Recognition of acute ischemic stroke (AIS) symptoms is often delayed in pediatric patients with developmental disabilities, such as autism, Down syndrome, and cerebral palsy. As a consequence, this population is less likely to receive intervention after AIS, leading to worsened outcomes that include increased inpatient mortality rates.

In a retrospective cross-sectional analysis presented at the American Academy of Neurology Annual Meeting from April 18-22, 2026, in Chicago, Illinois, Aarti Jain, BS, of New York Medical College, and colleagues assessed the incidence and outcomes of AIS in pediatric patients (<18 years old) with developmental disabilities. The authors used data from the National Inpatient Sample between 2015 and 2022, finding that a total of 3,850 pediatric patients were hospitalized because of an AIS, including 415 (10.8%) who had developmental disabilities.

Patients with developmental disabilities had a greater likelihood of sleep disorders and valvular disease as well as complications of aspiration pneumonia and dysphagia (all P<0.05). The majority of these patients were White (55.4%), male (51.8%), and Medicaid recipients (61.4%).

Among those with developmental disabilities, 94% did not receive IV thrombolysis (IVT) or endovascular therapy (EVT). Those who did receive EVT had a decreased likelihood of routine discharge (odds ratio [OR], 0.02; 95% CI, 0.001-0.32; P=0.006);  IVT was not associated with any difference in outcomes of routine discharge, inpatient mortality, or hemorrhagic transformation.

Overall, pediatric patients with developmental disabilities had a significantly decreased likelihood of routine discharge and an equivalent likelihood of inpatient death after an AIS. The authors note that further research on early identification of symptoms and intervention is needed to improve AIS outcomes in this population.