Background: Many researchers seek to measure people's knowledge of and attitudes toward neurodiversity concepts and advocacy. In this systematic literature review, we characterize measures of neurodiversity knowledge and attitudes and summarize studies that have used such measures. Methods: This study was funded by a Boston College Ignite grant aandwas preregistered on Prospero, ID# CRD420251013298. We searched ERIC, Education Source, PsycINFO, Scopus, Web of Science, and Sociological Abstracts databases on March 11, 2025. We hand searched the journal Neurodiversity on June 11, 2025. Inclusion criteria were that studies were peer-reviewed, published in English, and included a neurodiversity knowledge or attitudes measure. For formal validation studies, we follow the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for describing and evaluating measurement properties and study quality. Procedures include the COSMIN Risk of Bias checklist, the COSMIN Good Measurement Properties to rate study results, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for synthesis and presentation. For studies in which a neurodiversity knowledge and/or attitude measure was used but not formally validated, we used an abbreviated coding scheme to assess their basic characteristics and whether they were incidentally validated on any of the nine measurement properties. Results: We located 13 studies: four validation studies of four neurodiversity attitudes measures, and nine studies using a neurodiversity knowledge and/or attitudes measure. All four measures received "very low" GRADE ratings for all aspects of content validity, and no measure received more than two "high" ratings across all measurement properties. Only one measure received a high GRADE rating corresponding with positive evidence, and this was for internal consistency of the Autism and Neurodiversity Attitudes Scale. Conclusions: We cannot recommend any of the measures we examined for use in research, but our findings suggest that continued efforts at validating these measures could be promising.

This study explored the degree to which time spent in higher- and lower-order caregiver–child supported joint engagement was associated with later language in toddlers at increased likelihood for autism because they have an autistic older sibling (Sibs-autism) and in toddlers at population-level likelihood for autism (i.e., toddlers with non-autistic older siblings; Sibs-NA). Participants were 51 toddlers (27 Sibs-autism; 24 Sibs-NA) aged 21–27 months at the first time point (Time 1). Toddlers were seen again around 36 months (Time 2). Caregiver–child engagement states were measured via two, 15-minute caregiver–child free play sessions at Time 1. Child language was assessed via norm-referenced, standardized assessments and caregiver report questionnaires at Time 2. Regression models evaluated associations between engagement states and later receptive and expressive language. Time spent in supported joint engagement was significantly associated with later receptive language only. Higher-order supported joint engagement had a significant positive association with later receptive language, whereas lower-order supported joint engagement did not. This association was stronger for Sibs-autism. These results provide insights into how caregiver–child engagement relates to later language in Sibs-autism and Sibs-NA. Further work is necessary to understand how to best support caregivers to optimize language learning environments for toddlers.

Background: Young autistic children have a range of language and cognitive abilities and, as a result, may differentially benefit from interventions supporting skills in these and related domains. Although studies have previously examined the extent to which participant characteristics interact with intervention effects, they have primarily restricted the analyses to a single intervention approach. Method: In the present study, we drew on data from a comprehensive metaanalysis of group design, nonpharmacological intervention studies for young autistic children to test these effects. Specifically, we conducted a secondary meta-regression analysis to examine whether cognitive and language standard scores and age equivalents at study entry significantly moderated intervention effects across intervention type on adaptive, cognitive, language, and social communication outcomes and separately across outcome type for behavioral, developmental, naturalistic developmental behavioral interventions and technologybased interventions. Cognitive and language ability was quantified using reported or estimated standard scores, and cognitive and language level was quantified using reported or estimated age-equivalent scores. Analyses within outcome type were conducted using a data set of 1,911 effect sizes from 202 independent samples, and analyses within intervention type were conducted using a data set of 2,137 effect sizes from 144 independent samples. Results: Few studies reported standard scores and/or age equivalents for participant language. None of the putative moderators significantly predicted intervention effects by outcome domain (i.e., adaptive, cognitive, language, and social communication). Both cognitive standard and age-equivalent scores positively and significantly predicted effects of technology-based interventions exclusively, but we did not find robust evidence that language standard or age-equivalent scores significantly predicted effects by intervention type. Conclusions: These findings are exploratory and warrant cautious interpretation. Future intervention researchers should extensively characterize participant samples in terms of their language and cognitive ability to aid meta-analytic investigation. The field would benefit from additional high-quality randomized controlled trials testing whether intervention effects vary by participant characteristics, using preplanned moderator analyses, valid measures, and large representative samples. Supplemental Material: https://doi.org/10.23641/asha.31967844

We reassert the Double Empathy Problem (DEP) as a sociological account of autistic-non-autistic (and more broadly, between individuals with differing dispositions) interaction, rather than a social-cognitive theory of autism. The DEP reframes communicative breakdowns as relational rather than solely due to autistic deficits, countering harmful deficit-based theories of autism that rest on weak evidence. Evaluating the DEP solely through positivist social-cognitive frameworks risks undermining the DEP's original epistemological stance as a sociological and critical lens. We clarify the probabilistic framing of the DEP to emphasize that misunderstandings between autistic and non-autistic people shift with context and power. This framing invites applied inquiry into methods for increasing mutual understanding. Importantly, there is growing evidence in favor of such a probabilistic DEP, whereas there are serious validity and evidentiary concerns surrounding traditional deficit-based social-cognitive theories. By centering autistic perspectives, we argue that the DEP can promote ethical research agendas that integrate rigorous, context-sensitive methods to advance a relational, power-aware autism science that benefits the autistic community on its own terms.

Researchers' false, incomplete, or missing disclosures of conflicts of interest (COIs) can introduce bias into research, can erode public trust in research findings, and represent ethical violations of most academic journal policies. A 2020 study discovered that publications in applied behavior analysis (ABA) journals are particularly problematic in adherence to COI disclosure ethics. The current study is a 5-year update of this previously conducted study. We examined autism intervention research articles published over a 1-year period in eight ABA journals. Two coders extracted author names and COI disclosure statements from each study and conducted web searches to determine if authors were affiliated with organizations providing ABA services or consulting. One hundred and nineteen studies met our inclusion criteria, from which we compiled a database of 450 authors. Seventy-eight percent of authors held clinical and/or consultancy COIs. At the study level, 93% of studies were written by at least one author with a clinical and/or consultancy COI. Only 8% of studies disclosed any author COIs, and only 2% disclosed clinical and/or consultancy COIs. Ninety-three percent of statements claiming no COIs were false. COIs are increasingly pervasive in ABA autism intervention research, and the vast majority remain undisclosed.Lay AbstractThis study looked at how often researchers who publish about autism interventions in journals focused on one type of intervention called Applied Behavior Analysis (ABA) tell readers about their conflicts of interest (COIs). COIs happen when researchers benefit from showing something specific in their research, such as an intervention making things better for autistic people. The COIs we looked at are when researchers also receive money to provide ABA to autistic people or help other researchers provide ABA to autistic people (i.e., they worked as a consultant). COIs can negatively affect how research is designed, interpreted, and presented. We wanted to see if researchers tell readers about their COIs, or if they say they do not have COIs when they do. We reviewed autism-related intervention papers published over 1 year in eight ABA journals. For every paper, we copied the COI statement. Then, we searched online to see if authors were working as or consulting with ABA service providers. We looked at 119 papers with a total of 450 authors. This study is a five-year update of a 2020 study that found widespread but rarely reported financial COIs among ABA researchers. In our updated study, we found that 78% of authors had a COI. Some worked in ABA clinics, some offered paid consulting to other ABA providers, and some did both. Almost all papers (93%) had at least one author with these kinds of connections. But very few (8%) mentioned any COIs, and only 2% of papers stated that the authors worked as ABA providers or consultants. Most papers said the authors had no conflicts at all, but this was often not true. In fact, 93% of "no COI" statements were false. Although more ABA journals now require disclosure than in the past, many statements are still inaccurate, showing that the problem has not improved. The people in charge of publishing research, and the people who write research papers, need to do much better to let readers know about researchers' COIs.

In this commentary, I discuss methodological issues relevant to the programs of research outlined in the papers included in this special issue on including students with disabilities in educational psychology theory and research. First, I discuss how qualitative research that includes students with disabilities can offer critical insights into learners and the learning context, and advance theory development relevant to all students. Next, I extend calls made in this special issue on using quantitative approaches to understanding learner variation in relation to intervention effectiveness, and to test logic models that relate active ingredients of interventions to learner outcomes. Finally, I close with reflections on research quality, and how advancing these programs of research will require an understanding of research design limitations.

BACKGROUND: Some autistic children exhibit behavior that caregivers, clinicians, and researchers consider problematic. However, there is little consensus about the types of behaviors that should be treated as a problem and reduced via intervention. In autism intervention research, problem behaviors range from inherently harmful behaviors such as aggression and self-injury to nonnormative but not harmful behaviors associated with autism such as repetitive movements. Likewise, there are a variety of conceptualizations and measurement practices used to assess these behaviors. METHODS: In this secondary systematic review of group-design, nonpharmacological intervention studies for autistic children up to age eight, we explore researchers' conceptualizations of problem behavior and measurement systems to assess problem behavior. We defined problem behavior as any outcome where behaviors were targeted for reduction or elimination. A coding scheme was applied to 102 studies that met inclusion criteria for the secondary review. All studies were double coded by two independent coders. RESULTS: Sixty-two percent of studies described reducing behavior as a primary or secondary purpose of the study and/or intervention, 33% gave a rationale for targeting behaviors for reduction, and 28% offered a conceptualization of the behavior(s) they targeted. Only 8% offered a conceptual definition. The most common measures were 'off-the-shelf' measures that had undergone at least some previous validation beyond interrater reliability and that involved parent reports. For the 10 most common assessment measures, two were validated along six different validation dimensions in autistic populations. All but one full scale or subscale measured behaviors that were nonnormative but not inherently harmful, or a mix of behaviors that were inherently harmful and that were nonnormative but not inherently harmful. CONCLUSIONS: Intervention researchers should provide clear definitions and rationales for targeting behaviors for reduction via intervention and should develop refined measurement tools for assessing these behaviors in collaboration with the autistic community.

Background: Research on autistic employment has often focused on quantitative indicators such as employment rates and type of employment. Currently, there is only minimal research on autistic teachers' experiences, and most of this work was conducted in the United Kingdom. We sought to understand the perspectives of autistic teachers in the United States on their employment experiences.Methods: We conducted interviews with eight employed, licensed-diagnosed or self-identified autistic teachers working in U.S. schools. We asked teachers about their work experiences, including whether they were satisfied with their employment, barriers they faced, and strengths they brought as autistic teachers. Interview transcripts were analyzed using reflexive thematic analysis.Results: Our analysis generated four themes. First, we found that participants perceived a general disrespect toward the teaching profession; such attitudes may have specific negative impacts on autistic teachers and their ability to enact teacher agency. Second, participants expressed that their unique contributions to supporting neurodivergent and other students were often circumvented by neuro-normative expectations, which manifested in a lack of empathy from non-autistic colleagues and school leaders. Third, our participants reported that non-autistic colleagues participated in disability discourses that reflected ableist assumptions and a lack of knowledge about autism, which led to fears about disclosing their autistic identities. Fourth, some participants reported positive changes in their work experiences, when other school professionals and leaders were willing to be supportive.Conclusion: The perspectives of our autistic teacher participants reflect hope for cultural changes that would allow for them to thrive in the teacher workforce. However, there is much work to do to enact these changes; non-autistic teachers and school leaders need to be aware that they have autistic colleagues and make specific efforts to accommodate their needs and resist ableist assumptions about autistic teachers' potential contributions to the profession.

Although there are clear international standards for intervention science and reporting in healthcare, implementation and uptake have been limited within autism intervention research. To address this concern, a Special Interest Group (SIG) was convened at the International Society for Autism Research (INSAR) Annual Meetings in May 2023 and May 2024. This SIG comprised members of the autistic community, senior clinical scientists, clinicians, advanced researchers, and early career researchers, who discussed and debated quality standards for autism intervention trials. This commentary summarizes relevant literature highlighted by SIG panelists and recommendations generated from small breakout groups and larger group discussions with SIG attendees. We recommend that all journals publishing autism intervention findings, especially autism-focused journals, institute mandatory reporting practices (e.g., trial registration, protocol, analysis plan) to facilitate transparency and rigorous autism intervention science, as well as related education initiatives in support of this goal. Findings from the SIG offer practical, actionable recommendations that we advocate be systematically adopted across autism-focused journals.

This study examined autistic undergraduate students' college experiences and their perceptions about their intentions to persist in college. Semi-structured online interviews were conducted with 27 autistic undergraduate students (mean age = 21.8 years; 40.7% men), and their responses were analyzed using qualitative content analysis. Students discussed their perspectives about revealing their autism diagnosis, the value of the social community or lack thereof, the process ofgetting accommodations from professors, and autism acceptance on campus. Students perceived that their intentions to persist in college were related to their desire to learn, the practical utility of a college degree, the symbolic value ofa degree, and the value placed on education by their families.

In this secondary analysis of a previously conducted systematic review, we analyze social validity assessments in intervention research for transition-age autistic youth. Social validity is concerned with the acceptability of the intervention goals, the acceptability and feasibility of the intervention procedures, and the perceived importance of the intervention outcomes. We found that although just over half of intervention studies assessed some aspect of social validity, only 43% of those studies examined all three dimensions. There were several shortcomings of the social validation procedures, including a lack of psychometric validation for quantitatively scored questionnaires and a failure to describe qualitative procedures for analyzing open-ended questions. These shortcomings likely explain why interpretations of social validity assessments were nearly universally positive.

Following high school exit, many autistic young adults are not enrolled in post-secondary education or employed, and few are engaged in community activities. This disengagement among autistic young adults may be a result of the limited or inadequate supports provided to autistic transition-age youth in schools. Therefore, the purpose of the current study is to explore how school professionals report preparing transition-age autistic youth for adulthood and the barriers that make it difficult for school professionals to provide quality transition services. We surveyed 21 school professionals who work with transition-age autistic students. The survey solicited descriptions of transition supports provided to youth, and barriers that make it difficult for school professionals to provide high quality transition supports. Qualitative content analysis was used to identify themes from the data. Participants described barriers related to the autistic youth they taught or supported, their families, the classroom environment, and the community. Barriers were either framed as deficits inherent to autistic students and their families, or larger systemic issues that make it challenging to implement high quality transition supports. We recommend implementation of autism-specific trainings within teacher preparation programs and school districts, professional development opportunities that create spaces for educators to challenge and resist deficit views of autism, and development of strengths-based transition programs that are implemented by school-based professionals who work with autistic students.

We conducted a multi-pronged investigation of different types of reporting bias in autism early childhood intervention research. First, we investigated the prevalence of reporting failures of completed trials registered on clinicaltrials.gov, and found that only 7% of registered trials were updated with results on the registration platform and only 64% had associated published reports. Next, we investigated the extent to which inadequate reporting prevents inclusion in meta-analytic summary estimates by identifying reports of studies that were eligible for inclusion in a prior meta-analysis, and found that 25% were excluded due to inadequate reporting. Finally, we investigated selective reporting practices by analyzing the protocols of the studies included in the meta-analysis which had been registered on any trial registry and coding their timing, completeness, and consistency. We found that 23% of studies were pre-registered, 71% were late-registered, and 5% were registered at an unclear date. Only 8% of registrations specified all of the necessary components. Evidence of selective reporting was common; 36% failed to report a registered outcome, 61% reported unregistered outcomes, 23% switched primary and secondary outcomes, and 43% had assessment timepoints that differed from registration specification. Given the inadequacy of registration and reporting practices, we offer practical recommendations to facilitate improvement for the field of autism research.Lay Abstract When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better.

PURPOSE:This study aims to help researchers design observational measurement systems that yield sufficiently stable scores for estimating caregiver talk among caregivers of infant siblings of autistic and non-autistic children. Stable estimates minimize error introduced by facets of the measurement system, such as variability between coders or measurement sessions. METHOD:Analyses of variance were used to partition error variance between coder and session and to derive g coefficients. Decision studies determined the number of sessions and coders over which scores must be averaged to achieve sufficiently stable g coefficients (0.80). Twelve infants at elevated likelihood of an autism diagnosis and 12 infants with population-level likelihood of autism diagnosis participated in two semistructured observation sessions when the children were 12-18 months of age and again 9 months later. Caregiver follow-in talk was coded from these sessions. RESULTS:Two sessions and one coder were needed to achieve sufficient stability for follow-in talk and follow-in comments for both groups of infants at both time points. However, follow-in directives did not reach sufficient stability for any combination of sessions or coders for the population-level likelihood group at either time point, or for the elevated likelihood group at Time 2. CONCLUSION:Researchers should plan to collect at least two sessions to derive sufficiently stable estimates of caregiver talk in infants at elevated and general population-level likelihood for autism. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.27996875.

LAY ABSTRACT:How non-autistic people think about autistic people impacts autistic people negatively. Many studies developed trainings to reduce autism stigma. The existing trainings vary a lot in terms of study design, content, and reported effectiveness. This means that a review studying how the studies have been conducted is needed. We also looked at the quality of these studies. We collected and studied 26 studies that tried to reduce stigma toward autistic people. The studies often targeted White K-12 students and college students. Most trainings were implemented once. Trainings frequently used video or computer. Especially, recent studies tended to use online platforms. The study quality was poor for most studies. Some studies made inaccurate claims about the intervention effectiveness. Studies did not sufficiently address study limitations. Future trainings should aim to figure out why and how interventions work. How intervention changes people's behavior and thoughts should be studied. Researchers should study whether the training can change the societal stigma. Also, researchers should use a better study design.

Background: Some autistic children exhibit behavior that is described by caregivers and in research to be problematic. However, there is little consensus about the types of behaviors that should be reduced via intervention, which can range from inherently harmful behaviors such as aggression and self-injury, to non-normative but not harmful behaviors associated with autism such as repetitive movements. Likewise, there are a variety of conceptualizations and measurement practices associated with these behaviors.Methods: In this secondary systematic review of group-design, non-pharmacological intervention studies for autistic children up to age eight, we sought to explore researcher conceptualization and measurement practices of problem behavior. We defined problem behavior as any outcome where specific behaviors were targeted for reduction or elimination. A coding scheme was applied to 102 studies that met inclusion criteria for the secondary review. All studies were double coded by two independent coders.Results: Forty-seven percent of studies described reducing behavior as a primary or secondary purpose of the study and/or intervention, 33% gave a rationale for targeting behaviors for reduction, and 28% offered a conceptualization of the behavior(s) they targeted. Only 8% offered a conceptual definition. The most common measures were “off-the-shelf” measures that had undergone at least some previous validation beyond inter-rater reliability, and that involved parent reports. For the ten most common assessment measures, two were validated along six different validation dimensions in autistic populations. All but one full scale or subscale measured either behaviors that were non-normative but not inherently harmful, or a mix of behaviors that were inherently harmful and that were non-normative but not inherently harmful.Conclusions: Intervention researchers should provide clear definitions and rationales for targeting behaviors for reduction via intervention and should develop refined measurement tools for assessing these behaviors in collaboration with the autistic community.