Pubmed (TSA) du 01/11/26
1. Adams M, Downs J. Autism, anorexia nervosa, and the prevention of death: evidence supports adapted treatment, not assisted death. Eat Disord;2026 (Nov-Dec);34(6):690-698.
The practice of assisted death (AD) for people with eating disorders (EDs) is expanding, and a concerning revelation is the over-representation of autistic individuals among those with EDs who are offered (and complete) AD. Informed by our lived experience with EDs and being diagnosed with autism in adulthood, we examine the intersection of autism, EDs, and AD. We believe that the lack of autism assessment, autism-affirming treatment, and the over-specialization of ED care, exacerbated by futility narratives, are systemic failures that have contributed to autistic people with EDs being offered, and sometimes complete, AD. We challenge the notion of futility in ED care that justifies AD for autistic people with EDs and advocate for neurodiversity-affirming, trauma-informed adaptations to treatment that address the challenges autistic individuals may face in recovery, such as Multidiagnostic Eating Disorder Dialectical Behavior Therapy. We propose changes to safeguard autistic individuals and ensure they are offered meaningful pathways to treatment rather than being abandoned to premature death.
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2. Fatta LM, Di Tata D, Bianchi D, Lonigro A, Laghi F. Parents’ Diagnostic Resolution and Activation: Examining a Mediation Model on Emotional and Behavioral Outcomes in Autistic Children and Adolescents. J Genet Psychol;2026 (Nov 1):1-17.
A diagnosis of Autism Spectrum Disorder poses significant emotional and practical challenges for parents. Although diagnostic resolution and parent activation have been examined separately, little is known about whether parents’ psychological adjustment relates to active caregiving and, in turn, to child outcomes. This study tested: (1) a mediation model linking diagnostic resolution to child emotional-behavioral difficulties through parent activation; (2) psychometric properties of the Italian Parent Activation Measure for Developmental Disabilities (PAM-DD). We hypothesized that diagnostic resolution would be indirectly associated with lower levels of children’s emotional-behavioral difficulties through higher parent activation. Participants were 179 parents (87.7% mothers; M(age) = 43.91; SD = 5.63) of autistic children aged 6-13 years (81.6% boys; M(age) = 9.50; SD = 2.32). Diagnostic resolution was operationalized as a reliable reduction in negative emotional responses, and child difficulties were assessed using the Strengths and Difficulties Questionnaire (SDQ). Confirmatory Factor Analysis (CFA) examined PAM-DD structure, and path analysis tested the mediation model, controlling for child age and time since diagnosis. CFA supported a two-factor model (activated and passive dimensions) with acceptable fit (CFI = .92, TLI = .90, RMSEA = .06, 90% CI [.05, .08], SRMR = .07). Resolution was associated only with the activated dimension (β = .19, p < .05), which was negatively related to children's emotional-behavioral difficulties (β = -.25, p < .01). Findings suggest that psychological integration of the diagnosis may foster action-oriented parental engagement, which is linked to fewer child emotional-behavioral difficulties, highlighting parent activation as a potential intervention target.
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3. Johnston KJ, Hendricks M, Roberts ET, Macneal E, Dabas M, Pollack HA, Figueroa JF, Ne’eman A. Dual-Eligible Adults With Intellectual And Developmental Disabilities: Enrollment In Integrated D-SNPs Grew, 2021-23. Health Aff (Millwood);2026 (Nov);45(11):1255-1264.
Many US adults with intellectual and developmental disabilities are enrolled in both Medicare and Medicaid. Evidence characterizing coverage arrangements of these adults is limited, particularly in light of changes in the dual-eligible coverage market, including expansion of Dual Eligible Special Needs Plans (D-SNPs). D-SNPs are Medicare Advantage plans that exclusively enroll dual-eligible beneficiaries and, in some cases, financially integrate Medicare and Medicaid coverage. Whether D-SNPs integrate coverage for adults with intellectual and developmental disabilities may depend on whether states include this population in Medicaid managed long-term services and supports (MLTSS) programs. Using nationwide data on 644,112 dually enrolled adults with intellectual and developmental disabilities, we found that enrollment in integrated D-SNPs grew from 8.0 percent in 2021 to 11.4 percent in 2023. Among adults with intellectual and developmental disabilities residing in counties where integrated D-SNPs were offered, those who resided in states with (versus without) MLTSS available to them had greater integrated D-SNP enrollment in 2021 (23.9 percent versus 8.4 percent), 2022 (27.1 percent versus 10.9 percent), and 2023 (31.2 percent versus 12.6 percent). Availability of state MLTSS to adults with intellectual and developmental disabilities is likely a key driver of integrated D-SNP enrollment growth in this population.
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4. Martín TV, Neininger MP, Krause GE, Bertsche T, Bertsche A, Jeschke S. The COVID-19 Pandemic Experience of Families With Children With Developmental Disorders in Northeastern Germany. Child Care Health Dev;2026 (Nov);52(6)
BACKGROUND: Developmental disorders are associated with considerable challenges for affected children and their families. During the COVID-19 pandemic, families faced additional stress, including challenging decisions regarding COVID-19 vaccination for their children. This exploratory study therefore examined the experiences of families with children with developmental disorders during the pandemic and their attitudes towards vaccination, including the perceived benefits and disadvantages of their decision. METHODS: This exploratory study was conducted from April to June 2022 at a university hospital in Northeastern Germany. The semi-structured interviews included open and closed questions, as well as 5-point Likert scales. RESULTS: We interviewed 65 parents of children aged 3-17 years (median age: 6; Q25/Q75: 4/11). Among them, 69% reported a negative impact on their child, most frequently emotional and behavioural changes (45%), followed by developmental and educational setbacks (26%) and social and communication difficulties (14%). Seventy-three percent of parents perceived the influence of the COVID-19 pandemic on the parent-child interaction as very, rather or partly burdensome. Governmental support was judged as ‘not adequate’ or ‘rather not adequate’ by 64% of parents. Among the 44 children eligible for COVID-19 vaccination, 59% were not vaccinated. Fear of adverse events was the main reason against vaccination (81%), whereas fear of COVID-19 infection was the main motivation for those who chose to vaccinate (89%). Vaccination was associated with perceived benefits in daily life, whereas nonvaccination was associated with reduced participation and increased infection-related worries. CONCLUSIONS: Most parents of children with developmental disorders perceived negative effects of the pandemic on the lives of their child and themselves. Among children eligible for COVID-19 vaccination, more than half of the parents decided against vaccination, despite reported benefits of vaccination and reported disadvantages associated with nonvaccination. Future research is needed to develop tailored vaccination campaigns and safety-focused communication strategies for children with developmental disorders.
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5. Wang Z, Fang L, Wang S, Zhao J, Zhang Q, Zou X, Wu D. Efficacy and safety of pharmacologic therapies for irritability in pediatric autism spectrum disorder: A systematic review and network meta-analysis of randomized controlled trials. J Psychopharmacol;2026 (Nov 1):2698811261495555.
INTRODUCTION: Irritability is a common and clinically significant feature of pediatric autism spectrum disorder (ASD). We conducted a systematic review and network meta-analysis (NMA) to compare and rank pharmacological interventions for irritability in this population. METHODS: Multiple databases were searched up to September 1, 2025, for randomized controlled trials enrolling pediatric ASD with significant irritability. Risk of bias was assessed using Cochrane RoB 2.0, and confidence in network estimates was evaluated with Confidence in Network Meta-Analysis. Pairwise meta-analyses, subgroup analyses, and frequentist NMA were performed for efficacy and safety outcomes. RESULTS: Forty-three RCTs involving 2711 participants, evaluating 35 drugs across 41 regimens, were included. Traditional pairwise meta-analysis suggested that pharmacotherapy improved irritability more than placebo, with greater effects in younger children (<12 years) and shorter trials (⩽8 weeks). In the NMA, risperidone (Ris; MD = 8.81, 95% CI: 6.01-11.61) and aripiprazole (MD = 5.53, 95% CI: 2.61-8.45) led to larger reductions in ABC-I scores compared with placebo, showing the highest probability among monotherapies (surface under the cumulative ranking curve: 98% and 85%). Among Ris combination regimens, the most favorable effect was observed for the addition of topiramate, with an MD of 7.55 (95% CI: 5.89-9.21) relative to Ris + placebo. In terms of safety, pharmacotherapy was associated with an absolute adverse events (AEs) risk increase of 0.08 versus placebo, with no severe events reported. CONCLUSION: Ris and aripiprazole had the highest ranking probabilities among monotherapies, and topiramate was the most promising Ris adjunct in the NMA. Pharmacotherapy carried a slightly elevated AE risk, with no severe events. However, rankings should be interpreted cautiously because most comparisons were indirect. Large high-quality head-to-head trials are needed to confirm comparative efficacy and long-term safety.
