Journal of Autism and Developmental Disorders最新文献

Attention-deficit/hyperactivity disorder (ADHD) commonly co-occurs in autistic children. However, additional research is needed to explore the differences in motor skills and sensory features in autistic children with and without ADHD, as well as the impacts of these factors on daily living skills (DLS). This observational study sought to fill this gap with 67 autistic children (6.14-10.84 years-old), 43 of whom had ADHD. Autistic children with ADHD demonstrated higher sensory features and lower motor skills than autistic children without ADHD. In examining autism and ADHD features dimensionally, we found that overall sensory features, seeking, and hyporesponsiveness were driven by both autism and ADHD features, whereas motor skills, enhanced perception, and hyperresponsiveness were driven by only autism features. Additionally, in using these dimensional variables of autism and ADHD features, we found that differences in motor skills, sensory and autism features, but not ADHD features, impact DLS of autistic children, with autism features and motor skills being the strongest individual predictors of DLS. Together, these results demonstrate the uniqueness of motor skills and sensory features in autistic children with and without ADHD, as well as how autism features, sensory features, and motor skills contribute to DLS, emphasizing the importance of a comprehensive understanding of each individual and complexities of human development when supporting autistic children.

The stress literature suggests that coping strategies are implicated in mental health outcomes. However, the longitudinal relationship between coping strategies and mental health in the autistic adult population has not yet been examined. This 2-year longitudinal study examined the predictive role of both baseline and change in coping strategy use over time (i.e., an increase or decrease) on anxiety, depression, and well-being after 2-years in 87 autistic adults aged 16 to 80 years. Controlling for baseline mental health, both baseline and increase in disengagement coping strategies (e.g., denial, self-blame) predicted higher anxiety and depression, and lower well-being, while an increase in engagement coping strategies (e.g., problem solving, acceptance) predicted higher well-being. These findings extend the current coping literature in autistic adults, offering insight into mental health support and intervention options.

Purpose: A high-quality primary care clinic should provide clear action points and important care coordination for a child receiving a new diagnosis of autism spectrum disorder (ASD). Unfortunately, a substantial proportion of caregivers report little-to-no post-diagnosis support from their home clinics and primary care providers often report lack of training and resources in providing these supports.

Methods: We implemented an intervention package to investigate the impact on the frequency and quality of follow-up care for children with ASD in a busy, high-volume resident continuity clinic. The package consisted of a care coordination scheduling pathway and a standardized clinical template-embedded in the electronic health record (EHR)-that guided providers through best-practice recommendations and patient resources.

Results: As a result of these interventions, 74% of patients had ASD-specific follow-up, a more than threefold increase from baseline with a majority of providers using the EHR-embedded template to guide their visit. Providers also indicated a high degree of usability for the system and that it aided them in following best-practice guidelines for ASD care.

Conclusion: Through explicit scheduling pathways and a novel EHR template, we saw a significant increase in ASD-specific follow-up visits and implementation of best practices for ASD care, demonstrating a new process for training and engaging primary care providers in clear action steps for post-diagnostic care without having to rely on tertiary referrals.

Autistic individuals often exhibit motor atypicalities, which may relate to difficulties in social communication. This study utilized a smart tablet activity to computationally characterize motor control by testing adherence to the two-thirds power law (2/3 PL), which captures a systematic covariation between velocity and curvature in motor execution and governs many forms of human movement. Children aged 4-8 years old participated in this study, including 24 autistic children and 33 typically developing children. Participants drew and traced ellipses on an iPad. We extracted data from finger movements on the screen, and computed adherence to the 2/3 PL and other kinematic metrics. Measures of cognitive and motor functioning were also collected. In comparison to the typically developing group, the autistic group demonstrated greater velocity modulation between curved and straight sections of movement, increased levels of acceleration and jerk, and greater intra- and inter-individual variability across several kinematic variables. Further, significant motor control development was observed in typically developing children, but not in those with autism. This study is the first to examine motor control adherence to the 2/3 PL in autistic children, revealing overall diminished motor control. Less smooth, more varied movement and an indication of developmental stasis in autistic children were observed. This study offers a novel tool for computational characterization of the autism motor signature in children's development, demonstrating how smart tablet technology enables accessible assessment of children's motor performance in an objective, quantifiable and scalable manner.

Purpose: Fragile X syndrome (FXS) is a single-gene disorder characterized by moderate to severe cognitive impairment and a high association with autism spectrum disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Atypical visual attention is a feature of FXS, ASD, and ADHD. Thus, studying early attentional patterns in young children with FXS can offer insight into early emerging neurocognitive processes underlying challenges and contribute to our understanding of common and unique features of ASD and ADHD in FXS.

Methods: The present study examined visual attention indexed by the gap-overlap paradigm in children with FXS (n = 39) compared to children with ASD matched on intellectual ability and age (n = 40) and age-matched neurotypical controls (n = 34). The relationship between gap-overlap performance and intellectual ability, ASD, and ADHD across groups was characterized. Saccadic reaction times (RT) were collected across baseline, gap, and overlap conditions.

Results: Results indicate no group differences in RT for any conditions. However, RT of the ASD and NT groups became slower throughout the experiment whereas RT of the FXS group did not change, suggesting difficulties in habituation for the FXS group. There was no relationship between RT and intellectual ability, ADHD, or ASD symptoms in the FXS and ASD groups. In the NT group, slower RT was related to elevated ADHD symptoms only.

Conclusion: Taken together, findings suggest that the social attention differences documented in FXS and ASD may be due to other cognitive factors, such as reward or motivation, rather than oculomotor control of visual attention.

Purpose: Modifying gut bacteria in children with autism may influence behaviour, with potential to improve family functioning. We conducted a randomised controlled trial to assess the effect of prebiotics on behaviour, gastrointestinal symptoms and downstream effects on parental quality of life.

Method: Children with autism (4-10yrs) were randomised to 2.4 g/d of prebiotic (GOS) or placebo for six weeks. Pre and post stools samples were collected, and validated questionnaires used to measure change in social and mealtime behaviours, GI symptoms and pQOL. Linear mixed models evaluated group differences for behavioural variables, and Mann Whitney U tests were used to compare change between-groups for GI symptoms, differential abundance of genera and alpha diversity of the microbiome.

Results: Thirty-three parent-child dyads completed the trial. No group difference was seen for behavioural variables but both groups improved significantly from baseline. There was a medium effect size between groups for GI symptoms (d = 0.47) and pQOL (d = 0.44) driven by greater improvements in the prebiotic group. Bifidobacterium increased threefold following prebiotics (1.4-5.9%, p < 0.001) with no change in controls. Supplements were well tolerated, compliance with dose 94%.

Conclusion: Prebiotics modify levels of Bifidobacterium and prove well tolerated but in this instance, resulted in only marginal effects on GI symptoms and pQOL. A larger sample of children with more severe symptoms could help to determine the potential of prebiotics in autism.

Trial registration: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619000615189 .

Purpose: Differences in emotional experience and expression have long been recognized as common in the presentation of autism, yet research examining emotional expression in early childhood is limited, with mixed findings. Understanding emotional reactivity and expression in autism in early life is an essential step towards uncovering the mechanisms of these risks and identifying targets for intervention.

Methods: The present study examined emotional expression in autistic (N = 17) and non-autistic (N = 20) toddlers (mean age = 25.27; SD = 1.88) during emotion elicitation tasks aimed at eliciting joy, frustration, and unease. Video recorded tasks were coded in ten second intervals for emotional valence and intensity, and the following variables were computed: proportion of time in positive, neutral, and negative affect; maximum intensity of positive and negative affect; and range of affect (i.e., most negative to most positive intensity).

Results: Autistic toddlers spent more time in neutral facial expressions, less time displaying positive affect, and had somewhat less intense positive emotional expression than non-autistic peers. Small differences were apparent in intensity of negative affect expression, while no differences emerged in duration of time spent in negative affect.

Conclusion: Findings emphasize that differences may be more apparent in duration, rather than intensity of emotional expression, and that it may be particularly important to examine periods of "neutral" affect in young autistic children. Future research should consider the best ways to understand emotional reactivity in this population considering their unique interests, challenges, and communication styles.

In recent years, the Autism and Developmental Disabilities Monitoring Network has observed a shift in racial disparities in autism. To delineate the historical shift of racial disproportionality in US autism prevalence, our literature review examines three key topics: publication trends concerning racial disproportionality in autism, discernible national and state-level patterns, and underlying factors contributing to the disproportionality. Using the PRISMA framework, we synthesized 24 empirical studies on racial disproportionality in autism and its change over time. These studies explored national patterns and spatiotemporal variations to provide a comprehensive understanding of racial disparities in autism. Studies indicated similar national patterns for Black and Asian racial groups; both groups had had mixed results around the turn of the millennium. By 2007, the Asian group was overrepresented again. Hispanic and Native American groups have consistently been underrepresented. However, significant spatiotemporal variations were found, suggesting that these disparities might reflect inherent inequalities within the current identification and classification system. The patterns of racial disproportionality in autism seem to be influenced by numerous factors. These include varying state definitions of autism, disparities in resource distribution, differences in symptom recognition across cultures, service preferences, cultural mismatches between professionals and families, and prevailing biases and stigmas, as revealed by the reviewed studies. These findings prompt a closer look into the causes and implications of these disparities, offering the underlying issues within the current diagnostic system and highlighting the need for further research to ensure equal educational opportunities regardless of disabilities and race/ethnicity.

This study investigated whether attending mainstream school is associated with improved social inclusion among children on the autism spectrum and their parents. The cross-sectional study took place from July to August 2023 at 30 rehabilitation centers for children on the autism spectrum in Hunan Province, China. Participants included 860 children aged 3-14 years, with autism history receiving outpatient rehabilitation services, and their primary caregiver parents aged 23-54 years. Social inclusion among children on the autism spectrum was evaluated using the Chinese version of the social inclusion subscale of the KidsLife-ASD Scale. Parental social inclusion was assessed using the Chinese version of the Social Inclusion Scale. Linear mixed models were used to explore the association between attending mainstream school and social inclusion. Among children on the autism spectrum, 36.2% attended mainstream school. These children showed significantly higher levels of social inclusion compared to non-attenders. Subgroup analysis based on the severity of autism symptoms revealed that the significant association remained in both the mild and moderate/severe subgroups, being more pronouced in the mild subgroup (P_{for interaction} < 0.001). Parents of children attending mainstream school reported greater social inclusion levels than those whose children did not; however, after adjusting for severity of autism symptoms and other factors, this association became non-significant. Our study demonstrates a positive association between attending mainstream school and social inclusion for children on the autism spectrum, highlighting the critical role of mainstream school education in fostering social opportunities and providing diverse learning resources. It also underscores the need for targeted support strategies for parents.

Purpose: To investigate associations between possible sleep bruxism (PSB) and sleep disorders in children/adolescents with autism spectrum disorder (ASD) as well as parental perceived stress.

Methods: A cross-sectional study was conducted involving children/adolescents with ASD five to 19 years of age and their parents at a public institution that supports disabled people in the city of João Pessoa in Northeast Brazil. The parents answered a form addressing sociodemographic characteristics and medical data (schooling, income, age, sex, support level and use of medications). PSB was recorded based on the reports of the parents. Parental stress was investigated using the Perceived Stress Scale (PSS-10). Sleep disorders in the children/adolescents were investigated using the Sleep Disturbance Scale for Children (SDSC). Data analysis involved descriptive, bivariate and Poisson regression analyses (95% CI; p < 0.05).

Results: Fifty children/adolescents with ASD participated in the study. Boys accounted for 84.0% of the sample (n = 42). PSB in the children/adolescents was reported by 28.0% of the parents. The mean parental PSS-10 score was 20.3 ± 8.5 and the mean SDSC score was 48.8 ± 17.5. The adjusted Poisson model revealed associations between PSB and higher levels of perceived stress of the parents (PR = 1.05; 95% CI: 1.01-1.09), sleep breathing disorders (PR = 1.14; 95%CI: 1.05-1.24) and sleep-wake transition disorders (PR = 1.16; 95%CI: 1.00-1.36; p = 0.044).

Conclusion: The occurrence of PSB in children and adolescents with ASD was associated with higher levels of parental stress, higher scores for sleep breathing disorders and sleep-wake transition disorders.