Journal of Autism and Developmental Disorders最新文献

Purpose: This study investigated the interrelationships among sensory reactivity, repetitive behaviors, motor balance, and autism symptom severity in children with Autism Spectrum Disorder (ASD). The moderating roles of gender and pharmacological treatment were also examined.

Methods: A sample of 125 children with ASD (mean age = 8.7 ± 2.9 years; 52% male) was assessed using the Parent-Rated Sensory Reactivity Scale (ESRS), Repetitive Behavior Scale-Revised (RBS-R), Pediatric Balance Scale (PBS), and Childhood Autism Rating Scale (CARS). Statistical analyses included group comparisons (t-tests, Mann-Whitney U, ANOVA/Kruskal-Wallis), correlations, and multiple regression models.

Results: Girls showed greater sensory reactivity and slightly better motor balance, whereas boys demonstrated more compulsive, restricted, and ritualistic behaviors. Children receiving medication tended to have higher sensory reactivity, lower balance performance, and greater autism severity compared to unmedicated peers. ADHD medications predicted elevated sensory and compulsive behaviors, while antipsychotics were associated with greater ritualistic patterns Regression analyses indicated that gender, medication use, and medication category together explained approximately 17% of the variance in autism severity. Correlation analyses suggested associations among sensory, behavioral, motor, and severity domains.

Conclusion: Findings suggest gender-specific symptom clustering and context-dependent effects of pharmacological treatment in ASD. Sensory, behavioral, motor, and severity domains are interdependent, underscoring the need for individualized, multimodal interventions that target sensory sensitivities, behavioral rigidity, and motor coordination to enhance adaptive functioning and overall quality of life in children with ASD through integrated approaches of life in children with ASD.

Purpose: This study aimed to examine the association between age-specific sleep sufficiency (ASSS) and autism spectrum disorders (ASD) among U.S. children aged 6-17 years.

Methods: Data were gathered from the 2022-2023 National Survey of Children's Health (NSCH), including 63,866 children. ASSS was defined based on age-specific sleep hours guidelines from the American Academy of Sleep Medicine. Descriptive statistics, incidence risk, and adjusted regression models were used to assess associations, whereas stratified models were conducted to explore effect modification. Additionally, a machine learning model was developed to predict conditional probability with ROC curve and calibration were used for model evaluation.

Results: Children who did not meet ASSS recommendations had a significantly higher prevalence of ASD (5.16%) compared to those with ASSS (4.05%) (p < 0.001). In adjusted regression models, meeting ASSS criteria was associated with a markedly lower likelihood of ASD (OR = 0.78; 95% CI: 0.72-0.85; p < 0.001). Sex-stratified analyses demonstrated that this association persisted in both males (OR = 0.78; 95% CI: 0.71-0.86) and females (OR = 0.80; 95% CI: 0.68-0.93), though it was slightly stronger among males. Complementary machine learning analyses further supported these findings, revealing that females with sufficient sleep and aged below 14 years had the lowest predicted probability of ASD, whereas males aged 8-14 years without ASSS exhibited the highest likelihood of ASD.

Conclusion: ASSS was significantly associated with a lower likelihood of ASD, particularly among males, highlighting its role as an important behavioral factor and a potential focus for targeted psychological health interventions.

Purpose: Motor impairments are pervasive in Autism Spectrum Disorder (ASD), with atypical gait patterns often observed but understudied in early development. The aim of this pilot study was to analyze spatiotemporal gait parameters and variability in toddlers with ASD compared to typically developing (TD) peers.

Methods: The study included 12 ASD and 9 TD male toddlers, aged 18-30 months, walking independently. We extracted spatiotemporal gait parameters from laboratory recordings of walking. Gait variability was assessed via coefficients of variation for each parameter. Group differences were tested and exploratory correlations between gait parameters and motor skills were assessed.

Results: Results indicated increased gait variability in the ASD group across parameters, suggesting less consistent motor control. Significant differences in variability were observed in stride length, step length, stance time, and stride time.

Conclusion: This pilot study confirms that an objective assessment of gait is feasible in toddlers with ASD. Future research is needed to replicate the results in a larger sample, to explore underlying neurological mechanisms, as well as the impact of atypical gait maturation on other developmental domains. Early identification of atypical gait patterns could aid in designing interventions targeting motor development, potentially improving broader developmental outcomes in ASD.

Purpose: This study explores internet use patterns, safety challenges, and support needs among intellectually and developmentally disabled (IDD) adults, with the goal of informing the redesign of an internet safety intervention program.

Methods: A mixed methods study was conducted with 38 participants, including 17 IDD adults and 21 family caregivers (referred to as 'caregivers'), affiliated with a community-based organization. Participants completed surveys assessing digital behavior, challenges, and support needs. A subsample of 22 participants engaged in semi-structured interviews to provide in-depth perspectives. Quantitative data were analyzed using descriptive statistics and qualitative data were examined through thematic analysis.

Results: IDD adults demonstrated active digital engagement across multiple platforms for social connection, learning, and entertainment. Participants revealed that IDD adults face challenges related to interpreting social cues, avoiding scams, and managing digital boundaries. Survey results show that challenges like knowing who to trust online was a concern for 82% of self-reporters and 76% of caregivers. Four themes were identified: internet use, online challenges, strategies, and recommendations. Caregivers often served as digital gatekeepers but reported limited access to resources and training. Study participants emphasized the need for practical, adaptable tools that align with evolving technology and individualized support needs.

Conclusion: These findings highlight the need for accessible, stakeholder-informed interventions that address foundational digital literacy and emerging online risks. Results will inform the redesign of the Socialization, Education, and Learning for the Internet program and contribute to broader efforts to enhance digital safety, autonomy, and inclusion for IDD adults.

Purpose: This study systematically reviewed the effects of early parent-mediated training designed to promote social and communication skills among toddlers and preschoolers with autism spectrum disorder (ASD).

Methods: This study focused on randomized controlled trials (RCTs) and statistically validated effect sizes using meta-analysis. Relevant studies published in domestic and international journals between 2014 and 2024 were selected using PubMed, Web of Science, EMBASE, RISS, KISS, and the Yonsei University Library, following the PRISMA flow chart. A total of 15 RCTs that met the inclusion criteria were included for analysis. During the systematic review, the participants' general characteristics, intervention methods and duration, intervention effects, and assessment tools were examined. In addition, effect size analysis, heterogeneity assessment, publication bias evaluation, and sensitivity analysis were performed using the Comprehensive Meta-Analysis 4.0 program.

Results: All Fifteen RCTs included children with ASD. Early parent-mediated training showed moderate to large effects in improving social skills (1.09), communication skills (0.70), and reducing challenging behaviors (0.74), which were all statistically significant. The overall effect size was 0.80 (95% CI: 0.53-1.10). Although high heterogeneity (I² = 89%) was observed, the subgroup analysis suggested that intervention duration was a primary contributing factor. Although publication bias was observed, it did not significantly impact the results, and sensitivity analysis confirmed the stability of the findings.

Conclusion: Early parent-mediated training is empirically supported as an effective strategy for promoting the development of children with ASD. Future research should examine its long-term effects, address heterogeneity, and work toward the standardization of intervention protocols.

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.