Journal of Autism and Developmental Disorders最新文献

Autism and social anxiety (SA) share behavioral features like reduced eye contact, variable social attention, and differences in social interactions. However, the impact of the co-occurrence of these conditions (e.g., autism with co-occurring SA) on social attention remains unknown. Therefore, we evaluated whether the degree of SA characteristics in autistic youth modulated (e.g., amplified or lessened) a core hallmark feature of autism: social attention, or looking at faces. Fifty-four autistic and 35 non-autistic children and adolescents completed a gaze-contingent eye-tracking (ET) paradigm, in which faces dynamically expressed happy or fearful expressions contingent on participant eye contact. SA characteristics were assessed via standardized self- and parent-report measures. Social attention was measured by calculating the average percent looking time at the face and eye regions of each emotional expression. Autistic participants looked less at faces than non-autistic participants, and higher self-report SA was associated with less looking at eyes in both autistic and non-autistic participants. SA features affect social attention similarly in autistic and non-autistic youth, highlighting the importance of considering co-occurring psychiatric characteristics when assessing social attention and eye contact in autistic individuals.

Lockdown imposed by the COVID 19 pandemic increased the time families spent together at home. A negative impact of the lock-down on children with autism has been reported. Few studies described the positive impact of parents' presence on the severity of their children's autism symptoms during lockdown. To describe the positive impact of the COVID-19 lockdown on the evolution of Children' Symptoms with autism and parents' emotional status and to determine which variables had a positive or negative impact on the severity of autism features in Kinshasa. From April 15 to July 15, 2020, we analyzed the evolution of core symptoms of 68 children with autism and correlated these findings with the presence of a parent at home during lockdown. We performed multivariate logistic regression to assess the factors associated to autism symptoms improvement after adjustment by sex, age at ASD diagnosis, education, parent occupation, child's occupancy time, presence of parent's depression, and presence of comorbidities and core symptoms in children. Parents reported ASD symptom improvement in 42.6% of children. Factors positively associate with ASD symptoms improvement were presence of a parent for more than 8 h per day, improvement of social communication and autonomy. In contrast, severe to moderate depression in parents and presence of main comorbidities in children were associated with more severe autistic symptoms in their children. The presence of a parent at home, improved child communication and autonomy improved autism symptoms. On the other hand, parental depression and comorbidities in children with ASD aggravated the symptoms during lockdown in Kinshasa/DRC. These findings emphasize the importance of the physical presence of parents as well as the length of time they spend with their children with ASD. In addition, they show that depressive feelings in parents and comorbidities in ASD have a negative impact in the severity of their symptoms during lockdown.

The National Institute of Mental Health created the National Database for Autism Research (NDAR) to accelerate autism knowledge through data sharing and collaboration. However, our experience using NDAR reveals systematic challenges across several aspects of data submission, selection, management, and analysis that limit utility of this resource. We describe our NDAR experience in an ongoing project examining autism intervention outcomes among marginalized racial, ethnic, and gender groups. For this study, we planned to gather data from NDAR to conduct an individual participant data meta-analysis. Eighteen studies met inclusion criteria and reported data on participants at more than one point in time on the Vineland Adaptive Behavior Scales (Vineland) and the Autism Diagnostic Observation Schedule (ADOS). The difficulties with submitting, selecting, downloading, and managing data from NDAR posed limitations on data availability and analysis. Of the 3,850 unique participants in the selected studies, data at multiple time points were available for 312 participants on the Vineland and 278 on the ADOS. No participants had data on all assessment domains. To accelerate autism research via data sharing and collaboration with NDAR necessitates improving the processes for submitting, selecting, and managing data.

Purpose: Autistic adults are at high risk for mental health challenges, yet there has been limited research on mental health interventions for this population. Individual differences in how thoughts and emotions are perceived may directly relate to the success of specific therapy strategies. This study examined whether alexithymia and inner thinking patterns relate to helpfulness and ease of use of mental health therapy strategies among autistic adults.

Method: Participants (n = 269 autistic adults, ages 21-77) completed questionnaires assessing alexithymia, inner thinking patterns (i.e., self-talk, verbal thinking, visual thinking), and experiences with mental health therapy strategies. Ordinal logistic regressions were used to examine associations between alexithymia, inner thinking, and perceived helpfulness and ease of use of therapy strategies.

Results: Autistic adults with greater alexithymia found cognitive strategies more difficult to use, while those with greater frequency of self-talk found them easier to use. By contrast, autistic adults with greater visual thinking found guided imagery strategies easier to use. There were no associations between alexithymia or inner thinking and perceived helpfulness or ease of use of behavioral strategies (exposure, behavioral activation), mind-body relaxation strategies (deep breathing, progressive muscle relaxation), or mindfulness meditation.

Conclusions: The findings suggest that some mental health strategies may be more difficult to implement for some autistic adults, depending on individual thinking profiles. However, alexithymia and inner thinking patterns were unrelated to the perceived helpfulness of mental health strategies. Overall, this highlights the importance of providing individualized supports and accommodations to optimize mental health therapy for autistic adults.

The current study evaluates whether college students can identify characteristics of autism as diagnostic for autism, and characteristics of other disabilities as not diagnostic for autism. This study also examines metacognitive awareness of autism knowledge, evaluating whether college students can accurately calibrate their confidence in their beliefs about autistic characteristics. 283 college students completed the Autism Symptomatology Knowledge Assessment (McMahon et al. Research in Autism Spectrum Disorders 71:101499, 2020). In this assessment, participants were presented with characteristics of autism and other disabilities and asked to identify which characteristics could be used to diagnose someone with autism. For each characteristic, participants indicated how certain they were in their response. Participants more accurately categorized characteristics of autism, particularly social interaction and communication challenges, as being consistent with an autism diagnosis. Participants had more difficulty identifying that characteristics of other disabilities, especially anxiety, ADHD, and learning disabilities, were not diagnostic for autism. For autistic characteristics, participants' confidence and accuracy were positively correlated, such that participants who responded accurately were more confident in their response than those who responded inaccurately. For other disability characteristics, confidence and accuracy were typically not correlated or inversely correlated, indicating poor metacognitive awareness. College students confuse autism with other disabilities, which may have important implications in real-world contexts. Furthermore, individuals with poor metacognitive awareness of their autism knowledge may not realize that they are confusing autism with other disabilities, such that they may not seek out additional corrective information about autism.

Licensure is an option for some autistic adolescents and families that increases mobility by enabling independent travel to employment, school, and social activities. The objective of this study was to identify current strategies used by healthcare providers (HCPs) in their guidance to autistic adolescents and families on the transition to independent driving. Semi-structured interviews were conducted with 15 HCPs. The team's previous research, literature review and expert feedback informed the development of the interview guide. A content analysis approach was used in the coding of transcripts, nine of which were double coded. Study team members reviewed coded transcripts, provided and discussed narrative summaries, and identified themes. Interviews were conducted with physicians, social workers, psychologists, therapist and a nurse practitioner. HCP identified their perceptions of autistic adolescents' strengths and weaknesses to be addressed in their individualized approaches. They described using clinical interactions as time to address licensure and driving, but also referred to specialists as needed. HCPs described using existing resources, but also provided a wish list of future resources. HCPs use an individualized approach for guidance in the transition to independent driving, considering the unique needs of autistic adolescent patients and families. These HCPs identified a clear need for tailored resources and guidance they can use in support of independent driving when appropriate for their patients and families.

Adults with autism spectrum disorder (ASD) often experience co-occurring physical and mental health challenges throughout their lives. At the same time, they frequently face many barriers to accessing proper care. Strategies to improve communication and understanding can help to mitigate some of these barriers. This study examined the effects of an instructional package, including a video module accompanied by guided notes, the Autism Healthcare Accommodations Tool (AHAT), and behavior skills training (BST) to teach adults with autism to communicate their unique needs and request accommodations to a medical provider. Three participants independently completed a self-guided video module that modeled how to complete the guided notes and AHAT to identify appropriate accommodations and prepare for a doctor's appointment. Once finished, participants were taught to verbalize their needs and accommodations through BST. Results showed that participants' communication skills increased after introducing the instructional package, generalized to a novel provider and maintained once the instructional package was removed. This intervention proved to be an effective and socially valid method to improve communication for adults with autism in medical settings. Implications and suggestions for future research are discussed.

A growing body of research shows that children with autism exhibit selective limitations in their ability to direct their visual attention to social stimuli. The cause of this selective limitation, however, remains unknown. The main purpose of this study is to determine whether the limitations in social attention are influenced by the objects in the environment. Specifically, the study examines the differences in visual attention between children with autism and typically developing (TD) children as they view videos of social interactions under two conditions, with and without objects. The sample consisted of 53 children with autism and 74 TD children, aged between 18 and 36 months. The findings indicated that young children with autism exhibited differences in their social attention compared to their TD peers. The results revealed that the presence of objects did not affect the visual attention differences between the two groups. However, removing objects from the environment positively impacted the social attention of both groups. In the condition without objects, both groups directed more visual attention more toward the Face and Body Areas of Interests (AoIs), whereas in the condition with objects, both groups prioritized looking at the Toy AoI. These findings have important implications for evidence-based decision-making, especially in designing early intervention environments for children with autism.

Studies suggest that parents' emotional availability (EA) is associated with children's wellbeing, including in the case of children with autism. Our study extended prior research by examining the role of parents' representations in fostering parental EA and by focusing on fathers and on children with autism and severe behavior problems. We expected that parents' positive representations would be associated with higher EA and compared mothers' and fathers' representations and EA. Participants were 79 mothers and 69 fathers (child age range = 61-173 months, 21.95% girls). Representation assessments included the Reaction to Diagnosis Questionnaire, tapping resolution with respect to the child's diagnosis, and the coherence and positive comments in parents' Five Minute Speech Samples about the child. Parents' EA was coded from parent-child play interactions. Controlling for children's autism symptoms and adaptive functioning, mothers' resolution with respect to the child's diagnosis and positive comments (but not coherence) were associated with their EA, and fathers' coherence (but not positive comments and resolution) was associated with their EA. Mothers expressed more positive comments than fathers, and the resolution and EA scores of mothers and fathers were significantly correlated. Our results highlight the importance of considering both parents' representations and EA when studying and working with families of children with autism and severe behavior problems.