Autism Spectrum Disorder (ASD) and Intellectual Disability (ID) present substantial challenges for affected individuals and their families. This systematic review and meta-analysis screened 16,993 records and included 54 studies published between 1980 and 2025. Parental stress was markedly higher in families of children with ASD (SMD = 1.41) than in those with ID (SMD = 0.54). IQ and age showed no significant moderating effects. Families of individuals with ASD also reported significantly lower quality of life (SMD = -0.92). These findings underscore the need for holistic, family-centered approaches in neurodevelopmental care. By synthesizing extensive evidence, this review highlights the importance of system-level strategies that address the complex needs of families living with ASD and ID.
This review examined 86 single-case design studies on self-regulation interventions for autistic children aged 0–8 years. Results showed that most of the interventions were conducted in school settings where they were primarily implemented by researchers who focused largely on reducing challenging behaviors and enhancing alternative behaviors. An assessment of study quality revealed that although the majority of studies were of adequate or good quality, a significant number were weak. Findings suggest a need for more naturalistic intervention settings and comprehensive outcome measures, and for the development and adaptation of holistic self-regulation programs tailored to young autistic children. Implications for future research and practice, as well as the study limitation were also discussed.
This scoping review is the first to systematically map the literature on suicidality in autistic adults through the lens of Joiner’s Interpersonal Theory of Suicide (ITS). Reviewing 51 studies and distinguishing between those directly assessing ITS constructs and those conceptually interpreted in relation to its components, we find preliminary support for the relevance of thwarted belongingness, perceived burdensomeness, and acquired capability in this population, while identifying meaningful variability in how these constructs manifest compared to non-autistic individuals. A cluster of autism-specific risk processes, including camouflaging, intersecting minority identities, emotional and physiological dysregulation, and intolerance of uncertainty, extends beyond the original framework and warrants further longitudinal empirical investigation. Developed in collaboration with autistic co-researchers, we propose an autism-specific adaptation of the ITS as a theoretically informed scaffold, intended as a pragmatic starting point for future research and for informing suicide risk formulation in clinical practice with autistic adults.
Empathy difficulties are frequently cited as a hallmark of the social challenges experienced by autistic individuals. However, a growing body of research suggests that these difficulties may be more accurately attributed to co-occurring alexithymia rather than autism per se. This systematic review aimed to clarify the relationship between autism, alexithymia, and empathy. A comprehensive search following PRISMA guidelines identified 11 studies from an initial pool of 271 articles. Our findings indicate a high prevalence of alexithymia among autistic individuals and suggest that difficulties in both cognitive empathy (i.e., the ability to identify emotions in oneself and others) and affective empathy (i.e., the ability to share others’ emotions) are more strongly associated with alexithymia than with autism itself. Moreover, age-related differences appear to further shape this interaction. Together, these findings underscore the importance of distinguishing between autism and alexithymia in empathy research and point to key directions for future studies and clinical approaches.
Parents of autistic children are more prone to high levels of stress in their daily lives. This umbrella review synthesises evidence from 41 reviews on stressors parents face at micro-, meso-, and macrolevels. At microlevel, common stressors included children’s distress behaviours, autism characteristics, child-parent dependency, and parent’s worries and characteristics. At mesolevel, financial, marital, sibling, and community issues (e.g., stigmatisation, social isolation, and lack of social support) were frequent, while macrolevel stressors involved healthcare, education, and other support services. These findings highlight the need for an integrated approach to support parents, more attention to under-researched groups (e.g., fathers and parents of autistic daughters), and longitudinal research on parental stress over time.
Hyperscanning captures interpersonal neural synchrony (INS) during social interaction. To determine whether reduced INS characterizes autism spectrum disorder (ASD) or elevated autistic-like traits (ALTs). A PRISMA search (updated April 25th, 2025) screened 1552 records; 20 studies met inclusion. Quality was appraised with modified CASP checklists. Sixteen interpersonal analyses across 20 studies (15 ASD, five trait-based) using varied neuroimaging modalities reported attenuated synchrony in 14 cases when an autistic or high-trait partner was present; effect direction varied with task design and dyad composition, indicating methodological contingencies rather than a uniform deficit. Heterogeneity precluded meta-analysis. Reduced INS is a robust yet context-dependent correlate of autistic characteristics. Future work should directly test task- and dyad-level moderators.
This is a systematic review of authorship in Rapid Prompting Method (RPM), Spelling2Communicate (S2C), Spellers Method and variants, techniques akin to Facilitated Communication which are increasingly promoted for use on autistic individuals or people with intellectual or developmental disabilities who are minimally- or non-speaking. In this systematic review, RPM/S2C or variants had to be evaluated as an intervention using a research design capable of empirical demonstration of authorship. The resulting empty review documents a persistent knowledge gap which, in the context of increasing popularity and similarity to Facilitated Communication, constitutes a finding with clinical significance. Controlled authorship trials of RPM, S2C, and Spellers Method are warranted. Given the instrumental similarities between RPM, S2C, Spellers Method, and traditional Facilitated Communication, these methods should be discontinued (if in use) or not adopted until independent authorship studies have shown that these methods are indeed valid. Ethical implications of the findings are also discussed.
Drowning is a leading cause of accidental death among individuals with autism spectrum disorder (ASD), highlighting the critical need for swimming and water safety instruction. This systematic review synthesized 17 experimental studies (n = 107 participants) examining interventions targeting swimming skills in individuals with ASD. Findings indicate that behaviorally based strategies such Behavioral Skills Training (BST) produced moderate to very large improvements in skill acquisition. However, gaps were noted in reporting of demographic variables, instructor training, and treatment fidelity. Limited data on skill generalization and maintenance also highlight the need for further research. These results underscore the potential of structured aquatic interventions to enhance safety and adaptive skills in this high-risk population.
Neurodevelopment is a dynamic process involving genetic and environmental factors that influence motor, cognitive (e.g., learning, communication), social, adaptive, emotional, and behavioural domains. This systematic review and meta-analysis aimed to estimate the prevalence of NDDs among preschool children of migrants and refugees in high-income Western countries. Five databases, including Medline, Embase, Scopus, CINAHL, and PsycINFO, were searched for eligible studies from inception until October 1, 2025. Three reviewers independently screened and selected studies, extracted data, and assessed the methodological quality. We have used Stata to estimate the weighted pooled prevalence of autism from crosssectional and cohort study data using random-effects meta-analysis with (I²/Q>50
In recent decades, autism knowledge research has increased in frequency and range of target populations, informing professional development and training and aiding in the investigation of quality-of-life indicators for the autistic community. This increase in research output has coincided with the development, modification, and translation of several autism knowledge measures. This narrative review comments on critical issues in autism knowledge measurement research, such as the difference between measured and perceived knowledge, variance in the autism knowledge construct, and modifications to autism knowledge measures, especially as they pertain to different populations. Relevant case examples from the literature are discussed for these issues. Additionally, recommendations for selecting autism knowledge measures are provided. A flowchart outlines the process for selecting an autism knowledge measure and is a recommended resource for other professionals who are in the process of choosing a tool to use in their own research or clinical work.
Cognitive Behavioural Therapy (CBT) is a ‘gold-standard’ treatment in the general population but may be less effective for autistic adults. Intervention acceptability can impact its effectiveness. Using the Theoretical Framework of Acceptability, we explored and synthesised available literature on CBT acceptability for autistic adults. Seventy studies were included in this review. Analysis shows heterogeneous terminology and measures related to acceptability, rare use of acceptability definitions or theory and rare prioritisation of acceptability as a study focus. All TFA constructs have been reported on to varying degrees, though no study reports on all constructs. The review suggests need for further attention on acceptability of real-world practice for autistic adults and focus on specific acceptability constructs.
To investigate sex/gender differences in co-occurring neurodevelopmental and mental health conditions among autistic adults, we conducted a systematic review and meta-analyses of studies reporting prevalence rates separately for autistic people referred to as female (PRF) and autistic people referred to as male (PRM). Autistic PRF exhibited higher rates of anxiety, eating disorders and trauma-related conditions. Autistic PRM showed elevated rates of certain neurodevelopmental and externalising conditions. No sex/gender differences were found for obsessive-compulsive disorder, attention deficit/hyperactive disorder, and schizophrenia/psychotic disorders. This review highlights gaps in the evidence base. Findings underscore the need for heightened clinical attention to co-occurring neurodevelopmental and mental health conditions in autistic adults, particularly PRF, and can inform more targeted screening efforts and tailoring of treatment.
A systematic review of emotion-focused interventions in schools for youth with ASD was conducted, with 512 articles screened and 10 international studies (2001–2022) meeting inclusion criteria. An examination of participant, intervention, and study characteristics revealed varied practices, with most interventions delivered in group formats by researchers. Medium to large effects on foundational and advanced emotional competencies highlight the diverse value of these interventions for youth with ASD; however, few targeted emotion management, indicating a limited focus on emotion regulation skills. Moreover, substantial gaps in reporting methods, process evaluation efforts, and family-school practices underscore the need for enhanced implementation planning and delivery. Implications are discussed, and recommendations are offered to inform future school-based, emotion-focused research and practice involving youth with ASD.
The major challenge in research on the lived experience of time in autism is the absence of a shared conceptual vocabulary, which hinders the integration of data from different domains. Research is dominated by psychophysical studies focused on differences in time processing with neurotypical controls. Inquiry concerning the qualities of lived time is substantially lacking. This review of > 200 studies on autistic temporality groups the existing research into three domains concerning time processing abilities, observational and diagnostic criteria, and phenomenology. It also proposes phenomenologically grounded notions for organizing the methodological diversity of research findings into three categories: desynchronization, certainty and predictability, and chrononormativity.
Research suggests that autism rates may be higher in justice-involved populations than in the general population, but studies have focused on men. The aim of this concise systematic review was to report on the prevalence of autism spectrum disorder in women serving prison sentences, and to describe their biopsychosocial and criminal history characteristics. The systematic search yielded only two papers, from the same study. It reported prevalence rates among adolescents in secure care in England and Wales at a specific date in 2016. There were no young women with an autism spectrum condition in the youth justice system. Studies of imprisoned women with autism are scarce. There is a need for future studies of this important issue.
This scoping review examines the effectiveness of virtual reality (VR) interventions in improving assertiveness and conflict resolution among adolescents and young adults with Autism Spectrum Disorder (ASD). ASD often involves difficulties in social interaction, communication, and emotion regulation, limiting interpersonal relationships. Traditional training may be less effective due to cognitive and emotional differences, while VR offers immersive, controlled environments for practicing social skills. Following PRISMA guidelines, 15 studies (2015–2024) were analyzed, showing that VR improves assertiveness, emotional expression, and social reciprocity. Immersive VR better supports skill generalization to real-life contexts, though challenges remain regarding accessibility and individual adaptation. Larger studies are needed to evaluate long-term outcomes and explore integration with other intervention strategies.
This systematic review aims to identify the specific types of offences that individuals with autism spectrum disorder (ASD) are more likely to commit or fall victim to, given the unique characteristics of the disorder. A comprehensive search of keywords related to ASD, offence perpetration, and victimisation was conducted across four databases. Screening of titles and abstracts resulted in 175 studies being evaluated through full-text review, with 37 studies ultimately included in the review. The quality of the included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). The review found that individuals with ASD do not exhibit a higher likelihood of committing offences compared to typically developing peers. However, they are at a heightened risk of victimisation, including abuse, physical violence, sexual violence, and various forms of school bullying. While individuals with ASD do not demonstrate an increased propensity for offence perpetration, they do experience elevated rates of victimisation, highlighting the importance of addressing their special needs within the health, education, and justice systems.
Research on cognitive abilities, including cognitive profiles, language, and executive functioning, of autistic females is still scarce and results are contrasting. We conducted a PRISMA systematic review, including 22 studies (agreement = 94,59
Exergaming, an interactive intervention integrating physical activity with video gaming, has increasingly been applied in the rehabilitation and education of children and adolescents with autism spectrum disorder. This systematic review synthesized evidence from 19 studies involving 659 participants to evaluate the effects of exergaming on core symptoms and related functional domains. Results indicate preliminary improvements in motor skills, physical activity levels, and executive function, with the most consistent evidence for motor coordination and reaction time, while evidence for social behavior, repetitive behaviors, and emotion regulation remains limited. No adverse events were reported, and dropout rates were low, indicating good feasibility and acceptability. Cooperative or multiplayer formats may be more beneficial for social outcomes than solo play. Randomized trials are needed.
This systematic review synthesizes literature published between 2016 and 2025 on autism research in formal early childhood and primary school settings in Sub-Saharan Africa. Forty-one studies met the inclusion criteria. We critically analysed key study characteristics, including methodologies, geographical foci, and funding patterns. We also examined ongoing educational provisions in the region, focusing on pedagogical practices and playful learning. The findings show no studies explored playful learning in the classroom. While autism research in educational settings is increasing, it remains largely grounded in Northern epistemologies. Although teachers are consulted in most studies, we emphasize the need to recognize them as active agents through participatory designs. Finally, we argue for the ethical and methodological inclusion of autistic learners' voices in research.
