Frontiers in child and adolescent psychiatry最新文献

{"title":"Socio-cultural context as a protective factor: regional disparities in adolescent mental health in Mexico during the COVID-19 pandemic.","authors":"Rodrigo Ramirez-Rodriguez, Rafael Fernández-Demeneghi, Yuliana Yessy Gomez-Rutti, Sandra Cristina Pillon, Ángel Alberto Puig-Lagunes","doi":"10.3389/frcha.2026.1783057","DOIUrl":"10.3389/frcha.2026.1783057","url":null,"abstract":"<p><strong>Background: </strong>Globally, approximately one in seven adolescents experiences a mental disorder, which can negatively impact their quality of life. In Mexico, evidence of regional differences in adolescent mental health is limited. This study examined regional disparities in the prevalence and severity of mental health symptoms, substance use, and resilience among adolescents in southern Veracruz during the COVID-19 pandemic. Additionally, we identified psychosocial profiles and examined the protective role of resilience against psychopathology.</p><p><strong>Methods: </strong>A cross-sectional comparative study was conducted among adolescents from four regions of southern Veracruz: semi-urban, agro-commercial, industrial urban, and semi-rural. Participants completed online, self-administered questionnaires assessing psychoactive substance use, symptoms of stress, anxiety, and depression, and resilience. Descriptive analyses, binomial logistic and linear regression models, and k-means clustering were used to examine regional differences and the association between resilience and mental health outcomes. Analyses were performed in RStudio (macOS).</p><p><strong>Results: </strong>A total of 2,194 adolescents (mean age: 16.6 ± 1.1 years) were included. Overall, 28.3% reported alcohol consumption and 8.5% tobacco use. Anxiety was most prevalent (38.5%), followed by depression (33.7%) and stress (23.9%). Only 21.2% demonstrated high resilience. Significant regional differences were observed. Region 4 adolescents (semi-rural) showed fewer moderate-to-extremely severe cases and higher resilience (<i>p</i> < 0.001). Adolescents in Regions 1 and 3 were more likely to experience depression (OR = 1.04) and had fewer protective factors, whereas greater social support and structure were associated with Region 4 (OR = 0.69 and 0.92). Higher resilience was associated with lower depression (R² = 0.098) and anxiety (R² = 0.060). Two profiles were identified: Resilient (56.5%) and Vulnerable (43.5%), with Region 4 overrepresented in the Resilient Profile (66.4%) and Region 3 in the Vulnerable Profile (53.2%).</p><p><strong>Conclusions: </strong>Adolescents from Region 4 exhibited more favorable emotional profiles, characterized by higher resilience and lower symptom severity. The identification of psychosocial profiles and the protective role of resilience highlight the influence of regional context on adolescent mental health, thereby supporting the development of context-specific interventions.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1783057"},"PeriodicalIF":1.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of perceived household chaos and youth health outcomes across the COVID-19: insights from individual, dyadic, and triadic family analyses.","authors":"Chunyuan Xi, Jacinda Kay Dariotis, Dana Ann Eldreth, Iffat Noor, Rebecca Lee Smith","doi":"10.3389/frcha.2026.1717371","DOIUrl":"10.3389/frcha.2026.1717371","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic profoundly disrupted youth development; however, limited studies have explored the diverse patterns of household environments and their implications for youth and family well-being. This study aimed to identify trajectories of household chaos during the COVID pandemic and to investigate their associations with youth mental and physical health outcomes.</p><p><strong>Methods: </strong>Data were collected from 506 adults (<i>M</i> _age = 42.8, <i>SD</i> _age = 9.15) and 93 youth (<i>M</i> _age = 14.5, <i>SD</i> _age = 1.63). Using a retrospective cross-sectional design, participants reported their experiences across the COVID-19 pandemic. Parents and youth provided reports of household chaos for pre-, mid-, and post-COVID timepoints and on youth health-related outcomes at pre- and post. Latent Class Growth Analysis (LCGA), Analysis of Covariance, and Analysis of Variance were used.</p><p><strong>Results: </strong>Using parent and youth self-report data, LCGA identified three trajectories of household chaos (low-chaos \"thriving,\" 35.2%; high-chaos \"worsening,\" 24.5%; and moderate-chaos \"resilience,\" 40.3%). Dyadic and triadic analyses revealed differing parent and youth household chaos perceptions. Within the same family, younger youth showed greater concordance with parents compared to older youth. Youth on the high-chaos worsening trajectory exhibited higher levels of behavioral problems, emotional-behavioral dyscontrol, emotional distress-anxiety, sleep disturbance, and lower levels of positive affect and well-being, compared to one or both other trajectory groups.</p><p><strong>Discussion: </strong>Findings highlight meaningful differences in parent and youth pandemic-related household chaos experiences, which are linked to youth health outcomes. Public health intervention and prevention programs should account for both shared and nonshared family experiences to better support youth well-being as part of future pandemic preparedness.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1717371"},"PeriodicalIF":1.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of mealtime training for caregivers: effectiveness and social validity.","authors":"Lisa M Tereshko, Megan Magrauth, Mary Jane Weiss","doi":"10.3389/frcha.2026.1758507","DOIUrl":"10.3389/frcha.2026.1758507","url":null,"abstract":"<p><p>Common problems faced by families and caregivers of children exhibiting mealtime challenges include food refusal, food selectivity, and/or challenging behaviors. To fully address a mealtime challenge, the inclusion of families and caregivers is essential to ensure the generalization of appropriate mealtime behaviors (e.g., acceptance of foods) to actual familial mealtimes. This literature review includes 49 articles that implemented a training procedure to teach behavioral mealtime interventions to parents or caregivers. The researchers analyzed the effectiveness of the interventions across several dimensions with special attention to outcomes and social validity measures. This study discusses recommendations for best practices for mealtime interventions to be used when training parents and caregivers. Furthermore, the authors provide an analysis of limitations in the current literature along with suggestions for future research.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1758507"},"PeriodicalIF":1.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting schizophrenia spectrum disorders in pediatric outpatients: a prospective validation of the child psychosis-risk screening system.","authors":"Yukiko Hamasaki, Shugo Michikoshi, Yuko Sakaue, Takao Nakayama, Satoko Ueba, Naoki Kurimoto, Yoshiteru Mutsuda, Masanori Isobe, Toshiya Murai, Takatoshi Hikida","doi":"10.3389/frcha.2026.1840330","DOIUrl":"10.3389/frcha.2026.1840330","url":null,"abstract":"<p><strong>Objective: </strong>This study validated the prognostic ability of the Child Psychosis-risk Screening System (CPSS), an algorithm derived from the widely used Child Behavior Checklist (CBCL), and benchmarked its performance against a comprehensive machine learning model.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 491 pediatric psychiatric outpatients aged 6-18 years who visited clinics for developmental, psychosomatic, or psychiatric disorders. Baseline assessments (Visit 1) included the CBCL and extensive clinical data. Participants were followed-up for up to 5 years (n = 350; Visits 2+), including annual assessments for schizophrenia spectrum disorders (SSD). The predictive accuracy of the CPSS risk score was evaluated using receiver operating characteristic analysis and compared with that of a post-hoc machine learning benchmark model (Light Gradient Boosting Machine) incorporating 150 baseline variables.</p><p><strong>Results: </strong>The CPSS risk score demonstrated good predictive performance for final SSD status (area under the curve [AUC] = 0.906), significantly exceeding its discriminative ability for SSD at Visit 1 (AUC = 0.841). This discrepancy indicates that the CPSS sensitively captures prodromal vulnerabilities that do not yet meet diagnostic criteria. Although the complex Light Gradient Boosting Machine model achieved a marginally higher AUC (0.959), the CPSS yielded comparably robust accuracy using only eight CBCL subscales. Variable-importance analysis further showed that the CPSS risk score was a stronger predictor than the CBCL \"Thought Problems\" scale, a traditional marker of psychosis risk.</p><p><strong>Conclusion: </strong>The CPSS is a parsimonious and effective screening tool that translates behavioral observations into objective risk stratification. Its use in primary care settings could streamline referral pathways and facilitate timely early intervention for children at high risk of psychosis who present with ambiguous somatic or behavioral symptoms.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1840330"},"PeriodicalIF":1.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meaning in life, emptiness and depression among adolescents: a cross-sectional study.","authors":"Yue Sun, Yiting Zhao, Zhiyuan Xun, Jingjie Yu","doi":"10.3389/frcha.2026.1836277","DOIUrl":"10.3389/frcha.2026.1836277","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between meaning in life, emptiness and depression among adolescents.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using convenience sampling at a Senior High School in China, in May 2022. Validated questionnaires, including Center for Epidemiological Survey Depression Scale (CES-D), Revised Meaning in Life Questionnaire (RMLQ), and Emptiness Questionnaire (EQ), were administered to senior high school students. Binary logistic regression was employed to analyze associations between depression and independent variables.</p><p><strong>Results: </strong>A total of 2230 senior high school students were included, among whom 726 (32.6%) were classified as depressed (DEP) and 1504 (67.4%) as non-depressed (non-DEP). Compared with non-DEP, the DEP group had a significantly higher proportion of females (49.7% vs. 39.9%; <i>χ</i> ² = 19.30, p < 0.001). Moreover, the DEP group reported higher levels of emptiness (39.59 ± 7.63 vs. 37.34 ± 7.62, p < 0.001), lower presence of meaning (21.56 ± 6.32 vs. 26.97 ± 6.19, p < 0.001), and lower searching for meaning (24.85 ± 5.82 vs. 26.18 ± 7.05, p < 0.001). Correlation analyses revealed that depressive symptoms were positively associated with emptiness (r = 0.16) and negatively with presence of meaning (r = -0.46) and searching for meaning (r = -0.12) (all p < 0.001). In hierarchical logistic regression, emptiness (OR = 1.03, p < 0.001) and presence of meaning (OR = 0.88, p < 0.001) were significant predictors of depression, whereas searching for meaning was not (<i>p</i> = 0.08). The combined prediction model (emptiness, presence of meaning, and demographics) showed an AUC of 0.74 (95% CI: 0.72-0.76), indicating acceptable discriminative ability.</p><p><strong>Conclusion: </strong>In this cross-sectional sample, emptiness and limited presence of meaning in life were concurrently associated with depression status among high school students. Although directionality cannot be determined, these findings suggest that interventions targeting these constructs may warrant evaluation in future longitudinal and experimental research, and their combination shows potential for school-based screening.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1836277"},"PeriodicalIF":1.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring physical health in child and adolescent mental health inpatient care: findings from the Y-Health longitudinal feasibility study.","authors":"Rebekah Carney, Shermin Imran, Heather Law, Karina Lovell, Rathi Ravindrarajah, Clare Fenton, Nicola Green, Gillian Macafee, Olorunleke Erunkulu, Sophie Parker","doi":"10.3389/frcha.2026.1731769","DOIUrl":"10.3389/frcha.2026.1731769","url":null,"abstract":"<p><strong>Background: </strong>Young people with serious mental illness (SMI) face significant physical health inequalities, including increased risk of obesity, diabetes, and other preventable conditions, contributing to a 15-20-year reduction in life expectancy. Those in CAMHS inpatient care are particularly vulnerable due to high levels of psychological distress, psychotropic medication, obesogenic environments and high levels of adverse health behaviours. However, research in this setting is limited. This study aimed to assess the feasibility of monitoring physical health in CAMHS inpatient services, changes to physical and mental health over 6-months and explore young people's experiences of health care.</p><p><strong>Methods: </strong>A longitudinal feasibility study with a separate qualitative component was conducted across three CAMHS inpatient units, assessing physical and mental health at admission, 3-months and 6-months. Feasibility indicators and clinical outcomes including weight, cardiometabolic markers, lifestyle behaviours and wellbeing were collected through self-report, clinical records and physical health checks. A nested qualitative sub-study was conducted to explore participant experiences of physical health care in CAMHS.</p><p><strong>Results: </strong>Twenty-seven participants were recruited across three CAMHS inpatient units, with 93% (<i>n</i> = 25) retained at 6-month follow-up. Completion of assessments was high at baseline but declined post-discharge. At baseline 37% individuals were overweight or obese, which increased to 50% overweight or obese at follow-up. Metabolic conditions were frequently observed across all timepoints. Physical activity remained low, and diet quality was poor. Mental health and functioning appeared to improve, with reductions in HONOSCA scores suggesting improvements to overall health.</p><p><strong>Conclusion: </strong>This study provides the first longitudinal feasibility evidence on monitoring physical health among young people in CAMHS inpatient care, demonstrating high acceptability during admission and identifying substantial challenges with post-discharge monitoring. While descriptive trends indicated a high prevalence of physical health risk factors, the study was not powered to detect meaningful change. These findings highlight the need for integrated, developmentally appropriate models of physical health monitoring across inpatient and community services.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1731769"},"PeriodicalIF":1.5,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in child suicide rates and characteristics during the COVID-19 pandemic in England.","authors":"David Odd, Duleeka Knipe, Tom Williams, Sylvia Stoianova, Prathiba Chitsabesan, Karen Luyt","doi":"10.3389/frcha.2026.1657552","DOIUrl":"10.3389/frcha.2026.1657552","url":null,"abstract":"<p><strong>Introduction: </strong>Suicide in young people has risen in many countries over the last 10 years.</p><p><strong>Aim: </strong>The aim of this study was to report any changes, and characteristics of children dying by suicide in England, before, and during the COVID pandemic.</p><p><strong>Methods: </strong>Child deaths from suicide, occurring between 1st April 2019 and 31st March 2023 were linked to demographic, death-review and Hospital Episodes Statistics (HES) data; used to identify mental health disorders and self-harm events. Using Case-Cross Over methodology, we investigated the relative risk of suicide, after recent HES-coded events.</p><p><strong>Results: </strong>In total there were 498 deaths likely due to suicide, during the 4 year period. Risk of death by suicide was 14.31 (13.08-15.63) per 1,000,000 CYP per year, with little evidence that risk (<i>p</i> = 0.863) or method (<i>p</i> = 0.199) changed over the period. The relationship between deprivation and suicide risk was different by race/ethnicity (both <i>p</i> < 0.001), with decreasing deprivation associated with increasing risk of suicide in white children [IRR 1.12 (1.03-1.21)], and decreasing risk in Asian [IRR 0.52 (0.41-0.65)], Black [IRR 0.31 (0.21-0.44)] and Mixed/Other ethnicity (IRR 0.73 (0.60-0.89) children. Only a recorded diagnosis of self-harm was more common before the death than in the preceding control periods [OR 8.99 (4.27-18.94)].</p><p><strong>Conclusion: </strong>In England, suicide rates do not appear to be increasing, and the methods of suicide remain static. The role of deprivation and suicide risk appears to be different between race/ethnicity, while a recorded diagnosis of a self-harm events appears to predict suicide in the subsequent month.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1657552"},"PeriodicalIF":1.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying self-determination theory to understand maternal well-being in autism caregiving: a mini review.","authors":"J Kripamariya, P J Justin","doi":"10.3389/frcha.2026.1812579","DOIUrl":"10.3389/frcha.2026.1812579","url":null,"abstract":"<p><p>Mothers of children with autism spectrum disorder (ASD) often undergo psychological distress, care burden, and poor well-being, but current research has mostly focused on stress and deficit-based models instead of strengths-based mechanisms that facilitate well-being and resilience. Self-Determination Theory (SDT), the conceptual framework of understanding well-being because of saturation of autonomy, competence, and relatedness needs, provides a valuable conceptualization of maternal adjustment and mental wellness in caregiving situations. This mini review is a synthesis of current findings on empirical and theoretical literature on how these fundamental psychological needs are either upheld or inhibited in autism caregiving, with the focus on autonomy in decision-making, self-efficacy in caregiving, and social connectedness. It has been indicated that higher need satisfaction is always linked to better psychological health, less distress and higher caregiving confidence, whereas systemic challenges, stigma, and weak support sabotage these mechanisms. Nonetheless, very few studies formally use SDT; most of them are based on cross-sectional designs, and culturally varied populations are not well represented. Incorporating SDT into the study and intervention formulation of caregivers can help lead to empowering, need-enhancing services that encourage maternal health and child outcomes.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1812579"},"PeriodicalIF":1.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial maturity and institutional confinement from ages 15-22: a longitudinal reciprocal model.","authors":"Frances R Chen, Donia Chiciu, Hawi Geleto","doi":"10.3389/frcha.2026.1809393","DOIUrl":"10.3389/frcha.2026.1809393","url":null,"abstract":"<p><strong>Objectives: </strong>Psychosocial maturity develops rapidly during adolescence and early adulthood and is closely linked to delinquency and justice system involvement. Although incarceration and psychosocial immaturity have each been studied, they are rarely examined together within a single developmental framework, and modeling only one direction may inflate estimated effects. Moreover, psychosocial maturity is typically treated as a global construct, despite meaningful variation across its core components.</p><p><strong>Methods: </strong>We analyzed data from the longitudinal Pathways to Desistance study (<i>N</i> = 1,336), which follows serious adolescent offenders over time. Using Random Intercept Cross-Lagged Panel Models, we assessed bidirectional associations between psychosocial maturity and correctional time. Psychosocial maturity was assessed via three core components: temperance, responsibility, and perspective.</p><p><strong>Results: </strong>Lower psychosocial maturity predicted greater subsequent correctional time, and greater correctional time predicted slower-than-expected gains in psychosocial maturity. Standardized within-person effects were small but consistent across ages. Component-level analyses indicated that reciprocal associations were driven primarily by temperance.</p><p><strong>Conclusions: </strong>Initial incarceration driven by lower psychosocial maturity levels may foster heightened institutional contact that further disrupts normative developmental processes, particularly self-regulation. These findings support both importation and deprivation perspectives and provide empirical support for Moffitt's ensnarement hypothesis. Findings highlight the importance of jointly modeling developmental vulnerability and institutional exposure and underscore the role of self-regulatory capacities in justice system involvement. Developmental implications and juvenile justice policy are discussed.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1809393"},"PeriodicalIF":1.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic engagement index in autism: a hypothesis-generating framework for stratifying intervention responsiveness and adaptive therapeutic availability.","authors":"Yves Fuamba","doi":"10.3389/frcha.2026.1872562","DOIUrl":"10.3389/frcha.2026.1872562","url":null,"abstract":"<p><p>Autism spectrum disorder is characterized by substantial heterogeneity in developmental trajectories, learning profiles, therapeutic participation, and response to intervention. Although intervention type, intensity, timing, fidelity, and baseline developmental profile are important predictors of outcome, they do not fully explain why autistic children exposed to broadly comparable interventions may show markedly different patterns of participation, learning, generalization, and adaptive change. TEI is defined as a multidimensional, context-sensitive, and observable construct describing the degree to which an autistic child can access, tolerate, respond to, sustain, and generalize therapeutic input within a specific intervention context. TEI is not intended to replace established constructs such as treatment engagement, therapeutic alliance, readiness, motivation, compliance, participation, developmental readiness, or treatment response. The manuscript clarifies the conceptual novelty of TEI, distinguishes it from related constructs, proposes candidate observable domains and indicators, outlines testable hypotheses, specifies boundary conditions, and provides a staged validation roadmap. TEI is not presented as a validated scale, clinical decision tool, diagnostic measure, compliance metric, or indicator of child responsibility for treatment outcome. Rather, it is proposed as a research framework for identifying modifiable conditions of therapeutic accessibility, including regulation, support fit, relational access, context, intervention demands, and developmental state.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1872562"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}