Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 0 0 2026 08 15 1 13 Hamidreza Pouretemad Institute of Cognitive & Brain Sciences, Shahid Beheshti University, Tehran, Iran AND Center for the Treatment of Autistic Disorders-CTAD (Tehran Autism Center), Tehran, Iran. Saeid Sadeghi Institute of Cognitive & Brain Sciences, Shahid Beheshti University, Tehran, Iran. Sima Saniee Institute of Cognitive & Brain Sciences, Shahid Beheshti University, Tehran, Iran AND Center for the Treatment of Autistic Disorders-CTAD (Tehran Autism Center), Tehran, Iran. Elnaz Veisi Faculty of Psychology and Educational Sciences Department of Psychology, Shahid Beheshti University, Tehran, Iran. Fatemeh Farshchi Faculty of Psychology and Educational Sciences Department of Psychology, Shahid Beheshti University, Tehran, Iran. Katayoun Khoshabi Department of Psychiatry, University of Welfare and Rehabilitation Sciences, Tehran, Iran. Serg Brand Center of Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, 4002 Basel, Switzerland. 2025 11 27 2026 06 16 Objective: Applied Behavior Analysis (ABA) is an evidence-based intervention for autism spectrum disorder (ASD), but treatment discontinuation remains common. Adapted Intensive Applied Behavior Analysis (AIABA) is a culturally modified version of ABA developed for Iranian families, that integrates cultural and family values into daily routines. This study examined clinical and contextual predictors of AIABA discontinuation. Method: We reviewed clinical files of 529 children with ASD (mean age = 41.7 months, SD = 13.8) who received AIABA at the Tehran Autism Center (2011 2021). Predictors included parental engagement, programming mode (in person vs. semi online), medication use, age at diagnosis, comorbidity, motor development, additional therapies, and symptom severity. Logistic regression identified predictors of discontinuation. Results: Discontinuation occurred in 66.7% of children. Mean treatment duration was shorter in the discontinuation group (11.4 months) than the planned termination group (19.1 months). Significant predictors included lower parental engagement (OR = 0.03, 95% CI [0.01 0.07]), concurrent medication use (OR = 3.22, 95% CI [1.89 5.49]), semi online supervision (OR = 3.01, 95% CI [1.61 5.63]), higher pre cessation symptom severity (OR = 1.04, 95% CI [1.01 1.06]), and younger age at diagnosis (OR = 0.97, 95% CI [0.95 0.98]). The model explained 38.8% 53.9% of variance and correctly classified 83.4% of cases. Conclusion: Lower parental engagement, concurrent medication use, semi online supervision, higher pre cessation symptom severity, and younger age at diagnosis significantly predicted AIABA discontinuation. Targeting parental engagement, monitoring intensity, and coordinated care may reduce dropout risk. Given the retrospective, single center design and reliance on record-based measures, results require cautious interpretation. Prospective multi-site studies are needed to translate these predictors into retention focused planning. https://ijps.tums.ac.ir/index.php/ijps/article/view/4494 https://ijps.tums.ac.ir/index.php/ijps/article/download/4494/1348