{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:44:47Z","timestamp":1791989087173,"version":"4.4.0"},"reference-count":7,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Children with autism spectrum disorder (ASD) often experience significant distress during medical procedures, which can limit access to optimal treatments such as biologic therapy for atopic dermatitis (AD). However, practical strategies for initiating injectable biologic therapy without physical restraint in this population remain poorly described. We report a case demonstrating a structured and reproducible approach that enabled restraint\u2010free initiation of dupilumab in a child with ASD. A 6\u2010year\u2010old boy with moderate\u2010to\u2010severe AD and comorbid ASD had a history of severe procedural avoidance requiring physical restraint for blood sampling and vaccinations. He was admitted for remission induction and consideration of dupilumab therapy. A Certified Child Life Specialist conducted an individualized intervention beginning early in hospitalization, including assessment of sensory sensitivities, visual preparation, environmental modification, and procedural rehearsal. On hospital Day 11, the first subcutaneous injection of dupilumab was successfully administered without physical restraint or additional staff assistance. A coordinated multidisciplinary strategy was implemented, including minimized sensory stimulation, predefined team roles, and distraction techniques. No adverse events occurred, and subsequent injections were performed smoothly in the outpatient setting without further specialized support. This case provides a practical and reproducible framework for overcoming procedural barriers and safely initiating biologic therapy in children with ASD.<\/jats:p>","DOI":"10.1111\/1346-8138.70394","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:37:37Z","timestamp":1784090257000},"page":"1381-1384","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Restraint\u2010Free Initiation of Dupilumab in a Child With Autism Spectrum Disorder: Overcoming Procedural Barriers in Atopic Dermatitis"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3624-1105","authenticated-orcid":false,"given":"Takuma","family":"Yamai","sequence":"first","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1288-9620","authenticated-orcid":false,"given":"Kiwako","family":"Yamamoto\u2010Hanada","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Yonemichi","sequence":"additional","affiliation":[{"name":"Child Life Services National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4508-8328","authenticated-orcid":false,"given":"Shungo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6317-1147","authenticated-orcid":false,"given":"Chisato","family":"Jimbo","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1903-6922","authenticated-orcid":false,"given":"Tomoki","family":"Yaguchi","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9099-6835","authenticated-orcid":false,"given":"Kotaro","family":"Umezawa","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiko","family":"Hirai","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2333-1817","authenticated-orcid":false,"given":"Kenji","family":"Toyokuni","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5395-8226","authenticated-orcid":false,"given":"Mitsuru","family":"Kubota","sequence":"additional","affiliation":[{"name":"Child Life Services National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4962-2137","authenticated-orcid":false,"given":"Tatsuki","family":"Fukuie","sequence":"additional","affiliation":[{"name":"Allergy Center National Center for Child Health and Development  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"2","volume-title":"Guidelines for the Prevention and Treatment of Atopic Dermatitis in Children 2024","author":"Japanese Society of Pediatric Dermatology and Japanese Society of Pediatric Allergy and Clinical Immunology","year":"2024"},{"key":"e_1_2_8_3_1","first-page":"105","article-title":"Understanding and Considerations for Sedation in Children With Autism Spectrum Disorder","volume":"53","author":"Kurone H.","year":"2021","journal-title":"No to Hattatsu"},{"key":"e_1_2_8_4_1","first-page":"1","article-title":"Meeting the Needs of Children With Autism Spectrum Disorder and Their Families in Hospital Settings: Perspectives of Certified Child Life Specialists and Nurses","volume":"2","author":"Fedele E.","year":"2021","journal-title":"Journal of Child Life"},{"key":"e_1_2_8_5_1","unstructured":"Japanese Association of Certified Child Life Specialists \u201cRole of Child Life Specialists \u201d(2026) https:\/\/jaccls.org\/cls_about\/."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_7_1","unstructured":"Ministry of Health Labour and Welfare \u201cOptimal Use Promotion Guidelines: Dupilumab \u201d(2026) https:\/\/www.mhlw.go.jp\/content\/12404000\/001167635.pdf."},{"key":"e_1_2_8_8_1","unstructured":"Ministry of Health Labour and Welfare \u201cReiwa 6 Medical Fee Revision \u201d(2026) https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/0000188411_00045.html."}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70394","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1346-8138.70394","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:50:34Z","timestamp":1791985834000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.70394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":7,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/1346-8138.70394"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.70394","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"2026-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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