{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:28:48Z","timestamp":1790555328547,"version":"4.1.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009244","name":"Stockholm University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009244","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Res Child Adolesc Psychopathol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study examined the long-term outcomes of the Future Centre\u2019s Early Intensive Behavioural Intervention (FC-EIBI) for children with autism spectrum disorder (ASD) in a conflict-affected, low-resource setting in Syria. Sixty-six participants were assessed at baseline (2008), post-treatment (2010), early follow-up (2013), and long-term follow-up (2019) using the Childhood Autism Rating Scale (CARS), the Autism Behaviour Checklist\u2013Arabic (ABC), and the Adaptive Behaviour Scale\u2013Arabic (ABS-Arabic). Longitudinal change was examined using nonparametric repeated-measures analyses, with additional analyses of subdomains across six ABS-Arabic domains. Significant improvements were observed across all measures from baseline to post-treatment and early follow-up (all ps &lt; 0.001), indicating substantial reductions in autism symptom severity and marked gains in adaptive functioning. By 2019, small but significant attenuation of earlier gains was detected; however, outcomes remained significantly improved relative to baseline. Improvements in adaptive functioning were most pronounced between 2008 and 2013, particularly in Social Interaction and Communication\/Language, whereas later declines were most evident in Communication\/Language and Personal\u2013Emotional Adaptation. Overall, FC-EIBI was associated with considerable and durable developmental benefits over more than a decade, despite prolonged sociopolitical instability and service disruptions. These findings underscore the feasibility of sustaining meaningful developmental outcomes for children with ASD in conflict-affected, low-resource contexts.<\/jats:p>","DOI":"10.1007\/s10802-026-01438-x","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T14:28:24Z","timestamp":1772116104000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sustained Autism Outcomes Eight Years After Early Intensive Behavioral Intervention in a Conflict-Affected Low-Resource Setting: A Longitudinal Follow-Up Study"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9133-7618","authenticated-orcid":false,"given":"Wissam","family":"Mounzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"issue":"2","key":"1438_CR1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.jsr.2006.01.003","volume":"37","author":"AM Al-Hemoud","year":"2006","unstructured":"Al-Hemoud, A. M., & Al-Asfoor, M. M. (2006). A behavior-based safety approach at a Kuwait research institution. Journal of Safety Research, 37(2), 201\u2013206. https:\/\/doi.org\/10.1016\/j.jsr.2006.01.003","journal-title":"Journal of Safety Research"},{"key":"1438_CR2","volume-title":"Adaptive Behavior Scale: Researcher guide","author":"A Al-Kilani","year":"1981","unstructured":"Al-Kilani, A., & Al-Batesh, M. (1981). Adaptive Behavior Scale: Researcher guide (2nd ed). University of Jordan.","edition":"2nd ed"},{"key":"1438_CR3","unstructured":"Al-Shammari, A., & Sartawi, Z. (2002). CARS: Arab version of the scale. Golden Sheets Library."},{"key":"1438_CR4","unstructured":"American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev). American Psychiatric Association."},{"key":"1438_CR5","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425596"},{"issue":"2","key":"1438_CR6","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1111\/jcpp.13243","volume":"62","author":"VH Bal","year":"2021","unstructured":"Bal, V. H., Kim, S. H., Cheong, D., & Lord, C. (2021). Predicting adult outcomes in autism spectrum disorder: The role of adaptive functioning. Journal of Child Psychology and Psychiatry, 62(2), 133\u2013145. https:\/\/doi.org\/10.1111\/jcpp.13243","journal-title":"Journal of Child Psychology and Psychiatry"},{"issue":"3","key":"1438_CR7","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.ridd.2006.03.002","volume":"28","author":"E Ben-Itzchak","year":"2007","unstructured":"Ben-Itzchak, E., & Zachor, D. A. (2007). The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism. Research in Developmental Disabilities, 28(3), 287\u2013303. https:\/\/doi.org\/10.1016\/j.ridd.2006.03.002","journal-title":"Research in Developmental Disabilities"},{"issue":"3","key":"1438_CR8","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1080\/10705510701301834","volume":"14","author":"FF Chen","year":"2007","unstructured":"Chen, F. F. (2007). Sensitivity of goodness-of-fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464\u2013504. https:\/\/doi.org\/10.1080\/10705510701301834","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"key":"1438_CR9","volume-title":"Statistical power analysis for the behavioral sciences","author":"J Cohen","year":"1988","unstructured":"Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed). Lawrence Erlbaum Associates.","edition":"2nd ed"},{"issue":"3","key":"1438_CR10","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1093\/tropej\/fml090","volume":"53","author":"V Eapen","year":"2007","unstructured":"Eapen, V., Mabrouk, A. A., Zoubeidi, T., & Yunis, F. (2007). Prevalence of pervasive developmental disorders in preschool children in the UAE. Journal of Tropical Pediatrics, 53(3), 202\u2013205. https:\/\/doi.org\/10.1093\/tropej\/fml090","journal-title":"Journal of Tropical Pediatrics"},{"issue":"2","key":"1438_CR11","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1016\/j.rasd.2011.09.002","volume":"6","author":"S Eikeseth","year":"2012","unstructured":"Eikeseth, S., Klintwall, L., Jahr, E., & Karlsson, P. (2012). Outcome for children with autism receiving early and intensive behavioral intervention in mainstream preschool and kindergarten settings. Research in Autism Spectrum Disorders, 6(2), 829\u2013835. https:\/\/doi.org\/10.1016\/j.rasd.2011.09.002","journal-title":"Research in Autism Spectrum Disorders"},{"issue":"3","key":"1438_CR12","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1080\/15374410902851739","volume":"38","author":"S Eldevik","year":"2009","unstructured":"Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child & Adolescent Psychology, 38(3), 439\u2013450. https:\/\/doi.org\/10.1080\/15374410902851739","journal-title":"Journal of Clinical Child & Adolescent Psychology"},{"key":"1438_CR13","volume-title":"School, family, and community partnerships","author":"JL Epstein","year":"2002","unstructured":"Epstein, J. L., Coates, L., Salinas, K. C., Sanders, M. G., & Simon, B. S. (2002). School, family, and community partnerships (2nd ed). Corwin Press.","edition":"2nd ed"},{"issue":"7","key":"1438_CR14","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.jaac.2015.04.005","volume":"54","author":"A Estes","year":"2015","unstructured":"Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54(7), 580\u2013587. https:\/\/doi.org\/10.1016\/j.jaac.2015.04.005","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"key":"1438_CR15","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-024-01265-y","author":"V Fossum","year":"2025","unstructured":"Fossum, V., Nordahl-Hansen, A., M\u00f8rch-Jensen, A., et al. (2025). Longitudinal predictors of adaptive functioning in emerging adults with and without autism spectrum disorder. Research on Child and Adolescent Psychopathology. https:\/\/doi.org\/10.1007\/s10802-024-01265-y. Advance online publication.","journal-title":"Research on Child and Adolescent Psychopathology"},{"key":"1438_CR16","unstructured":"Ghazal, M. F. (2007). The effectiveness of a training program in the development of social skills among a sample of autistic children in Amman [Unpublished master\u2019s thesis]. University of Jordan."},{"issue":"2","key":"1438_CR17","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1177\/0271121410393285","volume":"32","author":"S Granger","year":"2012","unstructured":"Granger, S., des Rivi\u00e8res-Pigeon, C., Sabourin, G., & Forget, J. (2012). Mothers\u2019 reports of their involvement in early intensive behavioral intervention. Topics in Early Childhood Special Education, 32(2), 68\u201377. https:\/\/doi.org\/10.1177\/0271121410393285","journal-title":"Topics in Early Childhood Special Education"},{"key":"1438_CR18","doi-asserted-by":"publisher","unstructured":"Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114(1), 23\u201341. https:\/\/doi.org\/10.1352\/2009.114:23-41","DOI":"10.1352\/2009.114:23-41"},{"key":"1438_CR19","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1177\/0022002185016002001","volume":"16","author":"CH Hui","year":"1985","unstructured":"Hui, C. H., & Triandis, H. C. (1985). Measurement in cross-cultural psychology: A review and comparison of strategies. Journal of Cross-Cultural Psychology, 16, 131\u2013152.","journal-title":"Journal of Cross-Cultural Psychology"},{"issue":"3","key":"1438_CR20","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1097\/01.XME.0000434170.39029.4a","volume":"20","author":"H Hussein","year":"2013","unstructured":"Hussein, H., & Taha, G. R. A. (2013). Autism spectrum disorders: A review of the literature from Arab countries. Middle East Current Psychiatry, 20(3), 106\u2013116. https:\/\/doi.org\/10.1097\/01.XME.0000434170.39029.4a","journal-title":"Middle East Current Psychiatry"},{"issue":"2","key":"1438_CR21","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1007\/s40489-016-0074-7","volume":"3","author":"MP Kelly","year":"2016","unstructured":"Kelly, M. P., Dardas, L. A., Adly, S. Y., & Ahmad, M. M. (2016). An overview of autism and applied behavior analysis in the Gulf Cooperation Council in the Middle East. Review Journal of Autism and Developmental Disorders, 3(2), 154\u2013164. https:\/\/doi.org\/10.1007\/s40489-016-0074-7","journal-title":"Review Journal of Autism and Developmental Disorders"},{"issue":"1","key":"1438_CR22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1037\/0022-006X.55.1.3","volume":"55","author":"OI Lovaas","year":"1987","unstructured":"Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3\u20139. https:\/\/doi.org\/10.1037\/0022-006X.55.1.3","journal-title":"Journal of Consulting and Clinical Psychology"},{"issue":"3","key":"1438_CR23","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.rasd.2012.12.004","volume":"7","author":"JL Matson","year":"2013","unstructured":"Matson, J. L., & Konst, M. J. (2013). What is the evidence for long-term effects of early autism interventions? Research in Autism Spectrum Disorders, 7(3), 475\u2013479. https:\/\/doi.org\/10.1016\/j.rasd.2012.12.004","journal-title":"Research in Autism Spectrum Disorders"},{"issue":"4","key":"1438_CR24","first-page":"359","volume":"97","author":"JJ McEachin","year":"1993","unstructured":"McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97(4), 359\u2013372.","journal-title":"American Journal on Mental Retardation"},{"issue":"1","key":"1438_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s42822-019-00001-2","volume":"28","author":"KL Miller","year":"2019","unstructured":"Miller, K. L., Cruz, A. R., & Ala\u2019i-Rosales, S. (2019). Inherent tensions and possibilities: Behavior analysis and cultural responsiveness. Behavior and Social Issues, 28(1), 1\u201315. https:\/\/doi.org\/10.1007\/s42822-019-00001-2","journal-title":"Behavior and Social Issues"},{"issue":"3","key":"1438_CR26","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1177\/10883576211073686","volume":"37","author":"W Mounzer","year":"2022","unstructured":"Mounzer, W., & Stenhoff, D. M. (2022). Early intensive behavioral intervention program for children with autism in Syria. Focus on Autism and Other Developmental Disabilities, 37(3), 169\u2013178. https:\/\/doi.org\/10.1177\/10883576211073686","journal-title":"Focus on Autism and Other Developmental Disabilities"},{"key":"1438_CR27","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-27198-4","volume":"13","author":"W Mounzer","year":"2023","unstructured":"Mounzer, W., Stenhoff, D. M., Alkhateeb, J. M., & Al Khatib, A. J. (2023). A follow-up study of early intensive behavioral intervention program for children with autism in Syria. Scientific Reports, 13, Article 70. https:\/\/doi.org\/10.1038\/s41598-022-27198-4","journal-title":"Scientific Reports"},{"issue":"6","key":"1438_CR28","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1177\/0956797620916782","volume":"31","author":"M Muthukrishna","year":"2020","unstructured":"Muthukrishna, M., Bell, A. V., Henrich, J., Curtin, C. M., Gedranovich, A., McInerney, J., & Thue, B. (2020). Beyond WEIRD psychology: Measuring and mapping scales of cultural and psychological distance. Psychological Science, 31(6), 678\u2013701. https:\/\/doi.org\/10.1177\/0956797620916782","journal-title":"Psychological Science"},{"issue":"2","key":"1438_CR29","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1177\/0145445517748327","volume":"43","author":"A Perry","year":"2017","unstructured":"Perry, A., Koudys, J., Prichard, A., & Ho, H. (2017). Follow-up study of youth who received early intensive behavioral intervention as young children. Behavior Modification, 43(2), 181\u2013201. https:\/\/doi.org\/10.1177\/0145445517748327","journal-title":"Behavior Modification"},{"issue":"1","key":"1438_CR30","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.rasd.2010.03.011","volume":"5","author":"N Peters-Scheffer","year":"2011","unstructured":"Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 60\u201369. https:\/\/doi.org\/10.1016\/j.rasd.2010.03.011","journal-title":"Research in Autism Spectrum Disorders"},{"key":"1438_CR31","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009260.pub3","volume":"5","author":"B Reichow","year":"2018","unstructured":"Reichow, B., Hume, K., Barton, E. E., & Boyd, B. A. (2018). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 5, Article CD009260. https:\/\/doi.org\/10.1002\/14651858.CD009260.pub3","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"1438_CR32","doi-asserted-by":"crossref","unstructured":"Rosenthal, R. (1991). Meta-analytic procedures for social research. Sage. Rev. ed.","DOI":"10.4135\/9781412984997"},{"issue":"4","key":"1438_CR33","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1097\/00004356-199912000-00006","volume":"22","author":"AM Sartawi","year":"1999","unstructured":"Sartawi, A. M. (1999). Educational and behavioural characteristics of autistic children in the United Arab Emirates. International Journal of Rehabilitation Research, 22(4), 337\u2013339. https:\/\/doi.org\/10.1097\/00004356-199912000-00006","journal-title":"International Journal of Rehabilitation Research"},{"issue":"1","key":"1438_CR34","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/BF02408436","volume":"10","author":"E Schopler","year":"1980","unstructured":"Schopler, E., Reichler, R. J., DeVellis, R. F., & Daly, K. (1980). Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders, 10(1), 91\u2013103. https:\/\/doi.org\/10.1007\/BF02408436","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"4","key":"1438_CR35","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1177\/0145445520981201","volume":"45","author":"DP Smith","year":"2021","unstructured":"Smith, D. P., Hayward, D. W., Gale, C. M., Eikeseth, S., & Klintwall, L. (2021). Treatment gains from early and intensive behavioral intervention are maintained 10 years later. Behavior Modification, 45(4), 581\u2013601. https:\/\/doi.org\/10.1177\/0145445520981201","journal-title":"Behavior Modification"},{"issue":"6","key":"1438_CR36","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1111\/acps.12559","volume":"133","author":"HC Steinhausen","year":"2016","unstructured":"Steinhausen, H. C., Mohr Jensen, C., & Lauritsen, M. B. (2016). A systematic review and meta-analysis of the long-term overall outcome of autism spectrum disorders in adolescence and adulthood. Acta Psychiatrica Scandinavica, 133(6), 445\u2013452. https:\/\/doi.org\/10.1111\/acps.12559","journal-title":"Acta Psychiatrica Scandinavica"},{"issue":"4","key":"1438_CR37","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1177\/1098300712442242","volume":"14","author":"G Sugai","year":"2012","unstructured":"Sugai, G., O\u2019Keeffe, B. V., & Fallon, L. M. (2012). A contextual consideration of culture and school-wide positive behavior support. Journal of Positive Behavior Interventions, 14(4), 197\u2013208. https:\/\/doi.org\/10.1177\/1098300712442242","journal-title":"Journal of Positive Behavior Interventions"},{"issue":"9","key":"1438_CR38","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1001\/jamapsychiatry.2019.0878","volume":"76","author":"P Szatmari","year":"2019","unstructured":"Szatmari, P., Georgiades, S., Duku, E., Bennett, T., Bryson, S., Fombonne, E., Smith, I. M., et al. (2019). Developmental trajectories of adaptive functioning in autism spectrum disorder: The role of symptom severity and cognitive functioning. JAMA Psychiatry, 76(9), 911\u2013920. https:\/\/doi.org\/10.1001\/jamapsychiatry.2019.0878","journal-title":"JAMA Psychiatry"},{"issue":"21","key":"1438_CR39","first-page":"19","volume":"1","author":"M Tomczak","year":"2014","unstructured":"Tomczak, M., & Tomczak, E. (2014). The need to report effect size estimates revisited: An overview of some recommended measures of effect size. Trends in Sport Sciences, 1(21), 19\u201325.","journal-title":"Trends in Sport Sciences"},{"issue":"2","key":"1438_CR40","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/YCO.0000000000000043","volume":"27","author":"BJ Tonge","year":"2014","unstructured":"Tonge, B. J., Bull, K., Brereton, A., & Wilson, R. (2014). A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder: The core components of effective programs, child-focused interventions and comprehensive treatment models. Current Opinion in Psychiatry, 27(2), 158\u2013165. https:\/\/doi.org\/10.1097\/YCO.0000000000000043","journal-title":"Current Opinion in Psychiatry"},{"key":"1438_CR41","unstructured":"United Nations International Children\u2019s Emergency Fund (2019). Humanitarian needs overview: Syrian Arab Republic. https:\/\/www.unicef.org\/emergencies\/syrian-crisis"},{"key":"1438_CR42","volume-title":"Methods and data analysis for cross-cultural research","author":"F de Van Vijver","year":"1997","unstructured":"de Van Vijver, F., & Leung, K. (1997). Methods and data analysis for cross-cultural research. Sage Publications."},{"issue":"1","key":"1438_CR43","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/BF02211821","volume":"18","author":"FR Volkmar","year":"1988","unstructured":"Volkmar, F. R., Cicchetti, D. V., Dykens, E., & Sparrow, S. S. (1988). An evaluation of the Autism Behavior Checklist. Journal of Autism and Developmental Disorders, 18(1), 81\u201397. https:\/\/doi.org\/10.1007\/BF02211821","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"5","key":"1438_CR44","doi-asserted-by":"publisher","first-page":"e1303","DOI":"10.1542\/peds.2011-0426","volume":"127","author":"Z Warren","year":"2011","unstructured":"Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-VanderWeele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127(5), e1303\u2013e1311. https:\/\/doi.org\/10.1542\/peds.2011-0426","journal-title":"Pediatrics"},{"key":"1438_CR45","volume-title":"Wechsler Intelligence Scale for Children","author":"D Wechsler","year":"2003","unstructured":"Wechsler, D. (2003). Wechsler Intelligence Scale for Children (4th ed). The Psychological Corporation.","edition":"4th ed"}],"container-title":["Research on Child and Adolescent Psychopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10802-026-01438-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10802-026-01438-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10802-026-01438-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T11:52:14Z","timestamp":1777290734000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10802-026-01438-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["1438"],"URL":"https:\/\/doi.org\/10.1007\/s10802-026-01438-x","relation":{},"ISSN":["2730-7166","2730-7174"],"issn-type":[{"value":"2730-7166","type":"print"},{"value":"2730-7174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"assertion":[{"value":"27 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Damascus University Research Ethics Committee and the Swedish Ethical Review Authority (Ref. 2022-01262-01). Further details are provided in the Method section.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"The author declares that there are no conflicts of interest relevant to this research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}],"article-number":"39"}}