J Autism Dev Disord [JOURNAL]
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200 papers
Correction: Examining the Efficacy of Culturally Responsive Interventions for Autistic Children and Their Families: A Meta‑Analysis.
Lee JD, Kang VY, Terol AK … +1 more , Joo S
J Autism Dev Disord · 2026 Apr · PMID 42010197 · Publisher ↗
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Development of Autism Mealtime Behavior Questionnaire for Children With Autism Spectrum Disorder.
Lee TM, Wang TN, Hsieh YL
J Autism Dev Disord · 2026 Apr · PMID 41999548 · Publisher ↗
PURPOSE: Feeding challenges in ASD, including food selectivity, sensory sensitivities, and disruptive behaviors, can negatively impact nutrition, development, and family dynamics. Existing tools often fail to evaluate fe...
PURPOSE: Feeding challenges in ASD, including food selectivity, sensory sensitivities, and disruptive behaviors, can negatively impact nutrition, development, and family dynamics. Existing tools often fail to evaluate feeding behaviors across distinct domains and environmental contexts with cultural sensitivity. This study aimed to develop and validate the Autism Mealtime Behavior Questionnaire (AMBQ) to assess feeding difficulties in Asian children with ASD aged 2 to 8 years. METHODS: Fifty parents of children with autism spectrum disorder (ASD) completed the AMBQ to evaluate its reliability and validity, with 25 parents repeating it after two weeks to assess test-retest reliability. RESULTS: The psychometric analysis results of the AMBQ demonstrated satisfactory reliability in both of the frequency domain (Cronbach alpha = 0.72, inter-rater consistency = 0.96, percentage of minimum detectable change = 12.26%) and distress domain (Cronbach alpha = 0.72, inter-rater consistency = 0.88, percentage of minimum detectable change = 18.43%). Meanwhile, convergent validity analysis revealed moderate to strong correlation between the AMBQ and the Brief Autism Mealtime Behavior Inventory (BAMBI), with correlation coefficients of 0.60 for the frequency domain and 0.78 for the distress domain. CONCLUSION: Our findings support the AMBQ as a reliable and valid tool for assessing mealtime behaviors and associated parental distress in children with ASD.
Multi-View Analysis of Facial Expressions in Minimally Verbal Autism: Preliminary Evidence From Social Communication Observations.
Qu L, Yin T, Zeng J … +8 more , Zhang Y, Han X, Liu M, Chang F, Yuan Y, Shan S, Zhao H, Liu Q
J Autism Dev Disord · 2026 Apr · PMID 41995984 · Publisher ↗
PURPOSE: Minimally verbal children with autism spectrum disorder (ASD) face profound challenges in social-emotional communication, but objective methods to quantify their facial expression patterns remain limited. This s...
PURPOSE: Minimally verbal children with autism spectrum disorder (ASD) face profound challenges in social-emotional communication, but objective methods to quantify their facial expression patterns remain limited. This study applied an automated multi-view facial expression recognition (mFER) approach to examine the frequency, synchrony, and social directedness of facial expressions in minimally verbal children with ASD. METHODS: Fifty-two children aged 3–6 years participated: 18 with ASD, 17 with global developmental delay (GDD), and 17 typically developing (TD) peers. Children engaged in the Smart Observation for Social Communication (SOSC), a series of semi-structured, interaction-based activities adapted from the ADOS-2. Four synchronized cameras captured facial expressions, which were analyzed using a multi-view computer vision analysis. RESULTS: Compared with TD peers, the ASD group showed a higher probability of Neutral and Sad expressions and a lower probability of Happiness. These group differences were context-specific, with reduced positive affect during playful interactive activities (e.g., Peekaboo) and increased Sadness during task-based activities (e.g., Puzzle). Children with ASD showed lower facial expression synchrony with the examiner and fewer socially directed expressions. Facial expression features were significantly associated with standardized measures of adaptive functioning and autism symptom severity. CONCLUSION: Integrating the Smart Observation for Social Communication system with multi-view facial expression analysis revealed that children with ASD exhibit context-specific increases in neutral and sad facial expression alongside reduced happiness, synchrony, and socially directed expressions. These clinically valuable features correlated significantly with standardized diagnostic scores, demonstrating the framework’s potential for objective diagnostic complement and outcome monitoring in minimally verbal autism.
The Association Between Neonatal Jaundice and Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder: Findings From the Millennium Cohort Study.
Lee A, Higgins S, O'Driscoll D … +5 more , Mitchell JM, Walsh BH, O'Keeffe GW, Khashan AS, Maher GM
J Autism Dev Disord · 2026 Apr · PMID 41995983 · Publisher ↗
OBJECTIVE: To examine the association between neonatal jaundice requiring hospital treatment and autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring by age 14 years. METHODS: W...
OBJECTIVE: To examine the association between neonatal jaundice requiring hospital treatment and autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring by age 14 years. METHODS: We used data from the Millennium Cohort Study, a nationally representative longitudinal study of children born in the UK. Data on neonatal jaundice requiring hospital treatment and potential confounders were maternal-reported and collected at 9-months postpartum. Data on ASD and ADHD were based on maternal reported doctor diagnosis. A diagnosis of ASD or ADHD were assumed if parents reported ASD or ADHD diagnosis at age 5, 7, 11 or 14 years. We conducted crude and adjusted logistic regression analyses to examine the association between neonatal jaundice and ASD and ADHD, adjusting for a range of socioeconomic, maternal and lifestyle factors. RESULTS: 18,294 singleton babies were included at baseline. Of these, 1,254 (6.9%) experienced neonatal jaundice that required hospital treatment, and there were 575 (3.7%) cases of ASD and 497 (3.2%) cases of ADHD by age 14 years. Findings were consistent across all crude and adjusted models, with the fully adjusted odds ratio for the association between neonatal jaundice and ASD being 1.43 [95% CI:1.09 to 1.89] and 1.26 [95% CI:0.92, 1.74] for ADHD. CONCLUSION: Neonatal jaundice was associated with an increased odds of developing ASD by age 14 years. While the link between neonatal jaundice and ADHD did not reach statistical significance, the possibility of an association cannot be ruled out. Future studies should investigate the biological mechanisms that may mediate this relationship.
Validation of the Modified Checklist for Autism in Toddlers (M-CHAT): A Replication Study of Diagnostic Accuracy.
Harper AL, Sarver DE, Sly KF
J Autism Dev Disord · 2026 Apr · PMID 41995982 · Publisher ↗
PURPOSE: Early detection of autism spectrum disorder (ASD) is critical yet disparities persist in screening accuracy and identification within underserved populations. This study sought to replicate the only other prior...
PURPOSE: Early detection of autism spectrum disorder (ASD) is critical yet disparities persist in screening accuracy and identification within underserved populations. This study sought to replicate the only other prior study examining universal ASD screening (Guthrie et al. in Pediatrics 144(4):e20183963, 2019, 10.1542/peds.2018-3963) and evaluate the diagnostic accuracy of the modified checklist for autism in toddlers (M-CHAT) in a diverse cohort of toddlers screened in a large rural healthcare system. METHODS: A retrospective review was completed of 5300 primary care screening visits from 3956 children aged 16–30 months between 2015 and 2024. Screening completion rates at 18 months, 24 months, and both time points were examined, as well as diagnostic accuracy (sensitivity, specificity, positive predictive value, negative predictive value) both overall and within child/sociodemographic subgroups. RESULTS: Approximately 30% of children received screenings in alignment within AAP recommendations. Overall, the M-CHAT demonstrated moderate sensitivity (49.2%) and high specificity (94.2%), with a positive predictive value (PPV) of 28.9% and negative predictive value of 97.5% for detecting ASD. PPV increased substantially (91%) when identifying ASD or any other neurodevelopmental/behavioral condition. Diagnostic accuracy varied by child characteristics including sex, gestational age, and primary language. Children screening positive received an ASD diagnosis 20 months earlier on average. CONCLUSION: Findings provide evidence largely replicating and extending prior research, highlighting the importance of universal ASD screening. The M-CHAT demonstrates strong accuracy in ruling out ASD and identifying any neurodevelopmental/behavioral condition but shows poor to moderate predictive ability in detecting ASD specifically.
Mortality in Autism: A Longitudinal Register-Based Study.
Marinopoulou M, Mårland C, Gillberg C … +1 more , Billstedt E
J Autism Dev Disord · 2026 Apr · PMID 41989534 · Publisher ↗
PURPOSE: To examine mortality and causes of death in a population-based cohort of adults with autism spectrum disorder (ASD), and to compare findings with a sample drawn from the general population. METHODS: A population...
PURPOSE: To examine mortality and causes of death in a population-based cohort of adults with autism spectrum disorder (ASD), and to compare findings with a sample drawn from the general population. METHODS: A population-based cohort of individuals (N = 113) born 1962-1984 and diagnosed with ASD in childhood during the 1970's and 1980's was followed up through register between 2000 and 2023. Most individuals were diagnosed with co-occurring intellectual disability (ID). The group was compared to an age- and sex-matched group (N = 1130) from the general population. Data for both groups were obtained from the National Cause of Death Register in Sweden. Kaplan-Meier survival analysis was used to calculate the survival distributions of the participants with ASD and the comparison group, and Cox proportional hazards regression to estimate Hazard ratios for mortality. RESULTS: During the study period (2000-2023) 9.7% of the ASD group and 2.7% of the comparison group had died, p < .001. The ASD group had a higher risk of mortality than the comparison group (Hazard Ratio = 3.77, 95%CI = 1.89-7.52, p < .001). Mortality did not differ significantly between males and females in the ASD group. Significantly more individuals with severe ID had died compared to the rest of the cohort, X (1, N = 113) = 4.7, p < .05. CONCLUSION: Individuals with ASD and co-occurring ID may be at greater risk of death compared to the general population. Our findings emphasize the importance of monitoring and promoting health in individuals with autism, with special attention to individuals with co-occurring ID.
Caregiver Perspectives on Priorities and Barriers in Applied Behavior Analysis Service Delivery for Autistic Individuals: A Community-Engaged Sequential Mixed-Methods Study.
Pollard JS, Hustyi KM, Yan CKY … +1 more , Hall SS
J Autism Dev Disord · 2026 Apr · PMID 41989533 · Publisher ↗
PURPOSE: We conducted a community-engaged sequential mixed-methods study to identify the treatment and service delivery priorities and barriers that caregivers of autistic individuals experience when receiving applied be...
PURPOSE: We conducted a community-engaged sequential mixed-methods study to identify the treatment and service delivery priorities and barriers that caregivers of autistic individuals experience when receiving applied behavior analysis (ABA) services. METHODS: We first conducted semi-structured interviews with eight caregivers to identify common priorities and barriers. Using the themes derived from the interviews, we collaborated with community partners to co-develop the Caregiver Priorities and Barriers Survey (CPBS) and administered it to a large sample of caregivers (N = 376) who had received ABA services. We analyzed the interviews using thematic analysis (Framework Method) and the surveys were analyzed using standard statistical methods. RESULTS: There was significant concordance between the qualitative and quantitative analyses. Caregivers described prolonged waitlists, limited provider availability, and mixed experiences with telehealth. The most pressing priorities included minimizing delays in diagnostic evaluations, incorporating ABA more effectively in schools, and identifying appropriate telehealth models for their child. Families in rural areas reported greater barriers related to provider communication, medically necessary ABA delivered in the educational setting, disruptions on family life, and increasing their child's engagement in telehealth sessions. CONCLUSION: The findings reveal persistent inequities in access to ABA services and highlight opportunities to strengthen the behavioral health workforce, policy, and system-level coordination. Further refinement of existing telehealth models could help overcome common access barriers to ABA services for families.
Chronic Disease Incidence and Onset in Adults With Autism Spectrum Disorder: A 26-Year Matched Cohort Study.
Getzler I, Malachy A, Fremder A … +1 more , Stolar O
J Autism Dev Disord · 2026 Apr · PMID 41989532 · Publisher ↗
INTRODUCTION: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition, yet long‑term patterns of chronic disease in autistic adults remain poorly characterized. We examined incidence and age at diagnosi...
INTRODUCTION: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition, yet long‑term patterns of chronic disease in autistic adults remain poorly characterized. We examined incidence and age at diagnosis of common chronic conditions in adults with ASD compared with matched controls. METHODS: We conducted a retrospective cohort study within Maccabi Health Services, including adults ≥ 18 years with documented ASD and 3:1 controls matched on age, sex, and socioeconomic status, with up to 26 years of follow‑up (1998-2024). Chronic physical and psychiatric conditions were obtained from validated registries. Time-to-event analyses were performed using Kaplan-Meier curves and Cox proportional hazards models. RESULTS: The cohort comprised 6,965 adults with ASD and 20,871 controls; 51% of the ASD group versus 24.5% of controls had ≥ 1 chronic condition. Adults with ASD had higher hazards and earlier diagnosis of type 2 diabetes (HR 1.47, ~ 9 years earlier), hypertension (HR 1.24, ~ 5 years earlier), overweight/obesity (HR 1.49, ~ 7.4 years earlier), inflammatory bowel disease (HR 1.60, ~ 5 years earlier), and schizophrenia (HR 2.10, ~ 4 years earlier). Overweight status amplified diabetes and hypertension risk in ASD but not controls. No significant differences were observed for COPD or cardiovascular disease. CONCLUSIONS: Adults with ASD experience earlier and greater chronic disease burden than matched peers, supporting earlier, tailored preventive care and systematic metabolic and psychiatric screening in this population.
Cultural Adaptation and Validation of the Chinese Behavioral Inflexibility Scale: Clinical Interview Version for Children Aged 3-8 Years With Autism Spectrum Disorder in Mainland China.
Luo J, Zhou X, Shi Y … +5 more , Ma D, Li J, Zhou L, Cheng Y, Meng X
J Autism Dev Disord · 2026 Apr · PMID 41986818 · Publisher ↗
PURPOSE: This study seeks to sinicise the English version of the BIS-CI and to evaluate its reliability and validity. The aim is to provide clinicians and therapists with assessment tools and intervention guidance for ad...
PURPOSE: This study seeks to sinicise the English version of the BIS-CI and to evaluate its reliability and validity. The aim is to provide clinicians and therapists with assessment tools and intervention guidance for addressing behavioral inflexibility in children with ASD in China, while also establishing a theoretical foundation for the implementation of effective intervention strategies in clinical practice. METHODS: A total of 465 children aged between 3 and 8 years were recruited, comprising 158 with ASD and 307 typically developing (TD) children. Participants were assessed using the BIS-CI. Furthermore, the ASD group completed the Repetitive Stereotyped Behavior Scale - Revised Edition (RBS-R), the Social Response Scale (SRS), and the General Applicable Core Scale 4 for Quality of Life in Children (PedsQL 4) to evaluate reliability and validity, as well as to conduct correlation analyses. RESULTS: The findings indicated that the Cronbach's α coefficient for the Chinese version of the BIS-CI was 0.822, while the test-retest reliability was 0.956, demonstrating strong reliability. EFA revealed a unidimensional scale, which displayed moderate correlations with the RBS-R, SRS, and PedsQL4. CFA revealed that the model exhibited favourable fit indices. Furthermore, the BIS-CI scores for the ASD group were significantly higher than those of the TD group, with the differences achieving statistical significance. CONCLUSION: It offers clinicians and therapists a valuable assessment tool and a foundation for intervention guidance tailored to the behavioural inflexibility exhibited by children with ASD in China. Furthermore, it provides a theoretical basis for implementing effective intervention strategies in clinical practice.
Understanding Barriers to Caregiver Support Engagement During Their Autistic Youth's Transition to Adulthood: A Qualitative Analysis of Parental Perspectives.
Balser S, Wei W, Axner E … +1 more , Montoya C
J Autism Dev Disord · 2026 Apr · PMID 41984323 · Publisher ↗
PURPOSE: This study aims to build on previous findings by exploring the expressed reasons some caregivers of transition-aged autistic youth decide not to engage in support (i.e., asking for help or attending caregiver su...
PURPOSE: This study aims to build on previous findings by exploring the expressed reasons some caregivers of transition-aged autistic youth decide not to engage in support (i.e., asking for help or attending caregiver support groups). METHODS: This secondary data analysis of caregivers’ responses to open-ended questions about reasons for not engaging in caregiver-related support utilized an open-ended coding approach. RESULTS: A total of 90 caregivers shared insight into why they did not ask for help or attend caregiver support groups. Reasons for not asking for help included: the youth’s preferences, caregivers’ ability to care for the youth themselves, the lack of help available, the difficulty in receiving help as a child ages, barriers to trusting others with the care of their child, and awareness of barriers for others to help due to their busy schedules. Reasons for not engaging in caregiver support groups included: unique needs not served by available support, their time was better spent addressing other needs, and logistical barriers. CONCLUSIONS: These findings highlight critical gaps in service availability and accessibility and potential gaps in resources (i.e., more sources of appropriate support are needed) for caregivers, an often-understudied group in the related literature.
Co-occurring Psychiatric Symptoms in Verbal, School-Aged Children With Autism Spectrum Disorder and at Least Average IQ.
Linnenbank F, Linnenbank M, Beimdiek S … +2 more , Bender S, Vöckel J
J Autism Dev Disord · 2026 Apr · PMID 41973332 · Publisher ↗
PURPOSE: Increased levels of co-occurring psychiatric symptoms are observed in children and adolescents with autism spectrum disorder (ASD). Former research often investigated heterogeneous samples of youth with ASD. How...
PURPOSE: Increased levels of co-occurring psychiatric symptoms are observed in children and adolescents with autism spectrum disorder (ASD). Former research often investigated heterogeneous samples of youth with ASD. However, concurrent symptom presentation appears to differ with individual characteristics such as intellectual abilities. METHOD: The present study investigated verbal, school-aged children and adolescents (n = 103) with ASD and at least average intellectual abilities (i.e., full-scale intelligence quotient, FSIQ). Co-occurring psychiatric symptomatology was assessed with the Child Behavior Checklist (CBCL). Path analyses were conducted to investigate whether autistic characteristics or intellectual abilities predicted co-occurring psychiatric symptoms. RESULTS: In the investigated youth with ASD the extent of co-existing symptoms was elevated in all CBCL syndrome domains. Few associations of Autism Diagnostic Observation Schedule (ADOS-2), Autism Diagnostic Interview (ADI-R), and FSIQ scores with concurrent psychiatric symptomatology were found, limited to small effect sizes. CONCLUSION: Within the investigated youth with ASD likelihood of experiencing elevated levels of co-occurring psychiatric symptomatology is increased. However, among individuals above the diagnostic threshold for ASD, variance in ASD symptoms may be of limited influence on concurrent symptom severity. Findings highlight the importance of diagnostics for co-occurring psychiatric symptoms in youth with ASD.
Tracing the Evolution of Sleep-Related Behavioural Outcomes Research in Autistic Children: A Scientometric Review.
Xu Y, Zhong Y, Carollo A … +3 more , Adusumilli N, Esposito G, Dimitriou D
J Autism Dev Disord · 2026 Apr · PMID 41961437 · Publisher ↗
PURPOSE: Sleep disturbances are highly prevalent among autistic children and exhibit a complex bidirectional relationship with behavioural outcomes. To provide a comprehensive and systematic understanding of the evolutio...
PURPOSE: Sleep disturbances are highly prevalent among autistic children and exhibit a complex bidirectional relationship with behavioural outcomes. To provide a comprehensive and systematic understanding of the evolution of knowledge in this field, we performed a scientometric analysis of 1745 publications (1969–2025) from Scopus and 2530 publications (1968–2025) from Web of Science Core Collection. METHODS: After deduplication, 2878 publications were included in the analysis. CiteSpace was employed to perform a document co-citation analysis (DCA), identifying the most influential publications (n = 149) and major research clusters (n = 9). RESULTS: Combining the quantitative results of scientometric analysis with a qualitative discussion, we observed that research topics have gradually shifted from broadly discussing general sleep issues from a neurological perspective to examining the specific effects of certain sleep problems on certain behavioural outcomes and identifying some potential underlying mechanisms and possible interventions in this relationship. Also, increasing attention has been given to research on parents and to interdisciplinary integration between psychology/education and medicine/health sciences. However, there still exists a limited focus on non-Western countries and the role of daytime napping. CONCLUSION: We call for future research to adopt a cross-cultural perspective, deepen the understanding of the cognitive mechanism underlying sleep-related behavioural outcomes, and improve sleep and behavioural outcomes of autistic children through the integration of psychological, behavioural and medical approaches across individual, family, and social levels.
Child Autism Spectrum Disorder Following Maternal Abuse and Trauma History.
Coleman A, Fitzwater BM, Harden PA … +3 more , McColl C, Forrest J, Bailey B
J Autism Dev Disord · 2026 Apr · PMID 41961436 · Publisher ↗
PURPOSE: Several studies have found correlations between ASD and maternal stress, either during pregnancy or at delivery. This study examined whether a particular stressor, maternal history of abuse, predicted either sus...
PURPOSE: Several studies have found correlations between ASD and maternal stress, either during pregnancy or at delivery. This study examined whether a particular stressor, maternal history of abuse, predicted either suspected or diagnosed ASD by age three. METHODS: Medical records were reviewed from two pediatric practices in the Midwestern United States. “Maternal abuse history” was determined by whether the mother reported that she experienced abuse in her patient history form. Abuse was examined overall and separately by timing of the experience of abuse (abuse as a child or adult). ASD suspicions or diagnoses were considered positive based on both ICD codes and physician notes at all child well visits up to three years of age. RESULTS: Women who have reported history of any type of abuse prior to gestation were more than three times as likely to have a child suspected of having ASD by age three and were almost two and a half times more likely to have a child formally diagnosed with autism than those who do not report abuse history. Those who reported experiencing child abuse specifically were more than twice as likely to have a child suspected of ASD by age three. CONCLUSIONS: By identifying maternal abuse as potential ASD risk factor, medical professionals can be more attuned to potential ASD symptoms in their young patients at an earlier age, allowing for earlier intervention.
The Roles of Different Executive Functioning Skills in Early Mathematics Ability of Preschoolers With Autism.
Chen L
J Autism Dev Disord · 2026 Apr · PMID 41954876 · Publisher ↗
BACKGROUND: This study aimed to investigate the differential contributions of core executive functioning (EF) components-working memory (WM), inhibitory control (IC), and cognitive flexibility (CF)-to formal and informal...
BACKGROUND: This study aimed to investigate the differential contributions of core executive functioning (EF) components-working memory (WM), inhibitory control (IC), and cognitive flexibility (CF)-to formal and informal early mathematics abilities in Chinese autistic preschoolers compared to neurotypical peers, and to identify autism-specific cognitive correlates for targeted support. METHODS: A total of 130 preschoolers (autistic: n = 83; neurotypical: n = 47) aged 3-7 years completed standardized EF and mathematics assessments. To examine the unique contribution of EF skills to early mathematics ability, a three-step hierarchical regression was performed for each group. Step 1 included age and gender; step 2 added nonverbal IQ and verbal comprehension; and step 3 incorporated core EF skills (WM, IC, and CF) to assess their predictive power beyond the demographic and general cognitive factors. RESULTS: Autistic children had significantly lower EF and mathematics scores than their neurotypical peers (ps < 0.01). WM and CF were positively correlated with mathematics abilities in both groups (βs = 0.42-0.82, ps < 0.001), while IC was uniquely correlated with mathematics abilities in the autistic group (β = 0.58-0.73, p < 0.001). Crucially, EF components collectively explained significantly greater variance in informal mathematics in the autistic group (ΔR²=0.065, p < 0.001) than in the neurotypical group (ΔR²=0.027, p = 0.116) after accounting for covariates. CONCLUSION: IC is identified as a cognitive correlate characteristic of autism, and EF profiles predict mathematical development differently in autistic children than in neurotypical children. These findings highlight the need for EF-profile-targeted supports in early math instruction for autistic children, offering the first integrated evidence of the tripartite EF model's role in their mathematical development.
Persistent Sensory, Motor and Functional Difficulties From Childhood to Adolescence in Developmental Coordination Disorder.
Shahid J, Amin N, Davis S … +1 more , Chu V
J Autism Dev Disord · 2026 Apr · PMID 41944933 · Publisher ↗
PURPOSE: The purpose of this study was to examine sensory processing, motor proficiency, and functional performance in children and adolescents with Developmental Coordination Disorder (DCD) compared with typically devel...
PURPOSE: The purpose of this study was to examine sensory processing, motor proficiency, and functional performance in children and adolescents with Developmental Coordination Disorder (DCD) compared with typically developing children (TDC), and to explore the correlations among these domains across a broad developmental age range. METHOD: This cross-sectional study included children and adolescents aged 4-17 years classified as DCD and TDC. Sensory processing, motor proficiency, and functional performance were assessed using SPM, PEDI-CAT and BOT-2. Group differences and developmental trends were analyzed using analysis of variance. Pearson correlations were used to evaluate the association between sensory, motor, and functional performance. RESULTS: Children with DCD demonstrated significantly greater sensory-processing difficulties, lower motor proficiency, and reduced functional performance compared with TDC (all p < 0.001). Sensory processing, BOT-2 and PEDI-CAT scores for the DCD group consistently fell within the moderate difficulty range and below average across age groups, whereas TDC scores were within typical limits. A significant Group × Age interaction was identified for functional mobility (p = 0.02), reflecting an increasing functional gap with age. Sensory-processing difficulties were significantly associated with functional performance, whereas correlations between sensory processing and motor proficiency were not significant after correction. CONCLUSION: Sensory, motor, and functional performance difficulties in DCD persist throughout childhood and adolescence. Sensory-processing difficulties appear to be more closely related to functional performance than to structured motor proficiency. These findings support the importance of early comprehensive, developmental assessment and intervention approaches addressing both sensory and functional challenges in children and adolescents with DCD.
Using Artificial Intelligence to Support Emotionally Responsive Verbal Communication Among Autistic Workers in a Work Internship Setting.
Koegel LK, Wehman P, Claude CM … +9 more , Lam MS, Bruzzese T, Derry M, Brooke A, Ham W, Ponder E, Roane TJ, Rooney B, Anderson J
J Autism Dev Disord · 2026 Apr · PMID 41934559 · Publisher ↗
PURPOSE: Some autistic adults experience barriers to employment related to differences in social communication, including responding to others’ emotional cues in workplace interactions. This study extends prior randomize...
PURPOSE: Some autistic adults experience barriers to employment related to differences in social communication, including responding to others’ emotional cues in workplace interactions. This study extends prior randomized controlled evaluations of Noora by examining feasibility and individual-level change when the intervention is implemented with autistic young adults enrolled in an intensive vocational internship program, using a multiple baseline single-case design with repeated measurement to examine changes in relation to intervention onset within a real-world employment context. METHODS: Using a concurrent multiple baseline design across three participants, we evaluated the effects of Noora, an AI-based conversational training tool. Participants completed regular training sessions focused on practicing emotionally responsive verbal communication with real-time AI-generated feedback. The primary dependent variable was performance on standardized, human-delivered conversation probes designed to elicit emotionally responsive communication in workplace-relevant scenarios across baseline, intervention, and retention phases. RESULTS: All participants demonstrated immediate improvements in emotionally responsive verbal communication after starting the Noora program. Gains were observed within Noora training sessions and during generalization and retention conversation probes. These effects were supported by visual analysis and strong effect sizes, indicating a functional relationship between the program and improved emotionally responsive verbal communication. CONCLUSION: Findings suggest that Noora is a feasible and scalable intervention for supporting emotionally responsive communication in autistic young adults within vocational training contexts.
Stepped-Care Digital Gaming Intervention Enhanced Emotion Recognition in Autistic Children: A Randomized Controlled Trial.
Lu H, Li S, Peng S … +3 more , Zhang Y, Li N, Hu Z
J Autism Dev Disord · 2026 Apr · PMID 41934558 · Publisher ↗
PURPOSE: This randomized controlled trial (RCT) evaluated the efficacy of a novel stepped-care digital game intervention for improving emotion recognition in autistic children. METHODS: Thirty-six autistic children (aged...
PURPOSE: This randomized controlled trial (RCT) evaluated the efficacy of a novel stepped-care digital game intervention for improving emotion recognition in autistic children. METHODS: Thirty-six autistic children (aged 3-10 years) were randomly assigned to an experimental group (N = 18) or a control group (N = 18). The intervention, grounded in the Theory of Mind framework, comprised three hierarchically structured games designed to progressively train emotion recognition. Pretest and posttest including questionnaires and emotion recognition tests were administered before and after the intervention. RESULTS: Results indicated that the experimental group showed significant improvements in accuracy on the emotion recognition tests, whereas the control group did not. A significant interaction was found for scores on the autism treatment evaluation checklist (ATEC), suggesting differential change patterns across groups. Parenting stress increased significantly in the control group but remained stable in the experimental group. CONCLUSION: These findings demonstrated that this stepped-care digital game intervention can effectively enhance emotion recognition in autistic children and may bring benefits for their core traits and parenting stress.
Examining the Utility of the W-ADL to Assess Daily Living Skills in Non- or Minimally Speaking Autistic Adults.
Wilkinson E, Yu YY, Bal VH … +1 more , Clarke EB
J Autism Dev Disord · 2026 Apr · PMID 41934557 · Publisher ↗
PURPOSE: Non-or minimally speaking (NMS) autistic individuals are an understudied portion of the autism spectrum, particularly in adulthood. Efficient, validated measures of daily living skills (DLS) are needed to promot...
PURPOSE: Non-or minimally speaking (NMS) autistic individuals are an understudied portion of the autism spectrum, particularly in adulthood. Efficient, validated measures of daily living skills (DLS) are needed to promote the inclusion of NMS adults in research. This study examined the validity of the Waisman Activities of Daily Living (W-ADL), a brief, caregiver-report DLS measure, in NMS autistic adults by comparing it to the Comprehensive Parent/Caregiver Form, a survey version of the Vineland Adaptive Behavior Scales, Third Edition (VABS-3:Survey). METHODS: Caregivers of 94 NMS autistic adults (Mage = 20.66, SD = 1.45) completed both the W-ADL and the VABS-3:Survey. Criterion validity was examined by comparing W-ADL and VABS-3 DLS scores across parent-reported expressive language levels. Convergent validity was assessed via correlations between W-ADL total scores and VABS-3 Adaptive Behavior Composite, DLS domain, and DLS subdomain scores. Content validity was evaluated through conceptual item matching. RESULTS: W-ADL scores varied by expressive language level in a pattern consistent with VABS-3 scores and were strongly correlated with VABS-3 DLS domain and subdomain raw scores. Conceptual item matching demonstrated substantial overlap between W-ADL and VABS-3 DLS items, particularly for personal and domestic skills. In contrast, W-ADL coverage of community-based DLS was limited. CONCLUSION: This study provides support for the validity of W-ADL as a measure of DLS in NMS autistic adults. Availability of valid, open-access, low-burden measures such as the W-ADL is an important step toward better characterization of NMS research samples and increasing research on the characteristics, strengths, and challenges of NMS autistic adults.
Alterations in Amygdala and Hippocampal Volumes in Autism Spectrum Disorder: Meta-analysis.
Deniz Y, Maidi AZM, An SL … +1 more , Hong Y
J Autism Dev Disord · 2026 Apr · PMID 41926017 · Publisher ↗
OBJECTIVE: The amygdala and hippocampus play a critical role in socio-emotional and cognitive processes. This meta-analysis aimed to systematically evaluate volumetric differences in the amygdala and hippocampus in ASD c...
OBJECTIVE: The amygdala and hippocampus play a critical role in socio-emotional and cognitive processes. This meta-analysis aimed to systematically evaluate volumetric differences in the amygdala and hippocampus in ASD compared with non-autistic controls. METHODS: A literature search was conducted in the PubMed, Embase, and Web of Science databases. Forty studies were included in the meta-analysis, with 34 contributing data for the right amygdala, 35 for the left amygdala, 23 for the right hippocampus, and 24 for the left hippocampus. RESULTS: The meta-analysis indicated that individuals with ASD exhibited significantly larger volumes in the right amygdala (MD = 0.09 cm3, 95% CI [0.03, 0.15]; I2 = 94.87%; Z = 2.99; p < 0.001; Cohen’s d = 0.30), left amygdala (MD = 0.07 cm3, 95% CI [0.02, 0.11]; I2 = 90.99%; Z = 2.91; p < 0.001; Cohen’s d = 0.24), and left hippocampus (MD = 0.13 cm3, 95% CI [0.00, 0.26]; I2 = 95.31%; Z = 2.02; p = 0.04; Cohen’s d = 0.44). No significant difference was observed in right hippocampal volume (MD = 0.10 cm3, 95% CI [–0.04, 0.23]; I2 = 95.23%; Z = 1.40; p = 0.16; Cohen’s d = 0.35). Egger’s regression test indicated potential publication bias for both left (p = 0.0146) and right amygdala volumes (p = 0.0056). CONCLUSION: The current findings reveal significant volumetric increases in the bilateral amygdala and left hippocampus in ASD. However, given the high heterogeneity and potential publication bias, these findings should be interpreted as preliminary group-level neuroanatomical differences.
Association Between Autism-Related Symptoms and Mealtime Behavior Problems in Children With Autism Spectrum Disorders.
Tong J, Chen X, Wang T … +7 more , Ma S, Tao Y, Zhao H, Liu C, Wang Y, Wang X, Yan D
J Autism Dev Disord · 2026 Apr · PMID 41926016 · Publisher ↗
PURPOSE: Compared with typically developing children, children with Autism Spectrum Disorder (ASD) exhibit more mealtime behavior problems. These problems significantly affect the children’s nutritional development and m...
PURPOSE: Compared with typically developing children, children with Autism Spectrum Disorder (ASD) exhibit more mealtime behavior problems. These problems significantly affect the children’s nutritional development and may have implications for autism-related symptoms. Therefore, this study investigated the relationship between various autism-related symptoms and mealtime behavior problems in Eastern China. METHODS: A multicenter cross-sectional survey was conducted from November 2023 to May 2024 across five institutions in Eastern China. RESULTS: The mean total Brief Autism Mealtime Behavior Inventory (BAMBI) score in 405 children with ASD was 40.14 ± 10.61. The mean scores of the 3 subscales of food refusal, features of autism, and limited variety were 10.01 ± 3.86, 10.14 ± 3.05, and 19.99 ± 5.95, respectively. Multiple linear regression analysis showed that children with ASD who responded when their names were called (β = -2.504, 95% CI: -4.505–-0.504, P < 0.05), had no difficulty in learning new skills (β = -2.964, 95% CI: -4.983–-0.946, P < 0.01), did not exhibit fidgety symptoms (β = -2.441, 95% CI: -4.715–-0.167, P < 0.05), and had no sleep problems (β = -4.390, 95% CI: -6.902–-1.877, P < 0.01) were less likely to have mealtime behavior problems. CONCLUSIONS: Children with ASD in Eastern China exhibited significant mealtime behavior problems, which were associated with multiple autism-related symptoms. There is an urgent need to develop individualized interventions to mitigate mealtime behavior problems and to pay more attention to children with high-risk autism-related symptoms.
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