1. Aarthi D, Kannimuthu S. MACAFNet transformer-based multi-atlas fusion framework for autism spectrum disorder classification using functional connectivity. Sci Rep. 2026.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in communication, social interaction and behavior. ASD individuals develop symptoms such as recurrent actions, atypical facial expressions and challenges in social engagement. This study proposes a Multi-Atlas Context-Aware Fusion Network (MACAFNet) for ASD classification using functional connectivity (FC) features derived from resting-state functional MRI (rs-fMRI) to enable reliable ASD classification. This framework integrates information from multiple brain atlases such as AAL, CC200, Dosenbach160, EZ, HO and TT to capture complementary neurofunctional features across diverse brain parcellations. Each atlas-specific connectivity representation is projected into a shared embedding space and fused using a Transformer-based attention mechanism that explicitly models inter-atlas contextual dependencies. Unlike traditional static fusion systems, this allows for dynamic and adaptive feature integration. The fused representation is then processed by a neural classifier for ASD classification. Experiments conducted on the ABIDE-I dataset demonstrate that the proposed approach achieves an accuracy of 88.46% and an AUC of 0.9546, indicating strong discriminative capability. The results highlight the effectiveness of context-aware multi-atlas fusion in capturing complex brain connectivity patterns for research-oriented ASD classification.

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2. Aishworiya R, Gangi D, Ma VK, Parikh C, Yusoff NA, Likhitweerawong N, Ozonoff S. Psychological Impact of Autism Screening on Caregivers. Autism Res. 2026: e70267.

Autism screening in childhood is common, yet little is known about its potential psychological impact on caregivers. The U.S. Preventive Services Task Force, an independent national panel of disease prevention experts, stated that this gap in knowledge limited their ability to endorse universal autism screening. This study examined the psychological impact of autism screening, using data from a large community-based sample (n = 1272) involving online caregiver-completed autism screeners at child age 6, 9, 12, 18, and 24 months. Caregivers completed the Participation Impact Questionnaire retrospectively (mean child age at completion 37.2 ± 4.8 months) to measure feelings about screening. A minority (34.7%) of the sample reported presence of ≥ 1 negative feeling; the most commonly endorsed was « worried ». Among this subset, negative feelings were of short duration (lasted for < 1 day in 56.9%), were mild in severity (86.4%), and did not affect functioning (85.3%). A majority (86.2%) also reported ≥ 1 positive feeling. Our findings address a critical evidence gap regarding potential harms of autism screening and support universal screening, given that psychological harms are not common and have low functional impact, as well as possible psychological benefits. Although screening for presence of autism among young children is commonly done, little is known about its potential psychological impact on caregivers. There is very limited information related to this topic currently, with the U.S. Preventive Services Task Force, an independent national panel of experts, stating that this gap in knowledge limited their ability to make recommendations related to guidelines on routine autism screening for all children. This study addresses this knowledge gap and aimed to study the potential psychological impact (harms, as well as benefits) of autism screening in caregivers. Data was obtained from a longitudinal study involving online caregiver‐completed autism screeners at child age 6, 9, 12, 18, and 24 months. Caregivers were notified at child age 18–24 months if their children had screened positive at any time‐point and offered diagnostic evaluation to determine a final outcome by 36 months. Subsequently caregivers were invited to complete the Participation Impact Questionnaire (PIQ) which was designed to measure negative and positive feelings about screening, their duration, and functional impact. In our study, a total of 1272 caregivers completed the PIQ. Only a minority (34.7%) reported presence of ≥ 1 negative feeling; the most commonly endorsed feeling was “worried”. Among those who reported these feeling(s), they were of short duration, were mild in severity and did not affect day‐to‐day activities in the majority. A majority (86.2%) also reported ≥ 1 positive feelings; the most common ones were “interested” and “curious.” Study findings suggest that psychological harms reported by caregivers following autism screening are less common than positive feelings and even if present, have short duration, low functional impact, and low severity. Our findings are in support of recommendations toward universal autism screening recommendations, given low harm potential and possible psychological benefits of screening on caregivers. eng.

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3. Becker B. Accelerated non-invasive brain stimulation in childhood autism. Bmj. 2026; 393: s783.

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4. Christian P, Löfström R, Guterstam A. Dissociation between implicit and explicit gaze perception and their metacognitive representations scales with the degree of autistic traits. iScience. 2026; 29(5): 115602.

Gaze perception is crucial for inferring others’ attentional state. However, it remains understudied whether implicit (automatic) and explicit (deliberate) gaze perception rely on distinct underlying mechanisms and whether these are affected by autistic traits. We used the same real-life images with an actor being surrounded by objects for two separate tasks: Participants either identified the object the actor was gazing at (explicit task) or were instructed to detect a cued object, with the actor’s gaze being task-irrelevant (implicit task). Our findings demonstrate that implicit and explicit gaze perception rely on dissociable mechanisms, as implicit, but not explicit, attentional shifts, are driven by subtle social cues. Autistic traits selectively affected explicit inference of others’ attentional state as well as the metacognitive representation of these challenges, while implicit gaze perception remained intact. Our findings advance our understanding of the distinct mechanisms underlying gaze perception, which are distinctly affected by autistic traits.

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5. Fradley K, Haines-Delmont A. A longitudinal analysis of the prevalence of restrictive interventions involving women with mental health conditions, learning disabilities or autism in mental health services in England. Front Psychiatry. 2026; 17: 1787826.

INTRODUCTION: Restrictive interventions, including physical restraint, seclusion, chemical restraint, and segregation, continue to be used within mental health services, despite sustained policy efforts to promote least-restrictive and trauma-informed care. However, little is known about national trends affecting women, for whom restrictive interventions often carry heightened risks of re-traumatisation and stigma. METHODS: We conducted a longitudinal secondary analysis of publicly available administrative data from the Mental Health Bulletin covering NHS-funded mental health services in England between 2017 and 2025. Annual counts of restrictive interventions involving women were examined relative to the number of women detained under the Mental Health Act to estimate annual rates per 1,000 detained. Regression modelling was used to assess temporal trends overall, by age group and type of restrictive intervention, and interrupted time-series analyses to examine changes following implementation of the Mental Health Units (Use of Force) Act 2018 (« Seni’s Law »). Trends were also examined alongside available national data on restrictive interventions involving men. RESULTS: Rates of restrictive interventions involving women increased by approximately 12 percent per year over the study period, with no evidence of a reduction following the introduction of Seni’s Law. Increases were most pronounced for chemical restraint, seclusion, and segregation, while physical and mechanical restraint remained stable. Restrictive interventions declined among women under 18 but increased consistently across all adult age groups, indicating a widening age-related divergence. Although overall trends broadly mirrored those observed among men, the types of restrictive interventions used and their potential impact may differ, highlighting gendered dimensions in how restrictive practices are experienced and applied. DISCUSSION: Despite extensive national initiatives, restrictive interventions involving women have continued to rise in England, highlighting a persistent gap between policy intent and practice. The findings suggest that legislative frameworks alone are insufficient to achieve meaningful reductions without operational changes in clinical practice, organisational culture, and monitoring systems. Internationally, the study contributes rare gender-disaggregated longitudinal evidence and highlights the need for comparable monitoring systems and coordinated research to inform rights-based, trauma-informed strategies to reduce restrictive interventions in mental health services.

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6. Hull L, Mandy W, Belcher H, Petrides KV. Corrigendum to Validation of the Camouflaging Autistic Traits Questionnaire Short Form (CATQ-SF). Comprehensive Psychiatry 135 (2024) Nov:135:152525. Compr Psychiatry. 2026: 152703.

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7. Kim S, Cantin-Garside KD, Nussbaum MA. Feasibility of forecasting self-injurious behavior among autistic youth using wearable sensors and machine learning models. Sci Rep. 2026.

Self-injurious behavior (SIB) is a substantial clinical challenge for many individuals on the autism spectrum, and support strategies are often only reactive. Forecasting of SIB could enable timely support, especially using wearable sensors, but its feasibility is not well understood. We evaluated SIB forecasting using a previously collected dataset (n = 9) comprising motion and physiological data. We compared the performance of four machine learning models-Random Forest, AdaBoost.M2, Long Short-Term Memory (LSTM), and a Double-Stacked LSTM-across five forecast horizons (3s to 120s) and three feature sets: Motion-Only (from accelerometers), Physiological-Only (e.g., heart rate, skin conductance), and Combined. Performance was measured with a range of metrics, using Leave-One-Subject-Out cross-validation. We found a significant main effect of forecast horizon on the Area Under the Precision-Recall Curve; performance rose from near-chance at short horizons to having median scores above chance at one minute or longer. While aggregated results showed no significant differences between models or feature sets, subject-level analysis suggested predictive feasibility and that the optimal model configuration were highly person-specific. Our findings demonstrate that forecasting using wearable sensor data is feasible, but the substantial performance variability highlights a critical need for person-specific approaches to enable the development of clinically useful, proactive support systems.

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8. Mifsud S, Thomas D, Bowron R, Sutherland R. The Predominant Focus Is Still on Teaching Children to Make Requests: A Systematic Review of AAC for Autistic Adults and Children. Int J Lang Commun Disord. 2026; 61(3): e70251.

BACKGROUND: Autistic people with communication support needs can benefit from the use of augmentative and alternative communication. While research has considered the use of AAC to supplement communication and improve communication effectiveness, less is known about other potential outcomes across the lifespan such as wellbeing and social interaction. AIMS: The aim of this systematic review was to synthesise current research regarding the use of AAC for autistic adults and children; exploring how AAC supports the individual’s communication, adaptive functioning and quality of life. METHODS: A systematic search was conducted across six databases; PsychINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Educational Resources Information Centre (ERIC), and Google Scholar. Eligibility criteria included experimental design, peer-reviewed publications and papers published in English after 2013. Relevant papers were exported to Covidence; screening, full text review and data extraction were conducted in duplicate and quality appraisal was completed for all papers using the Scientific Merit Rating Scales (SMRS). Included studies were grouped by age, intervention types, AAC types and reported outcomes, and described qualitatively. MAIN CONTRIBUTION: The 69 included papers focused on a range of AAC types. The majority investigated speech-generating devices and low-tech picture exchange. Most used behavioural intervention techniques. Most papers focused only on children, with only three papers investigating outcomes of AAC use with adults. The results were largely descriptions of proximal outcomes, such as simple requests, with few considering generalisation of skills or distal outcomes such as quality of life. The quality of the papers was generally low, with limitations in study design and diagnostic ascertainment noted. CONCLUSIONS: AAC has the potential to be an important support for autistic people, however, evidence regarding the impact on the broad range of communication functions and quality of life is very limited. A greater focus on the impact of AAC on these areas is needed in both research and practice along with a stronger focus on adults and a greater range of AAC types. TRIAL REGISTRATION: PROSPERO number: CRD42023473247 WHAT THIS PAPER ADDS: What is already known on this subject The use of augmentative and alternative communication (AAC) with autistic adults and children is an established practice. Previous research has shown some effectiveness related to the specific goals being studied but it has centred mostly on children, and most research has focused on making requests, rather than broad communication or life outcomes. What this paper adds to existing knowledge This study explores the literature about autism and AAC and seeks to specifically examine the range of outcomes reported. We found that most of the research on this topic continues to focus on children, aided rather than unaided communication, and on outcomes related directly to the intervention, such as making requests. Very few studies included measures of generalisation or considered broader outcomes of AAC supports, such as quality of life, or enhanced social interactions. What are the potential or actual clinical implications of this work? Clinicians and researchers should consider the potential for broader impacts of AAC and ensure that goals focus on skills beyond immediate functions to areas such as quality of life, well-being, learning and employment, and the development of social relationships. Clinicians and researchers should also ensure that AAC interventions are offered to not only children, but also to autistic adults who may benefit from communication supports.

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9. Naguy A, Pridmore S, Abul HH, Alamiri B. Compulsive Polydipsia-Related Symptomatic Hyponatremia in a Low-Functioning Autistic Boy. Prim Care Companion CNS Disord. 2026; 28(2).

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10. Niranjana Murthy AS, Choudhary P, Sachdeva P, Shankarappa B, Paul P, Sud R, Manohar H, Udupi GA, Purushottam M, Jain S, Zafar I, Viswanath B. Generation of iPSC line NIMHi033-A from an Indian patient with Autism Spectrum Disorder carrying mutation in DYNC1H1 gene. Stem Cell Res. 2026; 94: 103999.

We report the generation of a human induced pluripotent stem cell (hiPSC) line from peripheral blood mononuclear cells of a 14-year-old male with Autism Spectrum Disorder carrying a de novo heterozygous likely-pathogenic variation c.4067C>T (p.Pro1356Leu) in Dynein Cytoplasmic 1 Heavy Chain 1 (DYNC1H1) gene. Variation in this gene that encodes a motor protein may affect retrograde transport of neurotrophic signals, synaptic vesicles, organelles like golgi complex and mitochondria. Therefore, this iPSC line will be an invaluable tool to study the effects of this high-risk autism-related variant on disease manifestation and cellular functions.

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11. Saniee S, Pouretemad HR, Mokhtari S. The relationship between cognitive flexibility and restricted, repetitive behaviors in children with autism: parents’ reports vs. cognitive task performance. Sci Rep. 2026.

Cognitive flexibility (CF), a core component of executive functioning, is often impaired in children with autism and closely linked to restricted and repetitive behaviors and interests (RRBIs). This study examined CF in 43 young children with autism (ages 3-7) using both performance-based measures (DCCS) and parent-reported CF (BFRS-R). We investigated the associations between CF and higher-order versus lower-order RRBIs, assessed convergence between performance-based and parent-report CF measures, and evaluated the contribution of other executive function (EF) domains and autism-related symptoms. Results revealed that higher-order RRBIs (e.g., ritualistic routines, insistence on sameness) were consistently associated with CF deficits, whereas lower-order RRBIs (sensorimotor behaviors) showed nonsignificant associations. Additionally, strong convergence between performance-based and parent-reported assessment of CF, with accuracy-based switch cost emerging as the most sensitive and robust indicator of CF in early childhood. Regression analyses confirmed that higher-order RRBIs, working memory, and communication difficulties significantly accounted for variance in cognitive flexibility. Taken together, these findings provide a comprehensive understanding of the relationships among cognitive flexibility, RRBIs as well as executive functions, and communication in early childhood autism. The integration of performance-based and parent-report assessments highlights the complementary value of multi-method approaches and offers a foundation for refining future assessment strategies and developmental research.

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12. Tan H, Ren T, Cao A, Fang S, Deng L, Hu B, Wang M, Cheng Y, Zhang X, Li Y, Zhang Y, Zhang L, Chen L, Zhou W, Zhang Q, Li J, Zhou X, Langley C, Luo Q, Zhang J, Sahakian BJ, Yuan TF, Li F. Accelerated continuous theta burst stimulation targeting left primary motor cortex for children with autism spectrum disorder: multicentre randomised sham controlled trial. Bmj. 2026; 393: e086295.

OBJECTIVES: To investigate the efficacy and safety of a five day accelerated continuous theta burst stimulation (a-cTBS) protocol in improving social communication impairment in children with autism spectrum disorder. DESIGN: Multicentre randomised sham controlled trial. SETTING: Three academic hospitals across three provinces in China, conducted from July 2023 to October 2024. PARTICIPANTS: 200 children aged 4-10 years with autism spectrum disorder (167 boys and 33 girls) all with a full scale intelligence quotient ≥50. INTERVENTIONS: Participants were randomised 1:1 to receive active a-cTBS (n=100) or sham (n=100) treatment stratified by full scale intelligence quotient (≥70 or <70) and study site. Participants received 10 sessions each day for five consecutive days, targeting the left primary motor cortex. Participants and evaluators were masked to interventions. MAIN OUTCOME MEASURES: Two primary outcomes were assessed using the Social Responsiveness Scale, second edition (SRS-2): changes in social communication impairment from baseline to post-intervention and from baseline to one month follow-up. Primary analyses were conducted on a modified intention-to-treat population, including participants who received at least one stimulation session. Secondary outcomes included language improvements assessed from baseline to one month follow-up and changes in SRS-2 subscales. RESULTS: Of the 200 participants, 198 were included in the modified intention-to-treat analysis (99 in each group) and 193 completed the full intervention. Compared with the sham group, the a-cTBS group showed significantly greater reductions in SRS-2 scores post-intervention (-6.25, 95% confidence interval -8.69 to -3.81; Cohen's d -0.92; P<0.001) and at one month follow-up (-6.17, -8.65 to -3.70; -0.90; P<0.001). Secondary outcomes also favoured a-cTBS, with significant improvements observed in language abilities (Cohen's d 0.12-0.47; all P<0.02; measured by Multilingual Assessment Instrument for Narratives). Reported adverse events were all mild to moderate and resolved without intervention. CONCLUSIONS: A five day a-cTBS protocol targeting the left primary motor cortex significantly improved social communication in children with autism spectrum disorder and showed a favourable safety profile. These findings support a-cTBS as a viable and scalable therapeutic option for children with autism spectrum disorder. TRIAL REGISTRATION: ClinicalTrials.gov NCT05927792.

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13. Wang L, Hua M, Xie Q, Yang G, Yu Y, Chen Y. Unpacking the daily dynamics of parenting strain: A 15-day diary study of caregiving role overload, depressive symptoms, and parental burnout among parents of autistic children. Res Dev Disabil. 2026; 173: 105300.

OBJECTIVES: To explore the day-to-day dynamics between daily caregiving role overload and daily depressive symptoms among parents of autistic children, and to examine gender differences in these variables’ average levels and day-to-day dynamics, as well as whether such differences help explain parental burnout. METHODS: We recruited parents of autistic children from autism intervention centers using convenience sampling (N = 210; 81.9% mothers) in mainland China. Parents completed a brief online diary survey each evening across 15 weekdays over three consecutive weeks to assess daily depressive symptoms and daily caregiving role overload. After the diary period, parents completed a post-diary questionnaire assessing parental burnout. Data were analyzed using dynamic structural equation modeling (DSEM). RESULTS: (1) At the within-person level, daily caregiving role overload and daily depressive symptoms showed reciprocal cross-day associations, forming a day-to-day feedback loop. (2) At the between-person level, mothers reported higher person-mean depressive symptoms than fathers, which in turn predicted higher parental burnout. (3) At the between-person level, mothers exhibited stronger day-to-day carryover of depressive symptoms than fathers, which in turn predicted higher parental burnout. CONCLUSIONS: The findings clarify processes through which parenting-related stressors contribute to day-to-day resource depletion and suggest gender-specific pathways and dynamic patterns in the development of parental burnout among mothers and fathers. These results have important implications for promoting parents’ mental health in families with high caregiving demands by informing early, sustained, and parent-tailored daily support to prevent resource depletion and reduce parental burnout.

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14. Wang L, Xu G, Li D, Gao X, Zhao J, He Y, Liu S, Guo H, Bu X. Effectiveness of Different Virtual Reality Technologies for Social and Communication Skills in Children With Autism Spectrum Disorder: Systematic Review and Network Meta-Analysis of Current Evidence and Future Directions. JMIR Pediatr Parent. 2026; 9: e82814.

BACKGROUND: Virtual reality (VR) technology offers a new approach for the intervention of social communication skills in children with autism spectrum disorder (ASD), but the comparative effects of different forms of VR technology remain unclear. OBJECTIVE: This study aims to conduct a systematic review and network meta-analysis (NMA) based on existing randomized controlled trials (RCTs) to initially explore and compare the effects of different VR technologies on improving the social and communication skills of children with ASD. METHODS: We systematically searched relevant RCTs in both Chinese and English databases from January 1990 to February 2025. The quality of the literature was evaluated using the revised Cochrane risk of bias assessment tool (RoB-2), and an NMA was conducted under the frequentist framework using STATA 18.0 software. The quality of evidence was assessed using the Confidence in Network Meta-Analysis framework. A total of 11 RCTs (718 children) were included, evaluating 8 VR technologies. The evidence network was extremely sparse, with most interventions connected by single studies. Pairwise meta-analysis revealed overwhelming heterogeneity (I²=91.9%, P<.001), indicating profound clinical and methodological diversity. Due to this heterogeneity and the sparse network, the NMA model failed to produce stable or clinically interpretable effect estimates. Formal assessment using the Confidence in Network Meta-Analysis framework rated the confidence in all comparisons as very low. CONCLUSIONS: The existing evidence is insufficient to support any comparative efficacy conclusions or rankings among VR technologies for ASD social skills. The key finding is the demonstration that current evidence is too heterogeneous and immature for valid quantitative synthesis. Future research must prioritize methodological standardization before head-to-head trials can be meaningfully conducted.

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15. Yao M, Wang S, Zhang F, Shi L, Xu Z. Autism-linked protein POSH balances NMDAR signaling via a self-limiting kinase-scaffold loop. iScience. 2026; 29(5): 115627.

POSH (plenty of SH3 domains), an autism-linked scaffold protein, is essential for N-methyl-D-aspartate receptor (NMDAR) complex assembly, and its loss causes ASD-like social deficits in mice. However, the synaptic mechanism remains unclear. Here, we reveal that POSH loss reduces SRC postsynaptic enrichment and weakens the interactions within the SRC-NMDAR-PSD-95 complex. Mechanistically, NMDAR activation triggers RAC1-GTP-dependent recruitment of POSH to membrane, leading NMDAR-induced activation of SRC, a key positive regulator of NMDARs. Notably, prolonged NMDAR activation induces the depletion of both POSH and SRC, establishing a negative feedback loop. This dual spatiotemporal mechanism-transient kinase activation coupled with scaffold degradation-constitutes a self-limiting circuit that prevents NMDAR hyperexcitation. Our findings establish POSH as a molecular rheostat that integrates RAC1-driven membrane targeting with SRC activation to precisely regulate NMDAR signaling. These insights would advance our understanding of synaptic homeostasis and may inform potential therapeutic strategies for ASD and glutamatergic disorders.

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16. Young R, Sadeghi S. Recommending Autism Detection in Early Childhood (ADEC) for use in low- and middle-income countries. Asian J Psychiatr. 2026; 120: 104976.

Early detection of autism spectrum disorder (ASD) is vital for early intervention; however, access to feasible and reliable screening tools remains a challenge in many low- and middle-income countries. The purpose of this letter is to highlight Autism Detection in Early Childhood (ADEC), a play-based observational and clinician-administered instrument for children aged 12-36 months with strong cross-cultural evidence of validity, specificity, and sensitivity. We are pleased to announce that, for the first time since its development in 2007, ADEC is now freely available to clinicians and researchers worldwide. LAY ABSTRACT: Early autism identification is crucial to help children and families access services and interventions early, which are more likely to be effective (Wankhede et al., 2024; Sadeghi et al., 2019; Sadeghi and Pouretemad, 2022). Many low- and middle-income countries, however, lack access to commonly used autism screening and diagnostic tools because these tools are costly, time-consuming, or require extensive training. Consequently, diagnosis and treatment may be delayed. The Autism Detection in Early Childhood (ADEC) is a short, play-based observational assessment for children between the ages of 12 and 36 months. It consists of 16 items that address social, communication, and behavioral aspects of autism. It has been demonstrated that the ADEC can accurately identify autistic children in multiple countries, including the United States, Mexico, Ecuador, Indonesia, and Japan. The brief and virtual versions of the tool is also available, making it suitable for use in clinics, telehealth services, and remote or underserved settings. It’s our pleasure to announce that the ADEC is now available free and openly for clinicians and researchers worldwide for the first time since its development in 2007. The ADEC offers a practical, reliable, and cost-effective option for early autism detection by removing financial and access barriers. This tool can be used and further validated by clinicians and researchers worldwide, especially in developing countries, to improve early identification of autism.

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