1. Adıgüzel S, Munir KM. Autism Diagnostic Observation Schedule (ADOS) in Unequal and Low-Resource Systems of Care. Psychiatry Clin Psychopharmacol;2026 (Aug);36(4):322-328.

The Autism Diagnostic Observation Schedule (ADOS) and its second edition (ADOS-2) have acquired a de facto « gold standard » status for reliably diagnosing autism in the United States, even though the developers themselves emphasize that the instrument should be used as part of a holistic, clinically driven developmental assessment. This narrative review is informed by diagnostic accuracy studies and the global mental health relevance of ADOS/ADOS-2 to low- and middle-income countries (LMICs) using Türkiye and the United States as point of contrast. We consider the benefits of ADOS/ADOS-2 -its contribution to standardized observation, cross-site comparability, and detailed phenotyping in research and complex clinical cases-as well as its limitations, including extensive training requirements, time-intensive administration, high kit costs, proprietary licensing, and tightly regulated translation policies. These factors substantially limit the practicality of routine ADOS/ADOS-2 use in LMICs and other resource-constrained settings, where most autistic children live. In the United States, ADOS/ADOS-2 based assessments have become deeply integrated into specialty services and, in some regions, even informally mandated by insurers or school systems, with consequences for wait times, access, and equity. In Türkiye, autism is primarily diagnosed through clinical assessment by child and adolescent psychiatrists without formal requirements for ADOS/ADOS-2, which expands clinical autonomy but results in less standardization and weaker cross-site consistency. We argue that treating the ADOS/ADOS-2 as a universal diagnostic « gold standard » is unachievable given the global public health resource constraints in LMICs. Autism diagnosis, service eligibility, and research, especially in such a poor resource setting will require scalable, open-access, and cost-effective tools for both routine care and population-level studies.

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2. Al-Beltagi M, Saeed NK, Elbeltagi YM. Psychobiotics in pediatric autism spectrum disorder: A systematic review of efficacy, mechanisms, and clinical translation. World J Clin Pediatr;2026 (Dec 9);15(4):121115.

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition frequently associated with gastrointestinal (GI) disturbances and alterations in gut microbiota composition. Increasing evidence suggests that the microbiota-gut-brain axis may play a role in the pathophysiology of ASD, raising interest in microbiome-targeted therapies, including probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT). However, the clinical effectiveness and mechanisms of these interventions remain incompletely understood due to heterogeneous study designs and variable outcomes across trials. AIM: To systematically evaluate the clinical efficacy and mechanistic implications of psychobiotic interventions, including probiotics, prebiotics, synbiotics, and FMT, in children with ASD. METHODS: We conducted this systematic review in accordance with PRISMA 2020 guidelines. We also followed the methodological recommendations of the Cochrane Handbook. We searched different electronic databases, including PubMed/MEDLINE, EMBASE, Web of Science, PsycINFO, CENTRAL, and CINAHL, from inception till February 2026. We included eligible randomized controlled trials, controlled clinical trials, cohort studies, and pre-post intervention studies evaluating psychobiotic therapies in children and adolescents (≤ 18 years) with ASD. The main outcomes were: (1) Changes in severity as assessed by a broad-spectrum measure of ASD symptomatology at the 3-month follow-up; and (2) Variation of core symptoms, based on validated behavioral scales, including the Autism Diagnostic Observation Schedule, the Childhood Autism Rating Scale (CARS), and the Social Responsiveness Scale (SRS). We measured the severity of GI symptoms, microbiome composition, biologicals, and safety as secondary outcomes. Risk of bias was determined with Risk of Bias tool version 2 and Risk of Bias in Non-randomized Studies of Interventions tools. Meta-analysis using random-effects models was conducted where appropriate. RESULTS: We reviewed 35 clinical studies that examined microbiome-targeted therapies in children with ASD. Overall, probiotics were associated with obvious improvements in GI symptoms and smaller, but noticeable, improvements in behavioral outcomes, although the benefits varied depending on the probiotic strains used, treatment duration, and whether children had GI problems at baseline. When data from selected probiotic studies were pooled, a moderate-to-large overall benefit was observed for GI symptom severity. Prebiotic supplementation mainly benefited gut function and microbial metabolic activity, with little and inconsistent impact on core autism symptoms. Synbiotic approaches-which combine probiotics with fermentable substrates-produced broader effects on the gut microbiome and were linked to modest improvements in both GI and behavioral symptoms. We observed that FMT showed the strongest overall effects among all microbiome-based interventions. Using quantitative analyses, we observed marked improvements in GI symptoms (GI SRS pooled SMD -2.71), along with a significant decrease in key behavioral measures, including social responsiveness (SRS pooled SMD -4.06), aberrant behavior (Aberrant Behavior Checklist -3.00), and overall autism severity (CARS -1.60). However, the strength of this evidence is tempered by the fact that many FMT studies were open-label or non-randomized, which limits confidence in the robustness of these findings. Across all microbiome-targeted therapies, benefits were most consistently observed for GI outcomes, whereas improvements in core ASD symptoms were more variable and less predictable. CONCLUSION: Microbiome-targeted therapies are a promising adjunctive strategy in managing children with ASD, especially for associated GI disorders. Probiotics and prebiotics provided the most reliable benefits for GI symptoms, while synbiotics may offer broader microbiome modulation, and FMT has the greatest observed improvements in both GI and behavioral outcomes. However, considerable heterogeneity across studies and limited high-quality randomized trials highlight the need for large, well-designed clinical trials with standardized intervention protocols to clarify clinical efficacy and guide future therapeutic recommendations.

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3. Ali WH, Omar A, Ali AH, Hefny HM, Nabil G, Mahmoud Y, Nasr AEA, Abdelhamid SM, Amin HM, Omar MM, El-Attar LM, Mohamed FS, Elgamal R, Ibrahem M, Abdelmotogaly HSM. Targeted Quantitative Polymerase Chain Reaction Analysis of Gut Microbiota and Its Association With Feeding and Mealtime Behavior and Intestinal Permeability in Children With Autism Spectrum Disorder. J Clin Med Res;2026 (Oct);18(10):759-769.

BACKGROUND: Gastrointestinal (GI) symptoms and feeding and mealtime problems are common in children with autism spectrum disorder (ASD). It is important to note that the gut microbiome is a hypothesized mechanism of action, but it is not yet known if specific bacterial profiles and markers of intestinal barrier function predict feeding problems in the target group of ASD. METHODS: This is a cross-sectional case-control study that examined 70 children with ASD (aged 3-12 years) and 70 matched neurotypical children. Autism was evaluated using the Childhood Autism Rating Scale (CARS), and mealtime behaviors were evaluated using the Brief Autism Mealtime Behavior Inventory (BAMBI). Six important bacterial taxa were quantified using real-time polymerase chain reaction (PCR), and fecal zonulin and calprotectin were quantified by enzyme-linked immunosorbent assay (ELISA). RESULTS: Children with ASD had significantly higher levels of fecal zonulin and calprotectin than controls (both at P < 0.001) and lower abundances of beneficial taxa (Prevotella, Bifidobacterium, Lactobacillus) and higher abundances of Clostridium difficile and Bacteroidetes (all P < 0.01). The overall BAMBI scores did not differ among the groups, but within the ASD group, feeding problem severity was highly correlated with lower Bifidobacterium (r = -0.68) and higher Clostridium difficile (r = 0.74) and was not significantly correlated with autism severity, zonulin, or calprotectin. CONCLUSION: Children with ASD have increased levels of gut dysbiosis and barrier dysfunction compared to their non-autistic peers, but the severity of their feeding and mealtime problems tracked the degree of gut microbial imbalance rather than the severity of their ASD symptoms in general. This suggests that feeding behavior is a characteristic that has been under-recognized as a component of the ASD phenotype and is related to the microbiome; if confirmed in longitudinal studies, these microbial associations could represent a candidate target for future gut-directed intervention research.

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4. Anu V, Devi S, Preethy M. Non-Metric Dental Traits, Dental Caries Experience, Parental Perceptions, and Oral Hygiene Status of Children With Autism Spectrum Disorder-A Step Towards Sustainable Smiles. Spec Care Dentist;2026 (Nov-Dec);46(6)

BACKGROUND: Autism Spectrum Disorder (ASD) is accompanied by poor oral health outcomes for children with ASD. AIM: To assess the occurrence of non-metric dental traits (NMDTs), dental caries experience, parents’ perception, and oral hygiene status of children with ASD. METHODOLOGY: A cross-sectional study was conducted among 150 children with ASD and their biological parents. Children with severe sensory or behavioural difficulties who were unable to cooperate for oral examination were excluded. A pre-validated questionnaire was used to assess parental perception. Oral hygiene index-Simplified (OHI-S), Decayed, Missing and Filled Teeth index (DMFT) for permanent and primary dentition was used to assess oral hygiene status and dental caries in children with ASD. Non-metric dental trait (NMDT) was assessed using ASUDAS (Arizona State University Dental Anthropology System). Chi-square test and multiple linear regression analysis were done. RESULTS: Most parents, 126 (84.0%) had a neutral perception score. The mean OHI(S) score for the children with ASD was 1.86 (SD 0.95). The prevalence of dental caries was 16% in deciduous dentition and 48% in permanent dentition. A statistically significant association was observed between palatogingival groove, cusp of Carabelli, and poorer oral hygiene status. Regression analysis showed that children with ASD whose mothers were employed showed a negative association with oral hygiene status (B = -0.533, p = 0.015). Higher maternal education was associated with lower DMFT scores (DMFT, B = – 1.044, p = 0.040 and for D, B = -1.319, p = 0.003). CONCLUSION: Parents’ perceptions regarding oral health among children with ASD are neutral with both behavioral limitations and oral hygiene practices affecting oral health. This study recommends early NMDTs identification and a multidisciplinary approach involving dental professionals, along with targeted parental education and regular follow-up, that may improve oral health outcomes.

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5. Blacher J, Eisenhower A, Bolourian Y, Hamsho N, Ledoux Galligan M. Improving Student-Teacher Relationships for Autistic Children: Pilot Randomized Controlled Trial of a Professional Development Program. J Autism Dev Disord;2026 (Oct 31)

PURPOSE: While most autistic students are placed in general education classrooms, the majority of general education teachers report a lack of autism training. We examined the feasibility and efficacy of Smooth Sailing, a relationship-focused, neurodiversity-affirming, professional development (PD) program, in a small, randomized controlled trial. METHODS: Participants were 32 general education teachers (kindergarten – 2nd grade) and their autistic students (one per teacher), randomly assigned to intervention or control groups. Teachers and caregivers completed measures at Time 1, Time 2, Time 3, and at the two-month follow-up. The intervention included structured, asynchronous modules, coaching (via Zoom), and in-vivo learning activities. Social validity was also examined throughout. RESULTS: Regarding efficacy, the program had medium to large effects on teacher-reported student-teacher relationship quality (d=0.79), teachers’ autism knowledge and self-efficacy (ds=1.49, 1.50), and caregiver-teacher relationship quality (d=0.54). Effects on child emotional-behavioral, social, and academic adjustment were medium to large (ds=0.63, 0.42, and 0.91). Outcomes were generally sustained at 2-month follow-up. Regarding feasibility, observed and teacher-reported data indicate excellent acceptability, implementation fidelity, and sustainability. CONCLUSIONS: Findings demonstrate the capacity for this program to enhance relationships and autism knowledge for general education teachers and to improve school adjustment for autistic students.

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6. Chiaramonte R, Cioni M, Vecchio M, Leonforte F, Mistretta A, Laganga Senzio G, Civello T. Assistive devices for mobility and communication in autism spectrum disorder: A retrospective cross-sectional cohort study on disability management. World J Clin Pediatr;2026 (Dec 9);15(4):120813.

BACKGROUND: Assistive devices are crucial for supporting communication and mobility for individuals with autism spectrum disorder (ASD). AIM: To investigate the provision of assistive devices for children and adolescents with ASD in a metropolitan area of Southern Italy, with specific focus on communication and mobility aids. METHODS: The study analysed specialist prescriptions to evaluate age distribution and device allocation in different healthcare districts, the specialty of the prescribing physicians, and integration with rehabilitation services. RESULTS: A total of 120 prescriptions were analysed, and the peak prescription rates occurred at the ages 7 years and 10 years. Child neurologists predominantly prescribed communication aids (P = 0.009), while physical medicine and rehabilitation specialists managed most mobility-related devices (P = 0.29). Device allocation was guided by functional needs rather than age (P = 0.73 for communication aids, P = 0.45 for wheelchairs, and P = 0.37 for gait aids, such as orthosis or insoles. Rehabilitation services, including home care and residential programs, were frequently integrated with device provision. CONCLUSION: This study provides one of the few evaluations of assistive device prescription patterns for children and adolescents with ASD, which are important for both holistic care and healthcare resource management. Further studies are warranted to establish standardized prescribing protocols and whether expanding prescriber training or implementing interdisciplinary pathways could improve equitable access without compromising quality.

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7. de Bildt A, Jonker J, Damen N, Alma MA. Improving Descriptive Diagnostics of Autism in People With Moderate or Severe Intellectual Disabilities: A Qualitative Participatory Study. J Autism Dev Disord;2026 (Oct 31)

PURPOSE: This study aimed to improve descriptive autism assessment for people with moderate to severe intellectual disabilities (ID) in the Netherlands. The goal was to co-design a framework including an overview of assessment instruments, and recommendations for evaluating broader functioning, for translating findings into daily care and for involving representatives and staff. METHODS: We used a participatory design, involving parents/representatives, clinicians, care staff, and management from ID and mental health services. The process included a literature study of autism-related instruments, a Delphi study to reach consensus on suitable instruments, and four focus group discussions (FGDs) exploring stakeholder involvement and the role of assessment instruments in the diagnostic process. RESULTS: The literature study identified 20 relevant instruments, of which 13 were selected through the Delphi study (n=37, three rounds). Key selection criteria included low burden for individuals, use of multiple information sources, and strong psychometric quality. While quick assessments were preferred, concerns arose about oversimplifying the autism assessment. FGDs (n=5-12) highlighted eight themes on stakeholder involvement, focusing on timing, roles, and goals. Although no consensus emerged on an optimal combination of tools, clarity about an instrument’s purpose and implications proved important. The final FGD identified five potentially overlapping phases in the diagnostic process. CONCLUSION: The co-designed framework provides an overview of instruments for the assessment of autism and emphasises early and continuous involvement of parents and caregivers. Their participation is essential for defining concerns, guiding assessment goals, sharing information, and applying diagnostic outcomes to improve daily care and support.

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8. Gengeç H, Toker M. A Cross-Sectional Study of Vocabulary and Listening Comprehension in Turkish-Speaking Preschoolers Aged 62-84 Months With and Without Autism Spectrum Disorder. J Autism Dev Disord;2026 (Oct 31)

PURPOSE: To compare receptive vocabulary, expressive vocabulary, and listening comprehension in Turkish-speaking preschoolers with and without autism spectrum disorder (ASD), and examine vocabulary contributions to comprehension in the ASD group. METHODS: This cross-sectional study included 44 preschoolers with ASD (62-84 months) and 44 typically developing preschoolers (62-74 months) from 12 state schools in three Turkish cities. Children with ASD attended inclusive classrooms. Eligibility required an estimated nonverbal mental age of 60-72 months on Raven’s Coloured Progressive Matrices and mean length of utterance in words ≥ 2.00, calculated from 15-minute play-based language samples using Turkish Systematic Analysis of Language Transcripts. The standardized Early Literacy Test assessed these three skills individually, face-to-face, using a printed tabletop battery without a computer. Parents and teachers completed paper-and-pencil demographic and socioeconomic status (SES) forms. Analyses comprised multivariate analysis of variance, multivariate analysis of covariance, Pearson correlations, and hierarchical regression within the ASD group. RESULTS: The ASD group scored lower on all three skills, with the largest difference in listening comprehension. Differences remained significant after adjustment for age, gender, and SES. Within the ASD group, adding vocabulary to a model containing SES, age, and nonverbal mental age increased explained variance in listening comprehension by 26.3% points, to 37.4%. CONCLUSION: Findings support assessing vocabulary and listening comprehension together. Vocabulary instruction combined with supported story-listening warrants investigation; the present cross-sectional results do not establish intervention effectiveness.

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9. Horowitz-Kraus T, Mostofsky SH, Deronda A, Crocetti D, Schlaggar BL, Farah R, Rosch KS. The Differential Role of Executive Functions in Reading Fluency in Children With Reading Difficulties, Children With Autism and Typically Developing Children. J Autism Dev Disord;2026 (Oct 31)

PURPOSE: Reading fluency depends in part on executive functions (EF). Dysfluent reading and reduced EF occur in both autism spectrum disorder (ASD) and reading disability (RD), but whether the EF-reading fluency associations established in RD also characterize ASD is unclear. We tested whether diagnostic group moderates these associations. METHODS: Two hundred twenty-three English-speaking children aged 8-12 years with ASD (n = 35), RD (n = 99), and typical development (TD; n = 89) completed measures of single-word, pseudoword, and contextual reading fluency, working memory (Digit Span), and processing speed (Coding, Symbol Search). Welch’s ANOVAs compared groups; linear models with Group×EF interactions and simple slopes tested moderation, with age covaried in sensitivity models. RESULTS: Both clinical groups showed lower reading fluency and EF than TD. Coding predicted word and pseudoword fluency most strongly in ASD (β = 0.40 and 0.43) and less strongly in TD, but not in RD. Digit span predicted word fluency in ASD, and pseudoword fluency in ASD and RD. For contextual fluency, a significant Group × Symbol Search interaction (p = .003) indicated that symbol search predicted performance in ASD (β = 0.52) and TD (β = 0.29) but not RD. Results were unchanged with age covaried. CONCLUSION: EF-reading fluency associations were strongest and most widespread in ASD, whereas in RD executive measures predicted decoding-level but not contextual fluency. Comparable dysfluency thus rests on distinct executive profiles, supporting the inclusion of EF measures in reading assessment for children with autism and cautioning against transferring RD-derived interventions without adaptation.

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10. Karuna YM, Shenoy R, Dutt A, Tong HJ, Bhat S, Nayak A, Rao A. Influence of oral sensory processing challenges on the maintenance of oral health in individuals with autism spectrum disorder (ASD): a scoping review. Eur Arch Paediatr Dent;2026 (Oct 31)

PURPOSE: The present review was conducted (1) to explore how oral sensory processing challenges (OSPCs) affect oral health maintenance in individuals with ASD and (2) to identify and summarize sensory-informed strategies reported in the literature to address OSPC during routine oral healthcare. METHODS: A scoping review was conducted using the Arksey and O’Malley framework and reported following the PRISMA-ScR guidelines. Six electronic databases were searched for studies published between January 2010 and January 2025 in English. Quantitative, qualitative, mixed-methods, and interventional studies linking SOR and oral health in individuals with ASD were included. Data were charted using the PCC framework and synthesized thematically. Methodological quality assessment was performed using the Crowe Critical Appraisal Tool. RESULTS: The search yielded 6476 articles. Following the application of predefined eligibility criteria and the removal of duplicates, 21 studies were included, comprising 11 quantitative, 7 qualitative, and 3 mixed-method studies. Thematic synthesis revealed three major themes: (1) OSPC was associated with challenges in home oral hygiene behaviours, including difficulties related to toothbrush use, toothpaste, environmental triggers, and delayed initiation of routines; (2) OSPC influenced the dental visits through enhanced dental anxiety, barriers to access care, and reduced tolerance to dental procedures; and (3) the included studies reported oral care and dental behavioural strategies to accommodate OSPC during oral care. CONCLUSION: Oral sensory processing challenges were found to influence oral health care maintenance among individuals with ASD. The review also identified sensory-informed strategies that may support oral health care, although further studies are needed to establish robust evidence on their effectiveness.

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11. Mohammed FI, Abualhoul M, Abohadida RM. Microlearning versus traditional instruction for improving nursing students’ knowledge and beliefs about autism spectrum disorder: a quasi-experimental study. BMC Nurs;2026 (Oct 31);25(1)

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent difficulties in social communication and interaction, along with restricted or repetitive behaviors and interests. Microlearning presents educational content in short, focused units and may facilitate knowledge acquisition and retention. Adequate knowledge and positive beliefs about ASD are important for nurses to provide individualized and evidence-based care. METHODS: A quasi-experimental, non-equivalent control group pretest-posttest design was conducted to evaluate the effectiveness of microlearning compared with traditional instruction in improving nursing students’ knowledge and beliefs regarding ASD. The study included 140 undergraduate nursing students at Irbid National University, Jordan. A convenience sampling technique was used. Students were assigned according to their existing class sections, academic and clinical schedules to either the microlearning group (n = 70) or the traditional instruction group (n = 70). Data were collected using three online tools: Tool I, a structured questionnaire for students’ characteristics and previous ASD-related educational exposure; Tool II, an ASD knowledge questionnaire; and Tool III, an ASD beliefs questionnaire. A post-test was administered one month after completion of the intervention. RESULTS: Mixed-design repeated-measures ANOVA showed significant improvements in knowledge and beliefs over time in both groups (p < 0.001). Significant time × group interactions were observed for knowledge (F(1,138) = 24.23, p < 0.001, partial η² = 0.149) and beliefs (F(1,138) = 14.73, p < 0.001, partial η² = 0.096), indicating greater improvements in the microlearning group than in the traditional instruction group. CONCLUSION: Microlearning was associated with greater improvements in nursing students' knowledge and beliefs regarding ASD compared with traditional instruction. These findings suggested that microlearning may be a useful educational approach for enhancing nursing students' preparation to provide evidence-based care for children with ASD. CLINICAL TRIAL NUMBER: Not applicable.

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12. Pulles T, Jenner B, den Berg MV, Rocha P, Martini A, Chamberlain K, Grandjean H. Consistent unmet needs and fragmented care in Rett syndrome: insights from a multi-country European caregiver study. Orphanet J Rare Dis;2026 (Oct 17);21(1)

BACKGROUND: Rett syndrome is a rare neurodevelopmental disorder associated with functional impairments that emerge in early childhood and persist throughout life. Despite improved understanding of its genetic basis and natural history, therapeutic options remain limited, and care frameworks across Europe are highly variable. This study aimed to characterize the lived experiences, unmet needs, and evolving challenges faced by individuals with Rett syndrome and their caregivers across multiple European countries. RESULTS: Sixty caregivers across eight countries completed five-day diaries, and thirty participated in in-depth interviews. The sample represented children (36%), adolescents (42%), and adults (22%) with Rett syndrome; 97% were female. Difficulty using hands (reported by 88% of caregivers) and difficulty communicating (78%) were the most frequently observed symptoms. Daily activities were heavily affected, with symptoms impacting 59% of activities for children, 61% for adolescents, and 38% for adults. Some comorbidities increased with age, including scoliosis (45% in children vs. 92% in adults) and pneumonia (54% in adults). Care demands were substantial, with caregivers of adults spending an average of 41 hours per week providing emotional support alone, along with high time requirements for feeding (20 hours), washing and bathing (8 hours), and administering medication (5 hours). CONCLUSIONS: Caregiver experiences across Europe reveal a consistent pattern of unmet needs, high symptom burden, and fragmented, poorly coordinated care for individuals with Rett syndrome. The changing needs across the lifespan underscore the importance of anticipatory, multidisciplinary care models and improved transition pathways into adulthood. As participants were recruited through patient advocacy groups, the study population may represent a comparatively informed and healthcare-engaged subgroup of caregivers, highlighting that unmet needs and care challenges across the broader RTT caregiver community may be even greater among families with less access to advocacy networks and specialized support resources. These findings highlight the need for system-level changes and the development of comprehensive, standardized care frameworks for Rett syndrome across Europe.

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13. Roschyk A, Campbell DB. Exploring long noncoding RNAs as a molecular connection between immune response and autism spectrum disorder. Front Toxicol;2026;8:1893084.

Autism spectrum disorder (ASD) is a neurodevelopmental condition increasingly linked to immune dysregulation, with long noncoding RNAs (lncRNAs) emerging as potential regulators of both neural and immune processes. This study commenced by analyzing ten unique lncRNAs and integrated ASD whole-blood datasets using the online platform GTex to identify expression of lncRNAs in various tissues. Moreover, the platform Network Analyst was utilized to assess differentially expressed lncRNAs and associated transcriptomic networks. A total of 93 upregulated and 51 downregulated lncRNAs were identified in people with ASD with tissue specific enrichment observed for MSNP1AS and LNC01238 in immune related systems. The transcription factor CEBPA was shown to interact with the upregulated lncRNA MALAT1, which influenced immune cell differentiation, inflammation and cytokine signaling. Intriguingly CEBPA simultaneously interacted with downregulated lnc RNA MIR22HG. Comparatively, downregulated lncRNAs were associated with the transcription factors TEAD2, CEBPA, CTCF, E2F4, TFAP2C, HIF1A, ETS1, HNF4A, SNAPC4, STAT1, STAT2, TEAD2, FOXC1, BRCA1, AR, E2F4, EOMES, SPI1, DACH1, E2F1, TP63, HMAP1, KLF9, HDGF, and MAZ. Overall, the findings support a role for lncRNAs in ASD pathophysiology and immune dysregulation, pointing to their potential as biomarkers and potential therapeutic targets for future research.

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14. Usta MB, Şenel ME, Aker Ş, Efe MM, Taflan FB, Bayrakdar U, Gülboy E, Kılınçel Ş, Kılınçel O. Patterns of Complementary and Alternative Medicine Use Among Children and Young Adults with Autism Spectrum Disorder. Psychiatry Clin Psychopharmacol;2026 (Aug);36(4):382-393.

Background: This study investigates the utilization of complementary and alternative medicine (CAM) practices, perceived benefits, and etiological beliefs among children and young adults with Autism Spectrum Disorder (ASD) and their families. Methods: This exploratory cross-sectional study included 136 participants (mean age 8.9 years; 72.8% male). Data were collected using questionnaires completed by parents regarding CAM utilization patterns, etiological beliefs, and primary information sources. To identify the predictors associated with the lack of parents’ perceived benefit from CAM methods, a logistic regression model was utilized among CAM users (n = 124), adjusting for selected clinical, sociodemographic, and informational variables. Results: A high prevalence of CAM use was identified, with 91.2% of participants reporting the use of at least one method. The most common practices were prayer (62.5%), vitamin/mineral supplementation (51.5%), and dietary supplements (44.1%). CAM preferences appeared to vary across developmental stages. Furthermore, logistic regression analysis revealed that child age was the only significant predictor for parents reporting no perceived benefit from CAM; each one-year increase significantly decreased the odds of perceiving no benefit (OR = 0.838; 95% CI, 0.762-0.921; P = .001). Sociodemographic variables and primary information sources did not significantly predict this outcome. Conclusions: CAM utilization is widespread and highly dynamic among families of children with ASD. The perceived lack of benefit is significantly associated with younger child age, likely reflecting unmet high expectations during the early post-diagnostic period. These findings highlight the psychosocial nature of CAM use and emphasize the crucial role of professionals in maintaining open dialogues to provide safe, cost-effective, and evidence-based guidance.

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15. Yang Y, Jiang H, An X, Wang X, Pan J. Unveiling determinants and system optimization: a CFIR-ToC integrated approach to rehabilitation service utilization for children with autism spectrum disorder. BMC Health Serv Res;2026 (Aug 12);26(1)

BACKGROUND: Addressing the research gaps, including incomplete analysis of influencing factors, limited scope of study populations, and insufficiently operational support systems, this study aims to extensively analyze the barriers and facilitators to service utilization among both service-engaged and non-engaged families of autistic children by adopting the Consolidated Framework for Implementation Research (CFIR). Additionally, it intends to construct multi-stakeholder action pathways and networks in combination with the Theory of Change, thereby forming an operational rehabilitation support system. The ultimate goal is to enhance the health equity and overall health status of autistic children and their families. METHODS: A two-phase mixed approach was used: (1) CFIR-based semi-structured interviews and qualitative analysis with structured coding (alphabets for facilitators, numerals for barriers), following COREQ guidelines; (2) ToC-guided translation of CFIR-identified facilitators into stakeholder responsibilities (matched with barriers) to construct a support system with multi-stakeholder pathways/networks. RESULTS: 37 caregivers (30 service-engaged, 7 non-engaged) were interviewed, revealing 9/15 facilitators/barriers for engaged families and 2/9 for non-engaged ones. Universal barriers include high costs, geographical resource gaps, and insufficient caregiver skills. An evidence-based pathway clarifies stakeholder responsibilities to target barriers; a multi-level network defines collaboration among Core, Intermediate, and Collaborative tiers. CONCLUSIONS: This study extensively analyzed the barriers and facilitators to rehabilitation service utilization among both service-engaged and non-engaged families of autistic children, addressing the research gaps of incomplete identification of influencing factors and limited representativeness of study populations. It constructed an evidence-based, multi-component action pathway involving multiple stakeholders and a multi-level, multi-stakeholders collaborative network, thereby forming an operational rehabilitation support system. This system provides a reference for global efforts to improve the accessibility, acceptability, geographic accessibility, and affordability of autism services, contributing to enhanced family well-being, improved social adaptability, and better health outcomes. Such a full-chain evidence-based pathway, spanning from problem analysis to solution formulation, offers an analytical framework for advancing health equity and overall health status among vulnerable populations.

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