1. Alyasseri ZAA, Hatim HA, Alogaili RRN, Ali N, Jamil N. Hybrid EEG Feature Fusion Framework for Accurate Autism Spectrum Disorder Diagnosis Using Ensemble Learning. IEEE J Biomed Health Inform. 2026; Pp.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition with increasing global prevalence and no standardized biological test for early detection. Current diagnosis methods rely heavily on behavioral assessments, which are subjective, time-consuming, and prone to variability. This study proposes a hybrid feature fusion framework for non-invasive ASD diagnosis using electroencephalogram (EEG) signals, specifically event-related potentials (ERPs) such as P300 components obtained from the BCIAUT-P300 dataset. EEG recordings were captured using a g.Nautilus wireless system with eight scalp electrodes, and preprocessed using 0.5-30 Hz bandpass filtering and baseline subtraction to enhance signal quality. Twenty-two EEG features were extracted across time, frequency, and time-frequency domains using methods such as Wavelet Transform, power spectral density, higher-order statistics, and principal component analysis. Five optimal methods, PCA, HOS, PSD, FDA, and CWT, were selected based on their classification potential and fused using both feature-level and decision-level strategies. Ensemble classifiers including SVM, XGBoost, LDA, and Random Forest were trained and evaluated on the fused feature set. The proposed hybrid fusion framework achieved a classification accuracy of 97.7%, sensitivity of 96.8%, and specificity of 98.5%, outperforming traditional single feature or single classifier approaches. The integration of multi-domain feature descriptors with ensemble learning contributes to increased robustness, generalizability, and diagnostic precision. Our work demonstrates the feasibility of combining EEG-based biomarkers with machine learning to support early ASD diagnosis. The framework offers a scalable approach that is aligned with biomedical informatics objectives, with potential for clinical deployment and integration into portable EEG-based screening systems.

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2. Bacopoulou F, Dimitriou D, Robins DL, Christou AI, Xenopoulou T, Prapas C, Efthymiou V. Validation of the Updated (March 2025) Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) in Greek. Children (Basel). 2026; 13(5).

Background/Objectives: The aim of this study was to translate, culturally adapt, and validate the updated (March 2025) version of the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) in Greek by examining its reliability, validity, and screening efficacy in a Greek sample. Methods: The M-CHAT-R/F was administered to Greek parents/primary caregivers of children aged 16-48 months, with no prior diagnosis of autism spectrum disorder (ASD), severe sensory impairments, or other chronic conditions causing neurodevelopmental delay. Parents/primary caregivers were invited to participate in the nationwide Program « Child and Family Health Promotion through the Paediatric Framework » of the Greek Ministry of Health in collaboration with UNICEF, implemented by the National and Kapodistrian University of Athens. Results: The final sample comprised 280 parents of children 16 to 48 months old (mean age ± SD 24.64 ± 7.75 months) with an almost equal sex distribution. Mean (±SD) parental age was 35.31 (±3.14) years, ranging from 30 to 48 years, and most respondents were mothers (94.3%). The Greek M-CHAT-R/F demonstrated acceptable reliability (KR-20 = 0.789) and acceptable scalability (monotonicity). Conclusions: The present study provides compelling evidence that the Greek M-CHAT-R/F is a reliable, valid, culturally appropriate instrument for screening children for the presence of ASD. The psychometric properties of the Greek version are consistent with previous international reports and warrant its use in routine pediatric practice in Greece.

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3. Băean ML, Nicu-Canareica O, Volovăț CC, Popa GA, Ciuc DM, Jinga V, Medar C. Bridging Brain Science and Technology: How AI Is Shaping the Future of Neuroimaging in Autism. Diagnostics (Basel). 2026; 16(10).

Background/Objectives: Autism Spectrum Disorder (ASD) is associated with structural brain alterations, particularly involving white matter and connectivity. Artificial intelligence (AI) enhances the detection of subtle neuroanatomical changes. This study aimed to characterize structural abnormalities and volumetric patterns in children with ASD using AI-assisted MRI. Methods: This retrospective study included 90 children diagnosed with ASD. Brain MRI scans were analyzed using the CE-certified AI platform mdbrain. Structural findings were classified into corpus callosum anomalies, white matter signal abnormalities (WMSA), ventriculomegaly, other abnormalities, or no detectable changes. Group differences were assessed using ANOVA and Kruskal-Wallis tests with Tukey post hoc analysis. Logistic regression, principal component analysis (PCA), and linear discriminant analysis (LDA) were applied. Results: WMSA were identified in 23.3% of patients, followed by other anomalies (27.8%), corpus callosum anomalies (8.9%), ventriculomegaly (8.9%), and no abnormalities (31.1%). Total white matter volume was significantly reduced in pathological groups and was the only independent predictor. PCA identified three principal components reflecting shared temporo-parietal covariance, hemispheric asymmetry, and a white matter-related axis. Exploratory LDA demonstrated partial separation among anomaly categories. Conclusions: Children with ASD in this cohort showed heterogeneous but partially structured MRI alterations involving both focal and global volumetric changes. Reduced total white matter volume was the most consistent multivariable association with structural abnormalities. AI-assisted morphometric analysis may support structural phenotyping in ASD. These findings are exploratory and require confirmation in larger, prospectively validated cohorts before biomarker applications can be considered.

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4. Bolognesi E, Guerini FR. Special Issue: Genetic Basis of Autism Spectrum Disorder. Int J Mol Sci. 2026; 27(10).

Autism spectrum disorder (ASD) encompasses a wide and diverse range of neurodevelopmental conditions, characterized by difficulties with social communication along with restricted and repetitive patterns of behavior […].

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5. Cangi AF, Bozduman Çelebi S. Sensory and Executive Function Subtypes Associated With Participation in Adolescents With Autism Spectrum Disorder: A Latent Profile Analysis Approach. J Autism Dev Disord. 2026.

PURPOSE: This study examined sensory processing profiles in adolescents with Autism Spectrum Disorder (ASD) and considered how these profiles connect with executive function (EF) and participation, based on reports from different informants. The goal was not only to describe these profiles. It was also to understand how they relate to everyday functioning across school, and community contexts. METHODS: A total of 102 adolescents aged 12-17 years with clinically confirmed ASD participated in this cross-sectional study. Sensory processing was assessed with the Adolescent/Adult Sensory Profile (A/ASP), executive function (EF) with the Behavior Rating Inventory of Executive Function-Second Edition (BRIEF-2), and participation with the Child and Adolescent Scale of Participation (CASP). Latent Profile Analysis (LPA) based on standardized A/ASP quadrant scores identified distinct sensory subtypes. Differences in EF and participation were analyzed using the BCH three-step method controlling for age, sex, and medication use. RESULTS: LPA revealed four sensory subtypes: Typical/Low Difficulty, Sensory Over-Responsive/Avoidant (SOR), Under-Responsive/Low Registration (SUR), and Sensation Seeking/Mixed. The SOR profile showed higher EF difficulties on BRIEF-2 and lower caregiver-reported participation (Hedges g ≈ 0.70-1.05, q < 0.01). The SUR group showed moderately higher EF difficulties and small participation decreases compared with the Typical group, while the Seeking/Mixed group showed minimal EF differences and context-dependent participation patterns. CONCLUSION: Distinct sensory modulation profiles are associated with executive function and participation in adolescents with ASD. Findings suggest that sensory-cognitive patterns reflect variability in everyday self-regulation. Profile-based, multi-perspective assessment may support individualized intervention planning in educational and occupational therapy contexts.

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6. Cantet N, Benevides TW, Meade MA, Jehu DA, McKee MM, Miller HL. Fall-Related Emergency Department Visits Among Adults With and Without Intellectual and Developmental Disabilities or Cerebral Palsy. Ann Fam Med. 2026; 24(3): 235-8.

Although older adults (>65 years of age) are considered the highest-risk population for fall-related injuries, adults with intellectual and/or developmental disability (IDD) or cerebral palsy (CP) are also at increased fall risk. We aimed to compare the incidence of fall-related emergency department (ED) visits with injury and age-related trends among adults aged 18-80 years with IDD or CP and a non-IDD/CP comparison group using the 2019 Healthcare Cost and Utilization Project State Emergency Department Databases. Fall-related ED visits with injury represented a greater proportion of ED visits among adults with IDD or CP compared with adults without. Among adults aged 62-65 years with no IDD/CP, 7.3% of ED visits were for falls with injury. Similar incidences of fall with injury were found at earlier ages among adults with IDD (aged 42-45 years) or CP (aged 34-41 years). Clinicians should consider screening for fall risk at younger ages among patients with IDD or CP.

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7. Carapelli C, Gerbella M, Tambuscio F, Di Cesare G. Structural and Connectivity Alterations of the Premotor Cortex in Autistic Children: Implications for Affective Motor Impairments. Brain Sci. 2026; 16(5).

When people interact, their actions reflect mood, attitude, and intention. Stern termed the affective qualities conveyed by actions, such as gentleness or rudeness, Vitality Forms (VFs). Previous research shows that children with autism spectrum disorder (ASD) differ from neurotypical (NT) peers in both perceiving and expressing these fundamental aspects of communication. It remains unclear whether these differences arise from structural or connectivity alterations in brain regions involved in VF processing. This study investigated structural and microstructural brain differences between children with ASD and NT peers, focusing on the VF-related network, which includes the dorso-central insula (DCI), premotor cortex (PM), middle cingulate cortex (MCC), and dorsolateral prefrontal cortex (DLPFC). Structural MRI data were collected from 60 right-handed boys aged 6-10 years (30 ASD, 30 NT), with diffusion MRI data available for a subset (20 ASD, 20 NT). A multimodal approach combined voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and probabilistic tractography. VBM revealed increased grey-matter volume in the PM, DLPFC, and MCC in the ASD group, with no differences in the DCI. TBSS showed white-matter microstructural alterations in premotor-related pathways. Probabilistic tractography further indicated atypical organization of tracts connecting the PM with the DLPFC, MCC, and DCI in children with ASD. Overall, the findings suggest atypical development of the premotor cortex and its associated white-matter connections in ASD, supporting theoretical accounts that link this network to altered processing of affective action dynamics during social interaction.

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8. Chen S, Chen QW. Toward More Open, Theoretically Grounded, and Sustainable Parental Involvement in Applied Behavior Analysis Interventions for Children with Autism Spectrum Disorder [Letter]. Psychol Res Behav Manag. 2026; 19: 619491.

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9. Colonetti NS, Costa MA, Silveira HP, Freitas APS, Gonçalves CL. Development and institutional implementation of a prehospital emergency care protocol for individuals with autism spectrum disorder. Prehosp Emerg Care. 2026: 1-17.

OBJECTIVES: Prehospital emergency environments are characterized by high sensory load, time pressure, and unpredictable dynamics – conditions that may exacerbate distress and behavioral dysregulation in individuals with Autism Spectrum Disorder (ASD). Despite increasing emergency service utilization among individuals with ASD, structured prehospital protocols tailored to their needs remain limited. To describe the development and institutional implementation of a prehospital emergency care protocol adapted for individuals with ASD within a state-level emergency medical service system. METHODS: A structured, multi-stage protocol development process was conducted between September 2023 and October 2024. The process included (1) targeted literature review on ASD-specific emergency care, (2) interdisciplinary expert meetings involving a psychologist, physician, ASD researcher, and emergency medical services trained firefighter, and (3) iterative refinement of operational procedures adapted from existing institutional standard operating protocols. Consensus was reached through structured discussions until full agreement was achieved among panel members. The final protocol was formally approved and implemented by the Santa Catarina Military Fire Department (Brazil) as an official Standard Operating Procedure (No. 03/2024). RESULTS: The resulting protocol provides operational guidance across five stages of prehospital care: emergency call triage, approach to scene, on-scene primary and secondary assessment, in-ambulance management, and transfer of care. Key components include sensory load reduction strategies, structured communication guidance, caregiver involvement, behavioral crisis management considerations, and environmental adaptations during transport. Institutional adoption enabled integration into routine training activities and operational workflows. CONCLUSIONS: To our knowledge, this study presents the first institutionally implemented state-level prehospital protocol in Brazil specifically designed for individuals with ASD. The protocol offers a structured, operationally feasible framework to improve safety, reduce sensory distress, and support emergency responders in managing neurodivergent patients. Future research should evaluate its impact on responder confidence, care quality, and patient-centered outcomes.

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10. Ding C, Wang X, Yuan Y, Zhang Y, Hu Y, Wang C, Du A, Qiu Z. CSNK2B gene replacement rescues autism-related phenotypes and establishes translational EEG biomarkers. Cell Rep Med. 2026: 102832.

Variants in CSNK2B cause neurodevelopmental disorders with autism and epilepsy, but therapeutic evidence and translatable biomarkers remain limited. We generate Csnk2b haploinsufficient mice that recapitulate key disease features, including social and cognitive deficits, anxiety-like behavior, spontaneous seizures, cortical abnormalities, and reduced inhibitory interneurons. Early postnatal, brain-wide gene replacement improves survival and rescues structural, behavioral, and seizure phenotypes. Treatment also normalizes brain activity signatures linked to circuit function, including theta and gamma power, power ratios, interregional coherence, and gamma-band directional connectivity. These findings show that reduced Csnk2b dosage disrupts cortical development and network synchronization but can be corrected after birth. They also identify a compact set of noninvasive brain activity biomarkers with potential value for target engagement, dose selection, and longitudinal monitoring in future gene therapy studies.

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11. Etherington JT, LaBrot ZC, DeFouw ER, Dufrene B, Garza BD, Sweaks A, Newcomb B. Increasing PRIDE Skills for Child Engagement Using CDI-Only iPCIT with Children with Autism Spectrum Disorder. Behav Sci (Basel). 2026; 16(5).

Many children with autism spectrum disorder (ASD) display elevated levels of challenging behaviors and decreased social engagement. Parent Child Interaction Therapy (PCIT) may help children with ASD increase rates at which they engage and interact with their caregivers. Existing barriers to treatment completion, including high attrition and travel time and costs, may be ameliorated by delivering PCIT virtually (iPCIT) and setting attainable mastery criteria. This study utilized a multiple baseline design across three caregiver-child dyads with ASD to determine whether an iPCIT protocol affected caregivers’ use of positive engagement skills, children’s engagement, and children’s challenging behaviors. Results demonstrated increased and improved caregiver-implemented engagement and behavior management practices with some improvements in child outcomes. These findings suggested that iPCIT is an effective treatment modality for teaching parents to increase and maintain their use of positive engagement skills across time. Without explicit instructions to avoid negative interaction behaviors, increases in positive engagement skills did not result in concomitant decreases in negative interaction behaviors. Increases in social engagement were observed for two children, but a decrease in engagement was observed in the third. Implications for future research and practice are discussed.

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12. Flynn CK, Carr K, Whiteley P, Nirmalkar K, Bellinghiere A, Hahn J, Liu H, Arici H, Hewitson L, Devlin M, Pollard EL, Pathak KV, Garcia Mansfield K, Rosales Torres A, Pirrotte P, Kalb DB, Keen R, Kenyon V, Fasano A, Krajmalnik-Brown R, Adams JB, Kadzielski S. Elevated microbially-derived metabolites in autism: a possible diagnostic screening test for a distinct ASD phenotype. Mol Psychiatry. 2026.

Many studies have confirmed that a subset of children with autism spectrum disorder (ASD) have unusually high urinary concentrations of microbially-derived metabolites (MDMs) such as p-cresol sulfate and indoxyl sulfate. We hypothesized that these MDMs may affect neurodevelopment through the gut-brain axis and that a sub-phenotype characterized by gut dysbiosis may be present in most ASD individuals. This multi-site study involved measuring the concentrations of many MDMs in the urine of 52 children with ASD and 47 healthy, typically developing (TD) children, aged 2 to 11 years. The measurements were conducted first with semiquantitative Liquid Chromatography and Mass Spectrometry (LC-MS), followed by targeted quantitative LC-MS. The ASD group had significantly higher concentrations of many MDMs compared to the TD group. The MDMs included phenylalanine-derived, tryptophan-derived, and yeast-derived MDMs. Almost all children with ASD had one or more MDMs at concentrations above any TD child, and sometimes 100-1000× higher. The children with ASD had an average of 3 MDMs at levels above any TD child, compared to zero (by definition) for the TD children. Classification using one or more elevated MDM yielded a sensitivity of 90% and a specificity of 100%. This MDM System(TM) is a promising non-invasive method for diagnostic screening for ASD in children ages 2 to 11 years. These data also suggest approximately 90% of children with ASD have a distinct phenotype of ASD, which we propose naming ASD associated with Microbially-Derived Metabolites (ASD-MDM), defined by objective, quantitative laboratory measurements of these metabolites in urine.

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13. French B, Newell V, Nalbant G, Wright H, Daley D, Cassidy S. Adverse outcomes for autistic people: an umbrella review of mental health, physical health, social and lifestyle domains. Front Psychiatry. 2026; 17: 1702822.

BACKGROUND: Autistic people experience an increased risk of a wide range of adverse outcomes across many domains, impacting all aspects of daily life. While individual reviews have explored specific outcome areas, a comprehensive cross-domain synthesis is lacking. Because the evidence spans diverse outcome types and review designs, a narrative umbrella synthesis is needed to integrate findings across heterogeneous reviews and provide a broader systems-level overview. METHODS: This umbrella review identified and synthesised published systematic, meta-analytic, and narrative reviews on the outcomes associated with autism. Five databases were searched from inception to June 2024. Dual screening and multi-reviewer data extraction were conducted, and methodological quality was appraised using established review tools. Findings were aggregated using inductive narrative synthesis, with domain grouping and thematic classification determined by consensus among reviewers. RESULTS: Of 13,841 records identified, 134 reviews met inclusion criteria. Outcomes were grouped into three organisational domains: mental health, physical health, and social and lifestyle. The most consistently reported adverse outcomes included anxiety and mood disorders, suicidality and self-harm, eating and psychotic disorders, sleep problems, epilepsy, gastrointestinal and feeding difficulties, obesity, oral health problems, increased mortality risk, victimisation and bullying, reduced quality of life, loneliness, relationship difficulties, and unemployment. Evidence strength varied across outcomes, but elevated risk patterns were reported across multiple independent reviews. DISCUSSION: Adverse outcomes for autistic people affect multiple areas of life. This umbrella synthesis identifies the principal outcome clusters supported by review-level evidence and highlights research, clinical practice, and service planning priorities. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42023475389.

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14. Golden MJ, Sideridis G, Hanson E, Brewster SJ, Barbaresi W, Harstad E. Sensitivity and Specificity of Common Autism Diagnostic Instruments for Early School-Aged Children. Children (Basel). 2026; 13(5).

Background/Objectives: This study assessed the diagnostic accuracy of two commonly used diagnostic instruments for autism spectrum disorder (ASD), the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R), in comparison to a best-estimate (BE) diagnosis made by a research psychologist. Methods: Two hundred and thirteen children aged 5 years 0 months to 7 years 11 months completed a comprehensive research assessment that included multiple diagnostic measures. Once each research assessment was complete, a research psychologist gave each participant an overall BE research diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) ASD based on all available information from diagnostic testing and behavioral observations during testing. We assessed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of both the ADOS-2 and ADI-R separately and in combination and used receiver operating characteristic (ROC) curves to compare the areas under the curve (AUCs) of these instruments. Results: Both the ADOS-2 Spectrum Criterion scoring (sensitivity = 96.2%; specificity = 97.5%) and ADOS-2 Autism Criterion scoring (sensitivity = 82.0%; specificity = 100%) had excellent accuracy in comparison to the BE ASD diagnosis. The ADI-R had good accuracy (sensitivity = 78.6%; specificity = 83.5%) compared to BE ASD diagnosis. In receiver operating curve analyses, both scoring criteria for ADOS-2 were significantly more accurate than the ADI-R. Conclusions: Overall, both instruments provide good, if not excellent, classification accuracies when used individually, as well as in combination. Thus, when deciding which measures to use for ASD research, other factors should also be considered.

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15. Gürgör EV, Beyaz EK, Bayram S. Food Selectivity as a Driver of Gastrointestinal Symptoms and Constipation in Children With Autism Spectrum Disorder. J Autism Dev Disord. 2026.

PURPOSE: This study examined the association between food selectivity-a common nutrition-related behavioral challenge-and constipation and overall gastrointestinal (GI) symptom severity in children with autism spectrum disorder (ASD). METHODS: In this cross-sectional study conducted in Türkiye, 105 parents of children aged 4-10 years completed a questionnaire assessing demographic characteristics and eating habits. Food selectivity/mealtime behaviors were evaluated using the brief autism mealtime behaviors inventory (BAMBI). GI symptom burden was assessed with a GI symptom severity index, and functional constipation was evaluated using Rome III diagnostic criteria. RESULTS: Based on the GI severity index, 41.0% of children were reported to have constipation. The GI severity index showed a positive, weak but significant correlation with the BAMBI total score (r = 0.353, p < 0.01). Consistently, the limited food variety subdomain of BAMBI was positively correlated with GI severity (r = 0.196, p < 0.05). The constipation subscore was positively correlated with the overall GI severity index score (r = 0.291, p < 0.01). Moreover, constipation was correlated with Rome III functional constipation (r = 0.226, p < 0.05). CONCLUSION: In children with ASD, greater food selectivity-particularly reduced dietary variety-was associated with higher GI symptom burden and constipation. These findings highlight the importance of assessing food selectivity and dietary diversity when addressing constipation and GI complaints in children with ASD.

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16. Ivančík V, Čavojská N, Straková A, Januška J, Celušáková H, Pečeňák J, Heretik A, Hajdúk M. Facial expressions and emotional experience during social interaction in autism and schizophrenia. Schizophrenia (Heidelb). 2026.

Blunted affect is a transdiagnostic feature that impairs social functioning across psychiatric conditions, including schizophrenia and autism. We quantified facial expression patterns and subjective emotional experience during standardized social interaction in 38 individuals with schizophrenia, 16 autistic adults, and 39 neurotypical adults using automated facial expression analysis. During social interaction, individuals with schizophrenia displayed more neutral expressions and reduced valence and arousal compared to neurotypical adults, whereas autistic adults showed typical facial expressions but subjectively experienced lower positive affect. These findings highlight distinct emotional profiles in schizophrenia and autism within social interactions, with blunted facial affect characterizing schizophrenia and reduced subjective positive affect characterizing autism.

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17. Jeong J, Lee SH, Park D. Serum MAP1A as a Potential Biomarker for Autism Spectrum Disorder. Brain Sci. 2026; 16(5).

Background/Objectives: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition currently diagnosed through subjective behavioral assessments. Objective blood-based biomarkers are needed to enable earlier and more accurate identification. In this study, we aimed to identify synapse-related biomarkers associated with ASD and evaluate their potential as serum-based indicators. Methods: RNA sequencing was performed on the cerebellum, hippocampus, and cerebral cortex of a valproic acid-induced rat model of ASD to identify differentially expressed genes (DEGs). Functional enrichment analyses, including Gene Ontology and Kyoto Encyclopedia of Genes and Genomes, were conducted to explore associated pathways. Synapse-related hub genes were selected by comparison with the SFARI autism gene database, and the serum expression of candidate proteins was assessed using Western blotting. Results: A total of 692, 813, and 1059 DEGs were identified in the cerebellum, hippocampus, and cortex, respectively. Enrichment analyses highlighted dendrite development, postsynaptic density, and glutamatergic synapse pathways as significantly affected. Six synaptic hub genes were prioritized, among which serum MAP1A expression was significantly elevated in the ASD rats. Conclusions: These findings suggest that serum MAP1A may represent a potential biomarker reflecting synaptic abnormalities in ASD. Further validation in human cohorts and integration into a multi-marker framework are warranted to account for the heterogeneity of ASD.

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18. Jo EH, Choi Y, Kim HB, Woo RS, Han D, Kim WC, Park SJ, Kang M, Choi Y, Kang KW, Kim HS. Prenatal valproic acid exposure alters striatal proteomic signatures associated with autism spectrum disorder in mice. Transl Psychiatry. 2026.

Prenatal exposure to valproic acid (VPA), a widely prescribed antiepileptic and mood‑stabilizing drug, is a well-established environmental risk factor for autism spectrum disorder (ASD). Although behavioral and anatomical abnormalities have been reported in VPA-exposed animal models, the underlying molecular mechanisms within specific brain regions remain unclear. In this study, we used tandem mass tag (TMT)-based quantitative proteomics to profile protein expression in the striatum of 9-10-week-old mice prenatally exposed to VPA. Behavioral assessment confirmed core ASD-like phenotypes, including reduced body and brain weights and increased repetitive self-grooming behavior. Proteomic profiling identified 101 differentially expressed proteins (DEPs), with 47 upregulated and 54 downregulated in VPA-exposed mice. Functional enrichment analysis revealed significant involvement of pathways related to synaptic transmission, neuronal development, metal ion homeostasis, oxidative stress response, and excitation/inhibition (E/I) balance. Notably, proteins such as parvalbumin (PVALB), NR2F1, and metallothioneins (MT1, MT2, MT3) were markedly downregulated, implicating impaired inhibitory signaling and redox regulation. Importantly, quantitative PVALB immunofluorescence analysis provided histological validation of the proteomic findings, revealing a significant reduction of PVALB immunoreactivity in the dorsolateral striatum, with a non-significant trend toward reduction in the dorsomedial striatum. Additionally, protein-protein interaction network analysis identified PVALB and MT2 as central hub proteins linking synaptic, glial, and oxidative stress-related modules, highlighting disrupted striatal network organization. Collectively, these findings provide subregion-specific molecular and histological insight into how prenatal VPA exposure alters striatal neurobiology and contributes to ASD-like behavioral phenotypes. Proteomic data are available via ProteomeXchange (PXD067574).

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19. Kerr-Gaffney J, Nimbley E, Austin A, Gillespie-Smith K, Sharpe H, Duffy F. A scoping review of the relationship between autistic traits and eating disorders: exploring the secondary impact of eating disorders and co-occurring psychiatric diagnoses. Front Psychiatry. 2026; 17: 1837078.

OBJECTIVE: Research has highlighted co-occurrence and phenotypic overlap between autism and eating disorders (EDs), however the origin of this overlap is uncertain. The aim of this scoping review was to assess existing evidence on the role of acute illness effects and co-occurring mental health difficulties in the relationship between autism and EDs. METHODS: The review was conducted following the PRISMA extension for scoping reviews. Electronic databases (PsycINFO, PubMed, Embase and Web of Science) and grey literature (ProQuest Dissertation and Theses) were searched up until 11th January 2026 for quantitative, qualitative, and mixed-methods empirical studies using autism and ED search terms. RESULTS: Longitudinal and qualitative evidence reporting Autistic traits in childhood, a lack of association between BMI and Autistic traits, and a link between autism and EDs not typically associated with low body weight suggests that the association between autism and EDs is not solely due to acute illness effects. High rates of additional mental health problems in those with EDs were not found to fully account for co-occurring autism or Autistic traits. DISCUSSION: Areas for further research include ED populations other than anorexia nervosa (AN), and EDs in Autistic individuals rather than trait-based research. The review highlights the need for early identification of autism and support for Autistic young people, as well as improved training and autism-specific support in ED and other mental health services. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework, https://osf.io/t5fwg.

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20. Kim G, Ahn S, Park DH, Kim H, Kim S, Kim HW. Comparison of the K-WPPSI-IV Profiles Between Children With Attention-Deficit/Hyperactivity Disorder and Children With Autism Spectrum Disorder: A Retrospective Study. Psychiatry Investig. 2026; 23(5): 613-23.

OBJECTIVE: This study aimed to: 1) compare the cognitive profiles of children with autism spectrum disorder (ASD), attention-deficit/ hyperactivity disorder (ADHD), and comorbid ADHD+ASD with typically developing (TD) children; and 2) examine the associations between indices of the Korean Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (K-WPPSI-IV) and other clinical assessments. METHODS: A retrospective chart review was conducted for 233 children aged 4-6 years who visited Asan Medical Center between April 2017 and September 2024. The study population included 74 children with ADHD+ASD, 46 with ASD, 84 with ADHD, and 29 TD children. The full-scale intellectual quotient, 5 indices, and 12 subtest scores of the K-WPPSI-IV were compared using analysis of covariance, adjusting for age. Correlations were analyzed between the K-WPPSI-IV indices and the symptom severity measures: Childhood Autism Rating Scale (CARS), ADHD Rating Scale (ARS), and Advanced Test of Attention (ATA) across the full population. RESULTS: Children with ADHD+ASD, ASD, and ADHD scored significantly lower than TD peers on the Working Memory Index (WMI; p<0.001) and Processing Speed Index (PSI; p<0.001). The ASD group showed significantly lower scores than the ADHD group in Vocabulary (p=0.001) and Comprehension (p<0.001). CARS scores negatively correlated with the WMI, while ATA negatively correlated with the PSI. CONCLUSION: Both ADHD and ASD are associated with relative weakness in processing speed and working memory. Furthermore, ASD is characterized by additional difficulties in verbal abilities. These findings highlight distinct and overlapping cognitive features across these disorders.

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21. Kim JY, Kim JH, Paeng EJ, Kim SS. Connecting with other parents matters: potential buffering role of parents’ group participation in the association between caregiving duration and mental health among 1,358 korean mothers caring for children with developmental disabilities. BMC Public Health. 2026.

BACKGROUND: It is well-known that mothers caring for children with developmental disabilities (DD) commonly suffer from social isolation. Connecting with other parents may play a critical role in the lives of mothers caring for children with DD. METHODS: We conducted a cross-sectional survey of 1,358 mothers caring for children with DD who are under 19 in 2024. Caregiving duration was defined as years since diagnosis and categorized into five groups: 0-3, 4-6, 7-9, 10-12, and 13-18 years. Depressive symptoms and burnout were measured by CES-D 11 and Copenhagen Burnout Inventory, respectively. Parents’ group participation was defined as attending disability-related parents’ group activities at least once a month. The association between caregiving duration and mental health was examined, stratified by group participation. RESULTS: The association differed by whether mothers participated in parents’ groups. Among participants, compared to the 0-3 years group, the prevalence ratios for depressive symptoms were 0.81 (95% CI: 0.68-0.97) for 4-6 years, 0.77 (95% CI: 0.61-0.97) for 7-9 years, 0.77 (95% CI: 0.60-1.00) for 10-12 years, and 0.74 (95% CI: 0.56-0.97) for 13-18 years. However, no association was observed among non-participants. Similar differential patterns were found in the analysis of burnout. CONCLUSIONS: Participation in parents’ group may play a potential buffering role in the association between caregiving duration and mothers’ mental health.

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22. Latchney SE, Ominuta JE, Smitha LEL, Blandin KJ, Lugo JN. Fmr1 Deletion and Early-Life Stress Interact to Increase Cell Proliferation and Glial Populations at the Expense of Immature Neurons in the Adult Dentate Gyrus. Int J Mol Sci. 2026; 27(10).

Fragile X Syndrome (FXS) is an inherited cause of intellectual disability and autism, arising from silencing of the Fmr1 gene and loss of Fragile X Messenger Ribonucleoprotein 1 (FMRP). FMRP is an RNA-binding protein critically involved in neurodevelopmental processes, including neurogenesis. We examined the proliferation and maturation of adult-born dentate granule cells (abDGCs) and glial populations in Fmr1 knockout (KO) and wild-type (WT) mice at 4, 12, and 24 weeks of age under control and early-life stress (ELS) conditions. Based on prior findings, we hypothesized that KO mice would exhibit increased neurogenesis and atypical responses to ELS compared with WT mice. Using immunohistochemistry, we quantified multiple stages of neurogenesis in the dentate gyrus, including proliferating (Ki67+), immature (doublecortin [DCX]+), and apoptotic (cleaved caspase-3 [CC3]+) cells. We also assessed glia using Iba1 (microglia) and GFAP (astrocytes) immunoreactivity. KO mice displayed significantly increased Ki67+ proliferating and reduced CC3+ apoptotic cells across ages, accompanied by increased Iba1+ and GFAP+ glial densities. However, KO mice exhibited fewer DCX+ neuroblasts at later time points. When reared in ELS conditions, KO mice show blunted or no changes in neurogenesis and glial populations relative to WT mice reared in ELS conditions or KO mice in control conditions. These results indicate that FMRP loss disrupts hippocampal neurogenesis by increasing cell proliferation while limiting neuronal maturation and expanding glial populations. Moreover, the absence of neurogenic and glial responses to ELS in KO mice highlights a gene-environment interaction that may influence FXS-related neuropathology by limiting the adaptive capacity of the hippocampal neurogenic niche.

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23. Madali NP, Hawamdeh S. Autism Information Progression and the Impact of Misinformation on Autism Knowledge, Awareness and Stigmatization. Behav Sci (Basel). 2026; 16(5).

Recent studies have shown a growing prevalence of autism spectrum disorders, accompanied by heightened concerns about the impact of misinformation on autism stigmatization, shaping public perceptions of autism. With the increase in autism cases worldwide, it is critical to have sufficient understanding, knowledge, and awareness about autism, especially among the autism information seekers. This study focused on the progression of autism information over time and investigated the relationships among various factors such as autism knowledge, awareness, stigma, misinformation, cultural beliefs, and social norms. Employing a two-phase research design approach comprising systematic literature review and survey, the study indicated an overall increase in autism knowledge and awareness, although it revealed disparities in certain ethnicities and areas such as genetic testing. Despite advancements, stigma was found to persist. Survey findings validated these observations, emphasizing the necessity for heightened autism awareness and the continued presence of stigma. Furthermore, the survey demonstrated that knowledge influences awareness, whereas cultural beliefs and social norms directly affect autism misinformation. Importantly, the study highlighted how cultural beliefs, and misinformation can hinder accurate understanding and knowledge of autism, potentially exacerbating stigma. By employing evidence-based approaches, this study offers comprehensive insights into autism, enriching the broader literature on the subject.

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24. Major DP, Cary E, Matsuba E, Russo N, Prieve B. Linking Auditory Brainstem Neural Stability to Parent-Reported Autistic Traits in School-Age Children. Brain Sci. 2026; 16(5).

Background: Neural stability, defined as trial-by-trial fluctuations in neural responses to the repetitive sensory input, is an indicator of neural processing stability. The auditory brainstem response (ABR) can provide an electrophysiological measure of neural stability. Findings on neural stability differences between autistic and neurotypical individuals are inconsistent, potentially due to methodological differences and sample heterogeneity. This study aimed to investigate the relationship between neural stability in the brainstem and autistic traits in a group of children with and without a diagnosis of autism. We examined whether the degree of neural stability differs based on the evoking stimulus and response component analyzed, and whether neural stability relates to parent-reported autistic traits, as measured by the Autism Spectrum Quotient (AQ) and social responsiveness scale-2 (SRS-2). Methods: In total, 41 participants had usable click ABRs and 34 had usable sABRs. Neural stability was quantified using Pearson correlation analyses between binaurally evoked subaverage ABR waveforms. Parent-reported measures of autistic traits were collected. Results: Neural stability differed across ABR components, with the click ABR being significantly more stable than sABR components. Decreased neural stability is significantly related to autistic traits measured by the AQ but not the SRS-2. There was no significant response component by AQ interaction. Conclusions: Neural stability in the auditory brainstem pathway is linked to individual differences in autistic traits measured by the AQ but not the SRS, implying that early sensory processing neural stability may be related to broader features of autistic traits rather than social communication alone.

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25. Mansooralavi N, Lowry WE. New insights into Rett syndrome pathogenesis: defining the role of MEPC2 in DNA damage. Front Neurol. 2026; 17: 1711771.

Rett Syndrome (RTT), a severe neurodevelopmental disorder, is caused by mutations in the X-linked MECP2 gene, which encodes a key chromatin-modifying protein. Originally described as a transcriptional repressor due to its ability to bind methylated DNA, RTT pathology was first to the misregulation of target genes. However, we present a synthesis of recent research that could re-frame the etiology of the disease. This model proposes that MECP2 deficiency triggers a cellular stress response that is one of the direct and primary causes of RTT pathology. The central hypothesis emerging from this body of work is that the loss of MECP2 function directly impairs cellular machinery for DNA repair. This failure in genomic maintenance results in an accumulation of DNA damage, which acts as a primary trigger for a senescence response triggered by the p53 pathway. This senescent state initiates a cascade of downstream physiological deficits, including severe metabolic dysfunction, reduced dendritic branching, and impaired synaptic activity. This model represents a repositioning of RTT from a disorder of simple transcriptional misregulation to a complex pathology rooted in a fundamental failure of genomic integrity and cellular homeostasis. The findings open new, targeted therapeutic avenues and offer not only a potential mechanistic understanding of RTT, and potentially other Intellectual Disability syndromes caused by mutations in genes that act in the same pathways.

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26. McConkey R, Murray F. The Role of Sport Coaches in Promoting the Health and Wellbeing of Athletes with Developmental Disabilities. Int J Environ Res Public Health. 2026; 23(5).

BACKGROUND: Children and adults with disabilities are widely acknowledged to have poorer health and emotional wellbeing than their non-disabled peers, which is further compounded by less access to health services and health-promoting activities. A relatively untried solution is to mobilize community initiatives such as sports to promote better health. METHOD: Special Olympics (SO) is an international sports organization present in over 200 countries and jurisdictions, engaging with just under four million athletes with intellectual disabilities annually. Research on the perceptions of sports coaches around incorporating health promotion within their sports training has been scarce. Likewise, little attention has been paid to identifying athletes’ understanding of what health means to them and actions that would make them healthier. A qualitative, descriptive study was conducted with eight national SO programs involving 62 coaches and 47 athletes. Group interviews were conducted via Zoom and a thematic content analysis was made of their responses. RESULTS: In all countries, coaches and athletes agreed that the most common needs were healthy eating, healthy weight and exercise. Good mental wellbeing and sleeping well were also named. Ideas were sought from both sets of participants regarding how coaches could assist their athletes to attain better health and the barriers they might face in doing so. CONCLUSIONS: Three main conclusions emerged. Athletes and coaches were aware of health deficits and knew of ways to reduce them. Both appreciated the contribution that coaches could make through motivating athletes and providing training activities but were dependent on suitable resources being available to them. Engagement with families and available health and social care services was essential. Health-oriented, sporting activities offer promise in improving the health and wellbeing of persons with developmental disabilities, particularly in less affluent countries with fewer health professionals and poorly developed primary care services.

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27. Menegas W, Zhang Q, Feng G. Marmoset models for the study of autism spectrum disorders. Biol Psychiatry. 2026.

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28. Ni SY, Chien YL. Response to the comment on « An exploratory study on predicting depressive symptoms in autistic individuals using wearable devices and machine learning ». J Formos Med Assoc. 2026.

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29. Nitahara K, Kawamura A, Tashiro A, Iwasaki T, Horike SI, Terakawa J, Daikoku T, Higashi K, Kurokawa K, Kato K, Nishiyama M. Defective ventral neurogenesis due to midfetal Chd8 mutation drives autistic-like behavior in mice. Nat Commun. 2026; 17(1).

Autism spectrum disorder (ASD) is a common neurodevelopmental condition characterized by behavioral abnormalities. Although mouse models have been widely adopted to recapitulate the pathology of ASD, the identification of specific neural abnormalities responsible for autistic-like behavior has remained challenging. Here we provide insight into this causal relation by identifying the critical period and cell type responsible for the development of such behavior in ASD model mice with a Chd8 mutation. We find that Chd8 mutation induced at embryonic day 14.5 gives rise to ASD-like behavioral phenotypes, including abnormal social interaction and increased anxiety-like behavior, as well as to accelerated cell-cycle exit and differentiation in ventral progenitor cells. Restoration of Chd8 expression in ventral progenitor cells ameliorates both the behavioral phenotypes and aberrant ventral differentiation in Chd8 mutant mice. Our findings indicate that Chd8 mutation during the midfetal period-in particular, in ventral progenitor cells-contributes to the development of autistic-like behavior.

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30. Otsugu M, Kadono M, Mikasa Y, Mohri I, Kagitani-Shimono K, Tachibana M, Taniike M, Nakano K, Kato T. Characteristics of orofacial function and sleep disorders in children with signs of autism spectrum disorder: A cross-sectional study. Dent Med Probl. 2026.

BACKGROUND: Children with autism spectrum disorder (ASD) have higher rates of feeding problems and sleep disorders. Research on feeding problems in children with ASD has focused on behavioral, psychological and nutritional aspects. However, the biomechanics underlying these issues remains unknown. OBJECTIVES: The present study aimed to evaluate the relationship between signs of ASD, orofacial function and sleep disorders in children. MATERIAL AND METHODS: A total of 56 Japanese early elementary school children aged 6-9 years were recruited. The subjects underwent physical examinations, intraoral inspections and orofacial functional assessments. The parents or legal guardians of the children completed questionnaires regarding the subjects’ dietary and meal habits, the Social Responsiveness Scale, Second Edition (SRS-2), and the Japanese Sleep Questionnaire for Elementary Schoolers (JSQ-ES). Each assessment item was compared between 2 groups divided according to the SRS-2 scores, and the relationships with psychological traits were investigated using Spearman’s rank correlation coefficient. RESULTS: Thirteen of the 56 children had SRS-2 T scores ≥60, indicating possible ASD. Masticatory performance was significantly lower in the high SRS-2 group than in the low SRS-2 group (p < 0.05). Additionally, the high SRS-2 group showed significantly higher T scores on the JSQ-ES for insomnia (p < 0.05) and excessive daytime sleepiness (p < 0.01). Occlusal force (p < 0.05), masticatory performance (p < 0.05), insomnia (p < 0.001), and excessive daytime sleepiness (p < 0.001) were significantly correlated with the SRS-2 score. CONCLUSIONS: These results suggest that low masticatory performance contributes to feeding problems in children with signs of ASD. Additionally, the severity of ASD symptoms is associated with the severity of orofacial functional and feeding problems, as well as sleep disorders.

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31. Pellegrini L, Di Salvo G, Rosso G, Maina G, Albert U. Obsessive-Compulsive Disorder (OCD) and Autism Spectrum Disorder (ASD): Clinical Fingerprints of the Comorbidity. Life (Basel). 2026; 16(5).

BACKGROUND: Obsessive-compulsive disorder (OCD) frequently co-occurs with autism spectrum disorder (ASD), but the prevalence and clinical correlates of this comorbidity remain incompletely understood. METHODS: We examined a clinical sample of 603 patients with a primary diagnosis of OCD, of whom 149 (24.7%) presented with comorbid ASD. Sociodemographic variables, clinical characteristics, comorbidities, and obsessive-compulsive symptom dimensions were compared between patients with and without ASD. RESULTS: Patients with OCD + ASD reported an earlier onset of both obsessive-compulsive symptoms and full-blown disorder. While overall symptom severity (Y-BOCS, HAM-D, and HAM-A) was comparable, OCD + ASD patients were characterized by a higher exposure to stressful and traumatic life events, including severe trauma (e.g., death of a close family member, sexual abuse, physical violence, serious illness, and bullying). Severe traumatic events, in particular, were independently associated with ASD comorbidity in our OCD cohort (exploratory model). Comorbidities were also distinct: onychophagia (66.4% vs. 0.4%) and trichotillomania (8.7% vs. 0%) were markedly more prevalent in the OCD + ASD group. Phenomenologically, OCD + ASD patients more often exhibited religious and somatic obsessions, as well as repetition compulsions. Specifically, somatic obsessions were independently associated with ASD in our regression analysis. CONCLUSIONS: OCD with comorbid ASD represents a clinically distinct subgroup, characterized by greater vulnerability to trauma, earlier onset, unique symptom profiles, and specific comorbidities. Recognition of these features, and in particular a history of severe traumatic experiences and the presence of somatic obsessions, may support earlier consideration of ASD comorbidity during OCD assessment and may inform personalized treatment planning.

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32. Pinheiro J, Afonso B, Seiça EC, Gonçalves R, Ribeiro L, Reis J. Autistic vs. Control Differences in MRI Scan Quality Across ABIDE-II Sites. Diagnostics (Basel). 2026; 16(10).

Background: Head motion and variability in scan quality remain major methodological challenges in autism neuroimaging. Large multi-site datasets such as ABIDE-II provide a unique opportunity to systematically quantify diagnostic differences in MRI data quality and assess the influence of site-level heterogeneity. Methods: Functional MRI Quality Assessment Protocol (QAP) metrics were combined with phenotypic data from ABIDE-II. Participants were classified as autistic (ASD) or typically developing (TD). Key quality metrics-including mean framewise displacement (mFD), proportion of volumes exceeding 0.20 mm (FD > 0.20), signal-to-noise ratio (SNR), and entropy focus criterion (EFC)-were analyzed alongside age, sex, IQ, and site. Group differences were evaluated using non-parametric tests and linear mixed-effects models with site as a random factor. Additional analyses examined site-level heterogeneity and the impact of quality-control (QC) thresholds on sample composition. Results: The final sample included 1277 participants (579 ASD; 698 TD) across 14 sites. ASD participants exhibited significantly greater head motion (median mFD = 0.101 vs. 0.081 mm; p < 1 × 10(-10)) and modest reductions in signal quality (lower SNR, higher EFC). Elevated motion in ASD was observed in 12 of 14 sites, although effect sizes varied substantially. Mixed-effects models confirmed that diagnosis remained a significant predictor of motion after adjusting for covariates. In contrast, signal-quality differences were small and largely explained by site effects. Simulated QC procedures disproportionately excluded ASD participants, with exclusion rates up to 31% compared to 18% in TD. Conclusions: ASD participants show consistently higher head motion, while signal-quality differences are minimal and largely site-driven. Standard QC procedures disproportionately exclude ASD individuals, highlighting the need for improved motion handling and more balanced quality-control strategies in multi-site studies.

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33. Pollard JS, Quiroz LS, Boyd JA, Jo B, Hall SS. Telehealth Versus In-Person Caregiver-Mediated Behavioral Treatment for Challenging Behaviors in Children With Autism Spectrum Disorder: Protocol for COACH (Caregiver Outreach for Autism Coaching at Home) Randomized Controlled Trial. JMIR Res Protoc. 2026; 15: e91840.

BACKGROUND: Approximately 40%-60% of children diagnosed with autism spectrum disorder (ASD) exhibit challenging behaviors such as aggression, elopement, self-injury, and property destruction that can endanger the health and safety of the child or others, often cause significant distress for families, and hinder the child’s developmental progress. Although behavioral treatments grounded in the principles of applied behavior analysis have been shown to effectively reduce or eliminate these behaviors, significant gaps remain in how to deliver these interventions equitably. OBJECTIVE: This study aims to compare the efficacy of delivering in-person versus telehealth caregiver-mediated behavioral treatment for challenging behaviors in children with ASD. METHODS: The Caregiver Outreach for Autism Coaching at Home trial is a single-site, multiarm, parallel-group randomized controlled trial to evaluate the efficacy of delivering caregiver-mediated behavioral treatment for children with ASD who exhibit challenging behaviors. We aim to recruit 90 caregiver-child dyads with children with ASD aged 2 years, 0 months to 7 years, 11 months from metropolitan, suburban, and rural areas across New Mexico and the neighboring El Paso, Texas region. Following a practical functional assessment to identify the potential social-environmental variables maintaining the child’s challenging behavior, caregiver-child dyads will be randomized into one of three parallel treatment arms: (1) caregiver-mediated behavioral treatment delivered via telehealth, (2) caregiver-mediated behavioral treatment delivered in person, or (3) caregiver online psychoeducation. Interventions will be delivered by clinicians in weekly 1-hour sessions in the home setting over 12 weeks. RESULTS: The study was funded in May 2022, and recruitment began in January 2024. As of March 2026, 81 caregiver-child dyads have been enrolled, with equal allocation across the 3 study groups (27 per group). Recruitment is expected to conclude in October 2026, with data analysis planned for Winter 2026 through Spring 2027. CONCLUSIONS: This study will address a critical gap in the scientific literature on scalable, family-centered approaches to safely and effectively reduce challenging behavior in children with ASD and decrease caregiver stress. Findings may inform best practices and payer policy for telehealth-delivered behavioral interventions targeting child safety and caregiver well-being.

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34. Poursoroush Z, Buder EH, Jameson M. Turn-Taking Transitions in Conversations Among Autistic-Autistic, Non-Autistic-Non-Autistic, and Mixed-Neurotype Adult Pairs. Behav Sci (Basel). 2026; 16(5).

Background: The Double Empathy Theory proposes that communication difficulties between autistic and non-autistic individuals arise from mutual misunderstandings rather than individual deficits. This study examines how autistic-autistic, non-autistic-non-autistic, and mixed-neurotype adult pairs coordinate conversations. We aimed to determine how neurotype matches or mismatches affect the types and durations of turn-taking transitions, backchannels, temporal alignment, and task performance. Methods: Thirty-two autistic and thirty-six non-autistic English-speaking adults were paired into autistic-autistic, non-autistic-non-autistic, or mixed-neurotype dyads. Each pair interacted virtually in a tangram task, alternating roles as describer and selector. A turn-taking coding scheme identified utterance segmentation and conversational events. Results: Turn-exchanges with a gap (perceived silence) were the most frequent transition type across all pairs. Matched autistic pairs produced significantly more gapless transitions than the other dyads. Mixed-neurotype dyads showed significantly longer gap durations between turns than both autistic-autistic and non-autistic-non-autistic dyads. Non-autistic-non-autistic pairs exhibited the highest proportion of backchanneling, while autistic-autistic pairs exhibited the highest proportion of simultaneous talk. Only in non-autistic-non-autistic pairs overlap frequency was associated with reduced rapport. Conclusions: Findings demonstrate distinct patterns in turn-taking dynamics across neurotype pairings, supporting the Double Empathy Theory highlighting the need for neurodiversity-informed rather than deficit-based approaches.

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35. Psaras C, Ryu RH, Baer R, Palmsten K, Kroh L, Townsend J, Barea J, Ballas J, Bandoli G. Maternal Intellectual and Developmental Disabilities and Infant Outcomes. JAMA Netw Open. 2026; 9(5): e2615005.

IMPORTANCE: Intellectual and developmental disabilities (IDDs) include cognitive and adaptive deficits beginning before ages 18 to 22 years. People with IDDs experience disparities in pregnancy and infant outcomes, yet little is known about how risks differ across IDD subtypes or the extent to which associated maternal health conditions contribute to these disparities. OBJECTIVES: To evaluate the associations between maternal IDD subtypes and adverse infant outcomes and to estimate how much these associations may be explained by modifiable maternal health conditions. DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed births in California from January 1, 2007, to December 31, 2021, using data from the Study of Outcomes in Mothers and Infants, which links vital statistics on births and infant deaths with maternal and infant hospital inpatient and emergency department records. All 6 435 742 singleton births with gestation between 22 and 44 weeks were included. Statistical analyses were completed on February 19, 2026. EXPOSURES: Maternal IDD diagnoses, including autism spectrum disorder, cerebral palsy, intellectual disability, chromosomal differences, and other IDDs (eg, fetal alcohol syndrome, tuberous sclerosis, and congenital malformations), were identified from hospital records. Potential mediators included prenatal care utilization, prenatal tobacco use, preexisting chronic and neuropsychiatric conditions, and body mass index. MAIN OUTCOMES AND MEASURES: Outcomes included neonatal intensive care unit (NICU) admission, small-for-gestational-age (SGA) birth, preterm birth (PTB) at less than 37 weeks, and very PTB at less than 32 weeks. RESULTS: Of 6 435 742 singleton births, 4492 were to mothers with IDD diagnoses (mean [SD] maternal age at birth: IDD cohort, 29 [7] years; overall cohort, 30 [6] years). Infants born to mothers with IDD had higher risks of NICU admission (14% [628 of 4492] vs 5% [327 345 of 6 426 048]; adjusted risk ratio [ARR], 2.76 [95% CI, 2.56-2.98]), SGA birth (14% [614 of 4492] vs 9% [569 146 of 6 426 048]; ARR, 1.56 [95% CI, 1.44-1.68]), PTB (16% [717 of 4492] vs 7% [452 177 of 6 426 048]; ARR, 2.34 [95% CI, 2.18-2.51]), and very PTB (3% [122 of 4492] vs 1% [62 290 of 6 426 048]; ARR, 3.20 [95% CI, 2.66-3.86]) compared with infants born to mothers without IDD. Risks were highest for maternal diagnoses of chromosomal differences, other IDDs, and intellectual disability. Preexisting hypertension, epilepsy, and mental health conditions were associated with a substantial portion of the risk, particularly for NICU admission. CONCLUSIONS AND RELEVANCE: In this cohort study of births in California, pregnant people with IDD diagnoses had substantially higher risks of adverse infant outcomes. Preexisting hypertension and neuropsychiatric conditions were key variables and may represent modifiable targets for preconception and prenatal intervention.

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36. Rao MG, Wen T, D’Alton M, Logue TC, Friedman A, Zork N. Adverse outcomes during delivery hospitalizations among patients with diabetes and an intellectual or developmental disability diagnosis. Am J Obstet Gynecol MFM. 2026: 101994.

BACKGROUND: Intellectual and developmental disabilities (IDD) are associated with increased risks for poor medical outcomes. However, there is limited national contemporary data on pregnancy outcomes in the setting of IDD and diabetes. OBJECTIVE: Diabetes in pregnancy (DIP) requires more intensive antenatal care including frequent glucose monitoring, medication adherence and titration, and more frequent visits. It is unclear whether IDD is an independent risk factor for adverse obstetric outcomes in this population. The purpose of this analysis was to evaluate whether IDD was associated with adverse outcomes among deliveries complicated by DIP. STUDY DESIGN: Delivery hospitalizations to patients with DIP (pregestational and gestational diabetes) aged 15-54 were analyzed using the 2000-2021 Nationwide Inpatient Sample. The primary exposure of interest was IDD. Temporal trends in the proportion of deliveries with IDD diagnosis were analyzed with join point regression to determine average annual percent change (AAPC) with 95% confidence intervals (CI). Unadjusted and adjusted survey-weighted logistic regression models (accounting for hospital, demographic, and clinical factors) were performed for adverse obstetric and diabetes-related outcomes including diabetic ketoacidosis, shoulder dystocia, gestational age at delivery, severe maternal morbidity, hypertensive disorders of pregnancy, infection, stillbirth, and cesarean and operative vaginal delivery with adjusted odds ratios (aORs) as the measure of association. RESULTS: Of 6,012,324 deliveries with DIP, 2389 (0.04%) patients had an associated IDD diagnosis. Deliveries among DIP patients with an IDD diagnosis increased from 2 per 10,000 in 2000 to 7 per 10,000 in 2021 (AAPC 7.8, 95% CI 6.4-10.3). Pregestational diabetes was more common among patients with IDD (30.2%) than among those without (13.5%). In adjusted analyses, patients with IDD had increased odds of diabetic ketoacidosis (aOR 2.66, 95% CI 1.06-6.69), preterm birth <37 weeks (aOR 1.46, 95% CI 1.10-1.92), cesarean delivery (aOR 95% CI 1.30, 1.05-1.60), non-transfusion severe maternal morbidity (aOR 2.06, 95% CI 1.26-3.32), hypertensive disorders of pregnancy (aOR 1.29, 95% CI 1.03-1.63), and stillbirth (aOR 1.94, 95% CI 1.07-3.5). Odds of shoulder dystocia did not differ significantly between deliveries with and without an IDD diagnosis. CONCLUSION: Among deliveries with DIP, the proportion of IDD increased over time. IDD is associated with increased odds of adverse outcomes among deliveries with DIP. Additional resources and surveillance may be warranted for patients with IDD and DIP to optimize outcomes.

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37. Redwood B, Erickson S, Loughman L, Vetten Z. A Life Without Lemons: A Case of Severe Pulmonary Arterial Hypertension Secondary to Vitamin C Deficiency in a Child With Autism Spectrum Disorder. J Paediatr Child Health. 2026.

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38. Reynolds H, Benders T, Verhagen J. Comparing to a Neurotypical Norm Is Normal in Autistic Language and Communication Research: A Cross-Sectional Systematic Review and Critical Analysis of Recent Literature. Autism Dev Lang Impair. 2026; 11: 23969415261441522.

BACKGROUND AND AIMS: Autism research has traditionally been shaped by the idea that autistic people have « deficits » compared to neurotypical people. This approach often involves directly comparing the two groups, with the expectation that autistic people will perform worse. However, neurodiversity advocates argue that autism should be seen as a valid way of being, and should not be defined in contrast to norm-centred ideals. This review aimed to assess to what extent autism research in the field of language and communication is structured around such norm comparisons. METHODS: Following PRISMA protocols, a cross-sectional systematic review methodology was used to gather a sample of 249 relevant articles published in 2023. Articles were assessed as to whether they included a neurotypical comparison group and how the autistic group was expected to perform in contrast to neurotypicals. Additionally, we coded whether the study was an intervention, and whether non/minimally speaking (NMS) participants or those with intellectual disability (ID) were included, as we expected patterns to differ in these cases. MAIN CONTRIBUTION: We found that almost half (49%) of the studies compared autistic and neurotypical participants, and this rose to 75% when interventions and studies involving ID or NMS participants were excluded. When predictions were made about which group would perform better, 60% of studies expected autistic people to do worse, while only 4% expected them to do better. Intervention studies were less likely to make direct comparisons, and studies involving ID or NMS participants also tended not to use neurotypical comparison groups. CONCLUSIONS: Overall, our findings show that autism research is still largely built on comparisons with neurotypical norms, reflecting an assumption of deficit. IMPLICATIONS: For research to align with the neurodiversity perspective, future studies will need to move away from these deficit-based traditions. Suggestions for alternative, less norm-based approaches are discussed.

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39. Saeliw T, Yuwattana W, Poolcharoen C, Erp MLV, Kanlayaprasit S, Vanwong N, Hu VW, Trairatvorakul P, Chonchaiya W, Sarachana T. Genome-Wide DNA Methylation Profiling of Peripheral Blood Mononuclear Cells Reveals Epigenetic Signatures in Autism Spectrum Disorder. Int J Mol Sci. 2026; 27(10).

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder caused by the interaction between genetic and environmental influences, potentially mediated by epigenetic mechanisms such as DNA methylation. Genome-wide DNA methylation profiling was performed using the Infinium MethylationEPIC v2.0 array on peripheral blood mononuclear cells (PBMCs) from 100 children with ASD and 50 typically developing controls. Differential methylation analyses were conducted by adjusting for age, sex, and estimated blood-cell-type composition as covariates. Functional enrichment, SFARI gene-overlap analysis, and cross-cohort validation were performed. We identified 3507 differentially methylated positions (DMPs) in the ASD cohort. Functional enrichment revealed pathways involved in neuronal signaling, synaptic activity, and immune regulation, suggesting coordinated neurodevelopmental and immune processes in ASD. Stratification by clinical severity demonstrated common and unique biological characteristics between the moderate and severe ASD groups. Furthermore, DMP-associated genes significantly overlapped with high-confidence ASD risk genes from the SFARI database and established transcriptomic signatures of neurodevelopmental disorders. Comparisons with independent post mortem brain tissue and peripheral blood datasets revealed partial overlap and directional concordance. However, the strength of concordance varied across datasets and was limited in the most directly comparable peripheral blood cohort. Our findings suggested that DNA methylation profiling of PBMCs provided peripheral epigenetic signatures and candidate loci for further validation in larger independent cohorts.

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40. Samee N, Belz L, Narboux-Nême N, Roux JC, Panayotis N, Levi G. Increased Osteoclast Activity Contributes to Bone Resorption and Osteopenia in a Rett Syndrome Mouse Model. Cells. 2026; 15(10).

Rett syndrome is a severe neurodevelopmental disorder caused predominantly by loss-of-function mutations in the X-linked gene MECP2. In addition to a vast array of neurological and physiological impairments, patients also frequently develop severe osteopenia with increased fracture risk; however, the mechanisms underlying these skeletal defects are not completely understood. Previous work in Mecp2-null mouse models has suggested that osteopenia is mainly due to impaired osteoblast function and reduced bone formation. Here, we examined bone mass, microarchitecture, and remodeling parameters in a Mecp2-null mouse model during postnatal development, with a particular focus on osteoclast involvement. Microcomputed tomography and histomorphometric analyses showed reduced bone mineral density and trabecular bone volume, which are associated with increased trabecular separation and cortical thinning. These structural alterations were accompanied by increased osteoclast number per bone surface, elevated urinary deoxypyridinoline, and higher expression of osteoclast-associated genes, including Cathepsin K. Furthermore, gene expression analysis revealed an age-dependent shift in bone remodeling. At postnatal day 35, mutant mice showed reduced expression of Dlx5 and Dlx6, consistent with low bone turnover. By postnatal day 55, Rankl and Cathepsin K were markedly upregulated, suggesting an increase in osteoclast resorptive activity, while key osteoblast markers and the RANKL/OPG ratio did not change significantly. A potential cell-autonomous contribution of Mecp2 to osteoclast maturation is also suggested by the analysis of public transcriptomic datasets on human osteoclast differentiation. Together, our findings identify increased osteoclast activity as a significant contributor to Rett-associated osteopenia and suggest that skeletal pathology in Mecp2 deficiency progresses from an early low-turnover state to a later phase of increased osteoclast resorption.

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41. Sánchez de Ocaña-Moreno ML, García-Muñoz AM, Timón IM, Ruiz GB, Sanz MP, Fernández RV, Martínez-Cayuelas E, Gisbert-Gustemps L, Lugo-Marín J, Pin-Arboledas G, Mengual-Luna I, Mulero-Cánovas J, Zafrilla P, Cerdá B, Rodríguez-Morilla B, Ballester-Navarro P. Sleep in Autism Across the Lifespan: A Protocol for a Cross-Sectional Survey with Nationwide Dissemination in Spain. Healthcare (Basel). 2026; 14(10).

Background: Autism spectrum disorder (ASD) is consistently associated with a high prevalence of sleep disturbances across the lifespan, with reported rates ranging from 60% to 86% depending on age and clinical characteristics. Although this issue has been widely described in the international literature, Spain currently lacks large-scale data to estimate the prevalence of sleep disturbances or to examine their relationship with factors such as age, intellectual disability, and co-occurring conditions. This study aims to estimate the prevalence and severity of sleep disturbances in individuals with autism spectrum disorder in Spain and to examine their associations with developmental stage, intellectual disability, affective symptoms, and contextual factors. Methods: This is a cross-sectional observational survey with nationwide dissemination approved by the Ethics Committee of the Universidad Católica San Antonio de Murcia. Data will be collected through an online survey (SurveyMonkey) including validated instruments: the Children’s Sleep Habits Questionnaire-Autism (CSHQ-Autism) and the Sleep Disturbance Scale for Children (SDSC) for pediatric participants; the Pittsburgh Sleep Quality Index (PSQI) for adolescents and adults without intellectual disability; and the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) for adults with intellectual disability. Anxiety and depressive symptoms will be assessed using the Child Behavior Checklist (CBCL) in children and adolescents and the Hospital Anxiety and Depression Scale (HADS) and DASH-II. Statistical analyses will be conducted using SPSS v22 by applying parametric or non-parametric tests according to data distribution. Conclusions: This study represents one of the first survey protocols with nationwide dissemination designed to assess sleep disturbances in individuals with ASD in Spain. The resulting findings are expected to help identify vulnerability profiles, inform public health strategies, and support the development of multidisciplinary interventions aimed at improving sleep and, consequently, the quality of life of individuals with autism and their families.

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42. Santos A, Caramelo F, Barbosa Melo J, Castelo-Branco M. Network analysis of serotonin CNVs shows biological convergence from genetic heterogeneity and discriminates between autism and developmental delay. Sci Rep. 2026.

Differentiating autism spectrum disorder (ASD) from developmental delay (DD) is critical for guiding early intervention, but overlapping features and shared biological mechanisms pose challenges. This study investigates whether copy number variations (CNVs) affecting serotonergic genes carry sufficient information to distinguish between these neurodevelopmental disorders (NDDs). Using network mapping and machine learning, we applied gene ontology (GO) terms related to serotonergic systems to filter CNVs and construct networks modeling genetic and biological variation in ASD and DD. We identified hub nodes and subnetworks reflecting distinct patterns in gene and GO term interactions. ASD networks analysis yielded six genetic clusters, five of which remarkably contained genes specifically linked to serotonergic receptor mechanisms. In contrast, DD networks exhibited greater genetic homogeneity, with just two clusters sharing serotonergic mechanisms. Random Forest classifiers using serotonergic gene features achieved an average prediction accuracy of 85.6%, increasing to 88.6% when combined with dopaminergic dosage features, consistent with the two systems capturing partially non-overlapping biological signal. GO-based features yielded comparable accuracy with fewer inputs, emphasizing their efficiency. These findings demonstrate that different genetic alterations may be associated with disruption of shared biological pathways, each leaving a distinct signature tied to clinical diagnoses. Importantly, although genetic heterogeneity is observed in ASD, we found a homogeneity of serotonergic biological terms, suggesting convergence of mechanisms, which was distinct for each condition. Together, these results suggest that serotonergic CNVs carry discriminatory information for ASD vs. DD classification, and that combining serotonergic and dopaminergic features captures partially non-overlapping biological signal.

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43. Sañudo JI, Feria A, Sánchez-Oliver AJ, Sañudo B. A co-designed gamified mHealth platform for adolescents and young adults with intellectual and developmental disabilities: System architecture and mixed-methods proof-of-concept. Proc Inst Mech Eng H. 2026: 9544119261454203.

Adolescents and young adults with intellectual and developmental disabilities (IDs) experience disproportionately low physical activity and high sedentary time yet remain insufficiently served by scalable and cognitively accessible health-enhancing physical activity (HEPA) programmes. This study reports proof-of-concept evidence for IDHEApp, a co-designed, gamified mobile health (mHealth) intervention integrated with a wearable activity tracker to promote physical activity in cognitively diverse users. We conducted an 8-week, convergent mixed-methods pilot randomised controlled trial across two European community IDs services (Rome, Italy; Rijeka, Croatia). Sixty adolescents and young adults were randomised (1:1) to an intervention arm (IDHEApp with Fitbit-enabled feedback and gamified step challenges) or a control arm (Fitbit monitoring plus usual routines). Quantitative outcomes were derived from wearable data (primary: daily step count; secondary: activity intensity and posture-related indicators) and analysed as exploratory behavioural signals using ANCOVA adjusted for baseline values. Qualitative data were obtained through two-phase focus groups (pre-implementation formative assessment and post-implementation technology exposure) with adolescents and young adults and caregivers and examined using reflexive thematic analysis. The intervention was technically feasible to deploy in real-world service settings at both sites. The strongest between-group signal was observed for daily steps (+2068 steps/day; p < 0.001), whereas activity-intensity and posture metrics demonstrated smaller and less consistent patterns. Thematic findings suggested that simple, non-competitive gamification (step goals, points, badges) was readily understood and perceived as motivating, supporting sustained engagement; however, technical barriers (Bluetooth pairing, synchronisation, device charging) increased reliance on caregiver support. Collectively, these findings indicate that IDHEApp is a promising mobile-wearable ecosystem to support HEPA in adolescents and young adults with IDs and justify further optimisation to enhance technical robustness, reduce caregiver burden, and evaluate effectiveness over longer follow-up periods.

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44. Sharda R, Kouznetsova VL, Tsigelny IF. Exploratory Machine Learning Analysis of circRNA-Derived Molecular Features in Autism Spectrum Disorder. Noncoding RNA. 2026; 12(3).

Background/Objectives: Autism Spectrum Disorder (ASD) is a set of neurological and neurodevelopmental disorders characterized by difficulties in social communication and interaction, repetitive behaviors, and sensory processing differences. Recent studies have shown that circRNAs play a crucial role in the pathophysiology of ASD. In this study, we present an exploratory machine learning framework integrating circRNA sequence features, miRNA interactions, gene targets, and pathway enrichment analysis to investigate ASD-associated molecular signatures. Methods: Differential circRNAs were identified from human peripheral blood datasets, and informative features were selected using attribute-based filtering and Information Gain ranking. Machine learning models were developed using the WEKA platform. Results: The HyperPipes classifier achieved the highest performance (92.5% accuracy under cross-validation). Analysis using an independent ASD gene expression dataset showed consistent discriminative patterns of the derived gene-level signatures across multiple machine learning classifiers. The competitive endogenous RNA network and enriched gene pathways were also analyzed. Conclusions: Overall, this study provides a computational, preliminary framework for analyzing circRNA-associated molecular patterns in ASD. Findings should be interpreted in the context of limited sample size and dataset availability.

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45. Smolko NA, Markelova MI, Synbulatova GE, Khusnutdinova DR, Sufianov AA, Sufianova GZ, Grigoryeva TV, Rizvanov AA, Faizullina RA, Mukhamedshina YO. Influence of Eating Behavior and Dietary Patterns on Gut Microbiota Formation in Children with Autism Spectrum Disorder. Nutrients. 2026; 18(10).

Background/Objectives: Autism spectrum disorder (ASD) is often associated with gastrointestinal dysfunction and gut microbiota alterations. This study aimed to characterize the gut microbiota in children with ASD in relation to nutritional factors and to evaluate the effects of dietary interventions combined with probiotics. Methods: The study included 96 children with ASD and 39 neurotypical controls. Follow-up data after intervention were available for 60 children with ASD. Gut microbiota composition was assessed by 16S rRNA sequencing, and fecal calprotectin and zonulin were measured before and after intervention. Most children with ASD (n = 91) received a rotational or elimination diet for six months, and all participants with ASD received probiotics for 1.5 months. Results: Children with ASD showed significant microbiota changes compared with controls, including increased Prevotella, Sarcina, NK4A214 group, and RF39 taxon, along with reduced butyrate-producing bacteria, such as Roseburia, Eubacterium xylanophilum group, and Eubacterium ventriosum group. Formula feeding was associated with increased Odoribacter, whereas food selectivity was linked to higher Prevotella, Sarcina, Methanobrevibacter, and RF39. A rotational diet increased Erysipelotrichaceae UCG-003 and Streptococcus, while an elimination diet increased Butyricicoccus and reduced fecal calprotectin (p = 0.023). Fecal zonulin decreased significantly after intervention in the follow-up ASD subgroup (p = 0.018). Conclusions: The obtained data suggest that children with ASD may exhibit certain microbiota features associated with nutritional patterns. Dietary interventions combined with probiotics appear to be associated with microbiota modulation and a tendency toward improvement in markers of intestinal inflammation and barrier function.

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46. Su WC, Tsuzuki D, Bhat A. Neural and Kinematic Characteristics of Reaching in Autistic Children During Movement Observation, Execution, and Synchronization: An fNIRS Study. Brain Sci. 2026; 16(5).

BACKGROUND/OBJECTIVES: Children with Autism Spectrum Disorder (ASD, here on termed autistic children) exhibit motor difficulties in social and non-social contexts. Although previous studies have reported behavioral and neural characteristics, their relationship remains largely unexplored. The current study aimed to investigate the behavioral and neural mechanisms underlying interpersonal synchrony in autistic children using simultaneous kinematic and Functional Near-Infrared Spectroscopy (fNIRS) recordings. METHODS: Fifty-eight autistic or non-autistic children participated (mean age = 10.1, standard error = 0.3). fNIRS and an inertial measurement unit were used simultaneously to record the neural activity over frontotemporal and parietal regions and arm movement kinematics during a reach-to-clean-up task across three conditions: Watch-the child observed the tester clean up the blocks; Do-the child cleaned up the blocks independently; and Together-the child and tester cleaned up the blocks synchronously. RESULTS: Behaviorally, autistic children demonstrated longer movement displacement, higher average velocity and acceleration, and a greater number of movement units. In terms of cortical activation, autistic children showed hypoactivation in the bilateral precentral gyrus and right inferior parietal lobe, along with hyperactivation in the right middle frontal gyrus, left inferior frontal gyrus, and left inferior parietal lobule. Correlations between kinematic and neural measures suggest that autistic children rely more on online/feedback control to compensate for reduced feedforward control. CONCLUSIONS: This study reveals unique compensatory strategies in autistic children, highlighting the connections between neural and behavioral characteristics. These findings have strong potential to inform the development of ASD screening tools and to guide targeted intervention strategies.

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47. Turco EC, Pisanò G, Caiazza L, Carestiato S, Piccolo B, Fecarotta S, Pochiero F, Ricci F, Brusco A, Ferrero GB, Esposito S, Fusco C, Pera MC. Genetic and Clinical Characterization of TANGO2 Deficiency Disorder: Insights from the Italian Multicentre Cohort. Int J Mol Sci. 2026; 27(10).

TANGO2-deficiency disorder (TDD) is a rare autosomal recessive condition characterised by neurodevelopmental delay, TANGO2 spells, life-threatening metabolic crises, and cardiac arrhythmias. Genotype-phenotype correlations remain poorly defined and the neurobehavioural profile of affected individuals is largely unexplored. We conducted a retrospective multicentre study of five Italian patients with genetically confirmed TDD, identified between June 2023 and May 2025. Clinical, neurophysiological, neuroimaging, genetic, and neurodevelopmental data were collected. Adaptive functioning, cognitive ability, and behavioural profiles were assessed using standardised instruments. All five patients carried biallelic TANGO2 mutations, including two previously unreported variants. Clinical severity ranged from an asymptomatic individual under preventive therapy to a fatal early-onset metabolic crisis. Marked intrafamilial variability was observed in two siblings sharing the same genotype. Systematic neurodevelopmental assessment revealed a spectrum of cognitive and adaptive outcomes, with attentional difficulties identified as a recurrent feature. No metabolic crises or TANGO2 spells were documented following initiation of B-vitamin and cofactor supplementation in surviving patients. This cohort expands the mutational and phenotypic spectrum of TDD and highlights the diagnostic value of TANGO2 testing in patients with neurodevelopmental delay or paroxysmal neurological episodes, even in the absence of metabolic crises. Early supplementation therapy may contribute to clinical stability, though prospective controlled studies are needed.

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48. Urban AM, Schiel K Md MA, Sonoda KM. Atypical Antipsychotics to Manage Behavioral Symptoms in Autism Spectrum Disorder. Am Fam Physician. 2026; 113: 428-9.

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49. Vonteru PL, Murthy TK, Aitharaju SV. Comment on « An exploratory study on predicting depressive symptoms in autistic individuals using wearable devices and machine learning ». J Formos Med Assoc. 2026.

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50. Wang H, Yu L, Hu S, Gao H, Shen Q. Prevalence and associated factors of sleep disorders in children and adolescents with autism spectrum disorder: a meta-analysis and systematic review. BMC Psychiatry. 2026.

BACKGROUND: Sleep disorders significantly impact the physical rehabilitation of children with autism spectrum disorder. The factors associated with these sleep disorders remain a subject of debate in clinical research. By identifying factors associated with sleep disorders in this population, more effective intervention strategies can be developed for the rehabilitation of children and adolescents with autism spectrum disorder. Therefore, this review aims to conduct an in-depth analysis of the factors associated with sleep disorders in children and adolescents with autism spectrum disorder, providing evidence-based references for advancing clinical prevention strategies. METHODS: A systematic search was conducted in the CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Embase, CINAHL, and Cochrane Library databases for studies investigating factors associated with sleep disorders in children and adolescents with autism spectrum disorder. The search period spanned from the inception of each database to August 31, 2025. Two researchers independently performed literature screening, quality assessment, and data extraction. Meta-analysis was conducted using Stata MP 17 software. RESULTS: This study included 22 research studies involving a total of 3,771 participants. Meta-analysis results showed that the prevalence of sleep disorders was 60%. with age(young), co-sleeping with parents, nighttime sleep duration, daytime sleep duration, child’s screen exposure time, family dysfunction, history of neonatal asphyxia, birth weight (low), parental education level, maternal perinatal nutritional support, child supplements, children are not picky eaters, child behavioral problems, autism severity, and parental screen exposure before child sleep were the primary factors associated with sleep disorders in children and adolescents with autism spectrum disorder (P < 0.05). CONCLUSION: Children and adolescents with autism spectrum disorder experience sleep disorders influenced by multiple factors. Identifying these associated factors can help in developing strategies for managing sleep problems in this population, which may contribute to improving their overall daytime functioning.

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51. Wang H, Zhao S, Chen Y, Hou F, Zhu K, Liu R, Xiang Z, Chen Q, Fan H, Huang M, Wang Z, Zhang J, Wang T, Liang X, Zeng X, Gong Z, Li L, Song R. m(6)A Modification Genetic Variants Associated with Autism Spectrum Disorder Risks. Mol Neurobiol. 2026; 63(1).

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with increasing prevalence and high heritability. As a key epigenetic mechanism in brain development and function, the specific mechanisms of N(6)-methyladenosine (m(6)A) modification in ASD remain unknown. This study conducted bioinformatics analysis of m(6)A-QTL data from Yoruba lymphoblastoid cell lines and the RMVar database to identify m(6)A-QTL SNPs and modification genes associated with ASD. A two-stage population validation includes 1244 Chinese children with ASD and controls, followed by replication in a large European cohort consisting of 18,382 cases and 27,969 controls. The potential functions of candidate variants and target genes were examined through functional annotations. There were 2830 SNPs associated with the m(6)A modification levels of target genes. We further identified 91 m(6)A-QTL-associated ASD candidate SNPs in Chinese samples and validated 8 variants in the European cohort (P < 0.05), including three high-confidence variants: rs10242048 (P (combined) = 8.06 × 10(-3)), rs2304447 (P (combined) = 5.01 × 10(-3)), and rs4074309 (P (combined) = 1.59 × 10(-2)). Functional annotations revealed that rs4074309 might potentially regulate m(6)A levels of STAT6 and modulate LRP1 expression in brain tissues, binding the transcription factor THAP1. Both STAT6 and LRP1 are implicated in crucial neurodevelopmental pathways, such as the JAK-STAT signaling and the tau-protein kinase regulation, respectively. Our study suggests that genetic variants in m(6)A modification genes may contribute to ASD susceptibility. The findings highlight the importance of m(6)A modification in neurodevelopmental disorders and provide insights into the epigenetic mechanisms involved in ASD.

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52. Wang P, Kannan L, Hodge E, Sanchez-Singh JM, Carrillo AA, Milla S, Meltzoff K, Seitz AR. Remote Sensory-Cognitive Assessment in Children with Autism: Evaluating Feasibility and Performance Outcomes. Behav Sci (Basel). 2026; 16(5).

This study evaluated the feasibility of remotely administered, multi-session digital sensory-cognitive assessments in children with autism spectrum disorder (ASD). Remote assessment in ASD presents challenges, including sustaining engagement across sessions, ensuring task comprehension, and maintaining data quality in home environments. Accordingly, this study quantified feasibility through task engagement and data integrity across a multi-domain assessment battery. A total of 121 children with ASD aged 8-16 years participated. The assessment battery was administered across three remote sessions targeting emotion discrimination, visual and cognitive processing, and auditory processing. Feasibility was evaluated using a structured data-quality coding system integrating trial-level performance with qualitative observations of engagement and data integrity. Across 11 behavioral tasks, an average of 85% of participants produced usable data. Exclusions occurred across most tasks but were broadly distributed, with no single task showing disproportionately elevated failure rates. Among participants with usable data, performance distributions fell within expected ranges. These findings indicate that remote sensory-cognitive assessment is feasible in children with ASD, supporting the scalability of multi-domain digital assessments and providing a foundation for larger studies investigating individual variability across perceptual and cognitive domains.

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53. Wu S, Chen H, Liu J, Chen R, Liu W, Wu Y, Liu Z, Zeng F, Wen D, Lin J, Li L, Jin Y. Interaction between parental preconception and prenatal smoking and alcohol use on autism-like behaviour in preschoolers: a cross-sectional study in Huizhou, China. BMJ Paediatr Open. 2026; 10(1).

BACKGROUND: This study aimed to investigate the associations between preconception and prenatal smoking and alcohol consumption and the risk of autism-like behaviour in preschool children, with the aim of providing evidence for early prevention strategies. METHODS: This cross-sectional study included 19,089 children aged 3-6 years from 111 kindergartens in Huicheng District, Huizhou City, Guangdong Province, China, between June 2022 and June 2023. Logistic regression was used to analyse the associations between parental smoking, drinking and autism-like behaviour in children. Multiplicative and additive interaction models were applied to evaluate the interaction between smoking and drinking on autism-like behaviour in children. RESULTS: Compared with the unexposed group, children with maternal prenatal passive smoking exposure (OR = 1.327, 95% CI: 1.042 to 1.690) and those with a paternal history of smoking (OR = 1.643, 95% CI: 1.036 to 2.605) exhibited significantly higher odds of autism-like behaviour. Among mothers with a prepregnancy smoking history, a significant negative additive interaction was observed between smoking cessation during pregnancy and concurrent alcohol consumption (RERI = -2.170, 95% CI: -4.035 to -0.304). CONCLUSIONS: This study identifies prenatal exposure to parental smoking-both maternal passive smoking and paternal smoking history-as a significant risk factor for autism-like behaviour in preschoolers. The finding of a negative additive interaction between maternal smoking cessation and concurrent alcohol consumption underscores the complexity of modifying health behaviours. These findings emphasise the key role of reducing parental tobacco and alcohol exposure in the primary prevention of autism spectrum disorder.

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54. Yang R, Zhang F, Huang J. Machine Learning-Based Identification of Immune Inflammation-Related Genes as Shared Potential Diagnostic Biomarkers in Autism Spectrum Disorder and Atopic Dermatitis. Biomedicines. 2026; 14(5).

Background: ASD is a class of neurodevelopmental disorders with onset in early childhood, whereas AD is a common chronic inflammatory skin disease. An increasing number of studies suggest that immune dysregulation and inflammatory responses play important roles in the onset and progression of both conditions; however, their shared molecular mechanisms remain unclear. Methods: First, ASD-related and AD-related datasets were obtained from the GEO database. After removal of batch effects, the common DEGs between the two diseases were identified. Subsequently, 107 machine learning-based model configurations were employed to screen for key genes. Functional enrichment analyses and PPI network construction were performed to systematically explore their potential functions. Finally, the CIBERSORT was applied to analyze immune cell infiltration and to assess the correlation between hub gene expression and immune cell infiltration. Results: 164 common genes between ASD and AD were identified. GO and KEGG enrichment analyses revealed that these shared differentially expressed genes were mainly enriched in pathways related to immune regulation and inflammatory responses, suggesting that immuno-inflammatory processes may constitute an important biological basis linking ASD and AD. Further screening and validation using machine learning identified BEX4, BIN2, BNIP3L, CCNO, JAK2, SLC39A7, and WASF3 as hub genes serving as common potential biomarkers for both diseases. Among them, BIN2, SLC39A7, and JAK2 may represent key shared genes and demonstrated good diagnostic value in ROC curve and nomogram analyses. In addition, immune infiltration analysis indicated that these key genes were significantly correlated with the infiltration levels of multiple immune cell types, further supporting their potential roles in immune regulation. Conclusions: This study reveals potential shared immuno-inflammatory molecular mechanisms between ASD and AD. Genes screened based on 107 machine learning models were verified as potential diagnostic biomarkers for both diseases after integrated analysis, providing a theoretical basis for further investigation of their immune-related pathogenesis and early clinical diagnosis.

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55. Yin BY, Deng YY, Chen X, Zhao JY, Ni YX, Zhong SS, Zou FY, Shen LS, Luo XW, Zhou X, Zhang JL, Zhou WY, Deng HZ, Guo RM. Neuroclearance dysfunction in autism with sleep disorder: MRI evidence and mediation by systemic iron deficiency. J Affect Disord. 2026: 122035.

BACKGROUND: Sleep disturbances are highly prevalent in children with autism spectrum disorder (ASD) and exacerbate neurodevelopmental impairments. Yet, the mechanistic link between sleep disruption, brain fluid clearance, and systemic trace element status remains unclear. METHODS: We enrolled 230 children with ASD (114 with sleep disorder, ASD-SD; 116 without, ASD-nSD) and 110 typically developing controls. Neuroclearance function was quantified using diffusion kurtosis imaging along the perivascular space (DKI-ALPS), free water fraction (FW), and perivascular space volume fraction (PVSVF). Serum iron (Fe), lead (Pb), and magnesium (Mg) were measured. Group comparisons, correlations, ROC analysis, and mediation modeling assessed relationships among sleep, iron status, and neuroclearance. RESULTS: ASD-SD children exhibited significantly reduced ALPS indices and elevated FW compared with ASD-nSD and controls, indicating impaired perivascular clearance. Serum Fe was markedly lower in ASD-SD, whereas Pb was elevated; Mg showed no significant differences. ALPS indices strongly correlated with Fe levels (r = 0.75-0.95). Mediation analysis revealed that iron deficiency partially reduced ALPS via increased FW, supporting a hypothesized « Fe deficiency → cerebral edema → impaired neuroclearance » pathway. Combined ALPS and serum Fe distinguished ASD-SD from ASD-nSD and controls with high accuracy (AUC up to 0.94). CONCLUSION: Children with ASD and comorbid sleep disorder exhibit pronounced neuroclearance dysfunction linked to systemic iron deficiency. The combination of DKI-ALPS and serum Fe shows potential as a candidate biomarker for ASD-SD, highlighting a potential cascade from sleep disruption to impaired neuroclearance and suggesting targeted interventions integrating iron supplementation and sleep optimization.

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56. Zhao X, Ji Y, Li L. Stage-Specific Animate Attention Bias in Individuals with High and Low Autistic Traits: Behavioral and Eye-Tracking Evidence. Behav Sci (Basel). 2026; 16(5).

Animate attention bias reflects the visual system’s tendency to prioritize animate over inanimate stimuli. This bias is reduced in autism spectrum disorder (ASD), suggesting that similar patterns may also be observed in individuals with high autistic traits (AT). Although previous research has reported reduced animate attention bias during early attentional orienting in individuals with high AT, how this bias unfolds across processing stages remains unclear. Using a dot-probe task combined with eye-tracking, the present study examined this stage-related pattern in individuals with high and low AT. Response time results showed that the low AT group had a significant animate-probe advantage, whereas the high AT group showed no significant advantage, broadly replicating prior findings. In stage-wise analyses, the low AT group showed a significant animate-probe advantage at the late stage, whereas the high AT group showed no significant advantage at either stage. However, this group difference was not reflected in most fixation-based measures. This RT-fixation dissociation suggests that reduced animate attention bias in high AT should not be interpreted simply as reduced overt fixation allocation to animate stimuli, but may reflect differences in using animacy-related cue-location information to facilitate subsequent probe detection and response selection.

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