Journal of Autism and Developmental Disorders最新文献

Purpose: This study examined the relationship between executive functioning (EF) and core features associated with autism in children aged 2 and 4 years. EF encompasses a set of goal-directed skills that enable organized thoughts and behavior which develop rapidly during the preschool period. To examine concurrent associations between EF and early autism expression, we analyzed whether EF performance relates to observed social communication and repetitive behaviors during parent-child interactions.

Methods: Participants included 110 autistic children aged 24 to 60 months diagnosed with autism. Developmental and cognitive abilities were assessed using the Mullen Scales of Early Learning. Social communication and repetitive behaviors associated with autism were coded from 10-minute free play parent-child videos using the Brief Observation of Social Communication Change (BOSCC), yielding total social communication, restricted/repetitive behaviors scores, and overall total scores. An EF score was derived from a test battery that included measurements of set-shifting, working memory, inhibition, and delay. Regression analyses were conducted to assess EF's contribution to autism expression, controlling for cognitive ability.

Results: For 2-year-olds, EF was not related to observed autism behaviors after controlling for cognition. Conversely, for 4-year-olds, EF related to overall behaviors associated with autism observed during parent-child interactions.

Conclusion: Findings of an association between EF and autism-related behaviors observed in parent-child interactions by preschool at age 4 but not in toddlerhood at age 2 highlight potential developmental differences in the relation between EF and autism-related behaviors. Longitudinal and experimental research is needed to establish directionality and malleability of EF and autism-related behaviors.

Purpose: The PANSS Autism Severity Score (PAUSS) has recently become a popular measure of autistic features in psychosis populations, but evidence on its longitudinal reliability and factor configuration is poor. The aims of this investigation were to examine psychometric characteristics of the PAUSS in young patients with First Episode Psychosis (FEP) treated in an early intervention service, with primary interest for its long-term stability across 2 years of follow-up and factor configuration.

Methods: All FEP participants completed the Positive And Negative Syndrome Scale (PANSS) and Autism Quotient (AQ) at baseline and across the follow-up. Statistical analysis mainly included Cronbach's α to examine internal consistency of the PAUSS, Cohen's k statistics and Spearman's ρ correlation coefficients for its longitudinal stability and convergent validity with AQ scores, and exploratory factor analysis to explore its dimensions' configuration.

Results: 301 FEP participants were recruited (170 with Schizophrenia Spectrum Disorder [SSD]). Cronbach's α value for the PAUSS was 0.806, but with unacceptable inter-item correlations for PANSS G5 and G15 items. K value for examining PAUSS convergent validity with AQ score was unacceptable (0.295), as well as ρ and k values to quantify long-term test-retest reliability (< 0.750 and < 0.600, respectively). No long-term stability of the PAUSS scores across the follow-up was also found using Wilcoxon's test for repeated measure. Our EFA found a 2-factor model in the FEP total sample and a 3-factor configuration in the SSD subgroup.

Conclusion: Our results suggest that the PAUSS does not represent a valid instrument to assess autistic features in FEP and SSD. Indeed, the it probably captures psychotic symptom severity rather than autistic features, especially reflecting negative symptom load.

Purpose: Coaching, which integrates structured guidance with systematic performance feedback, is increasingly used to enhance the instructional competencies of preservice teachers. Despite its growing application, limited research has investigated its direct impact on instructional fidelity and student reading outcomes. This study examines the effects of hybrid coaching on preservice special education teachers' instructional accuracy and students' reading fluency.

Methods: Using a single-case multiple probe design, four preservice special education teachers and four middle school students with intellectual disabilities participated in an intervention that incorporated structured coaching, systematic feedback, and fluency-based reading instruction. Data were collected through direct observation, implementation checklists, and reading fluency assessments. Visual analysis and Tau-U effect size calculations were used to assess the intervention's effectiveness.

Results: Results indicated a substantial improvement in instructional accuracy among preservice teachers, reaching and sustaining 100% across three consecutive probe sessions. In parallel, students demonstrated significant increases in reading fluency, with correct words per minute (CWPM) scores improving by 20-50%. Social validity data highlighted high levels of satisfaction, with preservice teachers reporting increased confidence and instructional proficiency.

Conclusion: The intervention's effectiveness was most pronounced in structured coaching, while shared variance across all coaching components contributed significantly to both teacher and student outcomes. Findings reinforce the potential of hybrid coaching as a generalizable and sustainable approach for strengthening instructional fidelity and improving reading fluency outcomes in students with intellectual disabilities.

Purpose: The purpose of this research was to investigate whether an intervention combining explicit and visually cued instruction could help upper primary students with ASD improve their social inferential reading comprehension performance.

Methods: A multiple probe design was used to evaluate the effectiveness of the intervention on four children with ASD, aged 10 to 11 years. The study was conducted two to three times per week, each lasting 60 min, over ten weeks. The interventionist used think-alouds to explicitly model cognitive processes, error correction prompts to scaffold thinking, and a graphic organiser worksheet to simplify the social inferential reading comprehension process. All test probes used in the study were developed based on the 'Strange Stories' test by Happé (1994), and they were statistically equated using Rasch analysis.  RESULTS: Results indicated a mean improvement ranging from 40% to 56% between baseline and intervention phases across different students. Supporting this finding, the effect size calculations using PND, PEM, PAND and Tau-U suggested an effective intervention. To reject the null hypothesis of no treatment effect, a randomization test was conducted using the SCRT-R software, yielding a p-value of 0.008.

Conclusions: With appropriate support, children with ASD may be able to develop the complex reading skills needed to interpret the emotions and intentions of story characters. While the findings of this study are promising, they should be considered preliminary. This exploratory research provides a foundation for future studies to build upon and to further investigate effective interventions for improving social inferential reading comprehension in students with ASD.

Purpose: Scurvy, a disease caused by vitamin C deficiency, occurs in populations at high risk for nutritional deficiencies. Avoidant/Restrictive Food Intake Disorder (ARFID), a condition frequently associated with Autism Spectrum Disorder (ASD), represents a predisposing factor for this and other micronutrient deficiencies. The purpose of this article is to report a case series of patients with ASD who presented with gait disturbance as the first manifestation of scurvy, emphasizing the importance of early diagnostic suspicion.

Materials and methods: We conducted a retrospective review of electronic medical records of patients with ASD and gait abnormalities evaluated at the pediatric neurology department of Hospital Italiano de Buenos Aires between 2013 and 2025. Inclusion criteria were ASD, restrictive eating patterns, and clinical features compatible with scurvy. Cases with conditions or medications that could alter vitamin C metabolism were excluded.

Results: Nine patients met inclusion criteria. All presented with subacute gait disturbance (limping, antalgic gait, or refusal to walk) associated with pain, cramps, or weakness. Five showed petechiae or purpura. None had a prior ARFID diagnosis despite marked dietary restriction, and all ultimately fulfilled diagnostic criteria during follow-up. Anthropometric parameters were within normal ranges in all cases. A targeted dietary history revealed severely restricted food intake. Based on clinical suspicion of scurvy, plasma vitamin C levels were measured and found to be significantly low. Treatment with ascorbic acid led to significant symptom improvement within the first week and full recovery of gait.

Conclusions: Scurvy should be considered in the differential diagnosis of children with ASD who present with restrictive eating behaviors and gait disturbances, even in the presence of normal anthropometric measurements or absence of a prior ARFID diagnosis. Early recognition and targeted laboratory testing enable timely treatment, preventing unnecessary investigations and allowing for rapid clinical recovery.

Purpose: Eating problems are prevalent among children with Autism. Early identification is crucial for intervention. This study aimed to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) for use in Iran and the Kurdistan Region of Iraq (KRI).

Methods: The study involved a sample of 873 children, including 540 with autism and 333 neurotypically developing children, with a mean age of 7.09 years. The translation process followed a rigorous methodology, including obtaining official permission, translation, back-translation, and pilot testing to ensure cultural relevance and accuracy.

Results: The BAMBI, a mealtime behavior scale, showed strong internal consistency (α = 0.832) and a stable three-factor structure in 873 children (540 autistic, 333 neurotypical) aged 2-14 in Iran and the KRI. The BAMBI demonstrated good discriminant and convergent validity, correlating strongly with autism diagnostic measures.

Conclusion: The BAMBI questionnaire has been successfully translated and validated for both Persian and Kurdish languages, enabling the evaluation of mealtime behaviors in clinical settings in Iran and the Kurdistan Region of Iraq.

Purpose: Applied behavioral analysis is the most common intervention for autistic children. It has long been proposed that more hours per week in ABA produce better outcomes. ABA practice guidelines typically recommend 30-40 h per week for young autistic children. While some studies support a dosage effect, other studies find no predictive relationship between ABA treatment hours and a range of child outcomes. Thus, the dosage question remains open, leaving parents and providers unsure of the ideal dosage of ABA for an autistic child to make meaningful progress. Real world data (RWD) can fill the gap between community treatment and controlled research often conducted by universities.

Methods: In this study, we examined the RWD data from 725 autistic children receiving ABA as part of community-based care. Using longitudinal multilevel modeling, we examined the relationship between average hours of ABA per month and change on proximal and distal measures: adaptive behavior, goal attainment, and dangerous behavior.

Results: Dosage was a significant predictor of goal attainment, indicating that clients who spent more time in treatment met more goals. Conversely, the relationship was negative for adaptive behavior and communication, such that higher hours predicted slower progress in these domains. Finally, dangerous behavior decreased over time and was independent of hours. Secondary analyses demonstrated that communication abilities at baseline predicted treatment outcomes above and beyond dosage, except for dangerous behavior.

Conclusion: While more research is needed, this study suggests that practice guidelines should temper language around dosage and ABA.

Purposes: This meta-analysis examined the post-intervention effects of joint attention interventions on children's joint attention skills and other outcomes for young children with autism spectrum disorder (ASD), as well as identifying characteristics associated with improvements in children's joint attention skills.

Methods: We searched four databases in February 2025. Randomized controlled trials (RCTs) of joint attention interventions for children with ASD under five years old were included. Risk of bias was assessed using the Risk of Bias 2.0 tool. Effects were synthesized using multivariate random-effects model meta-analysis using robust variance estimation.

Results: Eighteen RCTs with 1,165 child participants were included in this meta-analysis. We found improvements in joint attention skills (g = 0.53, 95% CI [0.34, 0.72]) with substantial heterogeneity. Child's chronological age and joint attention types were found statistically moderating the effect on children's joint attention skills. We also found improvements in play (g = 0.33, 95% CI [0.04, 0.63]), and autism symptomatology (g = 0.70, 95% CI [0.13, 1.26]).

Conclusion: This meta-analysis of 18 RCTs showed that joint attention interventions effectively improved joint attention skills in young children with ASD. Younger children showed greater improvements than older children. Larger effects on responding to joint attention were observed comparing to other types of joint attention. While positive effects on play skills and autism symptoms were observed, these findings require cautious interpretation due to methodological limitations. Results support joint attention interventions as beneficial for improving developmental outcomes in young children with ASD.