J Autism Dev Disord [JOURNAL]
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200 papers
A Multimodal Investigation of Flexibility and Socialization in Autistic Children With and Without ADHD.
Journal F, Godel M, Kojovic N … +3 more , Latrèche K, Schneider M, Schaer M
J Autism Dev Disord · 2026 Jun · PMID 42329288 · Publisher ↗
PURPOSE: This study investigated the multiple components of flexibility in autistic children with and without co-occurring ADHD, and their associations with social functioning. We aimed to determine ADHD co-occurence inf...
PURPOSE: This study investigated the multiple components of flexibility in autistic children with and without co-occurring ADHD, and their associations with social functioning. We aimed to determine ADHD co-occurence influence on flexibility profiles and the links between flexibility and social outcomes. METHOD: 124 children aged 6-12 years were drawn from the Geneva Autism Cohort. Flexibility was assessed across three domains: restricted and repetitive behaviors (RRBs; EC2R), daily behavioral flexibility (BRIEF-2), and cognitive flexibility (MTT and IED: CANTAB, and CST: Early Years Toolbox). Socialization skills were measured using the Vineland-II. Group comparisons and correlation analyses were conducted across three groups: typically developing (TD), autism (ASD), and autism with co-occurring ADHD (ASD + ADHD). RESULTS: Both ASD and ASD + ADHD groups showed higher levels of RRBs compared to TD, with no difference between ASD and ASD + ADHD. Daily and cognitive flexibility difficulties were more pronounced in ASD + ADHD, particularly on tasks involving time pressure or implicit learning. BRIEF scores correlated strongly with RRBs in both ASD groups, while links with task-based flexibility were weak. Socialization difficulties were observed in both ASD groups and were strongly associated with caregiver-reported flexibility. Notably, the inverse correlation between RRBs and socialization was significant only in ASD, suggesting co-occuring ADHD may alter the regulatory function of RRBs. CONCLUSION: ADHD co-occurrence contributes to a distinct flexibility profile in autistic children, especially under implicit instructions or timed conditions. Flexibility difficulties were strongly related lower socialization scores, underscoring the need for tailored supports that address both executive and social domains across neurodevelopmental profiles.
How Contact Experience Shapes Peer's Attitudes: Investigating Typically Developing Children's Attitudes Toward Autistic Typically Developing Siblings in Inclusive Education.
Wang Q, Li K, Wang Y … +4 more , Chen Y, Li L, Hou Y, Jia F
J Autism Dev Disord · 2026 Jun · PMID 42322534 · Publisher ↗
PURPOSE: This study systematically examined social attitudes of typically developing (TD) children toward typically developing siblings of children with autism (ASD-Sibs) in inclusive education schools. It assessed both...
PURPOSE: This study systematically examined social attitudes of typically developing (TD) children toward typically developing siblings of children with autism (ASD-Sibs) in inclusive education schools. It assessed both explicit and implicit attitudes, examined the moderating role of prior contact experience with autistic peers, and tested the efficacy of an imagined contact intervention among children with negative or no prior contact experience. METHODS: In Experiment 1, TD children's explicit (questionnaire) and implicit (Affective Misattribution Procedure) attitudes toward ASD-Sibs were measured, and their prior contact experience with autistic peers was categorized. Experiment 2 used a pre-post design with children reporting negative/no contact, testing effects of a single imagined-contact session on implicit attitudes and contact intentions. RESULTS: Explicit attitudes were favorable, but implicit attitudes depended on prior contact experience: positive contact predicted positive implicit attitudes, while negative/no contact predicted implicit bias. For the negative contact group, imagined contact significantly improved implicit attitudes and increased contact intention. CONCLUSION: This study uncovers the implicit bias against ASD-Sibs in inclusive education schools. Importantly, it demonstrates that such bias is malleable and can be effectively reduced through a brief, cost-efficient imagined contact intervention. This work not only extends contact theory by demonstrating attitude generalization from imagined contact, but also delivers a practical, evidence-based tool for educators to foster inclusion and support the well-being of children with autistic siblings.
Teaching Theory of Mind Skills to Individuals with Autism Spectrum Disorder: A Systematic Review and Meta-analysis.
Kat Şen B, Aydın A
J Autism Dev Disord · 2026 Jun · PMID 42319689 · Publisher ↗
PURPOSE: In this study, we examined the effectiveness of Theory of Mind (ToM) intervention programs on the ToM skills of individuals with Autism Spectrum Disorder (ASD) through a systematic review and meta-analysis. METH...
PURPOSE: In this study, we examined the effectiveness of Theory of Mind (ToM) intervention programs on the ToM skills of individuals with Autism Spectrum Disorder (ASD) through a systematic review and meta-analysis. METHODS: A comprehensive search was conducted in Web of Science, Scopus, EBSCO ERIC, Academic Search Complete, PubMed, ProQuest, and the Türkiye Council of Higher Education Thesis Center, completed on January 5, 2024. Studies were included if published in English or Turkish, involved participants with ASD, implemented interventions targeting ToM, used at least one ToM assessment tool, employed a randomized controlled trial (RCT) or quasi-experimental design, and provided sufficient data for meta-analysis. Methodological quality was evaluated using What Works Clearinghouse (WWC) standards. The meta-analysis used a fixed-effects model with Hedges' g in Comprehensive Meta-Analysis Software 4. RESULTS: We identified 20 studies (n = 924) meeting the inclusion criteria, of which 15 were included in the meta-analysis. Most interventions targeted understanding first- and second-order false beliefs and frequently used role-play and picture-based storytelling techniques. The results indicated a moderate positive effect (g = 0.492, 95% CI [0.322, 0.662]). Subgroup analyses showed no significant differences based on study characteristics. CONCLUSION: Findings should be interpreted cautiously due to publication bias, small sample sizes, and the lack of IQ, language, or prerequisite skill assessments. Crucially, insufficient reporting of social validity and generalization represents a major barrier to assessing real-world utility. Future research must prioritize rigorous RCTs and systematic functional reporting to strengthen the evidence base.
Investigating the Effects of Video-Enhanced Activity Schedules on Preacademic Skills for Young Children With Autism.
Augustine JJ, Osnaya RA, Lewis TJ … +3 more , Imler-Brandt MH, Kittelman A, Beversdorf D
J Autism Dev Disord · 2026 Jun · PMID 42319688 · Publisher ↗
PURPOSE: The purpose of this study was to evaluate the effects of a clinician-implemented video-enhanced activity schedule and an embedded Premack contingency on on-task behavior, independent task completion, and challen...
PURPOSE: The purpose of this study was to evaluate the effects of a clinician-implemented video-enhanced activity schedule and an embedded Premack contingency on on-task behavior, independent task completion, and challenging behavior for preschool-aged children with ASD. METHOD: Participants included four preschool-aged children with ASD and four registered behavior technicians in one clinic. The study utilized a concurrent multiple baseline across participants design to evaluate the effects of the video-enhanced activity schedule on child on-task behavior, independence, and challenging behavior. RESULTS: Results indicated a functional relation between the implementation of the intervention and an increase in on-task behavior and independence; however, the results suggest a functional relation was inconclusive for reductions of challenging behavior. Social validity results indicated that participants perceived the intervention to be socially valid for instructional contexts. CONCLUSIONS: Study findings suggest that video-enhanced activity schedules may be an effective instructional modification for increasing on-task behavior and independence for young children with ASD. Implications for future research and practice are discussed.
A Qualitative Study of the Treatment Experiences of Autistic Adults Allocated to Sertraline or Placebo for Anxiety in a Blinded Randomised Controlled Trial.
Norris JE, Realpe AX, Lorenc A … +5 more , Cotton L, Morgan Z, Rai D, Mills N, STRATA Collaboration Group
J Autism Dev Disord · 2026 Jun · PMID 42313362 · Publisher ↗
PURPOSE: The STRATA randomised-controlled trial (RCT) examined the antidepressant sertraline vs placebo for treating anxiety in autistic adults. Autistic people are often assumed to be reluctant to take part in RCTs due...
PURPOSE: The STRATA randomised-controlled trial (RCT) examined the antidepressant sertraline vs placebo for treating anxiety in autistic adults. Autistic people are often assumed to be reluctant to take part in RCTs due to intolerance of their inherent uncertainty. This study aimed to qualitatively examine autistic people's experiences of RCT participation, specifically regarding their random assignment to an antidepressant (sertraline) or placebo for their mental health, whilst blinded to treatment allocation. METHODS: Semi-structured interviews were undertaken with a purposive sample of 62 STRATA participants. The interviews examined why they chose to take part, why they continued in the trial and/or discontinued medication, and their overall experience of participation. Interviews took place either during participation, or at participants' final trial appointment at 52-weeks post randomisation ('exit interviews'). Data were analysed thematically through a collaborative process, with multiple researchers independently coding, discussing, and refining themes. RESULTS: Interviewees often discussed improved anxiety, attributing changes to believing they were taking sertraline, experiencing the placebo effect, or external factors. Post-analysis unblinding revealed that improved anxiety was discussed equally by participants in both the sertraline and placebo groups. Some participants, including those taking placebo, experienced side effects, which mirrored the types, frequency, and severity seen in the general population. Many were able to manage these and continue, but some discontinued medication as a result. CONCLUSION: Aspects of trial design and delivery facilitated continuation with the study medication, including frequent appointments, shared control over medication dose, and meaningfully involving autistic people in trial design. Such non-pharmacological factors may enhance therapeutic benefits, and may improve RCT design and therapeutic alliances with autistic people.
Brief Report: Child Emotion Dysregulation Mediates the Association Between Parenting Stress and Behavioral Challenges in Autistic Toddlers and Preschoolers.
Kim M, Swain D, Di Martino A … +1 more , Kim SH
J Autism Dev Disord · 2026 Jun · PMID 42313361 · Publisher ↗
PURPOSE: Emotion Dysregulation (ED) in children with ASD are linked to behavioral challenges, such as aggression, self-injurious behaviors, and anxiety. Parenting stress, often elevated in families of autistic children,...
PURPOSE: Emotion Dysregulation (ED) in children with ASD are linked to behavioral challenges, such as aggression, self-injurious behaviors, and anxiety. Parenting stress, often elevated in families of autistic children, also significantly influences child behavioral outcomes. However, little is known about the dynamics among parenting stress, child ED, and behavioral problems in ASD, especially during the early developmental period. The primary aim of the study was to examine the mediating role of child ED in the association between parenting stress and future child behavioral outcomes in toddlers/preschoolers with ASD. METHODS: The sample included 51 autistic young children aged 18-53 months and their caregivers. Parenting stress (PSI-SF), child ED (BRIEF-ECI), and behavioral problems (CBCL) were assessed, with 30 participants completing a 12-month follow-up. Analyses were conducted starting with Pearson correlations, followed by mediation analyses using the PROCESS macro to examine the mediating role of ED. RESULTS: Higher parenting stress was correlated with more severe ED and increased behavioral challenges in children. Mediation analyses revealed that child ED fully mediated the relation between parenting stress and child behavioral challenges. A significant mediation effect of child ED was found on the association between PSI-SF Parental Distress subdomain and child internalizing behaviors. CONCLUSIONS: Child ED may play a key role mediating the association between parenting stress and child internalizing behavioral problems in autistic toddlers/preschoolers. Interventions targeting both parental well-being and child ED development could improve behavioral outcomes.
Structure and Meaning in Mathematics: Divergent Roles of Syntax and Meaning-Based Language in Autism.
Cohen O, Shnitzer Meirovich S, Sukenik N
J Autism Dev Disord · 2026 Jun · PMID 42313360 · Publisher ↗
PURPOSE: Mathematical reasoning in adolescence relies on higher order language abilities, yet little is known about how specific language domains support mathematical performance in autistic adolescents, especially in mo...
PURPOSE: Mathematical reasoning in adolescence relies on higher order language abilities, yet little is known about how specific language domains support mathematical performance in autistic adolescents, especially in morphologically rich languages such as Hebrew. This study examined the roles of syntax and pragmatics in mathematical performance among Hebrew-speaking autistic and typically developing (TD) adolescents. METHOD: Participants were 67 adolescents (31 autistic, 36 TD; ages 12-19). Syntax and pragmatics were independently coded from a Definition Task, and mathematics was assessed across procedural thinking, arithmetic comprehension, and algebraic technique. Because groups differed in morphology, this variable was entered as a covariate. Group differences were examined using ANCOVA and mean-rank ANCOVA. Spearman correlations tested within-group associations, and moderation analyses assessed whether group affiliation moderated language-mathematics relationships. RESULTS: Autistic adolescents performed significantly lower than TD peers in procedural thinking, algebraic technique, and total mathematics, whereas syntax and pragmatic definition scores did not differ once morphology was controlled. Among TD adolescents, syntactic ability was positively associated with all mathematical measures. In contrast, among autistic adolescents, pragmatic ability-but not syntax-was positively associated with mathematical performance. Moderation analyses confirmed that the strength of language-mathematics associations differed by group. CONCLUSIONS: Language supports mathematical reasoning in adolescence, but the relevant pathways differ across developmental profiles. TD adolescents appear to rely primarily on syntactic-structural processing, whereas autistic adolescents rely more on meaning-based pragmatic abilities. These findings highlight the importance of examining specific language domains rather than composite scores and support tailoring mathematics instruction to the linguistic strengths of autistic learners.
Evaluating the Acceptability of an Early Adoption of the Tele-ASD Diagnostic Assessment Tool for Adults (TADA).
Coleman R, Weitlauf A, Hartnett H … +8 more , Castillo-Martinez G, Stone C, Swanson A, Foster T, Hundley R, Kehl L, Vehorn A, Warren Z
J Autism Dev Disord · 2026 Jun · PMID 42313359 · Publisher ↗
PURPOSE: Adults seeking autism evaluations are often met with significant barriers, including long wait times, high costs, and a lack of access to providers trained in adult autism assessment. In addition, many of the pr...
PURPOSE: Adults seeking autism evaluations are often met with significant barriers, including long wait times, high costs, and a lack of access to providers trained in adult autism assessment. In addition, many of the primary assessment tools in adult autism assessment were developed without the input of autistic adults. To help expand diagnostic options for this population, we developed the novel Tele-ASD Diagnostic Assessment Tool for Adults (TADA). This study sought to evaluate the acceptability and feasibility of the TADA's content, presentation, and scoring, according to autistic adults and clinicians administering the measure. METHODS: Participants (n = 32, 22 autistic, 10 non-autistic) attended a tele-health appointment where they were administered the TADA by a licensed psychologist who then scored their clinical impressions on whether participants were reporting and exhibiting behaviors consistent with autism. RESULTS & CONCLUSION: Both participants and clinicians rated their experience with the TADA favorably and indicated that it would be an acceptable addition to an assessment battery for adults seeking an autism evaluation.
Retraction Note: Examining the Impact of Assistive Technology on Psychological Health, Family Education, and Curriculum Research in Japan: Insights from Artificial Intelligence.
Guo Y
J Autism Dev Disord · 2026 Jun · PMID 42307882 · Publisher ↗
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Reading Minds in Stories: Neural Dynamics of Affective Perspective-Taking Skills in Children With Autism Spectrum Disorders.
Peristeri E, Machairas I, Ketseridou S … +5 more , Kartsidis P, Ntiniaropoulou A, Andreou M, Styliadis C, Bamidis P
J Autism Dev Disord · 2026 Jun · PMID 42307881 · Publisher ↗
PURPOSE: Autism spectrum disorders (ASD) is characterized by prominent difficulties with affective perspective-taking, which have been mainly investigated through autistic individuals' behavioral and electrophysiological...
PURPOSE: Autism spectrum disorders (ASD) is characterized by prominent difficulties with affective perspective-taking, which have been mainly investigated through autistic individuals' behavioral and electrophysiological responses to emotional pictorial stimuli. It seems likely that non-verbal pictorial tasks lack the discourse or situational context related to the emotional viewpoint of other individuals. Narratives, on the other hand, involve strong contextual information signaling the subjective viewpoints of other characters. To date, no electrophysiological marker of affective perspective-taking in ASD has been reported for narrative paradigms. The current study aimed to provide electrophysiological and behavioral evidence of the affective perspective-taking skills in ASD employing a narrative task. METHODS: Thirty-four autistic children and typically-developing peers performed an affective perspective-taking task while listening to stories with two protagonists involved in an offender-victim relationship. During the task, emotion attribution and late positive potentials of the children were recorded to assess emotional processing in reaction to adopting three perspectives, specifically, those of the observer/self, offender and victim. RESULTS: Autistic children showed attenuated late positive potential amplitudes as compared to their typically-developing peers when adopting the viewpoints of the offender and the victim, but not the observer's/self's. In terms of emotion attribution, the autistic group did so less appropriately and discriminately than the typically-developing group across the three perspectives. CONCLUSION: The findings provide behavioral and psychophysiological support for distinctive affective-perspective skills in autistic children, with the self-perspective being relatively more preserved.
Traumatic Experiences and Major Life Stressors in Children and Youth With Neurodevelopmental Disorders.
Lenz S, Rapley J, Canning E … +6 more , Rana S, Sivaloganathan A, Lai MC, Kaster TS, Kushki A, Baribeau D
J Autism Dev Disord · 2026 Jun · PMID 42287523 · Publisher ↗
PURPOSE: Traumatic experiences adversely affect mental health; children with neurodevelopmental disorders (NDDs) may be more vulnerable to these adverse effects. The objective of this study was to examine the prevalence,...
PURPOSE: Traumatic experiences adversely affect mental health; children with neurodevelopmental disorders (NDDs) may be more vulnerable to these adverse effects. The objective of this study was to examine the prevalence, types, and clinical correlates of traumatic experiences and major life stressors in children and youth with NDDs. METHODS: A longitudinal retrospective cohort study was conducted using electronic medical records from a large tertiary program supporting children and youth diagnosed with autism or intellectual disability and persistent behavioural or mental health concerns. Those with and without a documented history of trauma/major stressors were compared regarding clinical and demographic characteristics; longitudinal associations with crisis service utilization were examined using survival models. RESULTS: Of 389 individuals (94% autism, 40% intellectual disability; 17% female; mean age 10.7 ± 3.1 years), 58 (15%) had a recorded trauma/major stressor, most commonly physical assault/abuse (3%) or family member death/estrangement (3%). Those with prior trauma/stressors were less likely to be female (5% vs. 19%, p = 0.01) or minimally-verbal (22% vs. 53%, p < 0.001); they had more suicidality (29% vs. 13%, p = 0.009), aggression (91% vs. 78%, p = 0.01), crisis service utilization (57% vs. 32%, p = 0.002), and psychotropic polypharmacy (3 vs. 2 medications, p < 0.01). Older age, past crisis service use, financial strain, and more allied health supports, but not past trauma/stressors, were associated with subsequent crisis service use. CONCLUSION: Children and youth with NDDs and a history of traumatic experiences or major life stressors had more mental health and behavioural symptoms. Trauma and major stressors may be clinically under-identified in those with minimal verbal communication.
Effects of Community-Based Acceptance and Commitment Therapy on Quality of Life and Mental Health Outcomes for Mothers of Children With Autism Spectrum Disorder: A Pilot RCT in China.
Li M, Kong L, Wang C
J Autism Dev Disord · 2026 Jun · PMID 42287522 · Publisher ↗
PURPOSE: Acceptance and Commitment Therapy (ACT) has shown promise in improving psychological flexibility and reducing distress among parents of children with autism; however, evidence among Chinese mother remains limite...
PURPOSE: Acceptance and Commitment Therapy (ACT) has shown promise in improving psychological flexibility and reducing distress among parents of children with autism; however, evidence among Chinese mother remains limited. This study examined the feasibility, acceptability and preliminary efficacy of a community-based ACT intervention. METHODS: 42 participants were randomly assigned to ACT group received a 5-week ACT training (Mage=40.81, SDage=7.31) or control group received a 5-week Psychoeducation program (Mage=42.43, SDage=11.57). All participants completed post-intervention assessments; the ACT group also had a one-month follow-up with daily Loving-Kindness reminders. Feasibility was assessed through recruitment, compliance and attrition rates; acceptability was evaluated via qualitative interviews. RESULTS: Compared with the control group, the ACT group showed significant improvements in quality of life in the social (p =.021) and environment (p =.032) domains of quality of life after the intervention. The ACT group also showed sustained improvements in quality of life (physical, psychological, and social domains) at onemonth follow-up. Improvements in mental health (depression: p = .04; anxiety: p = .019; stress: p = .011) and psychological flexibility (experiential avoidance: p = .008; cognitive fusion: p = .011) were observed from baseline to follow-up. CONCLUSION: The ACT intervention demonstrated good feasibility and acceptability for Chinese mothers of children with autism, with preliminary findings indicating positive meffects on quality of life, mental health and psychological flexibility. As a scalable, lowintensity intervention deliverable in community settings, its benefits persisted when supplemented with follow-up reminders, indicating the need for larger, longer studies to compare strategies for sustaining long term effects.
Cognitive, Behavioural and Communication Correlates of Dysregulation in Australian Autistic Preschoolers.
Wu WT, John JR, Diaz AM … +2 more , Dissanayake C, Eapen V
J Autism Dev Disord · 2026 Jun · PMID 42287521 · Publisher ↗
PURPOSE: This study investigated whether cognitive, behavioural, and communication differences are associated with emotional dysregulation among preschool-aged autistic children in Australia. METHODS: Secondary data anal...
PURPOSE: This study investigated whether cognitive, behavioural, and communication differences are associated with emotional dysregulation among preschool-aged autistic children in Australia. METHODS: Secondary data analysis was undertaken in a sample of autistic preschool children as part of the Autism Subtyping Project, receiving early intensive intervention in six Autism Specific Early Learning and Care Centres (ASELCCs) across the six states in Australia. Multilevel multivariable logistic regression analyses were used to determine associations between sociodemographic factors, autistic traits (adjusted for sociodemographic covariates), and their dysregulation profile. Further, multivariable linear regression analyses were conducted to determine whether dysregulation profile was a significant predictor of changes in autistic traits following intervention. RESULTS: Among the sample of 415 children, 43% (n = 180) of the sample were classified as having a dysregulation profile (DP). Findings from the regression analyses showed that children with higher social communication (AOR 1.11, 95% CI: 1.05, 1.17) and repetitive behavioural (AOR 1.09, 95% CI: 1.06, 1.12) differences at baseline were associated with higher odds of having a DP. Key sociodemographic covariates including older age was associated with higher odds of having a DP whereas being from a culturally and linguistically diverse background and having a higher annual family income had protective effect on DP. Further, DP scores at baseline were not predictive of changes in social communication, repetitive behaviours, or cognitive functioning following receipt of EII. CONCLUSION: The study findings suggest screening for DP among autistic preschool children may lead to early identification and intervention of a discrete pattern of behavioural difficulties.
Asynchronous Social Communication Development in Autism: A Component-Level Analysis.
Rollins PR, Patel SD, Ulysse C
J Autism Dev Disord · 2026 Jun · PMID 42287520 · Publisher ↗
PURPOSE: Early social communication in autistic children is multidimensional and often develops asynchronously, with relative strengths in goal-directed communication and challenges in socially mediated behaviors. Compos...
PURPOSE: Early social communication in autistic children is multidimensional and often develops asynchronously, with relative strengths in goal-directed communication and challenges in socially mediated behaviors. Composite outcome measures may obscure component-level effects. This exploratory secondary analysis examined component-level effects of the Pathways Early Autism Intervention (Pathways) on social communication. METHODS: Data were drawn from a randomized controlled trial in which autistic children were stratified by age (< 3 years; ≥3 years) and randomized to receive Pathways or services as usual (SAU). Social communication was assessed using the Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP) Social Composite. Weighted raw scores from six components were analyzed using regression models to examine effects of group and age, and age-by-intervention interactions. Significant interactions were probed in follow-up analyses, whereas reduced models were estimated for non-significant interactions. RESULTS: Children receiving Pathways showed higher post-intervention scores in five of six components. Age-by-intervention interactions were observed at the nominal level for behavior regulation and communication rate but were not significant after false discovery rate correction. For other components, group-related differences were observed without evidence of age moderation. CONCLUSIONS: Component-level analyses suggest that intervention effects are not uniformly observed across domains of social communication. However, the study was not powered to test differences in effects across components; therefore, observed patterns should be interpreted as descriptive and exploratory. Findings further suggest that socially mediated components may remain responsive to intervention into the preschool years, although this interpretation should be considered in light of the exploratory nature of the analyses.
Unstable or Stable? Prosodic Features and Voice Quality in Autism Spectrum Disorder: A Systematic Review and Meta-analysis.
Song Y, Kuang C, Chen F
J Autism Dev Disord · 2026 Jun · PMID 42287519 · Publisher ↗
PURPOSE: Speech prosody is fundamental to human spoken communication, and it is frequently characterized by atypical patterns, alongside voice quality, in individuals with autism spectrum disorder (ASD). However, finding...
PURPOSE: Speech prosody is fundamental to human spoken communication, and it is frequently characterized by atypical patterns, alongside voice quality, in individuals with autism spectrum disorder (ASD). However, findings across studies regarding these acoustic features in ASD remain inconsistent. METHODS: Literature searches across four databases identified eligible studies comparing prosodic or voice quality acoustic parameters between individuals with ASD and matched TD individuals. A total of 40 studies involving 1023 individuals with ASD and 929 TD individuals were included. Subgroup and meta-regression analyses were conducted to assess potential moderators. RESULTS: The meta-analyses revealed a significantly higher mean pitch (Hedges' g = 0.43), broader pitch range (g = 0.29), and higher pitch standard deviation (g = 0.22) in the ASD group. For voice quality, significantly reduced shimmer (g = -0.44) and a trend toward reduced jitter (g = -0.26) indicated heightened stability of vocal fold vibrations in ASD. CONCLUSION: Our findings reveal a seemingly paradoxical acoustic profile in ASD: while individuals with ASD exhibit suprasegmental instability, they also demonstrate voicing hyper-stability. Moderators identified after subgroup and meta-regression analyses, including language background, IQ status, age span, mean age, and task type, may further moderate the prosodic features.
Autism and ADHD Strengths and Needs in a Nutshell - Parental Evaluation of a Digital ICF-Based Assessment Summary Report.
Hasslinger J, Alehagen L, Bilir K … +1 more , Bölte S
J Autism Dev Disord · 2026 Jun · PMID 42240698 · Publisher ↗
PURPOSE: Returning results from psychological assessments is increasingly viewed as an ethical duty and a way to strengthen engagement and trust. The WHO International Classification of Functioning, Disability and Health...
PURPOSE: Returning results from psychological assessments is increasingly viewed as an ethical duty and a way to strengthen engagement and trust. The WHO International Classification of Functioning, Disability and Health (ICF) offers a framework to describe functioning across strengths, challenges, and contextual facilitators/barriers. Although ICF-based approaches map functioning in autism and ADHD, their use for individualized feedback to caregivers is underexamined. We evaluated caregivers' perceptions of a digital summary report derived from a proxy-rated ICF-based assessment for children and adolescents with autism and/or ADHD. METHODS: A multiple-methods survey was sent to 707 caregivers from a prior ICF Core Sets study; 357 provided valid responses. Items covered perceived accuracy, changes in awareness and agency, and perceived usefulness in healthcare, education, and social services. Quantitative data were analysed with nonparametric statistics; qualitative responses were thematically categorized. RESULTS: Caregivers rated the report accurate for their child's strengths (91.3%) and challenges (92.2%). About half reported increased awareness of strengths (49.9%), challenges (48.7%), and environmental facilitators (49.3%) and barriers (49.6%). Many reported greater ability to use strengths (53.2%), manage difficulties (48.4%), and seek help (39.5%). Parents of autistic children reported larger awareness gains than parents of children with ADHD; no differences emerged by caregiver or child gender. The report was considered useful in healthcare (62.1%), education (65.3%), and social services (60%). CONCLUSION: ICF-based feedback was perceived as accurate, useful, and empowering, supporting clinical and educational practice. Impact may increase if delivered earlier and further tailored. Implementation studies should assess usability, acceptability, and benefits for decision-making.
Preliminary Evidence for Differentiating Functional Performance in Preschool Children on the Autism Spectrum Using the Basic Activities of Daily Living Evaluation-Preschool Version.
Barrios-Fernández S, Salas-Gómez D, Romero-Ayuso D … +1 more , Gozalo-Delgado M
J Autism Dev Disord · 2026 Jun · PMID 42236662 · Publisher ↗
PURPOSE: The ability to perform basic activities of daily living is a core component of child development and participation. Despite its relevance, the availability of tools to assess these activities in preschoolers on...
PURPOSE: The ability to perform basic activities of daily living is a core component of child development and participation. Despite its relevance, the availability of tools to assess these activities in preschoolers on the autism spectrum remains limited, particularly in the Spanish context. This study examined the psychometric properties and explored preliminary reference thresholds for interpreting functional performance of the Basic Activities of Daily Living Evaluation - Preschool Version (BADL-P), a culturally relevant and context-sensitive tool. METHODS: A total of 281 children (241 from the general population and 40 on the autism spectrum), aged 3-6 years, participated. THE BADL-P INCLUDES FOUR SCALES: Eating, Personal Hygiene, Dressing, and Daily Functioning (executive functioning during daily activities), comprising 84 items. Group differences, internal consistency, inter-scale correlations, and receiver operating characteristic (ROC) analyses were conducted to assess the instrument's discriminative validity as a measure of functional performance in preschool children, and to explore normative reference thresholds for differentiating between groups. RESULTS: Significant differences were observed between children from the general population and those on the autism spectrum across all scales, with large effect sizes in Dressing (rrb = 0.78) and Personal Hygiene (rrb = 0.88). The BADL-P demonstrated AUCs ranging from 0.88 to 0.94. CONCLUSIONS: This study provides preliminary evidence supporting the BADL-P as a culturally relevant and context-sensitive instrument for assessing functional performance in early childhood.
Sleep Disturbances Differentially Associated With First and Second Language Receptive Vocabulary in Autistic Children.
Zhang C, Li L, Wu R … +1 more , Ge H
J Autism Dev Disord · 2026 Jun · PMID 42234300 · Publisher ↗
PURPOSE: The present study aimed to investigate the relationship between sleep behaviors and receptive vocabulary in bilingual autistic children. While the facilitating role of sleep in language development is well estab...
PURPOSE: The present study aimed to investigate the relationship between sleep behaviors and receptive vocabulary in bilingual autistic children. While the facilitating role of sleep in language development is well established in typically developing (TD) children, autistic children commonly experience both sleep disturbances and language difficulties. However, little is known about the relationship between these factors, particularly with respect to second language (L2) vocabulary development. This cross-sectional study addresses this important and underexplored issue. METHODS: We examined sleep behaviors in 36 autistic children and 40 typically developing (TD) children (aged 5-10 years) in Hong Kong using a parent-administered sleep questionnaire, the Children's Sleep Habits Questionnaire (CSHQ). Receptive vocabulary in the first language (L1) and L2 receptive was assessed using standardized tests. RESULTS: Autistic children exhibited significantly greater sleep disturbances than their TD peers, including more frequent night wakings and parasomnias (e.g., bedwetting, sleep talking, and teeth grinding). Importantly, sleep disturbances in autistic children were adversely associated with L2 vocabulary scores (daytime sleepiness: B = -2.26, p = 0.019), but less so with L1. Autistic children who experienced greater daytime sleepiness showed lower L2 vocabulary scores, likely reflecting reduced attention and working memory in the cognitively demanding context of L2 learning. CONCLUSION: These findings highlight the association between sleep behaviors and L2 vocabulary in autistic children. Future longitudinal and intervention-based research should further investigate the directionality of these relationships.
Addressing Social Skills in Autistic Children: Feasibility and Parental Insights on Hanen's More Than Words.
Mohamadzade A, Hassanzadeh S, Faramarzi S … +1 more , Shokoohi-Yekta M
J Autism Dev Disord · 2026 Jun · PMID 42234299 · Publisher ↗
PURPOSE: Communication differences in autistic children may challenge parent-child interactions and social development. This study investigated the feasibility of implementing Hanen's More Than Words (HMTW) among Iranian...
PURPOSE: Communication differences in autistic children may challenge parent-child interactions and social development. This study investigated the feasibility of implementing Hanen's More Than Words (HMTW) among Iranian families and its impact on social communication in autistic children. METHODS: A sequential explanatory mixed-methods design was employed. In the quantitative phase, 22 autistic children were assigned to a controlled trial within a pretest, posttest, and follow-up framework, divided into an intervention and a control group. Parents in the intervention group received HMTW training for three months. After the follow-up, parents from the intervention group participated in semi-structured interviews analyzed using thematic analysis. RESULTS: Quantitative data demonstrated observable changes in the social communication of autistic children, characterized by an increase in mutually engaging behaviors and a decrease in behaviors that typically disrupted social interactions. Qualitative findings revealed four main themes: change in parental attitude and increased awareness, parent-perceived utility of HMTW Strategies for facilitating communication, psycho-emotional challenges of parents and personal issues, and the HMTW limitations in addressing behavior problems. These results suggest the potential usefulness of HMTW strategies in supporting social interactions, while also highlighting the gap in attention to the psychosocial needs of parents and strategies for managing challenging behaviors. CONCLUSION: In general, following cultural adaptation, the HMTW can be utilized as a feasible and acceptable parent-mediated early intervention to change the social skills of Iranian autistic children. However, integrating psychosocial support for parents in addition to complementary behavioral interventions, may enhance the implementation and potential impact of the program.
Correction: Altered Higher-Order Structural and Functional Connectivity Coupling in Autism Spectrum Disorder.
Dai Z, Yang L, Li Z … +6 more , Zhang X, Lu J, Wang W, Wang Y, Zhao S, Wang B
J Autism Dev Disord · 2026 Jun · PMID 42228236 · Publisher ↗
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