1. Ayoub G. Pollutant Burden in Autism Spectrum Disorder: Mechanistic Convergence, Genetic Susceptibility, and Clinical Translation. Curr Issues Mol Biol. 2026; 48(9).

Autism spectrum disorder (ASD) risk reflects genetic susceptibility and modifiable environmental exposures acting during fetal and early postnatal critical periods. Building on our prior two-path model, in which folate receptor autoantibody-driven cerebral folate deficiency and oxidative stress/neuroinflammation converge on disrupted neurodevelopment, this review provides the first full mechanistic treatment of environmental pollutants within that framework. We synthesize evidence across seven exposure categories: micro/nanoplastics, plastic-associated endocrine-disrupting chemicals, ambient/indoor air pollution, tire wear particles and 6PPD-quinone, heavy metals and pesticides, industrial chemicals and persistent organic pollutants, and ultra-processed food intake as a parallel, non-pollutant contributor to the same inflammatory pathway. Human biomonitoring of micro/nanoplastics has progressed beyond detection in the placenta, brain and breast milk to direct evidence of placental genotoxicity and fetal endocrine disruption, complementing rodent data linking early-life exposure to impaired corticogenesis, disrupted microglial synaptic pruning, and ASD-relevant behavioral deficits. Across categories, oxidative stress, barrier disruption, neuroinflammation, endocrine disruption, and epigenetic modification recur as convergent mechanisms acting on trimester- and age-specific windows of vulnerability. Genetic variation in folate pathway and mitochondrial genes, as well as folate/vitamin B sufficiency, are proposed as candidate effect modifiers rather than established protective factors to modify susceptibility to this pollutant burden. Most evidence is associational or mechanistic rather than trial-based; we grade evidence strength and translate findings into biomarker-guided clinical and population-level policy guidance.

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2. Bao C, Li W, Chu K, Liu Q, Wang Y, Ruan X, Lü H, Liu X, Ke X. Clinical Characteristics and Blood-Based Inflammatory Indices of Psychiatric Hospitalizations Among Children with Autism in China: A Retrospective Electronic Medical Records Study. Brain Sci. 2026; 16(9).

BACKGROUND/OBJECTIVES: This study aimed to investigate the clinical characteristics associated with psychiatric hospitalizations in children with ASD and to evaluate changes in blood-based Inflammatory Indices following treatment. METHODS: A retrospective study of 269 children and adolescents with ASD (≤18 years) admitted to Nanjing Brain Hospital between 2012 and 2023 was conducted. Electronic medical records were reviewed for demographic characteristics, primary reasons for hospitalization, ASD-specific clinical scale scores, and routine laboratory parameters. The systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and non-enzymatic antioxidant indicators (uric acid, total bilirubin, direct bilirubin, prealbumin) were calculated. RESULTS: The mean age at admission was 12.13 years, and 80.3% of admitted patients were male. The leading reasons for hospitalization were aggression (76.21%), psychosocial stressors (48.32%), and ADHD-related symptoms (46.09%), with distinct patterns observed by intellectual disability status, sex, and developmental stage. Multiple regression analyses revealed that age, sex, and specific admission indications were significantly associated with baseline inflammatory indices (SII, NLR, PLR, WBC, NEU, PLT; all p < 0.05) and antioxidant indices (UA, TBIL, DBIL, PA; all p < 0.05). Among 196 patients with 4-week follow-up data, significant post-treatment reductions were observed in SII, WBC, NEU, UA, TBIL, and DBIL, alongside increased prealbumin (all p < 0.05). CONCLUSIONS: Psychiatric hospitalizations of Chinese children with ASD are driven by distinct behavioral and neurodevelopmental profiles. Concurrently, accessible blood-based inflammatory and antioxidant indices show significant baseline clinical associations and post-treatment alterations, suggesting their potential as adjunctive biological markers in acute psychiatric settings. These findings are limited by the retrospective single-center design, absence of a control group, and lack of post-treatment clinical severity assessments.

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3. Bhuvaneswari Ramakrishnan A, NavaneethaKrishnan NK, Mahler W, Schoech A, Vimal Cruz M. Transdiagnostic EEG Signatures in ASD and ADHD: A Comparative Review of Computational Biomarkers and Neuromodulatory Interventions. Brain Sci. 2026; 16(9).

Background/Objectives: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are frequently co-occurring neurodevelopmental conditions with partially overlapping neurophysiological profiles. Electroencephalography (EEG) provides non-invasive access to candidate biomarkers, yet the literature remains largely organized around single-diagnosis frameworks, limiting comparison across conditions and constraining translation into intervention selection. This review compares EEG signatures across ASD and ADHD from a transdiagnostic perspective and examines how such signatures might inform the selection of non-pharmacological interventions. Methods: A structured search of PubMed, Scopus, IEEE Xplore and Web of Science identified peer-reviewed studies published between 2010 and 2026 reporting EEG findings in ASD and/or ADHD, spanning resting-state, task-based, connectivity, event-related potential, machine learning and intervention studies. Sixty-eight sources were synthesized thematically. Given substantial heterogeneity in acquisition parameters and analytic pipelines, evidence was integrated interpretively rather than pooled quantitatively, and no formal risk-of-bias assessment was undertaken. Results: Shared features across both conditions frequently included low-frequency theta excess, reduced alpha modulation under cognitive load, and flattened aperiodic (1/f) slopes-a pattern compatible with, though not a direct measurement of, altered excitation/inhibition balance. While substantial heterogeneity exists, disorder-specific signatures often comprised the ASD « U-shaped » spectral profile alongside elevated epileptiform activity, and frontally pronounced theta/beta ratio elevation in subsets of individuals with ADHD. Machine-learning studies increasingly emphasize interpretable, multidomain feature sets over binary classification. Mindfulness-based and neurofeedback interventions converge on theta reduction and alpha enhancement, although reported effects are frequently conditional on responder status, task context, or outcome-rater blinding. Conclusions: Convergent EEG features support a transdiagnostic account of neurodevelopmental dysregulation. A biomarker-informed framework for intervention selection is proposed, which requires prospective validation before clinical application.

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4. Bottini S, Johnson L, Gillespie S, Scheithauer M, Hardee A, Scahill L. Factor Structure and Validity of the Burnout Assessment for Developmental Disability Settings (BADDS). J Autism Dev Disord. 2026.

PURPOSE: This study examined the factor structure, reliability, and validity of the Burnout Assessment for Developmental Disability Settings (BADDS), a self-report scale for measuring workplace stressors that contribute to burnout specifically among behavioral health providers for autism and related developmental disabilities. METHOD: We conducted an online survey of 566 autism service providers that comprised the BADDS, the Maslach Burnout Inventory – Human Services Survey (MBI), Areas of Worklife Survey (AWS), and the Patient Health Questionnaire – 9 (PHQ-9). Conducted confirmatory factor analysis based on (Bottini et al., 2026) showed poor fit. An expert panel cut 17 redundant items. Exploratory factor analysis on the remaining 56 items resulted in further reduction to 39 items. To evaluate the validity of the 39-item version, the BADDS was compared to the MBI, AWS, and PHQ-9. RESULTS: The 39-item BADDS had six factors: Physical Safety, Training & Supervision, Stakeholder Interactions, Professional Development, Stress Management, and Ethics & Values. Across subscales, internal reliability ranged 0.75-0.92. Correlations with MBI and AWS subscales ranged from 0.04 to 0.60. Elevations across BADDS subscales were associated with incremental increases in MBI scores. CONCLUSION: The BADDS subscales showed solid internal consistency. Consistent increases in burnout symptoms (MBI scores) with elevations on BADDS subscales, supporting convergent validity. Additional research to confirm the psychometrics and utility of the BADDS is warranted.

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5. Chaval S, Tonk SS, Wilson GN, Tonk VS. Chromosome Microarray Analysis of 3832 Patients over 15 Years Confirms Genome-Wide Copy Number Variation in Patients with Developmental Disabilities Including Autism. Curr Issues Mol Biol. 2026; 48(9).

Ongoing need for chromosome microarray analysis (CMA) characterization prompted the description of all 16,138 copy number variants (CNVs) found in 3832 patients studied from 2009 to 2024, 92% of them with developmental disabilities and/or autism. Detailed reporting shows the overlap of variants qualified as benign (15,083 CNVs, sizes 0.1 Kb-3 Mb) or of uncertain significance (216 CNVs, sizes 11 Kb-20 Mb) with pathogenic CNVs (836, 11 Kb-31 Mb), which are emphasized in most studies. Further distinguishing pathogenic CNVs were 88 recurring microdeletion/duplications and 86 in single patients, with all of the former and 66 of the latter having previous syndrome associations. Diagnoses were provided in 749 (20% of) patients, increasing to 21% among the 2470 patients (2015-2024) with their karyotypes recorded. Diagnoses included 61 known chromosomal syndromes, with CMA confirming or clarifying the abnormal karyotype in 187 (7.6%) or 55 (2.2%). The 90 microdeletions averaged 6439 kb in length (with chromosomes 6, 8, 17, and 22 accounting for most cases), while the 90 microduplications averaged 6895 kb (with chromosomes 8, 14, 17, 22, and X accounting for most cases). Together, these represent an average imbalance of 798,000 nucleotides per patient (0.75% of their genome). Continued reporting that match detailed CNV findings with patient profiles, especially symptom spectra, is needed to optimize CMA potential for presymptomatic diagnosis and therapy.

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6. Hernández-Ramírez O, Orozco-Coles AP, Romero-Landín AJ, González-Pérez O, Buriticá J, Campos-Ordoñez T, Zarate-López D. Differential frontostriatal ΔFosB dynamics and behavioral flexibility in autism like VPA-exposed mice. Behav Brain Res. 2026; 517: 116500.

Autism spectrum disorder (ASD) involves social impairments, repetitive behaviors, and behavioral inflexibility, defined as an inability to adapt behavior to changing contingencies, and is linked to frontostriatal dysfunction. How behavioral training modulates these circuits is unclear, but ΔFosB, a marker of sustained neural activity, may be useful to establish their relationship. The aim was to evaluate frontostriatal ΔFosB expression following prenatal exposure to valproic acid (VPA) and to determine how experience in the midsession reversal (MSR) task modulates posterior ΔFosB expression. CD-1 mice were prenatally exposed to VPA (500 mg/kg) or vehicle. Brains from postnatal day (PND) 30 mice were analyzed to quantify baseline ΔFosB + cells in the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), dorsal striatum (DS), and ventral striatum (VS). In the second experiment, mice performed the MSR task for 13 days. Then, ΔFosB was re-evaluated at PND43 to assess experience-dependent changes. At PND30, VPA-exposed mice showed a significant increase in ΔFosB + cells in mPFC, OFC, DS, and VS, suggesting sustained activity-dependent engagement of the frontostriatal circuit. In the MSR task, mice adapted to contingency shifts using mixed strategies, including win-stay/lose-shift behavior and temporal estimation, whereas VPA mice showed less consistent strategy selection after reversal. After MSR, ΔFosB expression in the OFC and striatum of VPA mice normalized to control levels and remained persistently elevated in the mPFC at PND43. Thus, prenatal VPA induces long-term increases in neuronal transcriptional changes, suggesting activity-dependent plasticity in the frontostriatal circuit. Despite these neural alterations, behavioral flexibility was preserved, suggesting circuit-level adaptations underlying ASD-related strategies. Future studies could broaden these results by examining sex differences and characterizing the cellular and molecular changes dependent on frontostriatal ΔFosB dynamics.

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7. Kronfli FR, Kenney C, Vollmer TR, Kahng S. A Brief Assessment of Conversation Skills in Adolescents and Adults with Autism Spectrum Disorder. Behav Sci (Basel). 2026; 16(9).

Effective conversation skills are vital for navigating social interactions successfully. However, many individuals with autism spectrum disorder (ASD) face challenges in developing and maintaining these skills. We aimed to create a brief assessment to evaluate small talk among individuals with ASD. Three individuals diagnosed with ASD participated in the study. Assessment sessions were conducted in person, with questions asked at varying intervals to evoke participant responses. The assessment was effective in identifying potential conversation skills requiring improvement. The findings can inform the design of individualized and naturalistic interventions to enhance conversation skills in adolescents and adults with ASD, fostering improved social communication and engagement.

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8. Lee HY, Chang YC, Chen CL, Ko SH, Huang YL, Shen SP, Hsu YL, Lee WY, Lin HC. Associations Between Early-Life Exposure to Different Antibiotic Agents and the Risks of Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Study. Pharmaceutics. 2026; 18(9).

Background/Objectives: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) substantially affect quality of life. Previous studies have not evaluated whether the associations between early-life antibiotic exposure and the risks of ASD and ADHD differ according to the antibiotic agents administered during infancy. Methods: This nationwide case-control study used Taiwan’s National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database. The cohort included 1,693,718 term neonates born between 2004 and 2015 and followed through to 2022. For ASD (n = 7265) and ADHD (n = 39,056) cases, antibiotic-exposed children were matched 1:1 with unexposed children based on sex, gestational age, birth weight, and birth year. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. Results: Oral antibiotic exposure was associated with lower ASD but higher ADHD risk, while parenteral exposure was associated with increased risks of both outcomes. Amoxicillin and erythromycin exposure during the first year of life were associated with lower ASD risk, whereas ampicillin exposure at 4-12 months was associated with higher ASD risk (all p ≤ 0.033). For ADHD, exposure to amoxicillin/clavulanic acid, cefixime, ampicillin, and ampicillin/sulbactam was associated with increased risk, whereas erythromycin, cephalexin, and sulfamethoxazole-trimethoprim were associated with reduced risk (all p < 0.047). Conclusions: Associations between early-life antibiotic exposure and the risks of ASD and ADHD varied according to antibiotic agents, route of administration, and timing of exposure. These findings may help explain inconsistencies among previous studies and inform antibiotic prescribing during infancy.

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9. Lincoln AJ. Cerebellar Contributions to Cerebral Connectivity in Severe Mental Illness: A Developmental Cascade and Predictive-Modeling Framework with Autistic Disorder as the Focal Case. Brain Sci. 2026; 16(9).

Severe mental illness (SMI) includes neuropsychiatric disorders of adult onset, but also those that begin to show symptoms in adolescence and early childhood. This review treats the psychotic spectrum disorders and autism as neurodevelopmental in origin, each arising from perturbation of early brain development rather than from a process beginning at the age of clinical presentation. Grouping them is a claim about developmental origin and not about shared pathogenesis: they differ in the nature and timing of the perturbation and in the cortical systems being organized when it occurs. The diversity of social, language, behavioral, and cognitive symptoms and traits observed within this class is now well recognized. The language adopted to recognize such diversity has employed the term « spectrum » (e.g., autism spectrum disorder (ASD) and schizophrenia or psychotic spectrum). The substantial expansion of structural and functional connectivity research over the past 40 years has shown that both ASD and psychotic spectrum disorders have also been conceptualized as disorders of brain circuitry. Moreover, and particularly for ASD, this research was developed within a diagnostic time frame that itself underwent six revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), from the third edition (DSM-III; 1980) to the fifth edition, text revision (DSM-5-TR; 2022), with the largest changes involving the elimination of the early language onset requirement and the consolidation of prior subtypes into a single autism spectrum disorder. The present review develops a mechanistic account of cerebral connectivity differences in autistic disorder as defined under DSM-III and DSM-IV, where diagnostic practice, and in particular the exclusion of clinically significant language delay from Asperger’s disorder, enriched cohorts for a subgroup in which cerebellar vermal lobule VI and VII abnormality, posterior callosal reduction, and atypical predictive processing were originally identified. The present account proposes, as a hypothesis rather than as an established finding, that deviation of vermal lobules VI and VII from typical development, in the direction of either hypoplasia or hyperplasia, both reported within the same DSM-III/IV cohort, and on evidence consistent with prenatal origin, initiates a developmental cascade that may shape postnatal cerebral connectivity through disinhibition of deep cerebellar nuclei and altered excitatory drive to thalamocortical circuits during sensitive periods. Cross-condition evidence indicates that vermal abnormality also occurs in conditions with distinct primary diagnoses (Joubert syndrome, fragile X, Rett syndrome, Williams syndrome, schizophrenia), producing the autistic-disorder cluster only when the upstream perturbation also affects cortical context-integration substrates at the relevant developmental window. These conditions are treated as further instances of a common neurodevelopmental class rather than as separate kinds of disorder, with autistic disorder as the focal case because it is where the vermal findings were first identified. Transdiagnostic connectivity evidence spanning autism and schizophrenia cohorts is examined to establish whether the cerebellar account generalizes across the SMI class or is specific to autistic disorder, and the regional and directional distribution of the cerebellar findings in each condition is treated as the discriminating variable. The framework proposes the cerebellum as a substrate for predictive internal models scaffolding auditory, social, and contextual learning, and is empirically testable through infant connectivity and event-related potential studies and through stratified re-analysis of multisite samples.

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10. Liu X, Zhao H, Zhang W, Zhang C, Liu X. Multimodal Human-Computer Interaction Interventions for Children and Adolescents With Autism Spectrum Disorder: A Scoping Review. J Autism Dev Disord. 2026.

PURPOSE: Multimodal human-computer interaction (HCI) is increasingly used in interventions for children and adolescents with autism spectrum disorder (ASD), but technological and methodological heterogeneity limits cross-study comparison. This scoping review mapped recent evidence using a pathway framework defined by the dominant interaction mechanism. METHODS: Following JBI and PRISMA-ScR guidance, we searched Web of Science, Scopus, PubMed, and IEEE Xplore for peer-reviewed empirical publications from 2019 to 2025 and conducted backward and forward citation searches. Publications were classified into four mutually exclusive pathways: extended reality (XR), socially assistive robotics (SAR), exergames or embodied-interaction systems (EXG), and hybrid or adaptive systems (HYB). RESULTS: Seventy-two publications were included: XR (n = 25, 34.7%), SAR (n = 23, 31.9%), EXG (n = 13, 18.1%), and HYB (n = 11, 15.3%). Social communication appeared in 49 publications (68.1%) and cognition or executive function in 32 (44.4%), whereas daily-living or safety-related skills appeared in 5 (6.9%) and sensory processing in 3 (4.2%). Eighteen publications (25.0%) used randomized designs, and five (6.9%) used physiologically or neurally driven closed-loop adaptation. CONCLUSION: The pathway framework moves beyond device-based categories by focusing on the mechanisms that organize intervention. This framework helps align system design with intervention goals and participant needs in ASD research. Future research should strengthen pathway-specific reporting, longitudinal evaluation in real-world settings, and transparency of adaptive mechanisms.

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11. Miao H, Zhang T, Fang K, Chen S, Xu X, Zhang Y, Huang X. Three Novel de Novo SOX4 Variants Expanding the Phenotypic Spectrum: Case Series and Literature Review. Genes (Basel). 2026; 17(9).

BACKGROUND: Variants in SOX4 cause intellectual developmental disorder with speech delay and dysmorphic facies (IDDSDF), an autosomal dominant disorder characterized by global developmental delay, mild-to-severe intellectual disability, speech delay, distinctive facial features, digital anomalies, congenital heart defects (unique), and behavioral abnormalities. To date, only a limited number of patients have been described and the phenotypic spectrum of this disorder has yet to be fully delineated. METHODS: Clinical data from three patients were collected, including clinical features, growth and developmental profiles, neuropsychological assessments, and urogenital evaluations. Whole-exome sequencing (WES) was performed to screen for candidate variants, and variant pathogenicity was interpreted following the American College of Medical Genetics and Genomics (ACMG) guidelines. RESULTS: All three patients carried previously unreported de novo truncating variants in SOX4: c.583C>T (p.Gln195*), c.1347del (p.Cys450Alafs*5), and c.153G>A (p.Trp51*). Regarding the clinical phenotypes, Patient 3 (P3) was similar to previously reported cases, whereas Patient 1 (P1) and Patient 2 (P2) each exhibited distinctive features on the basis of overlapping with previous reports: P1 presented with severe hypospadias accompanied by cryptorchidism; to our knowledge, no case with this predominant clinical feature has been reported previously. P2 exhibited nystagmus, a novel phenotype not yet reported in the literature. CONCLUSIONS: We report three previously unreported de novo truncating variants in SOX4, expand the phenotypic spectrum of SOX4-related disorders to include nystagmus for the first time, and document one patient presenting with severe hypospadias and cryptorchidism. Our findings further expand the mutational and clinical phenotypic spectra of SOX4, underscore the marked clinical heterogeneity of this disorder, and provide new evidence to facilitate clinical recognition and genetic counseling.

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12. Salehi AM, Rabiei N, Shahverdi S, Farashi S, Jenabi E, Bashirian S, Seyedi M. Measurement Properties of Autism Spectrum Disorder Screening Instruments: A Systematic Review. Curr Pediatr Rev. 2026.

BACKGROUND: This study provides a systematic review of screening tools for Autism Spectrum Disorder (ASD) and evaluates their psychometric and measurement properties. METHODS: A comprehensive search was first conducted on PubMed, Scopus, Web of Science, and CINAHL, and PsycINFO databases. This search was conducted until 3 February 2022 to identify the best psychometric tools in various communities for screening patients with ASD. The quality of the included studies was assessed using the COSMIN checklist. RESULTS: The study included 68 papers and 33 measures; most of them were questionnaires, and the M-CHAT was the most extensively tested. According to the COSMIN checklist, the reliability of one study that used BSIQ for evaluation was excellent. The content validity of a study that used BISCUIT for evaluation was excellent. The hypothesis test was fully explained in 4 studies that used Q-CHAT, FYI, BITSEA, and CBCL1.5-5 tools for evaluation and got a perfect score. The crosscultural validity of a study that used M-CHAT was excellent. The criterion validity of 3 studies that used M-CHAT, BITSEA, and ASSQ was reported as excellent. DISCUSSION: ASD screening tools vary in quality based on age, informant, and culture. Some have solid validity and reliability, but evidence is inconsistent, stressing the need for careful interpretation and further validation. CONCLUSION: Each ASD screening tool assesses specific skills and various aspects of the disorder; careful evaluation is needed to select the appropriate tool. However, the results of this study highlighted the need for additional validation studies for all the measures.

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13. Tüysüz B, Çifçi Sunamak E, Durcan G, Öztürk B, Uludağ Alkaya D, Çulpan HC, Korkmaz MB, Doğangün B, Kıykım E. Insight into Essential and Complex Autism Spectrum Disorders: Clinical Characteristics, Chromosomal Microarray Analysis, and Risk Factors. Genes (Basel). 2026; 17(9).

Background/Objectives: Autism spectrum disorder (ASD) can present with either an essential or a complex phenotype. The aim of this study was to compare clinical characteristics and the diagnostic yield of copy number variations (CNVs) in essential and complex phenotypes, and to evaluate risk factors. Methods: A total of 163 Turkish children (126 boys, 37 girls) who met the DSM-5 diagnostic criteria for ASD were evaluated. Chromosomal microarray analysis was performed. Results: Among the patients, 21.5% had a complex phenotype and 78.5% had an essential phenotype. Overall, 13.7% of the patients had a developmental/intelligence quotient (DQ/IQ) below 50, most of whom had a complex phenotype. In contrast, 15.3% of the patients had a DQ/IQ of 70 or higher, all of whom had an essential phenotype. The frequency of verbal individuals was 30.5% and did not differ between the two phenotypes. Pathogenic CNVs were identified in 7.4%; 17.1% of the complex group and 4.7% of the essential group. CNVs of uncertain significance that were potentially causal because they included an ASD-associated gene were present in 12.3% of individuals. CNV positivity was significantly higher in individuals with an IQ below 50; interestingly, it was similar between the verbal and non-verbal groups. Besides ultra-rare CNVs, recurrent CNVs associated with ASD were identified. A novel pathogenic CNV was identified at 2q13.33, including NPHP1 and BUB1, both of which are expressed in the brain and are potentially associated with ASD. Advanced parental age and preterm birth were identified as possible risk factors. Conclusions: Deep phenotyping is important for the management of both essential and complex phenotypes and allows the identification of patients with a higher probability of having CNVs. Reporting novel or rare CNVs contributes to clarifying the pathogenesis of ASD.

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14. Xu D, Zhang B, Jiang P, Zhu P, Mi D, Huang W, Ba R, Zhao C. Disruption of FOXG1 Impairs the Development of Striatal dSPNs, Thereby Contributing to ASD-Like Phenotypes. Neurosci Bull. 2026.

Striatal dysfunction is a feature of autism spectrum disorder (ASD); however, the molecular mechanisms underlying its development remain unclear. Mutations in the transcription factor FOXG1 lead to FOXG1 syndrome, which shares core clinical features with ASD. In the present study, we conditionally deleted Foxg1 in the striatal direct pathway spiny projection neurons (dSPNs) to create Foxg1 conditional knockout (cKO) mice, which we found recapitulated classic ASD-like symptoms, including social deficits, communication impairments, and restricted repetitive behaviors. Loss of FOXG1 further resulted in simplified dendritic arborization and reduced dendritic spine density. We found that FOXG1 drives a set of ASD risk genes, including synaptic receptors and scaffolding proteins, to coordinate the development and function of dSPNs. Further, FOXG1 directly regulated the transcription of GABA(B) receptor subunit 2 to control the activity of dSPNs. Pharmacological enhancement of the GABA(B) receptor activity effectively restored the excitation/inhibition balance and ameliorated behavioral abnormalities in Foxg1 cKO mice. Our findings reveal a novel role for FOXG1 in dSPNs, provide new insights into the pathogenesis of ASD and FOXG1 syndrome, and indicate that targeting GABA(B) receptor activation may serve as a potential therapeutic strategy for ASD.

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15. Yeoman M, Cieplinska V, Lye V, Totsika V. School Exclusion as a Partial Mediator Between Autism and Adolescent Mental Health. J Autism Dev Disord. 2026.

PURPOSE: This study investigated whether school exclusion during secondary school mediates the association between Autism Spectrum Conditions (ASC) and adolescent internalising and externalising mental health difficulties. METHODS: We analysed data from the UK Millennium Cohort Study (N = 10,228, waves 1-7). Parents reported ASC diagnosis at ages 5-11 and whether their child had been excluded at ages 11-14. Internalising and externalising symptoms were self-reported by adolescents at age 17 on the Strengths and Difficulties Questionnaire. Confounders were mapped onto a Directed Acyclic Graph. Causal mediation analyses, using the g-formula for randomised interventional analogues, estimated direct and indirect effects while accounting for these confounders without biasing the causal pathway. RESULTS: Autism was associated with higher internalising and externalising scores, with autistic adolescents more likely to experience school exclusion than peers. School exclusion partially mediated the association between ASC and externalising symptoms (indirect effect = 0.03 (95% CI: 0.004, 0.06, p = 0.024) . No evidence of mediation was found for internalising symptoms. CONCLUSION: School exclusion acts as one modifiable environmental mechanism contributing to externalising difficulties in autistic adolescents, likely through the loss of protective school supports. Preventative, autism-informed strategies that reduce reliance on exclusion and provide appropriate support could form part of wider efforts to improve mental health outcomes in autistic adolescents.

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16. Zhou L, Hu X, Hao J, Chen X, Wu X, Mei Y, Chen J, Xu Z, Zhao J, Qi Q. An Auditory-Vocal Package for Story Recall in Chinese Children with Autism: Evaluating Forward Chaining and Emergent Divergent-Convergent Relations. Behav Sci (Basel). 2026; 16(9).

This study evaluated the effects of a strictly auditory-vocal instructional package, combining cued vocal rehearsal, forward chaining, and multiple stimulus control arrangements, on the acquisition of forward intraverbal story recall (RC, divergent relations) and the emergent performance on untaught reverse character identification (CI, convergent relations) probes across nine children with autism spectrum disorder (ASD). Utilizing a concurrent multiple-baseline design across character chains replication, the 1:1 intervention integrated the auditory-vocal components without initial permanent visual aids. All nine participants met the mastery criterion for the directly taught forward story-recall chains (mean = 4.6, 4.9, and 4.3 sessions across target characters). Following instruction, unreinforced probe performance on untaught CI relations increased above pre-instruction levels for all participants, with seven achieving mastery on these convergent tasks. Maintenance probes conducted at 2 and 4 weeks post-instruction demonstrated sustained responding for the majority of participants, though marked individual variability-including notable performance decays in story recall for two participants-was observed. Because a formal component analysis was not conducted, the specific contribution of vocal rehearsal cannot be isolated from the overall package, and theoretical mechanisms such as joint control serve only as a cautious, tentative conceptual account. While limited by CI’s functional problem-solving evidence being tempered by its measurement format within the staggered concurrent arrangement, the absence of component isolation, and direct classroom generalization probes, these preliminary findings suggest that package utilizing strictly auditory-vocal arrangements demonstrates initial feasibility for establishing complex intraverbal forward chains under controlled 1:1 clinical conditions. This foundation allows future research on adapting this package, considering temporal location parameter adjustments, to support multi-component stimulus control for vocal independence within inclusive classroom settings like Learning in Regular Classrooms (LRC).

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