spectrum disorder: a retrospective descriptive study. Front Child Adolesc Psychiatry. 2026; 5: 1910194.

PURPOSE: Autism is a heterogeneous neurodevelopmental condition characterized by persistent difficulties in social communication and interaction, together with restricted and repetitive patterns of behavior, interests, or activities. Camouflaging-related behaviors and co-occurring psychiatric disorders may make autistic features less visible and contribute to delayed recognition. This study aimed to examine clinical characteristics and camouflaging-related behaviors among children and adolescents with late-diagnosed autism. METHODS: This retrospective chart review included 46 children and adolescents aged 6-21 years who received an ASD diagnosis after the age of six. Autism diagnoses had been confirmed using a standardized observational assessment. Data were retrospectively extracted using structured case report forms based on clinical records, parental reports, and literature-informed camouflaging-related clinical features. RESULTS: Attention-Deficit/Hyperactivity Disorder was the most common co-occurring psychiatric condition. Masking-related social adaptation behaviors were more common among girls. Giftedness and easy temperament were also observed more frequently in girls and were identified among factors associated with delayed recognition. Boys showed greater behavioral difficulties than girls. Clinician-rated camouflaging scores demonstrated a moderate positive correlation with post-diagnosis Global Assessment Scale scores (r = 0.38). CONCLUSIONS: The findings describe a clinically heterogeneous group of late-diagnosed children and adolescents and suggest that camouflaging-related behaviors, co-occurring psychiatric conditions, and contextual factors may reduce the visibility of autistic features. Given the retrospective design, small sample size, and use of a clinician-developed measure of camouflaging-related features, the findings should be interpreted as exploratory.

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13. Ziab HM, Mazbouh R, Alshami A, Singh K, Nashwan AJ. Aquatic Interventions for Children and Adolescents With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Motor, Sleep, Executive Function, and Adaptive Measures. Cureus. 2026; 18(9): e116809.

Children and adolescents with autism spectrum disorder (ASD) frequently face challenges in motor coordination, balance, sensory processing, sleep, physical activity engagement, and social and adaptive functioning. Aquatic interventions can offer a supportive therapeutic setting by combining physical activity, sensory input, motor practice, and opportunities for functional participation. This systematic review and meta-analysis examined the effects of structured aquatic interventions in children and adolescents with ASD on aquatic skills and water safety, sleep, social and adaptive outcomes, motor and balance performance, executive function, biomarkers, quality of life, and participation-related outcomes. A search was conducted in PubMed, CINAHL, Web of Science, Cochrane CENTRAL, and PEDro for studies involving participants aged 0 to 18 years with ASD who underwent structured hydrotherapy, aquatic therapy, swimming-based therapy, or other water-based interventions. A narrative synthesis was carried out for all eligible studies, while random-effects meta-analyses were conducted for controlled studies reporting comparable outcomes. Nineteen studies, reporting ASD samples totaling 342 participants, were included, and seven of these contributed to the quantitative synthesis. Aquatic skills and water safety produced the most consistently favorable findings. Pooled estimates favored aquatic intervention for sleep (Hedges’ g = 1.76, 95% confidence interval (CI): 1.16 to 2.37), motor and balance outcomes (g = 1.49, 95% CI: 0.91 to 2.07), and executive function (g = 0.92, 95% CI: 0.35 to 1.46). Social and adaptive outcomes similarly favored aquatic intervention, though the pooled effect did not reach statistical significance (g = 0.38, 95% CI: -0.17 to 0.94). Since most domain-specific meta-analyses included only two studies, the pooled estimates should be viewed with caution. Overall, aquatic interventions appear to support water safety, motor and balance performance, sleep, and possibly executive function in pediatric ASD, while effects on social and adaptive functioning remain uncertain.

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