There is limited research on the long-term outcomes

The gap

Evidence profile

Stated in the future work and limitations and abstract and discussion and cells research gap sections of the source papers, classified as general, drawn from work published between 2024 and 2026, spanning 5 journals. Those papers have been cited 10 times in total.

Supporting evidence — 8 representative gaps

• Advances in supporting development in autistic children and youth (2026) · BMJ · doi

  This review highlights several important directions for future research to improve understanding and support for autistic children and adolescents. First, there is a need for more longitudinal studies that follow autistic individuals into adulthood, particularly those from underrepresented groups, including racialized communities, gender diverse populations, and individuals with higher support needs. Expanding the inclusivity of study populations is essential to producing more generalizable and equitable findings. Larger datasets are needed to include and analyze all potential predictors of wellbeing, allowing for precision outputs that can support individualized anticipatory guidance. Second, future research must move beyond binary or deficit based outcome measures to better reflect holistic understandings of autistic development that include strengths. This includes assessing wellbeing, identity formation, relationships and social connection, and participation in meaningful life activities. Studies that consider environmental influences, such as inclusive education, family acceptance, and access to affirming services, are needed to provide a more complete picture of the factors that support positive developmental outcomes. A key priority of advancing this field requires embedding autistic co-design as a standard research practice. This approach involves autistic people as active partners in shaping research questions, methods, and outputs and is essential to producing meaningful, applicable knowledge. Studies show that autistic co-design enriches research outcomes 16 doi: 10.1136/bmj‑2025‑086562 | BMJ 2026;393:e086562 | the bmj P r o t e c t e d b y c o p y r i g h t, i l i n c u d n g f o r u s e s r e l a t e d t o t e x t a n d d a t a m n n g i i, A I t r a i n n g i, a n d s i m i l a r t e c h n o o g i e s. l B M J: f i r s t p u b l i s h e d a s 1 0 1 1 3 6 b m. / j - 2 0 2 5 - 0 8 6 5 6 2 o n 1 0 J u n e 2 0 2 6. l D o w n o a d e d f r o m h t t p s: / / w w w b m. j. c o m / o n 1 1 J u n e 2 0 2 6 b y g u e s t. by incorporating the lived experience and unique insights of autistic individuals, which may reveal challenges that non-autistic researchers alone may not recognize.100 Importantly, co-design processes need to account for additional time investment and the need for clear communication, as well as autistic individuals’ sensory and communication preferences.64  101 While more resource-intensive, these efforts result in richer, more impactful research.

  generalstated in future workevidence 5/5
  Keywords: autistic support individuals need design review future populations essential producing needed include wellbeing outputs meaningful
• Social communication and brain network properties: cognitive predictors and modulation by autistic traits (2026) · Cognitive Neurodynamics · doi

  An important limitation is the sample size, while typical for resting-state fMRI studies with intensive cognitive char- acterization, limits statistical power and generalizability, especially for looking at individual variability. Replication in larger samples will be important to confirm the robust- ness of the observed brain–behavior relationships and mod- eration effects. In particular, the inclusion of more diverse samples, such as participants spanning a broader age range and varied sociocultural backgrounds, would enhance the ability to capture developmental trajectories and individual differences. Secondly, the exclusive use of a neurotypical adult sample, in the cognitive resources analyses, precludes direct inferences about autistic populations. Although the dimensional AQ framework provides valuable insights into trait-related variability, future studies should extend this approach to clinically diagnosed autistic adults to evalu- ate whether similar network principles apply. Finally, the reliance on resting-state fMRI limits conclusions about task-specific neural dynamics. This limitation is particu- larly relevant given that the current findings revealed higher global efficiency in the language network compared with pragmatic and ToM networks. Resting-state connectivity captures intrinsic network organization but may not fully reflect the context-dependent recruitment of social com- munication systems observed during active language, prag- matic or mentalizing tasks. Combining resting-state and task-based approaches will be critical for linking intrinsic network properties to communicative performance.

  generalstated in limitationsevidence 5/5
  Keywords: resting state network important limitation sample fmri cognitive limits individual variability samples observed autistic task
• Neurobiology of cognitive abilities in early childhood autism (2024) · JCPP Advances · cited 10× · doi

  Given recent interest in formulating new subtypes of autism, rather than continuing to conceive of ASD as a spectrum, as well as new subtypes that vary in the degree of severity along the spectrum, we identify gaps in knowledge and directions for future work in this complex and growing area.

  generalstated in abstractevidence 5/5
  Keywords: subtypes spectrum given recent interest formulating autism rather continuing conceive well vary degree severity along
• A systematic review and future research directions of sex differences in cognitive abilities of autistic children and adolescents (2026) · Review Journal of Autism and Developmental Disorders · doi

  Autism is partly characterized by socio-communicative abilities that diverge from the neurotypical population. These skills shape interpersonal interactions, influence navigation of the social world, and impact development across multiple domains. Research has established a bidirectional relationship between socio-communicative and cognitive abilities in both autistic and neurotypical individuals (Soto-Icaza et al., 2015; Weisberg, 2015), underscoring the relevance of investigating cognitive functioning to identify areas that may benefit from targeted interventions. Understanding the specific challenges present in a given population is essential for the development of targeted interventions that can be further tailored to individual profiles. Establishing standardized procedures is fundamental for ensuring scientific rigor in intervention strategies, particularly when addressing the needs of a specific population. However, standardization does not preclude personalized treatment approaches; rather, it provides a structured foundation that enhances the precision and effectiveness of individualized interventions. Potential differences in cognitive abilities may stem from variations in social skills and, in turn, contribute to further divergence in socio-communicative behaviors. Given that prior research on cognitive abilities has predominantly focused on male samples and evidence suggests that autistic females exhibit distinct social profiles (Cook et al., 2021; Dean et al., 2017; Hiller et al., 2016; Paolizzi et al., 2022), expanding knowledge in this area is critical. Accordingly, the second aim of this study is to outline future research directions to enhance its characterization. From a methodological point of view, current literature presents several limitations, one of the most prominent being small and unequal sample sizes, largely due to the limited availability of autistic females. One major methodological Review Journal of Autism and Developmental Disorders1 3concern arising from unequal sample sizes is that it is often overlooked in statistical analyses. In many cases, samples with unequal variances are analyzed using statistical tests that assume homogeneity of variance, such as ANOVA, which can lead to reduced statistical power and an increased risk of Type I errors. This methodological limitation may impact the reliability and generalizability of findings, underscoring the need for more robust statistical approaches and larger, more balanced samples in future research. Additionally, only six out of the twenty-one studies considered included control groups, highlighting the necessity of appropriate controls to determine whether observed findings are specific to the autistic population or reflect sex-normative differences.

  generalstated in future workevidence 5/5
  Keywords: cognitive population abilities autistic statistical socio communicative social interventions specific differences samples methodological unequal autism
• 10-Year Outcome of Community-based Early Intensive Behavioral Intervention for Autistic Children (2026) · Research on Child and Adolescent Psychopathology · doi

  Future research warrants further expanding upon under- standing of how an individual’s profile might guide deci- sions regarding programs and interventions – based both upon preferences and skills/ need. Emerging work that utilizes predictors and more sophisticated, individualized designs (such as Sequential Multiple Assignment Ran- domized Trials or “SMART” designs) may result in more customized intervention experiences. Considerations for clinical practice include promoting increased access and availability of interventions in community settings, such as through telehealth. This is particularly critical to ensure access for racially, ethnically, and linguistically diverse fam- ilies, who have historically been excluded both from service Research on Child and Adolescent Psychopathology (2026) 54:381 338 Page 10 of 12 systems and from intervention research studies (Dallman et al., 2021; Smith et al., 2020). Finally, in the field, our framing and understanding of EIBI has changed over time and as new research has become available. There has been support for the overall benefits of early intervention, and we have also learned more about the priorities and preferences of the autistic community with respect to intervention options. Autistic experts increasingly express that creating positive social opportunities should focus more on promoting inclusive practices and attitudes, rather than intervening on individuals to change their behav- ior (Botha et al., 2022; Gardner, 2017). Most importantly, the field should engage more autistic researchers and advo- cates in this work to better integrate their lived expertise with those who have expertise in intervention design and evaluation. This includes partnering with autistic individu- als to help identify value-based outcomes and what true early educational “success” might look like in 10–15 years.

  generalstated in future workevidence 5/5
  Keywords: intervention autistic upon interventions based preferences designs promoting access community field early expertise future warrants
• 10-Year Outcome of Community-based Early Intensive Behavioral Intervention for Autistic Children (2026) · Research on Child and Adolescent Psychopathology · doi

  In the context of a large body of intervention research focused on efficacy and comparative effectiveness, there has been very limited research on longitudinal outcomes for young children with autism, and even less research focused on exploring outcomes as related to early experi- ences with intensive interventions (such as EIBI).

  generalstated in discussionevidence 5/5
  Keywords: focused outcomes context large body intervention efficacy comparative effectiveness there limited longitudinal young children autism
• 10-Year Outcome of Community-based Early Intensive Behavioral Intervention for Autistic Children (2026) · Research on Child and Adolescent Psychopathology · doi

  There is limited research on the long-term outcomes of early intensive behavioral intervention on autistic children. - There is a need for more studies on the predictors of outcome in autistic children who received early intensive behavioral intervention.

  generalstated in cells research gapevidence 5/5
  Keywords: there limited research long-term outcomes early intensive behavioral
• A systematic review and future research directions of sex differences in cognitive abilities of autistic children and adolescents (2026) · Review Journal of Autism and Developmental Disorders · doi

  There is a lack of research on sex differences in cognitive abilities among autistic individuals. - The current literature is heterogeneous and results are contrasting. - There is a need for more research on sex differences in cognitive profiles among autistic individuals.

  generalstated in cells research gapevidence 5/5
  Keywords: there lack research sex differences cognitive abilities among

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