1. Al Qutub R, Luo Z, Essah E, Tavassoli T, Marcham H, Deng Q. Impact of indoor environment quality on autistic behaviours in autism schools of Saudi Arabia. Environ Pollut;2026 (Mar 25);397:127992.

Indoor Environmental Quality (IEQ) strongly influences students’ learning outcomes, yet its impact on autistic students remains underexplored. This study investigates the relationship between IEQ parameters and behavioural outcomes of 37 autistic students (DSM-5 Levels 1-2) aged 5-12 years attending two autism-specific schools in Saudi Arabia across winter and summer periods. IEQ parameters – temperature, relative humidity, carbon dioxide (CO(2)), particulate matter (PM(2).(5) and PM(10)), sound level, and illuminance – were continuously monitored, alongside behavioural observations. Behaviour and sensory reactivity were assessed using the Behavioural Assessment of Classroom Sensory Scale-School Observation System (BASC-SOS) and the Sensory Assessment for Neurodevelopmental Disorders (SAND), which capture external behaviours (movement, vocalisation, and task engagement). Repeated measures correlation analysis revealed significant relationships between PM(10) concentration and both adaptive (p = 0.04) and maladaptive behaviours (p = 0.05), sound levels and maladaptive behaviours (p = 0.05), and relative humidity and adaptive behaviours (p = 0.03). CO(2) levels in hypersensitive autistic students and both adaptive (p = 0.05) and maladaptive behaviours (p = 0.01). Pupils demonstrated heightened sensitivity to elevated CO(2) and noise fluctuations, highlighting the compounded sensory effects of air quality and acoustics. These findings underscore the need to tailor environmental conditions in autism-specific educational settings to accommodate the sensory reactivity of autistic students. The study not only advances foundational knowledge of IEQ’s impact on autistic behaviour but also offers practical implications for designing educational environments that foster both academic engagement and student s’ well-being.

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2. Barall RJ, Shillingsburg MA. Improving Use of Social Communicative Gestures by Children with Autism. Behav Sci (Basel);2026 (Mar 10);16(3)

Difficulties in social communication are a core characteristic of autism. Gesture use in children with autism is often delayed or atypical, with reduced frequency, diversity, and spontaneity. Pointing gestures, which typically emerge between 9 and 12 months of age, have been shown repeatedly to predict later language acquisition in both neurotypically developing children and those with autism. Thus, the deficits in proximal and distal pointing gestures observed in children with autism may impede social communication and language learning. Employing a nonconcurrent multiple baseline across participants design, this study examined the efficacy of prompting and reinforcement for teaching proximal pointing to request in 12 children with autism, aged 3 to 11 years. Results showed that 9 of the participants acquired proximal pointing and subsequently emitted distal pointing at distances of 0.61 m, 1.22 m, and 1.83 m (2, 4, and 6 feet) without additional intervention. Proximal and distal pointing was maintained at 4-week follow-up. However, not all participants acquired proximal pointing, highlighting potential variability related to individual characteristics and the need for modified procedures. These findings provide support for the use of prompting and reinforcement to teach socially communicative gestures in children with autism.

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3. Beyaz EN, Öznurhan F. Association Between Parental Oral Health Literacy and Oral Health-Related Quality of Life in Children with Autism Spectrum Disorder: A Comparative Cross-Sectional Study. J Clin Med;2026 (Mar 17);15(6)

Background/Objectives: Children with autism spectrum disorder (ASD) may have difficulty maintaining effective and routine oral hygiene practices because of sensory sensitivities, behavioral challenges, and barriers to dental care. These difficulties may adversely affect oral health-related quality of life (OHRQoL). Parental oral health literacy may also influence oral health outcomes in this population. This study compared parental oral health literacy and OHRQoL between children with ASD and typically developing children and examined the association between parental oral health literacy and OHRQoL in the ASD group. Higher POQL scores indicate poorer OHRQoL. Methods: This cross-sectional study included 72 children with ASD and 70 typically developing children aged 3-15 years. Data were collected using the Sociodemographic and Oral Health Behaviors Questionnaire, the Turkish version of the Oral Health Literacy Assessment Task for Pediatric Dentistry (TOHLAT-P), and the parent-report Pediatric Oral Health-Related Quality of Life measure (POQL). Group differences were analyzed using the Mann-Whitney U test. Associations were evaluated using Spearman correlation and multivariable linear regression. Results: Parental oral health literacy scores were significantly lower in the ASD group than in the control group (26.89 ± 7.94 vs. 31.61 ± 10.98; p = 0.002). Significant between-group differences were found in the POQL total score and the social functioning subscale (p = 0.025 and p = 0.003, respectively). In the ASD group, higher parental oral health literacy was associated with lower POQL total scores (Spearman r = -0.239; p = 0.043). In multivariable linear regression, parental oral health literacy remained significantly associated with the POQL total score in children with ASD (B = -0.589; p = 0.029; R(2) = 0.117). Conclusions: Parental oral health literacy was associated with OHRQoL in children with ASD, although the explained variance was modest. These findings support the potential value of family-centered oral health education in this population.

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4. Bitensky DR, Clauss-Ehlers CS, Veksler KM. Expanding Understanding of Autism Spectrum Disorder in Girls and Women: A New Paradigm. Behav Sci (Basel);2026 (Mar 9);16(3)

The definition of Autism Spectrum Disorder (ASD) has evolved since the diagnosis was first conceptualized. However, past and current understandings of ASD have largely been shaped by research focused on individuals assigned male at birth. This has influenced current diagnostic criteria, which often fail to capture female presentations and likely contribute to lower reported prevalence rates in girls. Recognizing female-specific presentations is critical to reducing misdiagnosis and underdiagnosis; therefore, this paper reviews research on how the DSM-5-TR two-factor model applies to girls. We then describe how female presentations of ASD are characterized by distinct cognitive profiles and frequent use of camouflaging to mask typical ASD symptoms, particularly social difficulties, which can obscure clinical presentation and delay diagnosis. Subsequently, we evaluate how current assessments and accommodations may fail to address the needs of females. Clauss-Ehlers introduces the Multimodal Autism Assessment for Girls and Women, which emphasizes the importance of assessing girls within an appropriate contextual lens. Finally, the paper calls for a gender-focused neurodiversity paradigm that highlights differences in presentation, promotes an approach focused on strength-based interventions, and outlines directions for future research and clinical implications based on this framework.

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5. Blackburn AD, McKinney W, Birnschein AM, Esbensen AJ, McKinley S, Rosselot H, Hoffman EK, Erickson C, Shaffer R. Adapting a Behavioral Intervention for Caregivers of Children with Down Syndrome or Fragile X Syndrome: A Pilot Study of RUBI-DD. Behav Sci (Basel);2026 (Mar 22);16(3)

Challenging behaviors, including noncompliance, aggression, hyperactivity, and impulsivity, are common among individuals with Fragile X Syndrome (FXS) and Down Syndrome (DS). To identify treatment needs specific to these populations, we conducted focus groups with caregivers and educators and used their input to adapt an evidence-based caregiver training program originally designed for caregivers of autistic children (i.e., The Research Units in Behavioral Intervention; RUBI). We then completed a feasibility trial in which five families of children with FXS and four families of children with DS completed a nine-session caregiver training program targeting behavioral principles, syndrome-specific information, and visual supports tailored to the unique needs of FXS or DS (adapted version of RUBI for non-autism developmental disabilities; RUBI-DD). The program demonstrated strong acceptability, with high caregiver satisfaction, 100% retention, and 100% session attendance. Across the combined sample, caregiver reports indicated significant improvements in irritability/aggression (F((2,15.14)) = 4.42, p = 0.03), lethargy/social withdrawal (F((2,14.47)) = 3.97, p = 0.04), stereotypies (F((2,15.29)) = 4.45, p = 0.03), hyperactivity (F((2,15.14)) = 6.51, p = 0.009), social inflexibility (F((2,15.43)) = 6.33, p = 0.01), demand-based noncompliance (F((2,15.41)) = 4.95, p = 0.02), and the impact of behavior on the family (F((2,15.07)) = 4.23, p = 0.04) following participation in RUBI-DD. Caregivers of children with FXS reported significant reductions in lethargy/social withdrawal (F((2,8.000)) = 6.256, p = 0.023) and hyperactivity (F((2,8.000)) = 12.497, p = 0.003) immediately post-treatment and upon 12-week follow-up (g = 1.153, p = 0.044, and g = 1.178, p = 0.003, respectively). Among families of children with DS, caregivers reported reductions in irritability and aggression (F((2,5.047)) = 14.073, p = 0.009) and improvements in the impact on the family (F((2,6.000)) = 5.489, p = 0.044) immediately post-treatment and at follow-up (g = 1.643, p = 0.016, and g = 0.448, p = 0.045, respectively). These findings support the feasibility, acceptability, and preliminary efficacy of RUBI-DD for children with FXS or DS.

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6. Chang YC, Shih W, Kasari C. Predictors of Play Development at Home After Parent-Mediated Early Intervention for Autistic Preschool Children. Behav Sci (Basel);2026 (Mar 8);16(3)

Play is a critical developmental domain linked to social communication, cognitive growth, and later peer relationships; however, young autistic children often demonstrate delays in their play skills, especially higher level play skills (i.e., symbolic play). Although play-based, parent-mediated interventions show promise in improving parent strategies for engaging their children in play, we know less about how these strategies translate to child play improvement outside of the therapeutic sessions. The current study examined the home activities of 97 caregiver-child dyads following their participation in parent-mediated Joint Attention Symbolic Play Engagement Regulation (JASPER), among families in low socioeconomic circumstances. Naturalistic home observations identified the types of daily activities in which the dyads engaged, including play. Within play contexts, children whose caregivers received JASPER demonstrated a greater change from functional to symbolic play compared to those in a parent education control condition. Additionally, child-level, but not family-level, characteristics predicted greater gains in symbolic play. The results provide insight into the ecological validity of parent-mediated, play-based interventions delivered in home settings and highlight factors associated with variability in play outcomes. These findings have implications for tailoring parent-mediated interventions to better support equitable and sustainable developmental gains for autistic children.

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7. Cox SK, Barrett CA, Chavez G, Saur R, Feury M, Huber G, Booms B, Snyder G. Informing Intervention: An Exploration of Behavioral and Social-Emotional IEP Goals for Students with ASD. Behav Sci (Basel);2026 (Mar 12);16(3)

Students with autism spectrum disorder (ASD) experience impairments in reciprocal social interactions, communication, and a restricted range of interests or repetitive behaviors that impact the development of their behavioral and/or social-emotional skills. In schools, students with ASD receive Individualized Education Programs (IEPs), which include goals to understand the types of behavioral and/or social-emotional skills students are working to develop. However, there is scant empirical research examining the nature of IEP goals that target behavioral and/or social-emotional skills among students with ASD. The current study explores the content, scope, and location of behavioral and social-emotional IEP goals for 153 students with ASD in Grades K-12 in one state in the Upper Midwest. Understanding the nature of IEP goals is a critical first step to increase access to evidence-based behavioral and social-emotional interventions for students with ASD. Implications for school-based behavioral and psychosocial interventions for students with ASD are discussed.

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8. Esposito M, Trasolini M, Fadda R, Lucarelli L, Caputi M. Parent-Mediated vs. Staff-Mediated Behavioral Models in Families of Autistic Children: A Comparative Study on Parental Stress, Co-Parenting, and Quality of Life. Behav Sci (Basel);2026 (Mar 1);16(3)

BACKGROUND: Parental and caregiver stress represents a critical factor influencing family functioning and the quality of care in families of autistic children. Although previous research has identified multiple correlates of caregiver stress, the interplay between individual stress, co-parenting quality, and psychosocial contextual factors in families of autistic children remains insufficiently characterized within an integrated framework. METHODS: This study adopted a cross-sectional exploratory design to examine stress levels, co-parenting quality, and associated psychosocial variables in caregivers. Standardized self-report measures were administered, and analyses included descriptive statistics, correlational analyses, and exploratory person-centered clustering procedures to identify patterns of co-occurring characteristics rather than discrete typologies. RESULTS: Caregiver stress was significantly associated with indicators of co-parenting quality and psychosocial burden. Exploratory clustering analyses identified distinct patterns of caregiver experiences, characterized by differing levels of stress, perceived support, and co-parenting quality. These clusters should be interpreted as statistical profiles that reflect heterogeneous configurations of variables, rather than as stable or causal categories. CONCLUSIONS: Findings highlight the multidimensional nature of caregiver stress and underscore the importance of considering co-parenting quality and contextual factors within mental health promotion frameworks. The results are hypothesis-generating and support the need for future longitudinal and confirmatory studies to validate these patterns and clarify their implications for preventive and supportive interventions targeting families and care professionals.

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9. Filiz KD, Abate N, Pizzella A, Ferraro MG, Speranza L, Cristiano C, Mollica MP, Di Giaimo R, Miniaci MC, Lacivita E, Leopoldo M, Perrone-Capano C, Crispino M, Volpicelli F. Involvement of serotonin receptor 7 in synaptic dysfunctions in a mouse model of autism spectrum disorder. Eur J Pharmacol;2026 (Mar 28);1019:178689.

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by deficits in social interaction and communication, repetitive behaviors, and altered brain plasticity. Emerging evidence indicates that impairment in the serotonergic system, particularly involving serotonin receptor 7 (5-HT(7) receptor), plays a crucial role in ASD pathophysiology. In this study, we investigated the synaptic alterations in the brain of juvenile and adult BTBR T + Itpr3tf/J (BTBR) mice, a well-established ASD model, emphasizing the pivotal role of 5-HT(7) receptor in regulating synaptic morphology and functions. Our analyses revealed a significant alteration of pre- and post-synaptic proteins expression, impaired synaptic protein synthesis, and abnormal dendritic spine morphology in the brain cortex of BTBR mice. These synaptic deficits were accompanied by a reduction in 5-HT(7) receptor expression in brain cortex synaptosomes of BTBR mice, underscoring the importance of 5-HT(7) receptor in maintaining synaptic homeostasis. Remarkably, pharmacological activation of 5-HT(7) receptor with the selective agonist LP-211 restored synaptic protein synthesis and ameliorated dendritic spine abnormalities in brain cortex of BTBR mice. Altogether, our findings provide new insights into the molecular underpinnings of ASD, suggesting that targeting the 5-HT(7) receptor is a promising therapeutic approach to address synaptic dysfunctions in neurodevelopmental disorders.

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10. Gao L, Shen J, Gao J, Li T, Yan D, Zeng X, Meng J, Li H, Chen D, Wu J. Melatonin Ameliorates decaBDE-Induced Autism-Relevant Behaviors Through Promoting SIRT1/SIRT3/FOXO3a-Dependent Mitochondrial Quality Control. Antioxidants (Basel);2026 (Mar 23);15(3)

The etiology of autism spectrum disorder (ASD) implicates genetic predispositions and environmental chemicals, such as polybrominated diphenyl ethers (PBDEs). We aimed to identify whether mitochondrial quality control (MQC) was involved in ASD-relevant behavioral changes induced by decabromodiphenyl ether (deca-BDE, BDE-209) and the alleviation by melatonin. Pregnant rats exposed to BDE-209 (50 mg/kg i.g.) were administrated melatonin through drinking water (0.2 mg/mL) during gestation and lactation. Behavioral assessments integrated open-field test, three-chamber social test, and Morris water maze; mitochondrial detections took transmission electron microscopy, immunofluorescence, and homeostasis together; hippocampal molecular network was identified through transcriptomics profiles, combining dendritic morphology analysis after Golgi-Cox staining. Melatonin supplementation attenuated BDE-209-reduced social and cognitive ability, accompanied by improvements in hippocampal synaptic plasticity (dendritic spines, PSD95, SNAP25). Mitochondrial dysfunctions, shown as decreases in complex IV activity, ATP content, and mtDNA copies, plus redox imbalance (ROS/SOD2) and resultant mitochondrial membrane potential disruption and apoptosis, together with fusion/fission dynamic (MFN2/DRP1), biogenesis (SIRT1-PGC1α-TFAM), and mitophagy (SIRT3-FOXO3-PINK1) suppression, were reversed by melatonin partially through SIRT1 (Sirtuin-1)-dependent pathways, as these protections were abolished by inhibitor EX527. This study highlighted the SIRT1-SIRT3 axis in MQC and behavioral effects, providing novel intervention for PBDEs’ neurodevelopmental impairment.

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11. Grillo VD, Zani M, Veronesi V, Venuti P. From Participants to Community Partners: A Novel Community-Based Participatory Research (CBPR) Approach to Autistic-Led Inquiry in Digital and Virtual Environments. Healthcare (Basel);2026 (Mar 10);14(6)

Background/Objectives: Autism research has often interpreted autistic sociality through neurotypical norms, limiting ecological accounts of autistic meaning-making and context-sensitive support needs. Social virtual environments (SVEs), such as VRChat, allow modulation of sensory exposure, social distance, and participation pace, potentially enabling autistic-led interaction with greater autonomy and predictability. This study examined how autistic young adults co-construct meanings around social interaction, identity, and self-regulation in peer-led discussions within an SVE; identified context-sensitive processes relevant to well-being; and evaluated the feasibility and acceptability of SVEs as a participatory research setting. Methods: Sixteen autistic young adults (18-38 years; DSM-5-TR, Level 1) participated in nine remote sessions conducted in VRChat, coordinated via a co-designed Discord server. The peer-led discussions were audio-video recorded, transcribed, and anonymized. Data were analyzed using reflexive thematic analysis, combining inductive session-level coding, cross-session thematic clustering, and participatory refinement with community partners. Results: Autistic experience was framed as a context-dependent negotiation of interpretive risk, interactional workload, masking-related energy costs, and epistemic injustice, alongside future-oriented accounts emphasizing access, dignity, and systemic redesign. Observational memos documented multimodal participation, distributed peer facilitation, and accessibility-relevant sensitivities to environmental stability. Community partners reported positive experiences and supported the acceptability of private-world VRChat sessions. Conclusions: Peer-led discussions in an SVE can support ecologically grounded, participant-centered qualitative research, offering methodological opportunities to study autistic meaning-making under conditions that reduce demands and risks.

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12. Hafeez N, Aslam AR, Altaf MAB. Biomarker Discovery for Autism Prediction Using Massive Feature Extraction Based on EEG Signals. Sensors (Basel);2026 (Mar 16);26(6)

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder that requires early diagnosis for better intervention. However, current clinical behavioural examinations are time-consuming and prone to human error. Objective and effective biomarkers are essential for the diagnosis and prognosis of the disorder. Electroencephalography (EEG) is a non-invasive and inexpensive brain-imaging technique that is widely applied in the diagnosis of ASD. Feature-based methods have shown better performance in EEG-based applications. Here, we present a prediction framework based on massive feature extraction using the highly comparative time-series analysis (HCTSA) method and a hybrid feature selection method for the classification of ASD from resting-state EEG. Machine-learning models are trained and tested on a different number of selected features. Our models demonstrated 100% accuracy with ≥50 features on a balanced dataset of 56 participants. The most discriminating EEG channels and features were used in the prediction process, as well as those using Shapley values to provide explainability of our framework. Whilst these results are promising, we acknowledge the limitations of a single small-scale dataset and emphasise the need for validation on larger independent cohorts before clinical translation.

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13. Huntley T, Haebig E. Communication Research Priorities for Autism Research: Insights from a Caregiver Survey. Behav Sci (Basel);2026 (Mar 16);16(3)

Currently, autism researchers have limited knowledge about stakeholders’ priorities for research. This raises concerns because the autism community has increasingly called for more involvement in research. The present study aimed to provide initial insight into caregiver’s priorities for research that specifically focuses on language and communication in autistic children. Seventy-three caregivers of autistic children completed an online survey with an option to participate in a follow-up feedback session (n = 14). Within the survey, caregivers ranked the importance of 15 communication research topics. Participants also answered questions about barriers and incentives to participating in research. Caregivers highly ranked research that focuses on learning new words, echolalia, and learning to read. Additionally, 87% indicated that they would participate in research that did not involve intervention for their child. The top barrier to participating in autism research was time, and the top incentive was if a study was virtual. Associations between priority rankings and child language skills were also explored. Word learning research was particularly important to caregivers of children who communicated using shorter utterances or through augmentative and alternative communication devices, and research that focused on abstract language was particularly important to parents of autistic children with more advanced language skills. Caregiver feedback sessions provided additional insight into the rankings of research priorities. Caregivers of autistic children value pediatric language and communication research. Many valued research topics aligned with clinical goals in therapy (e.g., learning new words) and skills that highlight less understood learning and communication processes (e.g., echolalia). We discuss how these data can guide researchers as they conduct future autism research.

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14. Jagadapillai R, Tuncali I, Nagarajan N, Barnes G, Gozal E. Cerebellar Abnormalities: A Component of Autism Pathophysiology. Medicina (Kaunas);2026 (Feb 25);62(3)

Background and Objectives: Autism spectrum disorder (ASD) is a prevalent and largely idiopathic developmental disorder with relatively widespread etiology. Currently, there are no validated diagnostic or screening biomarkers for ASD, besides addressing the associated comorbidities. ASD is primarily diagnosed based on behavioral, motor, and cognitive characteristics. Until recently, although the cerebellum was particularly implicated in motor control, it was under-researched for its potential role in the development of ASD. However, cerebellar circuitry is altered in ASD, impacting its brain interconnections, affecting brain development, as well as social and behavioral outcomes associated with ASD. Methods: We reviewed the potential role of the cerebellum in ASD, particularly how its dysfunction during development or its early postnatal injury may impact on the maturation of other connected circuits and play a role in the development of core ASD symptoms. Results: Based on the literature, we addressed cerebellar changes that may alter synaptic pruning, immune cells’ function, neurotransmitters, blood-brain barrier permeability, and potential signaling pathways involved in ASD, and how these changes may interplay to contribute to ASD pathophysiology. Conclusions: Further research is needed to understand these interactions that may provide novel therapeutic options specifically targeted at the cerebellum.

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15. Kim A, Cho A, Kim J, Sayson LV, Lee HJ, Cheong JH, Kim HJ, Kim BN, Yi EC. Unveiling Diagnostic Biomarkers in Autism: A Comparative Proteome Analysis of CNTNAP2 Knockout Mice and Human ASD Patients. Biomolecules;2026 (Feb 24);16(3)

Autism Spectrum Disorder (ASD) is a biologically heterogeneous neurodevelopmental condition, presenting a major barrier to the identification of robust and translatable molecular biomarkers. Here, we employ a cross-species proteomic framework to identify conserved protein signatures associated with ASD. Quantitative proteomic profiling of brain and serum from CNTNAP2 knockout mice, integrated with serum proteomes from individuals with ASD, revealed 132 proteins consistently dysregulated across species. Functional pathway analyses implicated coordinated alterations in lipid metabolism, synaptic signaling, and immune regulation. To prioritize diagnostically informative candidates, we applied machine learning-based feature selection and identified a minimal panel of ten proteins (COL1A1, ITIH4, CLU, NID1, C5, MASP1, PON1, PLTP, HSPA5, and FETUB) that robustly discriminated ASD from control samples. Gene ontology and KEGG pathway analyses highlighted enrichment of immune regulatory pathways, synaptic transmission, oxidative stress responses, and lipid metabolic processes, consistent with emerging models linking neuroimmune dysregulation and metabolic imbalance to ASD pathophysiology. An XGBClassifier trained on this biomarker panel achieved strong performance in independent test sets (AUC = 0.75). Together, these findings establish cross-species proteomic integration combined with machine learning as a powerful strategy for uncovering conserved, biologically grounded biomarkers in ASD, providing a framework for future validation and translational development.

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16. Krzysztofik K. Temperamental Traits and Sensory Responsiveness in Children on the Autism Spectrum: The Moderating Role of Age. J Autism Dev Disord;2026 (Mar 28)

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17. Kuwabara H, Kojima M, Benner S, Otowa T, Watanabe T, Kuroda M, Owada K, Yassin W, Hamada J, Kano Y, Uno Y, Kushima I, Mori D, Arioka Y, Munesue T, Kasai K, Higashida H, Abe O, Takao H, Wakuda T, Kameno Y, Inoue J, Harada T, Yamauchi A, Ogawa N, Honda N, Kikuchi S, Seto M, Tomita H, Miyoshi N, Matsumoto M, Kawaguchi Y, Kanai K, Ikeda M, Nakamura I, Isomura S, Hirano Y, Onitsuka T, Takahashi N, Nakashima M, Saitsu H, Kondo K, Ikeda M, Iwata N, Shimada M, Sasaki T, Takei N, Ozaki N, Kosaka H, Okada T, Yamasue H. A key gene modulating oxytocin efficacy in autism: genome-wide discovery and verification in randomized controlled trials datasets. Mol Psychiatry;2026 (Mar 28)

Previous studies suggest that oxytocin has therapeutic potential for modulating core symptoms of autism spectrum disorder (ASD), although findings have been inconsistent. The unknown mechanisms underlying oxytocin’s effects and the substantial individual variability in treatment response impede the development of effective oxytocin-based therapies. In this study, we conducted a genome-wide association study (GWAS) using data from a randomized controlled trial (RCT) that examined the effects of a single dose oxytocin on behavioral and neural correlates of ASD. We further tested the association between the SNP identified in the GWAS and clinical efficacy in an independent, larger dataset comprising participants from three additional RCTs. In these trials, males with high-functioning ASD received repeated doses of oxytocin, and treatment response was assessed using the social reciprocity domain of the Autism Diagnostic Observation Schedule (ADOS), the common primary outcome across all three studies. The GWAS identified a significant association between oxytocin-induced improvements in medial prefrontal cortex activity during a social judgment task and the single nucleotide polymorphism (SNP) rs1871303 in the ryanodine receptor 2 (RYR2) gene (β = 2.37, t = 7.82, df = 72, P = 3.47 × 10⁻⁹). The validation analysis supported the association between this RYR2 SNP and individual variability in ADOS reciprocity improvement (β = 0.194, t = 2.30, df = 135, P = 0.023), with no significant association observed for placebo response (P > 0.1). To our knowledge, this is the first GWAS to investigate the pharmacogenomics of oxytocin efficacy in ASD. These findings highlight RYR2 as a key gene influencing oxytocin response, possibly through its role in calcium channel signaling and regulation of endogenous oxytocin release.

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18. Li R, Dybvik H, Feng D, Eng CM, Lee CH, Bartholomay KL, Zhang Y, Lightbody AA, Reiss AL. Atypical inter-brain synchrony and social communication deficits in girls with fragile X syndrome: Evidence from functional near-infrared spectroscopy hyperscanning. Eur Child Adolesc Psychiatry;2026 (Mar 28)

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19. Liu F, Yang H, Wu X. Single-Cell Gene Module Inference Reveals Alternative Polyadenylation Dynamics Associated with Autism. Int J Mol Sci;2026 (Mar 21);27(6)

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by genetic heterogeneity. Post-transcriptional regulation-particularly alternative polyadenylation (APA)-plays a critical role in the pathogenesis of ASD. APA controls mRNA stability, translational efficiency, and subcellular localization through modulating the length of the 3′ untranslated region of mRNA. APA profiling can uncover functionally relevant post-transcriptional alterations often missed by conventional gene expression analyses. However, current ASD analyses still largely rely on differential gene expression or individual APA event detection, which ignores the collective explanatory power of ASD risk genes or co-dysregulated functional gene modules within specific cell types. In this study, we present an integrative computational framework that combines matrix factorization and machine learning to identify ASD-associated gene modules driven by APA and to predict cell-type-specific ASD-related cells. Applied to human brain single-nucleus RNA sequencing (snRNA-seq) data, our approach systematically uncovers APA regulatory patterns that are specific to cell type, brain region, and sex in ASD. The identified APA modules are significantly enriched in pathways related to synaptic function, neurodevelopment, and immune response, with the strongest signals observed in excitatory neurons of the prefrontal cortex. Using APA genes from these modules as features, we built a classification model that effectively distinguishes ASD cells from normal cells. Moreover, we found that integrating APA with gene expression-two complementary modalities-substantially improves prediction accuracy, underscoring APA as an independent and biologically informative regulatory layer. Our work delineates a high-resolution APA regulatory landscape in ASD, offering novel insights and potential therapeutic avenues beyond transcriptional abundance.

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20. Locke J, Williams NJ, Sridhar A, Shih W, Espeland C, Tagavi D, Bearss K. Study protocol for coaching and leadership in autism support settings: a cluster randomized controlled hybrid type 2 effectiveness-implementation trial. Implement Sci;2026 (Mar 28)

BACKGROUND: The increased prevalence of autism spectrum disorder creates a sense of urgency to improve outcomes for this population in publicly funded education systems, the primary setting in which autistic children receive behavioral health services in the United States. Important barriers to progress include a lack of feasible clinical interventions that address autistic children’s externalizing behaviors in schools and major challenges sustaining fidelity to newly implemented programs over time. This trial addresses these gaps by (1) testing the clinical effectiveness of the Research Units on Behavioral Interventions in Educational Settings (RUBIES) program relative to educator psychoeducation on externalizing behaviors of autistic children in public elementary schools, and (2) testing the effects of adding a leadership-focused organizational implementation strategy, Helping Educational Leaders Mobilize Evidence (HELM), to educator coaching in RUBIES on RUBIES sustainment. METHODS: In a cluster-randomized, hybrid type 2 effectiveness-implementation trial, schools will be randomized to one of 3 arms: 1) educator coaching in RUBIES and school participation in HELM; 2) educator coaching in RUBIES only; or 3) a control condition incorporating an active clinical comparator, educator psychoeducation. We will enroll 42 schools and 126 educators yoked to 126 elementary-aged autistic children. Depending on arm, educators will complete study instruments up to six times: 1) Spring semester prior to the year of school and student enrollment (implementation baseline; arms 1-2); 2) Fall semester Year 1 (clinical baseline; arms 1-3); 3) 16 weeks (arms 1-3); 4) 24 weeks (arms 1-3); 5) 52 weeks (arms 1-2); and 6) 76 weeks (arms 1-2). The primary clinical outcome compares arms 1 & 2 vs. 3 on change in autistic children’s externalizing behavior from clinical baseline to 24 weeks. The primary implementation outcome compares arms 1 vs. 2 on RUBIES sustainment, operationalized as educators’ average RUBIES fidelity at 52 and 76 weeks. DISCUSSION: Generating evidence for the clinical effectiveness of RUBIES addresses a significant gap in educator-delivered interventions to minimize highly prevalent externalizing behaviors among autistic children in public schools. Simultaneously, testing the effectiveness of HELM on sustainment of RUBIES will inform future efforts to successfully implement and sustain new innovations for autistic youth in public schools. NAME OF THE REGISTRY: Clinical Trials. TRIAL REGISTRATION: NCT07276750. Date of registration 12/10/25. URL of trial registry record https://clinicaltrials.gov/study/NCT07276750?cond=Autism&intr=RUBIES&rank=1.

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21. Marenco C, Pozzolini G, Casciaro M, Morales M, Barone C, Morciano D, Barillari C, Zakirova E, Antoniazzi G, Lahoud T, Mosconi F, Cabassi D, Noonan JP, Bacchelli E, Nicolis SK. So Fragile, So Human: Noncoding DNA Regions Orchestrating Gene Expression Involved in Neurodevelopmental Disorders and in Human Brain Evolution. Int J Mol Sci;2026 (Mar 19);27(6)

The development of the human brain starts with the orchestrated expression of our genes during embryogenesis. Non-protein-coding DNA sequences (gene promoters and enhancers) dynamically interact to form a three-dimensional (3D) network, orchestrating gene expression. We discuss novel perspectives on how DNA sequence variants within regulatory DNA, identified by whole-genome sequencing (WGS), contribute to the development of neurodevelopmental disorders (NDDs), including autism spectrum disorders (ASDs). We discuss two recent models explaining the evolution of a subset of regulatory sequences, Human Accelerated DNA Regions (HARs), proposed to be involved in the evolution of uniquely human brain features through their participation in the 3D interactions network. We connect this with the recent proposal that rare, recessive inherited sequence variants within HARs, interacting with distant target genes in neural cells, represent risk factors for the development of ASDs. The SOX2 transcription factor, whose heterozygous mutation causes NDDs, shapes the noncoding-DNA interaction network in neural cells, and binds DNA together with FOS, whose recognition sequence is enriched within HARs carrying human-specific substitutions modulating enhancer activity. SOX2 also binds regulatory regions (including HARs) carrying ASD-associated mutations. We highlight research directions based on these findings, which will hopefully improve our understanding of the connection between SOX2-dependent gene regulatory networks, NDDs, and brain evolution.

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22. Miao H, Zhang T, Chen S, Xu X, Fang K, Wu D, Zhang Y, Huang X. De Novo Heterozygous KDM3B Variants Expand the Mutational Spectrum of Diets-Jongmans Syndrome: Case Series and Literature Review. Genes (Basel);2026 (Feb 28);17(3)

BACKGROUND: Pathogenic variants in KDM3B have been implicated as the cause of Diets-Jongmans syndrome (DIJOS), an autosomal-dominant disorder characterized by growth retardation, intellectual disability, facial dysmorphism and autism-spectrum disorder. However, only a limited number of cases have been reported. METHODS: The general characteristics of four patients were recorded, including clinical features, child development, neuropsychological assessment and therapeutic interventions. Whole exome sequencing (WES) was performed for potential genetic causes and interpretation of variants was performed in accordance with ACMG guidelines. RESULTS: All patients carried de novo variants in the KDM3B gene, namely, c.2832-3C>G, c.1188del p.(Glu397Argfs*21), c.4580T>C p.(Leu1527Pro), and c.3220dup p.(Glu1074Glyfs*48). Unlike other patients with DIJOS who presented with growth retardation, mild to moderate intellectual developmental disorder and facial dysmorphism, our patients mainly presented with growth retardation, while their neurodevelopment was either normal or mildly impaired. In addition, our patients received primarily supportive care. One patient treated with recombinant human growth hormone (rhGH) showed improvement in growth. CONCLUSIONS: Our results broaden the mutational spectrum of KDM3B-related disorder and highlight the inter-patient variability of the clinical phenotype. For the first time, we demonstrate that rhGH therapy can partially promote growth, providing novel evidence for genetic counseling.

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23. Milne N. Critically Appraised Paper: In children with mild autism, non-immersive virtual reality combined with traditional physiotherapy is superior to traditional physiotherapy alone for improving balance and postural control [synopsis]. J Physiother;2026 (Mar 26)

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24. Młynek M, Wicher D, Cieślikowska A, Urbańska K, Przywoźna-Zduńczyk K, Zawadzka-Więch U, Markowska-Krawczyk K, Bal A, Purwin S, Sielska-Rotblum D, Halat-Wolska P, Iwanowski P, Iwanicka-Pronicka K, Jędrzejowska M, Kowalczyk-Rusak M, Pietrasik J, Chrzanowska K, Domańska-Pakieła D, Kotulska-Jóźwiak K, Krajewska-Walasek M, Madej-Pilarczyk A. Epilepsy as a Component of the Dysmorphic-Neurodevelopmental Phenotype in Pediatric Patients with Recurrent Copy Number Variants. Genes (Basel);2026 (Feb 25);17(3)

Objective: Copy number variants (CNVs) overlapping genes associated with neurodevelopmental disorders in patients with epilepsy are particularly concentrated in epilepsy hotspot loci. The aim of this study was to evaluate epilepsy as a component of the dysmorphic-neurodevelopmental phenotype in patients with recurrent CNVs. Methods: The study included genetic and clinical data from 177 pediatric patients carrying 17 recurrent CNVs showing well-documented enrichment in epilepsy or associated with genetic OMIM syndromes. Results: Epilepsy was diagnosed in 50 of 177 children (28.2%), developmental delay in 147 (83.0%), dysmorphic features in 104 (58.8%), behavioral problems in 62 (35.0%), and congenital anomalies in 55 (31.1%). Among recurrent CNV hotspots, the del16p11.2 BP4-BP5 deletion was the most frequent, occurring in 39 of 177 patients. Ten children (25.6%) with del16p11.2 presented with epilepsy as part of the phenotype. Other frequently represented CNVs included del15q11.2 BP1-BP2 (OMIM #615656; 19/177 patients, 4/19 with epilepsy), del1q21.1 (OMIM #612474; 15/177, 6/15 with epilepsy), del15q13.3 (OMIM #612001; 13/177, 4/13 with epilepsy), and dup16p11.2 (OMIM #614671; 12/177, 1/12 with epilepsy). The highest proportion of epilepsy as a phenotypic component was observed in patients with del1p36 (OMIM #607872; 6/9 patients) and del1q21.1 (OMIM #612474; 6/15 patients). Conclusions: Our data support the clinical utility of CNV testing in patients with epilepsy accompanied by additional neurodevelopmental or dysmorphic features, in line with current diagnostic guidelines. The epilepsy-plus phenotype may help clinicians identify patients who are most likely to benefit from CNV analysis.

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25. Nair A, Jalal R, Lawrence KE, Verma N, Gutierrez H, Laulette K, Karlsgodt KH, Bearden CE. Triple-Network Functional Connectivity in Adolescents With Autism Spectrum Disorder Compared to Early-Onset Psychosis. Autism Res;2026 (Mar 28)

Both autism spectrum disorder (ASD) and psychosis are associated with challenges in social cognition. The triple-network model posits that dysfunction within and between the default mode network (DMN), central executive network (CEN), and salience network (SN) contributes to these deficits. However, the relationship between triple-network connectivity and social cognition has not been systematically compared across these groups during adolescence. We examined whole-brain functional connectivity of the triple-network in a sample of youth with ASD (N = 24), youth with early-onset psychosis (EOP; N = 25), and age-matched typically developing (TD) controls (N = 26, overall mean age = 16.39 ± 2.36, % female = 41%). Additionally, we examined relationships between connectivity patterns of the triple-network and behavioral measures of social cognition and emotion recognition in each group. ASD youth showed mixed over- and under-connectivity in the DMN, CEN overconnectivity, and SN underconnectivity, while EOP youth showed DMN and CEN overconnectivity, with relatively intact SN connectivity, compared to TD controls. Compared to EOP, ASD participants had reduced SN connectivity and mixed disruptions in DMN connectivity. Across groups, connectivity patterns were linked to social behaviors: in EOP, DMN overconnectivity was associated with poorer social cognition; in ASD, SN underconnectivity was associated with poorer social cognition. These findings highlight both shared and distinct patterns of triple-network dysconnectivity in ASD and EOP, supporting transdiagnostic models of social cognitive dysfunction, and reinforcing adolescence as a key developmental window for network-based brain changes. Youth with autism spectrum disorder (ASD) and early‐onset psychosis (EOP) can both struggle to understand and respond to social situations. In this study, we used resting‐state MRI scans to examine how three key brain networks—those involved in theory of mind, attention, and detecting socially salient information—function in adolescents with ASD and EOP compared to neurotypical youth. We found different patterns of brain connectivity in each group, with ASD youth showing weaker connections in the brain network that helps to notice and respond to important social cues, and in contrast, EOP youth showing stronger‐than‐usual connections in key regions for attention and working memory. Subsequently, these patterns were linked to how well participants performed on tasks involving emotion recognition and social cognition. These findings suggest that social difficulties in ASD and EOP may stem from differing patterns of disruptions in similar social brain networks. eng

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26. Naviaux RK. The 3-Hit Metabolic Signaling Model for Autism Spectrum Disorder: A Summary. Autism Res;2026 (Mar 28):e70228.

Autism spectrum disorder (ASD) is a highly heritable yet environmentally sensitive neurodevelopmental condition whose biological heterogeneity has resisted a unifying causal explanation for over 100 years. The 3-hit metabolic signaling model proposes that ASD arises from abnormal persistence of an evolutionarily conserved stress-response program-the cell danger response (CDR)-during critical windows of neurodevelopment. In this framework, ASD emerges from the sequential interaction of: (1) inherited genetic or epigenetic variants that sensitize mitochondrial metabolism, intracellular calcium handling, and purinergic signaling to environmental change; (2) early prenatal or postnatal activation of the CDR by infection, immune dysregulation, metabolic disturbance, or environmental toxicant exposure; and (3) prolonged or recurrent exposure to CDR-activating triggers for 3-6 months from the late 1st trimester to 18-36 months of age. The CDR is initiated by extracellular ATP (eATP)-associated purinergic signaling and mitochondrial changes that are resource- and energy-intensive. Persistent or recurrent activation of the CDR during the critical neurodevelopmental window is proposed to sensitize developing cells to eATP-related signaling, leading to false alarms and a mixture of chemical, immune, and neurosensory under- and over-responsivity. More frequent cycles of CDR activation and recovery are proposed to cause cellular competition for key bioenergetic, mitochondrial, and metabolic resources needed to support the normal trajectory of child development. Phenylketonuria (PKU) provides a proof-of-principle example. Untreated PKU historically caused intellectual disability and autistic features, while universal newborn screening and early treatment interrupt this sequence and prevent or decrease these outcomes despite strong genetic predisposition. A 3‐hit developmental model for autism spectrum disorder is described. New methods in systems biology have identified a pattern of changes in mitochondrial function and metabolism that underlie the core symptoms of ASD. The metabolic features of the cell danger response (CDR), maintained by abnormalities in ATP‐related purinergic signaling, have emerged as a common denominator for each of the genetic and environmental causes of ASD studied to date. eng

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27. Newey CR, Lewtas JF, Voller ME. Strategies to enable workplaces to support autistic clinicians in the dental workforce: learnings from the Buckland Review of Autism Employment. Br Dent J;2026 (Mar);240(6):425-428.

Embracing neurodiversity in the workplace can enhance productivity, job satisfaction, and ultimately create a more compassionate and effective healthcare environment. This can positively impact the wider dental team and overall patient care. Autistic individuals often encounter unique challenges in the workplace, particularly in fields like dentistry. This article focuses on the experiences of autistic dental clinicians, highlighting the barriers they face in employment and the potential need for reasonable adjustments in the workplace. Evidence such as the 2024 Buckland Review of Autism Employment emphasise that autistic adults often experience challenges securing and maintaining employment due to an absence of understanding and support. Legislations such as the Equality Act 2010, and other initiatives, including the Disability Confident Scheme and the Autistica Neurodiversity Employer Index, can protect autistic people in the workplace and help to overcome barriers. By implementing personalised adjustments specific to the individual needs of an autistic employee, such as sensory accommodations, flexible routines, and mentorship programmes, dental practices can cultivate a more inclusive environment. This article draws attention to the need for a dynamic shift towards valuing the unique strengths of autistic clinicians and integrating them into a diverse and equitable dental community.

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28. Santana-Coelho D, Porter G, Morales J, O’Connor JC. Analysis of Gene, Environment, and Sex Interaction in the Development of Autistic-like Phenotype in Mice. Int J Mol Sci;2026 (Mar 11);27(6)

Autism Spectrum Disorder (ASD) is a developmental disorder that manifests a broad variability of phenotypes. The underlying factors contributing to the diverse presentation of autistic phenotypes remain poorly understood. Studies have shown that environmental and genetic factors could contribute to ASD. Additionally, there is a sex bias in the disorder, where the prevalence in males is higher than in females. But it is still unknown how exposure to similar risk factors can lead to different phenotypes. The three-hit theory states that the vulnerability of an individual to develop ASD is modulated by the interplay between genetic predisposition, sex, and environmental insults. To better understand this phenomenon, we investigated whether an environmental insult, via maternal immune activation (MIA) during pregnancy could influence the development of the autistic-like phenotype in a genetically predisposed mouse strain, contactin-associated protein-like 2 (CNTNAP2) knockout. CNTNAP2 knockout, sex, and maternal immune activation had significantly additive effects on repetitive/stereotyped and social behavior in the offspring, while working memory and sensory gating were not affected by hits. These results indicate that genetics, sex, and environment interact to influence autistic-like phenotypes in a behavior-specific manner.

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29. Shyu HJ, Chen YR, Ng DY, Bundy A, Tseng MH, Cordier R. Autistic Adolescents’ Quality of Life: Perceived Social Competence and Social Anxiety as Key. Autism Res;2026 (Mar 28):e70240.

Autistic adolescents often report lower social and overall quality of life (QoL) associated with limited social skills and behavioral challenges. Awareness of social limitations and social anxiety can worsen QoL, yet the specific roles of these factors remain underexplored. This study examined how social skills, challenging behaviors, social anxiety, and self-perceived social competence influence QoL in autistic adolescents. A total of 117 autistic participants (age = 12.6 ± 2.2 years; female = 13.7%, male = 86.3%) completed measures including the Pediatric Quality of Life Inventory, the Social Anxiety Scale for Adolescents, and the Self-Perception Profile for Children/Adolescents Social Competence Subscale. Caregivers assessed social skills and challenging behaviors using the Social Skills Improvement System Rating Scales. Linear regressions, controlling for age, sex, and autistic characteristics, revealed that lower overall QoL was significantly associated with higher social anxiety (β = -0.48, p < 0.001), lower perceived social competence (β = 0.21, p < 0.05), and more challenging behaviors (β = -0.24, p < 0.01) among autistic adolescents. Furthermore, lower social QoL was associated with social anxiety (β = -0.52, p < 0.001) and perceived social competence (β = 0.28, p < 0.01). These factors accounted for 45.5% of overall and 51.6% of social QoL variance. The findings highlighted the importance of supporting self-perception, addressing emotional distress, and managing behavioral challenges to improve QoL in autistic adolescents. Autistic teenagers might feel a bit nervous in social situations and sometimes find it hard to behave in ways they want. They may also see themselves as less socially capable, which can affect their overall happiness. This study shows that social anxiety, behavioral challenges, and how teens view their social abilities are closely linked to how they feel both overall and in social settings. By supporting their self‐confidence and emotional health, we can help make their daily lives better and more fulfilling. eng

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30. Singh J, Chishti S, Santosh P. Co-Occurring Genetic Mutations in Rett Syndrome and MECP2-Related Disorders-Clinical and Diagnostic Implications from a Case Series. Genes (Basel);2026 (Feb 27);17(3)

Background/Objectives: Factors modulating phenotypic variability in Rett syndrome (RTT, OMIM 312750) include X chromosome inactivation (XCI), type of MECP2 variant, and/or disease modifiers. Emerging evidence also points to multi-locus genetic variants. Understanding the phenotypic variability associated with multi-locus genetic diagnoses in individuals with RTT and MECP2-related disorders would be important not only for accurate diagnosis, risk stratification and clinical management but also to explain symptoms that might not be typically associated with RTT. Methods: We present a case series of five individuals with a diagnosis of RTT or an MECP2-related disorder with co-occurring genetic findings, including pathogenic variants, variants of unknown significance and chromosome duplications. Clinical features such as neurodevelopmental history and comorbid medical conditions were assessed alongside the genetic findings. Results: A review of 200 cases with RTT identified five cases (all females aged 7-27 years) with a co-occurring genetic finding. Each case harboured at least one additional genetic variant that included a beta thalassaemia trait, Calmodulin 3 (CALM3) missense variant, maternally inherited 22q12.3 to q13.1 duplication, 7p14.3 and Dynein Cytoplasmic 1 Heavy Chain 1 (DYNC1H1) variants of uncertain significance and a pathogenic Set Domain-containing protein 5 (SETD5) variant. A rare triple genetic finding was illustrated in a single case, combining MECP2, CALM3, and DYNC1H1 variants. Conclusions: This case series supports the premise that RTT and MECP2-related disorders exist in a more complex neurogenetic spectrum than previously defined. It also emphasises the complexity within MECP2-related disorders. They are not static, and in the context of severe treatment resistant epilepsy, MECP2 disorders can evolve over time, necessitating diagnostic reclassification. Although the co-occurrence of multiple genetic disorders in RTT and MECP2-related disorders is rare, these cases underscore the importance of considering cumulative genetic burden when evaluating individuals with atypical features or evolving neurodevelopmental phenotypes.

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31. Trelles P, Levy T, Jain S, Lerman B, Friedman K, Chung WK, Dominick KC, Dunham-Carr K, Lamy M, Levin AR, Luccarelli J, O’Connor R, Samsel C, Smith JR, Srivastava S, Thurm A, Siegel M. Catatonia in Autism and Neurodevelopmental Disorders: A Scoping Review for Advancing Identification, Practice, and Research. J Am Acad Child Adolesc Psychiatry;2026 (Mar 25)

OBJECTIVE: To systematically review the clinical presentation, prevalence, neurobiological mechanisms, and treatment strategies for catatonia in individuals with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDDs) to inform care and research. METHOD: We conducted a systematic search of PubMed, Embase, and Cochrane Library in November 2024, following PRISMA-ScR guidelines. Peer-reviewed articles published after 2000 were eligible if they assessed catatonia in individuals with ASD or related NDDs. Data on prevalence, clinical features, etiology, and treatments were extracted and synthesized using a narrative approach. RESULTS: The search yielded 1966 records; 210 met the inclusion criteria, with 17 additional studies identified through cross-referencing, for a total of 227 included studies. Pooled prevalence estimates for catatonia suggest a rate of 10.4%, but the true prevalence remains uncertain due to research limitations. Overlapping symptoms between ASD and catatonia hinder timely diagnosis and intervention. Key pathogenic factors include excitatory/inhibitory neurotransmitter imbalances, neuroimmune dysregulation, and genetic vulnerabilities and their interplay with environmental exposures. Overlapping neurobiological mechanisms position catatonia as a distinct outcome within a broader spectrum, reflecting shared vulnerabilities among individuals with NDDs. Benzodiazepines and electroconvulsive therapy are the main treatments, with higher doses and longer durations often required than when treating neurotypical patients. Dopaminergic agents must be used cautiously, and evidence supporting immunomodulators is emerging. CONCLUSION: Catatonia in autism and other NDDs is underrecognized, causing delays in care and suboptimal outcomes. Addressing this requires standardized diagnostic tools, robust studies, and targeted interventions informed by genetic, immune, and epidemiologic research. Despite treatment advances, progress is hindered by heterogeneous study designs, reliance on case series, and limited clinical trials. Future efforts should refine diagnostics and therapies to improve outcomes for this vulnerable population.

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32. Tsai YH, Huang GS, Hu MH. Febrile Seizures and Subsequent Autism Spectrum Disorder: A Nationwide Population-Based Cohort Study. Children (Basel);2026 (Mar 17);13(3)

Objectives: To access the effects of febrile seizures from coexisting neurodevelopmental conditions that are commonly associated with autism spectrum disorder. We examined whether febrile seizures are independently associated with ASD after considering neurodevelopmental comorbidities and seizure-related clinical characteristics. Methods: We conducted a nationwide population-based matched cohort study using Taiwan’s National Health Insurance Research Database. The study included 948 children with FS and 3804 age- and sex-matched controls without FS. Participants were followed longitudinally for incident ASD. Associations were evaluated using Cox proportional hazards models with additional analyses restricted to the FS cohort. Neurodevelopmental comorbidities assessed included attention-deficit/hyperactivity disorder (ADHD), epilepsy, and Tourette syndrome/tic disorder. Results: Among 4752 children followed for more than 10 years, 43 (0.9%) developed ASD. FS were not independently associated with ASD in adjusted Cox regression models. In contrast, ADHD, epilepsy, and Tourette syndrome/tic disorder were strongly and consistently associated with ASD across analytic models. Conclusions: Febrile seizures were not independently associated with autism spectrum disorder. Instead, ASD risk was largely explained by coexisting neurodevelopmental comorbidities, consistent with a shared neurodevelopmental susceptibility framework. These findings suggest that developmental surveillance should prioritize children with neurodevelopmental disorders rather than those with febrile seizures alone.

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