Journal of Autism and Developmental Disorders最新文献

The Aberrant Behavior Checklist (ABC) was originally developed to evaluate interventions, and is a well-established assessment tool for challenging behaviours in people with intellectual disabilities and autistic people. However, whether the ABC displays longitudinal measurement invariance (i.e., whether it captures the same constructs over time) has been sparsely explored. The aim of the current study is to explore the factor structure, longitudinal measurement invariance, and clinical correlates of the ABC in autistic individuals with intellectual disabilities. Using data from a multicentre study of mental health assessment and treatment in autistic people with intellectual disabilities, the intake ABC scores of 200 autistic individuals with intellectual disabilities were used to explore the ABC factor structure, internal consistency, and clinical correlates (age, gender, level of intellectual disability, autism characteristics, communication skills). Scores across three time points (intake, post-intervention, follow-up) were used to explore longitudinal measurement invariance and internal consistency over time. The original five-factor structure showed a non-optimal but acceptable fit, which was similar or slightly improved compared to previous studies. Associations for some ABC subscales were found to be positive for autism characteristics and negative for communication skills. Four of the five subscales (irritability, social withdrawal, stereotypic behaviour, inappropriate speech) showed residual levels of longitudinal measurement invariance, while one subscale showed noninvariance (hyperactivity/noncompliance). The current study demonstrates the construct validity and applicability of the ABC in autistic individuals with intellectual disabilities, while also indicating that caution is advised for one of its subscales in comparisons across time.

There is a substantial time gap between when parents develop concerns about their child (ages 1-2) and when they receive a diagnosis of autism (ages 3-5), delaying the onset of critical interventions. Few studies have examined how the timing, type, and quantity of early parental concerns are associated with age of diagnosis. The aims of this study were to describe characteristics of parents' concerns in a large community-based sample and explore how characteristics of concerns relate to age of diagnosis. This study included 853 parents of 2- to 5-year-old children with an autism diagnosis. Parents completed an online survey including questions regarding their child's age when they first became concerned about their development, what their first concern was, all concerns they have had about their child, and age of diagnosis. An earlier age at first concern and the presence of several specific types of concerns (i.e., delayed/absence response to name, reduced eye contact, developmental regression, delayed gesture development, limited emotional response) were found to be significant predictors of earlier age at diagnosis. In addition, when accounting for age of first concern and the presence of specific types of concerns, a higher number of concerns was associated with a later age of diagnosis. Several specific types of concerns significantly predict the age at diagnosis, although several of these specific types are not commonly reported by parents. Educating parents and pediatricians about these concerns may improve early detection and intervention, ultimately improving long-term outcomes for children and families.

Youth with autism spectrum disorder (ASD) are at nearly twice the risk of experiencing obesity, compared to youth without ASD. Wellness Education to Create Healthy habits and Actions to Thrive (WE CHAT) is a novel chatbot that engages participants to enhance primary care delivery and associated care coordination services through mobile health (mHealth) technology focused on social determinants of health (SDOH) and social-emotional health. This study examines multiple perspectives regarding the development and implementation of innovative mHealth technology among youth with ASD. The phases of this study include (1) discussion among individuals and parents of children with ASD, (2) in-depth interviews with primary care providers (PCPs) who treat youth with ASD, and (3) in-depth interviews with interdisciplinary rehabilitation providers who treat youth with ASD. Phases 1 and 2 employed rapid qualitative analysis, and Phase 3 involved inductive thematic analysis to provide context to gaps identified in prior phases. Key themes across the three phases included the variability of symptoms among individuals with ASD, the differences in perceived value of mHealth technology, the importance of family-centered care, and the role of interdisciplinary support. Participants recommended the development of branching logic to increase the flexibility of mHealth technology designed for youth with ASD. This study gathered insight from multiple perspectives to identify opportunities for supporting independent participation in mHealth technology while reducing associated caregiver burden among youth with ASD. These findings may inform refinement and expansion of WE CHAT for patients with varying health needs.

Purpose: Dynamic eye-tracking paradigms are an engaging and increasingly used method to study social attention in autism. While prior research has focused primarily on younger populations, there is a need for developmentally appropriate tasks for older children.

Methods: This study introduces a novel eye-tracking task designed to assess school-aged children's attention to speakers involved in conversation. We focused on a primary outcome of attention to speakers' faces during conversation between three actors and during emulated bids for dyadic engagement (dyadic bids).

Results: In a sample of 161 children (78 autistic, 83 neurotypical), children displayed significantly lower overall attention to faces compared to their neurotypical peers (p <.0001). Contrary to expectations, both groups demonstrated preserved attentional responses to dyadic bids, with no significant group differences. However, a divergence was observed following the dyadic bid: neurotypical children showed more attention to other conversational agents' faces than autistic children (p =.017). Exploratory analyses in the autism group showed that reduced attention to faces was associated with greater autism features during most experimental conditions.

Conclusion: These findings highlight key differences in how autistic and neurotypical children engage with social cues, particularly in dynamic and interactive contexts. The preserved response to dyadic bids in autism, alongside the absence of post-bid attentional shifts, suggests nuanced and context-dependent social attention mechanisms that should be considered in future research and intervention strategies.

To examine the effect of using Virtual Reality distraction on salivary cortisol levels in children with Autism Spectrum Disorders (ASD) during routine dental treatments. A randomized cross-over study was designed and children with a known diagnosis of ASD, between 8 and 15 years of age, requiring routine, non-invasive dental treatments, were recruited. They were divided into 2 groups (group 1 and group 2) and scheduled for dental treatments using conventional behavior management and/or VR distraction techniques in their first and second dental visit, accordingly. Wong-Baker Faces pain rating scale, Venham's picture test and Frankl's behavior rating scale were administered at the end of each visit to assess subjective parameters of pain, anxiety, and behavior. Salivary cortisol levels were estimated in all children at 3 intervals (baseline, pre-treatment, and post-treatment). 19 children completed the study protocol (group 1 = 10, group 2 = 9) and statistically significant changes were observed in subjective ratings of pain (between groups) and dental anxiety and behavior (between dental visits), in favor of when VR distraction was used. Statistically significant differences were noted in the physiologic stress of the children between dental visits at pre-treatment (in group 2), post-treatment (in both groups), and between the 2 groups at post-treatment (in visit 2), all in favor of VR distraction being used. VR distraction may be recommended as an effective behaviour management technique for children with ASD. CTRI/2018/05/013982 "Retrospectively Registered".

Purpose: Autistic adults experience high rates of traumatic events and PTSD. However, little work has evaluated motor vehicle accident (MVA) related trauma symptoms. The goal of this brief report was to provide pilot data characterizing MVA-related peritraumatic reactions, trauma symptoms, and rates of PTSD diagnosis and mental health service use among Autistic compared to non-autistic adults.

Method: Participants were 637 adults in the United States (276 Autistic, 361 non-autistic) who completed an online survey assessing MVA experiences. Participants provided information about peritraumatic reactions to the accident, and whether they were diagnosed with PTSD or sought mental health services relating to the MVA. Participants also completed the Posttraumatic Symptom Checklist for DSM-5 (PCL-5) in relation to the worst MVA experienced.

Results: 48.7% of Autistic adults had experienced an MVA relative to 64.5% of non-autistic adults. Of those who experienced an MVA, Autistic adults reported higher peritraumatic dissociative reactions, and higher MVA-related total, negative mood/cognition, and hypervigilance PTSD symptoms than non-autistic adults, when adjusting for covariates. Autistic adults were significantly more likely to have sought mental health treatment relating to the MVA (11.9% compared to 0.9% of non-autistic adults), and to have received a PTSD diagnosis relating to the MVA (5.9% compared to 0.4% of non-autistic adults).

Conclusion: Autistic adults reported higher levels of trauma-related sequalae in response to MVAs than non-autistic adults. Future research should examine MVA-related trauma in more diverse samples, and develop assessment and support strategies to better identify, prevent, and reduce trauma-related symptoms post MVAs for Autistic people.

Purpose: This study explored the narrative coherence of the accounts of an experienced event produced by autistic and neurotypical children (ages 6-15 years) after delays of two weeks and two months.

Methods: The sample comprised 27 autistic children and 32 neurotypical peers, who were interviewed about the event using the Revised National Institute of Child Health and Human Development (NICHD) Investigative Interview Protocol. The study focused on assessing the narrative coherence of children's reports, emphasizing key story grammar elements and temporal features in their narratives.

Results: Results revealed that, over time, both autistic and neurotypical children showed a decrease in narrative coherence. Autistic children, particularly those who were cognitively and verbally able, demonstrated the ability to convey their experiences coherently, with performances comparable to those of their neurotypical peers. Interviewer prompts differentially influenced the narrative coherence of autistic and non-autistic children's accounts.

Conclusion: This research showed that, when questioned appropriately, cognitively and verbally able autistic children can effectively communicate their personal experiences, even after significant delays.

Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders. A recent clinical trial found that parent-led CBT - in which parents led their child through a guided CBT workbook with varying degrees of therapist support - was efficacious for reducing anxiety and associated functional impairment. While such findings demonstrate promise for future intervention development and dissemination efforts with this population, more work is needed to elucidate clinical factors that impact response to treatment as well as drop-out. Using data from the aforementioned clinical trial (N = 87), the present exploratory study examined pre-treatment patient characteristics, including family accommodation (FA), anxiety severity, autism features, and externalizing psychopathology, and their relationship with relevant treatment outcomes (i.e., anxiety severity and functional impairment) at both post-treatment and three-month follow-up and drop-out/completer status. Our findings did not reveal any consistent relations between pre-treatment patient characteristics and clinical outcomes, with several isolated exceptions: (a) baseline autism features were associated with greater post-treatment functional impairment; (b) non-male (vs. male) gender was associated with greater functional impairment at 3-month follow-up; and (c) Hispanic ethnicity (vs. non-Hispanic) was associated with greater likelihood of premature treatment drop-out. Findings are discussed in the context of the importance of continuing to elucidate unique patient characteristics predictive of optimal clinical outcomes for autistic youth with anxiety disorders.

Autism spectrum disorder (ASD) has been reported to exhibit altered local functional consistency. However, previous studies mainly focused on male samples and explored the temporal consistency in the ASD brain ignoring the spatial consistency. In this study, FOur-dimensional Consistency of local neural Activities (FOCA) analysis was used to investigate the sex differences of local spatiotemporal consistency of spontaneous brain activity in ASD. This study used resting-state functional magnetic resonance imaging data from the Autism Brain Imaging Data Exchange database, including 64 males/64 females with ASD and 64 male/64 female neurotypical controls (NCs). Two-way analysis of variance was performed to ascertain diagnosis-by-sex interaction effects on whole brain FOCA maps. Moreover, granger causal analysis was used to investigate effective connectivity between the brain regions with interaction effects and the whole-brain in ASD. Significant diagnosis-by-sex interaction effects on FOCA were observed in the bilateral precuneus (PCUN), bilateral medial prefrontal cortex and right dorsolateral superior frontal gyrus. Specifically, FOCA was significantly increased in males with ASD but decreased in females with ASD in the PCUN compared with the sex-matched NC group. In addition, the lack of sex differences in the causal influences from the bilateral anterior cingulate cortex/medial prefrontal cortex to the PCUN was observed in ASD. Our results reveal altered sex differences in the spatiotemporal consistency of spontaneous brain activity and functional interaction of the anterior and posterior default mode network (DMN) in ASD, highlighting the critical role of the DMN in the sex heterogeneity of ASD.

Parental stress can be debilitating for parents and their families. This is particularly true for parents who have a child with autism spectrum disorder (ASD) or other intellectual and developmental disability (I/DD). Effective screening and measurement of parental stress leads to accurate and effective intervention. The purpose of this study was to understand the psychometric properties of the Parental Stress Scale (PSS) for families who have a child with I/DD (ages ranging from 1 to 18 years old, with a mean of 5.28). Caregivers of 3220 families who have a child with I/DD (91% diagnosed with ASD) completed the scale. The psychometric properties including internal reliability and factor structure were completed as well as discriminant validity. Results of confirmatory factor analysis with the 18-item scale revealed a poor model fit with three items not meeting minimum factor loading threshold. Given this, the three items were removed, and confirmatory factor analysis was reconducted with 15 items of the PSS. Results revealed good internal consistency and discriminant validity, as well as a good model fit with all 15 items loading above the minimum threshold. The identified two-factor structure is consistent with the dichotomous (rewarding/burdensome) construct of parental stress that Berry and Jones (J Soc Pers Relationsh 12(3):463-472, 1995) originally designed the scale to index. Thus, the 15-item PSS has initial psychometric evidence in a large sample of families with a child with I/DD.