Journal of Autism and Developmental Disorders最新文献

Purpose: The purpose of this study was to address the importance of sensory input within the built environment and develop design guidelines to accommodate the needs of all users. Typically, people receive information about the surrounding environment through their senses collectively. However, sensory processing problems may occur when sensory signals do not integrate to provide appropriate responses. As a result, the environment may cause a person to feel confused or irritated.

Methods: A mixed methods approach was utilized to gather data including 1) focus group, 2) interviews, 3) observations, and 4) surveys. Over 600 subjects participated including education specialists (n = 546), adults with developmental disabilities (n = 58), and administrators and staff (n = 30). The target population was individuals who experienced difficulties with sensory processing, integration and modulation, caregivers, educators, and administrators who worked with the target population.

Results: The findings show that individuals with sensory processing disorder view their environment differently than the general population. The data gathered was analyzed and coded to reflect six sensory categories: sight, touch, hearing, taste, smell, and motion (includes proprioception and vestibular senses). Each of these themes were further evaluated to develop "Design Principles for Inclusive Environments." Auditory and Tactile sound triggers were found to be the most problematic sensory responses and are the main focus of this manuscript. Unexpected sounds, background noise, and noise from mechanical systems were among the most problematic, while incorporating music and nature sounds were found to alleviate sound triggers. Tactile sensitivity in the environment was increased or reduced based on textures and materials, available personal space, and temperature.

Conclusion: The research also showed that all users of a space benefited from the integration of inclusive design principles. This information is communicated in an easy-to-understand format that might benefit design professionals, educators, administrators, parents and the general public.

Purpose: This work evaluates use of the TELE-ASD-PEDS-Preschool (TAP-P), a telemedicine-based autism assessment tool for the preschool age range. The TAP-P is a play-based instrument with varied administration and scoring procedures based on a child's language level. This study compared tele-assessment using the TAP-P to in-person autism assessment.

Methods: Participants were 116 children (aged 36-71 months) referred for autism evaluation. Participants first completed in-home tele-assessment (administration of the TAP-P, clinical interview, and Developmental Profile 4). All participants then completed in-person assessment with a different psychological provider, including cognitive or developmental assessment, adaptive behavior assessment, and autism-focused assessment (ADOS-2). Caregivers completed questionnaires after each appointment assessing their perceptions.

Results: When asked to make a binary decision about presence or absence of autism, tele-assessment and in-person clinicians agreed for 82% of participants (n = 95). In most instances of diagnostic disagreement (n = 17), tele-assessment clinicians indicated the absence of autism and in-person clinicians indicated the presence of autism. When given the option to select "unsure," tele-assessment clinicians reported uncertainty for 28% of participants assessed using Form 1 of the TAP-P (designed for children with less verbal language, defined as two-word phrases or less) and 52% of children assessed using Form 2 (for children with more verbal language). Families reported broad satisfaction with tele-assessment procedures.

Conclusion: This work highlights potential utility of tele-assessment for identification of autism in preschool-aged children with less verbal language, while emphasizing the critical need for additional research related to use of tele-assessment for children using more complex and flexible verbal language.

Purpose: Routine developmental screening is essential for early identification of autism. Reliable autism screening is even more valuable for individuals from minoritized groups who are often under-detected and receive later diagnoses. Despite this importance, disparities in access to screening and accurate identification persist. Given these disparities, we were interested in examining group differences in autism screening rates at 18 and 24 months of age among children referred to Georgia's Part C Babies Can't Wait (BCW) program between 2018 and 2022.

Method: Among a sample of 52,282 infants and toddlers enrolled in BCW, as hypothesized males and children with private insurance had higher screening likelihoods compared to females and children with public insurance.

Results: Unexpectedly, Black and Hispanic children were more likely to be screened than their counterparts. To examine this further, an examination of screening timing revealed that White and male children were more likely to be screened before their referral to BCW compared to peers.

Conclusion: This reveals continued inequities in screening timing but suggests that BCW providers serve an important role in identifying children who may have been missed in other settings.

Purpose: Cognitive flexibility is a key neurocognitive process that is often challenging in children with autism. Recent research has highlighted the potential influence of motivation on cognitive flexibility; however, the impact of different types of motivation (intrinsic vs. extrinsic) on the cognitive flexibility performance of children with autism remains unclear.

Method: This study aims to investigate the impact of intrinsic and extrinsic motivation on cognitive flexibility in 43 children with autism and 89 typically developing children (TDC) (age range 36-84 months), using the three versions of dimensional change card sorting task (standard, extrinsic reward and intrinsic motivation versions).

Results: Results indicate that manipulating cognitive flexibility through motivation can improve performance, particularly in children with autism, with a significant impact of intrinsic motivation on this group. In the age range of 36-48 months, intrinsic motivation enhance accuracy in children with autism but not in TDC. From 49 to 60 months of age, both intrinsic and extrinsic motivation contribute to improved accuracy in children with Autism, with intrinsic motivation having a more significant impact. In TDC, however, only intrinsic motivation is associated with enhanced accuracy. In older children, both intrinsic and extrinsic motivation enhance performance in both groups, suggesting the maturation of cognitive systems. This evidence suggests that, in children with autism, the impact of motivation emerges at an earlier age than in typically developing children. Notably, intrinsic motivation has a more significant and profound effect at a younger age compared to extrinsic rewards.

Conclusion: The study provides insights into the developmental trajectory of cognitive flexibility in children with autism and highlights the significance of leveraging motivation to enhance this essential cognitive function.

Purpose: The assessment of adaptive functioning is essential in neurodevelopmental disorders, such as Intellectual Disability (ID) and Autism Spectrum Disorder (ASD), as a diagnostic criterion and as a definer of the level of severity or support. The Adaptive Functioning Scale (Escala de Funcionamento Adaptativo - EFA) is a Brazilian instrument for assessing adaptive functioning in children and adolescents aged 6 to 15. This study aimed to investigate evidence of the validity of EFA criteria as a screening instrument FA difficulties in individuals with ID and ASD.

Method: 917 EFA children and adolescents without diagnoses of neurodevelopmental disorders participated, 76 with a diagnosis of ID, and 65 with ASD.

Results: Variance analyses indicated differences in Z values in the three dimensions for the three groups. The differences presented a medium effect size, with the following partial Eta squared values: Social = 0.40; Practical = 0.43; Conceptual = 0.58. Sensitivity values ranged from 90 to 91% and 87 to 94%, while specificity values ranged from 64 to 74% and 63 to 90% in the ASD and ID groups respectively. The AUC values obtained for the EFA indicate that it has an excellent discriminatory capacity between the different aspects of adaptive functioning in the three domains of the instrument.

Conclusion: The EFA showed a greater ability to identify individuals with ASD and ID compared to individuals without diagnosis for all domains.

Purpose: This study aimed to identify profiles of autistic youths' sibling relations and examined if social-ecological variables (i.e., youth characteristics, family and caregiver functioning, peer relations, academic performance) were associated with these profiles.

Method: Caregivers (N = 2,142; 88.1% mothers) of autistic youths aged 6-17 years (M = 11.07 years; SD = 3.17; 80.1% male) completed electronic measures assessing social-ecological variables and youths' sibling relations. We used a latent profile analysis (LPA) to define sibling relation profiles based on the qualities (emotional support, companionship, conflict, and criticism) of relations between autistic youths and their closest-in-age siblings. We performed ANOVAs to compare sibling profiles on social-ecological variables.

Results: The LPA yielded a 3-profile solution: a positive group (18.2%), a negative group (17.2%), and a low engagement group (64.5%). ANOVAs and χ² analyses revealed no between-group differences on age, gender, history of co-occurring cognitive impairment, or autism characteristics. Youths with positive sibling relations had more adaptive family and caregiver relations than did youths with low engagement sibling relations, who, in turn, had more adaptive family and caregiver relations than the youths with negative sibling relations. Youths with positive sibling relations had more friends and closeness with friends than did youths with low engagement or negative sibling relations.

Conclusion: Most sibling relations among autistic youth fit a low engagement profile based on caregiver report. Positive sibling relations were linked with positive functioning in other social-ecological domains. The nature of these linkages warrants further investigation, particularly using longitudinal, multi-informant, and mixed-method designs.

Purpose: The concept of profound autism was coined in 2021 to better describe and understand the needs of autistic people with low cognitive and adaptive functioning skills and limited verbal communication. We sought to examine the clinical and demographic features of children referred to a multidisciplinary diagnosis and assessment clinic who were at risk of profound autism and those that did meet the definition of profound autism.

Methods: Participants were 513 autistic children aged 1-16 years seen in a large diagnosis and assessment clinic for a multidisciplinary assessment of social, communication, adaptive, cognitive/developmental skills and behaviour.

Results: A quarter of children presenting to the assessment service with autism also met the 'at risk' profound criteria. These children were of younger age (Age = 1.79 years) at first concern and at diagnosis (Age = 3.93 years) than children in the not profound group. They also had more concerns pertaining to elopement (escape from the caregiver's care).

Conclusion: These findings add to our understanding of the characteristics of children who are at risk of profound autism. These findings have implications for clinical practice, including informing assessment processes, need for longitudinal follow up assessment, support planning and helping diagnosticians determine the appropriate level of support needed. Furthermore, these findings support calls for consideration of this group in policy planning, funding and earlier service access and ongoing follow up.