Pubmed (TSA) du 02/05/26
1. Guo J, Chen M, Zhou Y, Wang J, Huang Q, Ding J, Li M. The global burden of autism spectrum disorders in children aged 0-14 years from 1990 to 2021: A population-based study. Psychiatry Res. 2026; 362: 117181.
BACKGROUND: Autism Spectrum Disorder (ASD) significantly impacts patients and their families. This study analyzes the global burden and trends of ASD in children (aged 0-14) from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021) data, providing epidemiological insights for prevention and early intervention. METHODS: We utilized GBD 2021 data and conducted various analyses including descriptive analysis, correlation analysis, age-period-cohort analysis, decomposition analysis, and projection analysis to evaluate the burden and trends of ASD in children. Statistical analyses and visualizations were performed using R 4.3.3. RESULTS: From 1990 to 2021, the age-standardized incidence rate (ASIR) of ASD initially increased, then declined, while the age-standardized prevalence rate (ASPR) and disability-adjusted life years (DALYs) showed an upward trend. Projections suggest further increases in ASPR and DALYs through 2030. In 2021, the global ASIR of ASD in children was 61.88 (95 % UI: 52.20, 72.92) per 100,000, with ASPR at 857.92 (95 % UI: 723.24, 1009.34) and DALYs at 165.09 (95 % UI: 111.88, 232.19). The onset of ASD is predominantly before the age of 5, with a higher burden in males. Severe burdens are more prominent in higher Socio-Demographic Index (SDI) regions, although low-SDI regions also exhibit notable burdens. Population growth is a key factor in increasing ASD burden, while aging has a mitigating effect. CONCLUSION: Although the ASIR of ASD has declined, ASPR and DALYs continue to rise and are expected to increase further, requiring enhanced efforts to reduce ASD’s global burden.
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2. Ma X, Calabria V, Zhang S, Wang N, Zhang X, Ma W. Initiate-manage-sustain: A multimodal conversation analytic approach to understanding therapeutic engagement for children with autism spectrum disorder. Soc Sci Med. 2026; 401: 119217.
While children with Autism Spectrum Disorder (ASD) are often perceived as disengaged from social interaction, fine-grained analyses of how they are actively guided into engagement remain limited in scope. This study adopts a multimodal conversation analytic (CA) approach to examine naturally occurring interactions in specialized therapy sessions involving Mandarin-speaking children with ASD, with a focus on the multimodal practices through which therapists scaffold children’s responsiveness. Drawing on video-recorded data, we identify a locally recurrent three-phase interactional structure-Initiating, Managing, and Sustaining-through which therapists systematically deploy embodied resources to organize interactional sequences in therapeutic settings. In the Initiating phase, therapists use gaze, gesture, and tactile cues to establish joint attention prior to instruction. In the Managing phase, directives are enacted through gestural modeling and co-occurring embodied actions, which make abstract instructions perceptually accessible and imitable. In the Sustaining phase, multimodal positive assessments (e.g., verbal praise, thumbs-up gestures) reinforce participation and stabilize engagement. Within this clinical context, embodied practices are not supplementary to talk but interactionally constitutive, as they scaffold verbal input and co-construct children’s understanding. The findings show that effective engagement is achieved not simply by overcoming communicative challenges but through the sequential organization of multimodal resources. Our analysis suggests potential strategies for designing responsive engagement that nurtures communicative potential through flexible integration of verbal and embodied resources. These context-specific insights may inform clinical approaches that integrate language and embodiment in comparable therapeutic settings-offering empirical grounding for future theoretical and practical development. In an era of standardized protocols, this study returns us to the irreducible truth: therapy happens in the space of multimodal actions, not merely words. Therapists are thus encouraged to integrate verbal and non-verbal resources in a laminated, context-sensitive manner, attending to multimodal processing and individual communicative style, as the foundation of person-centered care.
