Journal of Autism and Developmental Disorders最新文献

Purpose: This study examined the relationships between teachers' technological competence, pedagogical beliefs, and the effective implementation of innovative technologies for students with autism spectrum disorder (ASD) in Saudi Arabia; further, it explored how these factors ultimately influence student learning outcomes.

Methods: Using a cross-sectional survey design, data were collected from 122 special education teachers across Saudi Arabia and analyzed using partial least squares structural equation modeling.

Results: While technological competence alone did not show a significant direct effect, the results revealed that teachers' pedagogical beliefs significantly predicted effective technology implementation. Student characteristics mediated the relationship between pedagogical beliefs and implementation effectiveness, while institutional factors did not demonstrate significant mediating effects. Notably, effective implementation of innovative technologies strongly predicted student learning outcomes. The model explained substantial variance in implementation effectiveness and student learning outcomes.

Conclusions: These findings suggest that, besides their technical skills, teachers' belief systems drive effective technology integration for students with ASD. Educational initiatives should prioritize developing positive attitudes toward technology alongside technical training, particularly emphasizing how technology can address the specific learning needs of students with ASD.

Purpose: This study aimed to identify core joint attention behaviors and examine their network structures and associations with autistic traits in school-aged children diagnosed with Autism Spectrum Disorder (ASD).

Methods: A total of 183 children with ASD (mean age = 7.33 ± 1.11 years; 67.8% male) were recruited. Participants were assessed using the Childhood Joint Attention Rating Scale (C-JARS) and the Childhood Autism Rating Scale (CARS). Network models of joint attention behaviors were estimated to identify central and bridge behaviors relating to core autistic traits.

Results: Network analysis revealed key behavioral dyads including sharing interests with cooperative digital play, and conversational engagement paired with gaze aversion during requests. Central hub behaviors such as helping others, hyperfocus on inanimate objects, and recalling shared positive experiences showed the highest influence within the joint attention network. Gaze avoidance and lack of shared interest were less central. Bridge analysis demonstrated that imitation and relating to people had strong negative associations with joint attention difficulties, suggesting that greater joint attention corresponds to lower severity of certain autistic traits.

Conclusion: The findings highlight distinct joint attention profiles in children with ASD and underscore imitation as a critical intervention target to improve social communication. This network-based approach offers nuanced insights into social communication deficits and supports the development of tailored therapeutic strategies for ASD.

Purpose: This study aimed to assess type 2 diabetes mellitus (T2DM)-related avoidable mortality in individuals with developmental disabilities using national claims data, comparing outcomes with those of other disabilities and non-disabled controls.

Methods: We used de-identified national claims data from the National Health Insurance Service merged with Causes of Death Statistics. The cohort included individuals over 30 years old with developmental disabilities who were newly diagnosed with T2DM between 2012 and 2016. Matched controls (non-disabled, mild, and severe disabilities) were selected based on sex, age, income proxy, and region. T2DM-related avoidable mortality (ICD-10 code "E11") within 1, 3, and 5 years was assessed using multiple logistic regression, adjusted for sociodemographic factors and comorbidities.

Results: T2DM-related avoidable mortality rates in the developmental disability group were 0.05%, 0.23%, and 0.55% at 1, 3, and 5 years post-diagnosis, respectively-lower than those in individuals with severe disabilities but higher than those of individuals without disabilities. Multiple logistic regression revealed no significant difference in 1-year mortality between individuals with developmental disabilities and those without disabilities; however, the risk was significantly higher at 3 years (OR = 4.84; 95% CI: 1.80-13.00) and 5 years (OR = 3.82; 95% CI: 2.14-6.81). Compared with individuals with mild disabilities, the 5-year mortality risk was also higher (OR = 2.41; 95% CI: 1.38-4.21).

Conclusion: Individuals with developmental disabilities exhibit significantly higher T2DM-related avoidable mortality than non-disabled and mild disability groups, highlighting critical gaps in healthcare accessibility. Strengthening targeted interventions and support services is essential to reducing avoidable deaths and improving health outcomes in this population.

Purpose: The purpose of this study was to address the importance of sensory input within the built environment and develop design guidelines to accommodate the needs of all users. Typically, people receive information about the surrounding environment through their senses collectively. However, sensory processing problems may occur when sensory signals do not integrate to provide appropriate responses. As a result, the environment may cause a person to feel confused or irritated.

Methods: A mixed methods approach was utilized to gather data including 1) focus group, 2) interviews, 3) observations, and 4) surveys. Over 600 subjects participated including education specialists (n = 546), adults with developmental disabilities (n = 58), and administrators and staff (n = 30). The target population was individuals who experienced difficulties with sensory processing, integration and modulation, caregivers, educators, and administrators who worked with the target population.

Results: The findings show that individuals with sensory processing disorder view their environment differently than the general population. The data gathered was analyzed and coded to reflect six sensory categories: sight, touch, hearing, taste, smell, and motion (includes proprioception and vestibular senses). Each of these themes were further evaluated to develop "Design Principles for Inclusive Environments." Auditory and Tactile sound triggers were found to be the most problematic sensory responses and are the main focus of this manuscript. Unexpected sounds, background noise, and noise from mechanical systems were among the most problematic, while incorporating music and nature sounds were found to alleviate sound triggers. Tactile sensitivity in the environment was increased or reduced based on textures and materials, available personal space, and temperature.

Conclusion: The research also showed that all users of a space benefited from the integration of inclusive design principles. This information is communicated in an easy-to-understand format that might benefit design professionals, educators, administrators, parents and the general public.

Purpose: This work evaluates use of the TELE-ASD-PEDS-Preschool (TAP-P), a telemedicine-based autism assessment tool for the preschool age range. The TAP-P is a play-based instrument with varied administration and scoring procedures based on a child's language level. This study compared tele-assessment using the TAP-P to in-person autism assessment.

Methods: Participants were 116 children (aged 36-71 months) referred for autism evaluation. Participants first completed in-home tele-assessment (administration of the TAP-P, clinical interview, and Developmental Profile 4). All participants then completed in-person assessment with a different psychological provider, including cognitive or developmental assessment, adaptive behavior assessment, and autism-focused assessment (ADOS-2). Caregivers completed questionnaires after each appointment assessing their perceptions.

Results: When asked to make a binary decision about presence or absence of autism, tele-assessment and in-person clinicians agreed for 82% of participants (n = 95). In most instances of diagnostic disagreement (n = 17), tele-assessment clinicians indicated the absence of autism and in-person clinicians indicated the presence of autism. When given the option to select "unsure," tele-assessment clinicians reported uncertainty for 28% of participants assessed using Form 1 of the TAP-P (designed for children with less verbal language, defined as two-word phrases or less) and 52% of children assessed using Form 2 (for children with more verbal language). Families reported broad satisfaction with tele-assessment procedures.

Conclusion: This work highlights potential utility of tele-assessment for identification of autism in preschool-aged children with less verbal language, while emphasizing the critical need for additional research related to use of tele-assessment for children using more complex and flexible verbal language.

Purpose: Routine developmental screening is essential for early identification of autism. Reliable autism screening is even more valuable for individuals from minoritized groups who are often under-detected and receive later diagnoses. Despite this importance, disparities in access to screening and accurate identification persist. Given these disparities, we were interested in examining group differences in autism screening rates at 18 and 24 months of age among children referred to Georgia's Part C Babies Can't Wait (BCW) program between 2018 and 2022.

Method: Among a sample of 52,282 infants and toddlers enrolled in BCW, as hypothesized males and children with private insurance had higher screening likelihoods compared to females and children with public insurance.

Results: Unexpectedly, Black and Hispanic children were more likely to be screened than their counterparts. To examine this further, an examination of screening timing revealed that White and male children were more likely to be screened before their referral to BCW compared to peers.

Conclusion: This reveals continued inequities in screening timing but suggests that BCW providers serve an important role in identifying children who may have been missed in other settings.

Purpose: Cognitive flexibility is a key neurocognitive process that is often challenging in children with autism. Recent research has highlighted the potential influence of motivation on cognitive flexibility; however, the impact of different types of motivation (intrinsic vs. extrinsic) on the cognitive flexibility performance of children with autism remains unclear.

Method: This study aims to investigate the impact of intrinsic and extrinsic motivation on cognitive flexibility in 43 children with autism and 89 typically developing children (TDC) (age range 36-84 months), using the three versions of dimensional change card sorting task (standard, extrinsic reward and intrinsic motivation versions).

Results: Results indicate that manipulating cognitive flexibility through motivation can improve performance, particularly in children with autism, with a significant impact of intrinsic motivation on this group. In the age range of 36-48 months, intrinsic motivation enhance accuracy in children with autism but not in TDC. From 49 to 60 months of age, both intrinsic and extrinsic motivation contribute to improved accuracy in children with Autism, with intrinsic motivation having a more significant impact. In TDC, however, only intrinsic motivation is associated with enhanced accuracy. In older children, both intrinsic and extrinsic motivation enhance performance in both groups, suggesting the maturation of cognitive systems. This evidence suggests that, in children with autism, the impact of motivation emerges at an earlier age than in typically developing children. Notably, intrinsic motivation has a more significant and profound effect at a younger age compared to extrinsic rewards.

Conclusion: The study provides insights into the developmental trajectory of cognitive flexibility in children with autism and highlights the significance of leveraging motivation to enhance this essential cognitive function.

Purpose: The assessment of adaptive functioning is essential in neurodevelopmental disorders, such as Intellectual Disability (ID) and Autism Spectrum Disorder (ASD), as a diagnostic criterion and as a definer of the level of severity or support. The Adaptive Functioning Scale (Escala de Funcionamento Adaptativo - EFA) is a Brazilian instrument for assessing adaptive functioning in children and adolescents aged 6 to 15. This study aimed to investigate evidence of the validity of EFA criteria as a screening instrument FA difficulties in individuals with ID and ASD.

Method: 917 EFA children and adolescents without diagnoses of neurodevelopmental disorders participated, 76 with a diagnosis of ID, and 65 with ASD.

Results: Variance analyses indicated differences in Z values in the three dimensions for the three groups. The differences presented a medium effect size, with the following partial Eta squared values: Social = 0.40; Practical = 0.43; Conceptual = 0.58. Sensitivity values ranged from 90 to 91% and 87 to 94%, while specificity values ranged from 64 to 74% and 63 to 90% in the ASD and ID groups respectively. The AUC values obtained for the EFA indicate that it has an excellent discriminatory capacity between the different aspects of adaptive functioning in the three domains of the instrument.

Conclusion: The EFA showed a greater ability to identify individuals with ASD and ID compared to individuals without diagnosis for all domains.