Access to early autism intervention remains limited for many families, increasing interest in alternative service delivery models such as telehealth-based parent-mediated intervention. However, few studies have examined developmental trajectories observed under different service delivery formats within naturalistic clinical settings. This longitudinal observational study examined developmental trajectories during a 20-session parent-mediated intervention delivered either in-person or through telehealth-based caregiver coaching for young autistic children. A total of 320 children were initially enrolled, and 297 were included in the final analytic sample (99 per group: in-person intervention, telehealth intervention, and typically developing comparison group). Developmental outcomes were assessed using the Ages and Stages Questionnaires (ASQ) and CDC developmental milestone indicators. Children in the intervention groups were assessed at baseline, Week 10, and Week 20. The typically developing group was assessed at baseline and Week 20 and was included for descriptive developmental context only. Linear mixed-effects models were used to examine developmental trajectories over time and to explore differences between service delivery formats. Across both intervention formats, caregiver-reported developmental scores increased over time on ASQ and CDC measures, with higher scores observed at Week 10 and Week 20 relative to baseline (ps < 0.001). The typically developing comparison group maintained higher developmental scores throughout the study period and demonstrated expected age-related developmental progression over time. Although children in both ASD intervention groups demonstrated substantial developmental gains over 20 weeks, developmental functioning remained below that of the typically developing group at follow-up, indicating that the developmental gap narrowed but was not eliminated. Analyses did not detect statistically significant differences in developmental trajectories between in-person and telehealth delivery formats (ps ≥ 0.27). Children participating in both in-person and telehealth parent-mediated intervention demonstrated increasing caregiver-reported developmental scores over time. Differences in developmental trajectories between service delivery formats were not detected within the precision of the present analyses. These findings should not be interpreted as evidence of equivalence or comparative effectiveness. Rather, they provide observational information regarding developmental trajectories under two real-world, family-centered service delivery models. Further research using randomized comparative designs, blinded outcome measures, standardized fidelity monitoring, and formal noninferiority or equivalence frameworks is needed to evaluate comparative effectiveness across delivery formats.
This review investigated the efficacy of behavioral skills training (BST) when training caregivers to teach mand skills to their children with autism. Additionally, this review evaluated aspects of BST to increase its efficacy and time efficiency. This review addressed five questions: (1) what are the effects of BST when teaching caregivers to implement procedures to teach manding skills to their children with autism? (2) do caregiver-implemented procedures produce maintenance and generalization of communicative responses by their children? (3) what are the effects of booster training? (4) what is the BST training time or sessions to mastery reported across studies to reach optimal performance by caregivers? and (5) what are the settings in which BST training was delivered to caregivers? Using academic databases (PsychINFO, ERIC), this review assessed peer-reviewed articles that evaluated BST to train caregivers to implement communication procedures using single-case designs. The initial search resulted in 1,394 articles. 14 studies met inclusion criteria in this review. Results suggested the efficacy of BST procedures during the training of caregivers to teach manding skills. Further evaluations of the effect of BST with caregivers related to communication instruction to their children with autism are needed. Also, an analysis of variables that could potentially improve aspects of BST delivery warrant further investigation (e.g., training time, setting, child presence during training). The state of the research base related to the efficacy of BST in this context, and recommendations for future research and implications for the practice are discussed.
Emerging adult siblings of individuals with autism may become increasingly involved in current and future caregiving during a developmental stage typically associated with identity exploration, autonomy, and life planning. This qualitative study examined how emerging adult siblings describe their present involvement, emotional experiences, and anticipated future responsibilities in relation to a sibling with autism. Participants were 122 emerging adult siblings of individuals with autism in Israel who completed an anonymous online questionnaire in Hebrew. Written responses to open-ended questions were analyzed using inductive qualitative content analysis. Descriptive frequency counts were used to indicate the relative prominence of themes across the dataset. Five interrelated themes were identified: emotional overload, worry, and public embarrassment; everyday practical and emotional care; mediation as social interpretation and participation support; premature responsibility and adultification; and anticipated future care and long-term responsibility. The findings show that emerging adult siblings' roles extend beyond occasional assistance and may include ongoing emotional, practical, social, and future-oriented forms of involvement. Emerging adult siblings may constitute a distinct group within family support contexts. Their involvement in current and future planning should remain voluntary, supported, and sensitive to their own developmental needs, as well as to the rights and preferences of individuals with autism.
Despite growing recognition of autism spectrum disorder (ASD) in the Gulf region, little is known about how caregiver characteristics relate to ASD-related knowledge and quality of life (QoL) in Kuwait. This study examined the association between demographic factors and both ASD-related knowledge and caregiver QoL among family caregivers of children and adolescents with ASD. A cross-sectional survey was conducted with 130 unpaid family caregivers of children and adolescents with a confirmed ASD diagnosis in Kuwait. Participants completed a demographic questionnaire, the Autism Spectrum Disorder Parent/Caregiver Quality of Life questionnaire (ASDPC-QoL), and a 31-item ASD knowledge questionnaire. Chi-square tests, independent-samples t tests, and one-way ANOVAs were used to examine group differences. Most participants were mothers (68.5%) and female (82.3%). Mean knowledge was 50.7% (SD = 19.2), with 64.6% classified as having poor knowledge. Misconceptions were most prevalent regarding curability, vaccination, and exceptional abilities. Mean overall QoL was 64.7 (SD = 14.5) on a 0-100 scale, with preoccupations scoring lowest. Higher income and educational attainment were associated with better knowledge. Male caregivers reported significantly higher mental health QoL than female caregivers (d = 0.46). Mothers and caregivers of children receiving rehabilitation services reported lower mental health and overall QoL. Caregiver knowledge gaps and QoL burden varied systematically by gender, education, income, and caregiving role. Findings support the need for targeted, culturally informed psychoeducation and mental health support for caregivers in Kuwait, particularly mothers and lower-income families.
Autistic people experience high rates of anxiety and depression, yet an evidence-based understanding of how and why these difficulties first develop is lacking. By centring autistic young people's accounts, this study aims to understand how interactions between autistic people and their environment throughout childhood and adolescence give rise to anxiety and depression. Twenty autistic young people aged 10-18 and 30 parents of autistic young people aged 5-18 completed semi-structured qualitative interviews about experiences of anxiety and depression. Framework Analysis identified three themes. External demands and pressures: Participants described the weight of pressures to meet non-autistic standards within school, social and sensory environments. Autonomy and control: Young people struggled with environments not under their control. They benefited from a balance of structure and autonomy within home and school settings. Safety, trust and predictability: Trust and acceptance from others (such as family, peers, teachers and professionals), access to safe places (such as home and nature), and engaging in interests were important protective factors. Autistic young people can feel pressure to meet non-autistic demands, impacting mental health. Factors such as academic expectations, parenting styles, understanding of autism among family, teachers and peers, and low sensory demand spaces may be important targets for intervention.
To examine caregiver age and mutuality as moderators in the relationship between caregiver strain and quality of life (QoL) among caregivers of offspring with intellectual and developmental disabilities (I/DD). A cross-sectional online survey was conducted with 186 parents of offspring with I/DD. Moderation and three-way interaction analyses were performed using Hayes' PROCESS macro to test caregiver age, mutuality, and their interaction as moderators of the association between caregiver strain and quality of life. The three-way interaction (caregiver strain × mutuality × caregiver age) was statistically significant (p = .01). Higher mutuality buffered the negative impact of caregiver strain on quality of life, but only among younger caregivers. Mutuality serves as an important buffer against the detrimental effects of caregiver strain on quality of life for younger caregivers. However, this buffering effect diminishes as caregivers age. Interventions may benefit from an age-tailored approach, such as enhancing mutuality and relational support for younger caregivers while prioritizing tangible, practical support for older caregivers. These strategies could strengthen the design and delivery of caregiver support programs and policies.
Reliable and up-to-date data on autism spectrum disorder (ASD) prevalence in France remain limited. This study aimed to describe long-term trends in ASD diagnosis rates at age 8 in a French county between 2003 and 2024 and to provide a detailed epidemiological, clinical, educational, and care-related profile of children with ASD in the most recent years. Data were drawn from the Haute-Garonne Child Disability Registry, which records children diagnosed with ASD by age 8 using multiple sources and validated diagnoses. Long-term registry-based prevalence trends were examined considering children born between 1995 and 2016. Descriptive and comparative analyses were conducted for children born between 2014 and 2016, focusing on sex, intellectual disability (ID), associated conditions, age at diagnosis, schooling and care arrangements. The registry-based prevalence of ASD at age 8 increased markedly ranging from 2.1‰ in 2003 to 13.5‰ in 2024. In 2024, the prevalence reached 21.1‰ among boys. The increase was predominantly driven by ASD without ID, which accounted for nearly 70% of recent cases. For recent cases the median age at diagnosis was 4 years. Over 20% had co-occurring attention deficit hyperactivity disorder, while sleep and eating disorders were also frequent. Schooling and care arrangements differed substantially according to the presence of ID. The increase in registry-based prevalence does not appear to have levelled off, with diagnoses overwhelmingly and increasingly being made in children without ID. The situation regarding neurodevelopmental disorders in France is changing profoundly and requires ongoing monitoring, which registries are contributing to.
In Aotearoa New Zealand (NZ), families face persistent barriers to accessing evidence-based early support for Autistic children. This randomized controlled trial (RCT) evaluated the effectiveness of Let's Play; a bespoke, caregiver-mediated early support program for Autistic children and their caregivers. This single-blind (rater) RCT included 91 parent-child dyads, randomly assigned to the Let's Play program (active support; AS [n = 45]) or a waitlist control (WLC; n = 46). Participants were caregivers of children aged 0 to 5 years with a formal diagnosis or characteristics of autism. Let's Play was delivered over 9 weeks via group workshops and in-home coaching. Primary child and caregiver outcomes, assessed at baseline, post-support, and 6-month follow-up, included parent-child engagement and parental stress, respectively. Children showed descriptive evidence of improvement in caregiver-child engagement, health-related quality of life and behaviour from baseline to post-support. Improvement in parental stress, depression and anxiety symptoms, and self-perceived parenting competence were also evident, across timepoints. However, there were no significant Group x Ttime effects for caregiver-child engagement, number of utterances or number of different words. A Group x Time effect was evident for all other child and caregiver outcome variables, underscoring the benefits of Let's Play. This research provides preliminary evidence of the effectiveness of a low-intensity, community-based, caregiver-mediated early support program for Autistic children's health-related quality of life and behavior and caregiver well-being. However, more targeted or sustained approaches to supporting caregiver-child engagement and vocal communication may be needed for improvement to be observed. The research protocol was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622001139763).
The etiology of autism spectrum disorder (ASD) is poorly understood, with sparse data from the Middle East and North Africa (MENA) region, which has a unique socio-epidemiological setting. This research investigated early-life developmental risk factors associated with ASD in the MENA region. In this systematic review and meta-analysis, we searched the PubMed, Embase, Scopus, and CINAHL databases for observational studies that conducted adjusted analyses of ASD risk factors in the MENA region. We analyzed associations between ASD and factors related to conception, inheritance, maternal morbidity during pregnancy and adverse pregnancy outcomes. After study quality assessment, meta-analyses for each risk factor were carried out using a bias-adjusted inverse variance heterogeneity model. Heterogeneity was assessed using I2 and publication bias using Doi plots and funnel plots. The systematic review included 19 case-control studies from eight countries within the MENA region. In overall synthesis, male sex (OR = 3.27, 95% CI: 2.39-4.48, I2 = 40.9%), family history of ASD (OR=7.02, 95% CI 3.30-14.95, I2 = 85.0%), and consanguinity (OR = 1.77, 95% CI: 1.38-2.28, I2 = 57.1%) were associated with ASD. Although with limited studies, a review of the literature showed some possible associations between ASD and gestational diabetes, gestational hypertension, macrosomia, NICU admission, respiratory distress syndrome, cesarean delivery, gestational age, and older maternal age. These findings confirm the association between male sex, family history of ASD and consanguinity with ASD, potentially suggesting some inherited mechanism in the etiology of ASD in the MENA region. Some maternal co-morbidities during pregnancy and adverse pregnancy outcomes may contribute to higher ASD risk, although more studies are needed in the region. The protocol for this systematic review and meta-analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42024499837.
Parents face heightened stress during emergencies and wartime, with those raising children with autism spectrum disorder (ASD) encountering especially intensified challenges. Psychological and social resources such as psychological flexibility and community resilience (CR) may buffer against distress, yet little is known about their role under extreme conditions. This study examined differences in psychological flexibility, CR, and psychological distress (depression, anxiety, and stress) between parents of children with ASD and parents of typically developing (TD) children during the Israel-Gaza "Swords of Iron" War. A total of 166 Israeli parents participated, including 80 of children with ASD and 86 of TD children, recruited online through purposive sampling. Results indicated that parents of children with ASD reported lower psychological flexibility and CR compared to TD parents, but groups did not differ significantly in overall distress. Moderation analysis showed that group status moderated the link between CR and distress, with CR more strongly associated with lower distress among parents of children with ASD. These findings underscore the importance of interventions and policies that foster psychological flexibility and strengthen CR for all families, while prioritizing tailored support for parents of children with ASD who demonstrate particular vulnerability during crises.
Whether autism is increasing is a subject of growing interest to researchers, health and social care professionals, policymakers, and the general public. We examined trends over time in the proportion of adults in England self-reporting as autistic, utilising data from an annual repeated cross-sectional survey series of adults registered with a General Practice in England. We report annual unweighted frequencies and weighted percentages (with 95% confidence intervals) for survey respondents self-reporting autism for 2018 to 2025, with equivalent data for self-reporting learning disability and a mental health condition. We additionally report the percentage change for 2019 to 2025, compared to a 2018 survey year baseline. Disaggregated data was reported according to age group, gender identity, and ethnicity. The weighted percentage of adults self-reporting as autistic has increased from 0.9% (95% CI 0.9-0.9) in 2018 to 2.6% (95% CI 2.5-2.7) in 2025, representing a 188.9% increase over a 7-year period. More modest percentage increases over this same time period were observed for learning disability (26.7%) and mental health condition (51.6%). The majority of the increase in adults self-reporting as autistic took place between the 2021 and 2025 survey years, over which time there was a 136.4% increase. There has been a substantial increase in adults self-reporting as autistic in England over a relatively short period of time, with an absence of similar increases in self-reporting as having a learning disability or a mental health condition. Further research is required to better understand the factors underpinning this change.
IntroductionAutism support needs can be viewed as 'wicked problems', underpinned by various disrupting factors distributed across time and space. This complexity strains care providers' ability to act swiftly and decisively. An integrative autopoietic-enactive approach may offer guidance by taking the individual's interactional social-ecological system as the central unit of analysis. In clinical practice and research, however, this approach is only beginning to take shape. A lack of definition and codification hinders practical guidance and clinical innovation.MethodTo explore what autopoietic-enactive autism healthcare might mean in practice, this scoping review maps healthcare practices that are already based on autopoietic enactivism or bear affinity with it.ResultsForty-nine publications met with inclusion, representing 2.21% of the initial corpus. Findings were synthesized using four analytical lenses: aspects of (I) ecological-, (II) tangible-, (III), intersubjective-, and (IV) socio-cultural life, representing distinguishable albeit not separable dimensions of a person's social-ecological system.ConclusionOur findings present a rich but still loosely integrated picture of healthcare practices. This scoping review provides a reference point from which the approach may be further defined and consolidated into a clinical research field. IntroductionSupporting autistic people can be challenging because their needs are complex and evolve over time. This complexity makes it difficult for care providers to determine exactly what to do. One promising way forward is autopoietic enactivism, which looks at a person in relation to their environment. In clinical practice and research, however, an autopoietic-enactive approach is still new and not clearly defined.MethodTo explore what autopoietic enactivism can bring to the clinical domain, we conducted a scoping review of autism healthcare practices that already use ideas from autopoietic enactivism.ResultsOut of the full body of literature that we screened, 49 publications met our criteria. These findings were brought together using four different lenses that reflect different but connected parts of everyday life: aspects of (I) ecological-, (II) tangible-, (III), intersubjective-, and (IV) socio-cultural life– or, more precisely: the everyday life domains that people live in, the material things they interact with, the other people they interact with, and the wider social and cultural context that influences these interactions.ConclusionOur findings provide a comprehensive overview of healthcare practices, but the overall picture is not yet fully coherent. By providing an overview of existing work, this scoping review can help turn autopoietic-enactive autism healthcare into a clearer, coherent, and more well-defined research field.
This study aims to comprehensively evaluate the relationships between TMJ dysfunction, cervical posture, functional balance, dual-task performance, and social adaptive skills in individuals with Autism Spectrum Disorder (ASD). The study included 23 individuals with ASD aged 4-17 years and 23 age- and gender-matched typically developing controls. Participant information was collected using a case evaluation form. TMJ dysfunction was assessed using the Helkimo Index, cervical posture using the PostureScreen application, and functional balance using the Timed Up and Go (TUG) test. Dual-task performance was evaluated through motor and cognitive task combinations, and social adaptation was measured with the Vineland Adaptive Behavior Scale. the ASD group had significantly longer TUG durations compared to controls (p < 0.05). Mandibular movements and Helkimo Index scores were also significantly higher in the ASD group (p < 0.05). In the Ten-Meter Walk Test across all motor and dual-task conditions, the ASD group again demonstrated significantly longer durations (p < 0.05). No significant differences were found in cervical range of motion between groups (p > 0.05). However, the ASD group scored significantly lower on Vineland total and subscale scores (p < 0.05). Postural analysis revealed significant differences in several head and shoulder displacement distances and angles (p < 0.05). Moderate positive correlations were found between the Ten-Meter Motor Test (and its sub-dimensions) and Helkimo scores. Individuals with ASD exhibit TMJ dysfunction, balance impairments, dual-task difficulties, and reduced social adaptation skills, supporting the need for multidimensional assessment approaches.
Wikipedia is a major health information resource, yet little is known about how autism is represented across language editions. To examine sourcing, framing, editorial dynamics and readership of autism-related Wikipedia pages in six languages (English, Spanish, French, Italian, Norwegian and Georgian). We constructed a corpus of the main autism article in each language and used Python-based pipelines to extract references, revision histories (2004-2024) and monthly pageviews (2020-2024). We conducted descriptive statistics, lexicometric analyses and inductive thematic coding. Across languages, autism is lexically and thematically framed primarily as a childhood, biomedical condition: child-related terms outranked adult-related terms in all editions, and "neurodiversity" appeared only marginally. Sourcing patterns differed markedly, with English and Italian relying more heavily on journals, French and Spanish on websites, Norwegian on institutional documents and Georgian under-sourced. Pageviews were highly unequal in absolute terms but, once normalised per million speakers, smaller language communities (Georgian, Norwegian and Italian) showed the highest relative demand. These high-demand editions nonetheless had the smallest editorial bases and fewest cumulative edits. Autism-related Wikipedia pages constitute pivotal but uneven knowledge infrastructures. Strengthening adult, lifespan and neurodiversity perspectives and supporting smaller language communities could improve the robustness of online autism information.
The Autism Diagnostic Observation Schedule (ADOS) is regularly cited as the standalone 'gold standard' or an essential inclusion for diagnosis of Autism Spectrum Disorder. This research considers whether the evidence is consistent with the strength of such beliefs. A random sample of 100 published articles referring to the ADOS as having 'gold standard' status was reviewed. Analysis of cited evidence for this proposition was performed over three iterations, exploring the source of each 'gold standard' statement. The first iteration found 62% of 'gold standard' statements were either unreferenced or only cited test materials. From the remaining 38%, a total of 47 discrete sources were referenced. In the second iteration, about 60% of papers did not include any supporting reference, with another five citing references inconsistent with 'gold standard' statements. Only one paper from the third iteration cited source material that had not been reviewed in the first and second iterations. Two of the three associated references cited in that one paper contained no mention of the ADOS as a 'gold standard'. The majority of papers reviewed failed to cite support for a 'gold standard' statement. Failure to identify these issues at peer-review suggests a pervasive, but erroneous, assumption that there is a broad consensus about the status of the ADOS. In reviewing this sample, 'gold standard' consensus appears based more on hearsay and marketing than clinical support, suggesting a need for greater vigilance during the review process by requiring authors to establish evidence for significant assertions.
While distinct pragmatic profiles are well-documented, grammatical abilities in autistic children show considerable heterogeneity: some exhibit grammatical difficulties, while others demonstrate age-appropriate grammar. Yet, one construction remains underinvestigated: passives of psychological/mental state verbs ("remember", "love"). This is critical because young children are known to comprehend passives of agentive verbs ("kiss", "push") via an adjectival passive strategy before acquiring passive grammar. This strategy fails for psychological verbs, making them the true test of passive knowledge. Despite extensive research in typically developing (TD) populations and populations with other neurodevelopmental conditions, there is little research examining both types of verbal passive in English-speaking autistic children. We examined comprehension of agentive and psychological passives, short and long, in 48 autistic children divided into those with co-occurring language impairment (ALI, n = 26, mean age: 11;10), and those without (ALN, n = 22, mean age = 11;02), compared to two control groups matched on non-verbal reasoning (TD-Match-ALI, n = 22, mean age: 5;11 and TD-Match-ALN, n = 22, mean age: 10;03), on a sentence-matching task. Children with ALN demonstrated age-appropriate performance across all constructions. In contrast, children with ALI performed at or below chance on both agentive and psychological passives, indicating absence of the adjectival strategy, and a profile distinct from all other groups including younger TD children. The findings reveal distinct developmental trajectories: children with ALN show age-appropriate grammatical development, while children with ALI demonstrate fundamental syntactic impairments. These results highlight the importance of testing psychological verb passives to accurately identify grammatical difficulties that standardised assessments may miss.
Prader-Willi Syndrome (PWS) is a rare, complex, genetic neurodevelopmental disorder that induces a hypothalamic dysfunction with a global developmental delay and specific trajectories. Behavioral and psychiatric disorders are recurrent in PWS, emerging during childhood and varying considerably in their manifestations. This study aimed to gain a better understanding of the relationship between emotion, cognitive and behavioral regulation abilities in children with PWS, and explore the impact on daily life. Twenty-five children with PWS aged between 9 and 15 took part in the study, along with an equal number of age-matched control children. A series of assessments was proposed to children and their parents to measure cognitive and executive competencies, affective and behavioral problems, and family impact. The children with PWS were clearly distinguished from the control group, displaying marked deficits in cognitive skills, including executive ones, and affective problems. Inter-task correlation analyses showed that many variables were significantly interrelated in the PWS group, in contrast with the control group. Inter-individual variation was strong and cluster analyses revealed that three subgroups emerged; one marked by cognitive and executive deficits, a second by a high level of affective problems, while a third displayed relatively preserved cognitive, executive and emotional skills. The three clusters did not differ in the family impact. The variability of behavioral problems observed in children with PWS seems to be underpinned by cognitive and emotional regulatory mechanisms. This original approach is discussed in light of the literature.
Vision plays a pivotal role in development. Congenital and early acquired visual impairment (VI) may adversely impact several domains related to everyday functioning, such as social and academic inclusion, autonomies and quality of life. In recent years, the inclusion of these dimensions as key targets of the assessment and re-habilitation of paediatric VI has received increasing consensus. This cross-sectional study enrolled patients attending 5 centres specialized in paediatric VI care and aimed to draw an integrated profile of functioning, autonomies, quality of life and emotional-behavioural domains in a large cohort of children with VI. 91 caregivers of as many visually impaired children (age range 6-18, mean age 11.05 years, 47 females) - split into two age groups: 6-10 years; 11-18 years - were enrolled in an on-line survey including three validated questionnaires to assess children's: a) autonomies, via a Patient Reported Outcome Measure (PROM) tool; b) socio-emotional and behavioural problems; c) quality of life (QoL). Clinical and socio-demographic information were also collected. Both age groups showed medium-high average level of autonomy in every investigated area as well as appropriate socio-emotional, behavioral, and QoL scores. Interestingly, adolescents showed lower scores in autonomies compared to the younger age group overall. Autonomy score significantly associated with better QoL and less socio-emotional and behavioural problems, both internalizing and externalizing. Our results highlight the importance of assessing autonomy in the context of paediatric VI re-habilitation as they largely associate and potentially impact on young patients' psychological well-being.
Social media has become an important platform for Autism Spectrum Disorder (ASD) communication. This study aimed to analyze online posts and comments related to ASD on Chinese social media, focusing on the emotional tendencies and topics about ASD. This study used Python to retrieve ASD posts and comments, including 1,563 posts and 17,908 comments on Chinese social media. We employed content analysis to categorize posts and utilized the BERTopic model alongside Kernel Density Estimation (KDE) to examine sentiment distribution and thematic clusters. (1) Content analysis revealed that in addition to Educational Information (44.5%), Personal Experience (25.5%), and Daily Life (23.1%), a fourth distinct category emerged in Chinese social media posts concerning ASD: Media Representation. This category captures how film, television series and novels shape public perception about ASD; (2) Sentiment analysis uncovered a stark "emotional polarization." While post content remained relatively balanced (52.8% positive), comment sections exhibited an overwhelming negative bias (66.9% negative), with sentiment scores heavily skewed toward the extreme low range (0-0.2); (3) BERTopic modeling identified four positive topics centered on family narratives, emotional support, intervention strategies and future survival planning. In contrast, the ten most prevalent negative topics emerged: half focus on conceptual controversies surrounding ASD, while the remainder address caregiving burdens, media criticism, and profound ethical conflicts regarding the life value of autistic individuals. Social media in China plays an important role in public education regarding the conceptual understanding of ASD. However, these platforms provide limited emotional and informational support for affected families, while also perpetuating negative narratives and stereotypes that contribute to the stigmatization of ASD.
Despite the growing awareness of neurodivergence, autistic adults continue to face disproportionately low employment rates worldwide compared to the neurotypical population. This scoping review investigates the impact of social stigma on the employment outcomes of autistic individuals, aiming to understand the experiences of autistic adults in the workplace with the research question: How does the stigma surrounding autism affect the employment outcomes of autistic individuals? This scoping review examined 14 qualitative studies published over the last 10 years and synthesized the perspectives of both employers and autistic employees to identify key themes shaping their workplace experiences. The findings suggest that stigma, evident through misconceptions and a lack of inclusive workplace cultures, often results in discriminatory practices and limits employment opportunities while negatively affecting the well-being of autistic individuals. Four consolidated themes emerged from the autistic perspective: inclusive practices, the importance of fitting in, generalizations about autism, and masking or social camouflaging. From the employer's perspective, three consolidated themes were identified: inclusive versus non-inclusive practices, understanding of autism, and attitudes towards discrimination and disclosure. These results highlight the need for a societal shift in perceptions toward more inclusive workplace practices, including community-level anti-stigmatization education and workplace accommodations that support all employees.