Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 0 0 2026 08 24 1 11 Kareem Jebur Dhaian Pediatric Nursing Department, College of Nursing, University of Karbala, Karbala, Iraq. Enas Ahmed Abdel Karim Pediatric Nursing Department, College of Nursing, University of Al-Qadisiyah, Al-Diwaniyah, Iraq. Qasim Kadhim Ashour Pediatric Nursing Department, College of Nursing, University of Karbala, Karbala, Iraq. Rasha Hussein Oleiwi Department of Maternal and Neonatal Nursing, College of Nursing, University of Karbala, Karbala, Iraq. Asmahan Qasim Mohammed Pediatric Nursing Department, College of Nursing, University of Baghdad, Baghdad, Iraq. 2026 06 17 2026 07 22 Objective: This study investigated the predictive relationships between kindergarten teachers' knowledge of communication skills for children with autism spectrum disorder (ASD), the teachers’ self-efficacy beliefs, their attitudes towards inclusive education, their perceived organizational support, and their self-reported utilization of evidence-based communication strategies. Method: A cross-sectional predictive correlational design was employed across government-operated kindergartens in Kerbala Governorate, Iraq. Stratified random sampling recruited 243 kindergarten teachers. Data were collected using a comprehensive self-administered questionnaire comprising validated instruments measuring demographic characteristics, autism-specific communication knowledge, teacher self-efficacy for inclusive practices using the Teacher Efficacy for Inclusive Practices Scale, attitudes towards inclusion using the Multidimensional Attitudes Scale Toward Persons with Disabilities, perceived organizational support using the Survey of Perceived Organizational Support, and frequency of evidence-based strategy use. Hierarchical multiple regression analysis was conducted to identify significant independent predictors of strategy implementation. Results: The final regression model was highly significant (F (7, 235) = 25.32, P < 0.001) and accounted for 42% of the variance in teachers' use of evidence-based communication strategies (R2 = 0.42). Teacher self-efficacy emerged as the strongest independent predictor (β = 0.35, P < 0.001), followed by perceived organizational support (β = 0.28, P < 0.01) and professional experience (β = 0.22, P < 0.05). General knowledge about autism spectrum disorder (β = 0.06, P = 0.12) and attitudes towards inclusion (β = 0.05, P = 0.23) did not retain statistical significance as independent predictors when self-efficacy and organizational support were controlled. Conclusion: Effective communication support for children with autism in inclusive preschool environments is determined by a complex interplay of individual psychological factors and organizational contextual variables. Professional development initiatives should prioritize cultivating teacher self-efficacy through experiential learning and coaching while fostering supportive school cultures and providing adequate resources and administrative encouragement. https://ijps.tums.ac.ir/index.php/ijps/article/view/4672 https://ijps.tums.ac.ir/index.php/ijps/article/download/4672/1351