Journal of Autism and Developmental Disorders

Hwang, Caleb P.; Øien, Roald A.; Volkmar, Fred R.

doi: 10.1007/s10803-026-07428-8pmid: 42362933

PurposeNational autism guidance increasingly shapes diagnostic practices and service pathways, yet comparative research has focused primarily on clinical content and methodological quality rather than the governance structures through which guidance is produced. We argue that differences in autism guidance are influenced not only by clinical recommendations but also by governance structure, lived-experience participation, and implementation architecture. This study examines how autism guidance is commissioned, who participates in development, and how guideline processes are linked to implementation across six countries: Australia, England, Norway, Scotland, Sweden, and the United States.MethodsUsing qualitative comparative document analysis, publicly available guideline documents and associated methodological materials were examined to assess each country’s guideline authority, document function and scope, procedural transparency, lived-experience participation, implementation linkages, and relationship to broader national autism strategy. Participation was categorized along a spectrum from consultation to representation to co-production.ResultsThe analysis reveals substantial cross-national variation in how authority, participation, and implementation are structured within national autism guidance systems. Countries with centralized guideline authorities documented the most formalized mechanisms for incorporating lived-experience perspectives, while distributed or consultation-based models afforded less formal influence. Procedural transparency was generally high where centralized bodies existed but variable in distributed systems. Implementation linkages ranged from formal quality standards, indicators, and national strategy alignment to informal regional adoption.ConclusionThese governance differences are not fully captured by existing appraisal tools such as AGREE II. The findings provide a descriptive foundation for future research examining how governance arrangements influence autism guidance implementation, legitimacy, and impact.

Moreno, Laura; Manfredi, Mirella; Di Poi, Giona; Gruber, June; McPartland, James C.; Samson, Andrea C.

doi: 10.1007/s10803-026-07391-4pmid: 42371304

PurposeAutism research has primarily emphasized difficulties with negative affect, while positive emotions remain underexplored despite its central role in well-being and social functioning. This scoping review synthesizes existing evidence on positive emotions and affect in autism, focusing on the recognition, experience, and regulation of positive emotions as well as relevant interventions.MethodUsing the Arksey & O’Malley (2005) framework and PRISMA-ScR (Peters et al., 2020; Tricco et al., 2018), we included 29 studies from 1,119 database records and added 43 manually identified papers (72 in all).ResultsResults for positive emotions in autism are variable relative to their neurotypical peers. However, they do not point to overall group differences; instead, results suggest that potential difficulties depend on the specific emotion, the stage of emotional processing, perceptual approaches, cognitive and social capacities, and contextual factors.ConclusionThese findings call for future studies to sample a wider range of positive emotions and processes as well as using tasks and measures that account for the individual in a more ecological context. Deepening our understanding of positive emotional processes in autism may reveal potential psychological strengths as well as inform tailored interventions.

Larsen, Kenneth; Mishra, Sambeet

doi: 10.1007/s10803-026-07394-1pmid: N/A

PurposeWorkplace inclusion has gained prominence in autism–employment research, but it remains unclear whether it represents an extension of outcome-focused scholarship or a structurally distinct subdomain. We examined whether the two traditions can be consistently distinguished across bibliometric dimensions, and whether inclusion-oriented growth exceeds overall expansion of autism research output.MethodsA comparative bibliometric study used two curated corpora retrieved from Scopus and Web of Science (February 23, 2026): inclusion-oriented (INCL; n = 514) and outcome-oriented (OUT; n = 310), totaling 824 unique publications after deduplication. Structural differentiation was examined using document-level bibliographic coupling with Louvain community detection, complemented by modularity and cluster–corpus association tests. Author, journal, and keyword overlap were quantified using Jaccard indices. Annual counts were normalized against total ASD publication output in Scopus.ResultsThe coupling network yielded 22 clusters (Q = 0.426). Cluster membership was strongly associated with corpus affiliation, χ²(21) = 105.87, p < .001, Cramér’s V = 0.556. Author overlap was low (J = 0.057), journal overlap modest (J = 0.179), and keyword overlap moderate (J = 0.26). The inclusion-oriented share of ASD output grew approximately 4.1-fold from 2011 to 2015 to 2021–2025, against 1.6-fold for outcome-oriented research and 2.4-fold for the broader field.ConclusionMultiple bibliometric indicators consistently differentiate outcome-oriented and inclusion-oriented corpora, indicating distinct but conceptually adjacent strands of scholarship. Inclusion-oriented research has grown at a rate substantially exceeding overall field expansion. Findings provide hypothesis-generating evidence consistent with disciplinary diversification and highlight the need for integrative frameworks linking vocational rehabilitation and organizational inclusion research.

Guo, Yanqi

doi: 10.1007/s10803-026-07395-0pmid: N/A

Journal, Fiona; Godel, Michel; Kojovic, Nada; Latrèche, Kenza; Schneider, Maude; Schaer, Marie

doi: 10.1007/s10803-026-07404-2pmid: N/A

PurposeThis 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.Method124 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).ResultsBoth 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.ConclusionADHD 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.

Dai, Zhen; Yang, Lan; Li, Zhifeng; Zhang, Xi; Lu, Jiayu; Wang, Wei; Wang, Ying; Zhao, Shuo; Wang, Bin

doi: 10.1007/s10803-026-07389-ypmid: N/A

Kat Şen, Betül; Aydın, Aydan

doi: 10.1007/s10803-026-07393-2pmid: N/A

PurposeIn 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.MethodsA 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.ResultsWe 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.ConclusionFindings 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.

Kalandadze, Tamara; Gabunia, Maia; Javakhishvili, Nino; Kobuladze, Tamar; Tchintcharauli, Tinatin

doi: 10.1007/s10803-026-07422-0pmid: 42371303

PurposeAutistic people often experience mental and physical health challenges that require high-quality healthcare. However, several barriers hinder their access to healthcare, including difficulties communicating in healthcare settings. Communication-related barriers might differ between countries but have been mainly investigated in high income countries. Less is, therefore, known about the barriers to access to healthcare in middle-income countries such as Georgia.MethodsIn this study, we investigated challenges in communication between autistic people, parents and non-autistic healthcare professionals for the first time in Georgia. We report qualitative data from three focus groups comprising seven autistic participants (aged 13–29 years), two healthcare specialists (a child psychiatrist and a paediatrician), and four mothers.ResultsThe findings revealed that autistic people and parents of autistic individuals often experience communication breakdowns in healthcare settings and beyond. Limited knowledge of autism among professionals, as well as the lack of services and support remain a big problem, affecting the lives of autistic people.ConclusionThese findings have implications for healthcare practice and future research and policy in Georgia and other countries with similar socio-political characteristics.

Lenz, Sophia; Rapley, Jesiqua; Canning, Emma; Rana, Sajeela; Sivaloganathan, Ajilan; Lai, Meng-Chuan; Kaster, Tyler S.; Kushki, Azadeh; Baribeau, Danielle

doi: 10.1007/s10803-026-07375-4pmid: 42287523

Coleman, Ryan; Weitlauf, Amy; Hartnett, Hannah; Castillo-Martinez, Gabi; Stone, Caitlin; Swanson, Amy; Foster, Tori; Hundley, Rachel; Kehl, LeAnna; Vehorn, Alison; Warren, Zachary

doi: 10.1007/s10803-026-07392-3pmid: N/A

PurposeAdults 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. MethodsParticipants (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 & ConclusionBoth 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.