Development and contextual adaptation of the first national clinical practice guideline for autism spectrum disorder in children and adolescents in Tunisia
6 affiliations
- 1Department of Child and Adolescent Psychiatry, Fattouma Bourguiba University Hospital, University of Monastir, Faculty of Medicine
- 2Research Laboratory LR05ES10 “Vulnerability to Psychosis”
- 3Department of Child and Adolescent Psychiatry, Mongi Slim University Hospital, University of Tunis El Manar, Faculty of Medicine
- 4Research Laboratory ‘Mother-Baby Health’ LR22SP01
- 5Department of Child and Adolescent Psychiatry, Hedi Chaker University Hospital, University of Sfax, Faculty of Medicine
- 6Department of Child and Adolescent Psychiatry, Razi University Hospital, University of Tunis El Manar
Abstract
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition requiring long-term, coordinated, and multidisciplinary care. Although ASD services in Tunisia have improved, coordination across health, education, and social sectors remains limited, affecting equitable access and continuity of care. This study aimed to develop a national, evidence-based clinical practice guideline for the screening, diagnosis, and management of children and adolescents with ASD adapted to the Tunisian healthcare context.
Assessment of guideline development and practice implications: The guideline was developed by the Tunisian Society of Child and Adolescent Psychiatry and accredited by the National Authority for Evaluation and Accreditation in Health. Using the ADAPTE framework, a multidisciplinary panel adapted international ASD guidelines to the Tunisian context. After systematic searches and AGREE II appraisal, the 2023 Singapore ASD guideline was selected as the main source document. Recommendations were adopted, adapted, or newly developed according to contextual relevance and applicability. An additional literature search was performed to incorporate high-level evidence published between June 2023 and January 2025.
Actionable recommendations: The final guideline includes 96 evidence-based recommendations and 87 good practice points organized into ten chapters, covering the screening, diagnosis, intervention, and follow-up of autism spectrum disorder in children and adolescents across all levels of care in Tunisia. This article summarizes the key practice-oriented recommendations across these chapters.
Conclusion: This first Tunisian ASD guideline aims to harmonize practices, improve the quality of care, and strengthen integrated care pathways.
Related
- Problematic Internet Use and Anxiety in Adolescents: A Scoping Review of Mechanisms and Contextual Influences
- Longitudinal associations between screen time activities and working memory neural signatures in adolescents: Sex differences and contextual moderation.
- Smart scaffolds: how WD40 proteins integrate plant development, metabolism and stress adaptation
- Non-monotonic cardiovascular adaptation and stroke output-stroke output coupling reorganization in high-altitude adolescents: a cross-sectional study along altitude gradients
- Host Pre-Adaptation and Sublethal Indoxacarb Interactively Affect Growth and Development of Cnaphalocrocis medinalis, with Potential Involvement of P450 and Juvenile Hormone-Related Genes
BibTeX
@article{ayoub2026development,
title = {{Development and contextual adaptation of the first national clinical practice guideline for autism spectrum disorder in children and adolescents in Tunisia}},
author = {Randaline Ayoub and Hela Ben Abid and Soumaya Bourgou and Imen Hadj Kacem and Soumeyya Halayem and Khaoula Khemekhem and Fatma Charfi and Asma Bouden},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1926851},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1926851/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Development and contextual adaptation of the first national clinical practice guideline for autism spectrum disorder in children and adolescents in Tunisia
AU - Randaline Ayoub
AU - Hela Ben Abid
AU - Soumaya Bourgou
AU - Imen Hadj Kacem
AU - Soumeyya Halayem
AU - Khaoula Khemekhem
AU - Fatma Charfi
AU - Asma Bouden
PY - 2026
DA - 2026/10/20
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1926851
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1926851/full
AB - Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition requiring long-term, coordinated, and multidisciplinary care. Although ASD services in Tunisia have improved, coordination across health, education, and social sectors remains limited, affecting equitable access and continuity of care. This study aimed to develop a national, evidence-based clinical practice guideline for the screening, diagnosis, and management of children and adolescents with ASD adapted to the Tunisian healthcare context. Assessment of guideline development and practice implications: The guideline was developed by the Tunisian Society of Child and Adolescent Psychiatry and accredited by the National Authority for Evaluation and Accreditation in Health. Using the ADAPTE framework, a multidisciplinary panel adapted international ASD guidelines to the Tunisian context. After systematic searches and AGREE II appraisal, the 2023 Singapore ASD guideline was selected as the main source document. Recommendations were adopted, adapted, or newly developed according to contextual relevance and applicability. An additional literature search was performed to incorporate high-level evidence published between June 2023 and January 2025. Actionable recommendations: The final guideline includes 96 evidence-based recommendations and 87 good practice points organized into ten chapters, covering the screening, diagnosis, intervention, and follow-up of autism spectrum disorder in children and adolescents across all levels of care in Tunisia. This article summarizes the key practice-oriented recommendations across these chapters. Conclusion: This first Tunisian ASD guideline aims to harmonize practices, improve the quality of care, and strengthen integrated care pathways.
SN - 1664-0640
ER -