Journal of Autism and Developmental Disorders最新文献

Difficulties in controlling emotions - a proxy for emotion dysregulation (ED)-and difficulties in expressing feelings in words-'absence of emotion labelling' or alexithymia-co-exist in autism and contribute to elevated levels of impulsive and suicidal behaviour. To date, studies linking the two phenomena have relied on retrospective self-reported measures, lacking support for generalizability to real-life situations. The present study investigated in vivo emotion labelling and its impact on emotion control in 29 autistic adults without intellectual disability (ASC) and 28 neurotypical (NT) individuals of similar age, sex, and educational level. Participants were trained in an Ecological Momentary Assessment (EMA) to label their emotions, the arousal dimension, and their emotion control via smartphone over a one-week period. Findings showed that the ASC group experienced more instances of 'having an emotion that I cannot name' and, when they were able to label their emotions, they reported higher rates of negative and conflicting (simultaneously positive and negative) emotions. In both groups, the absence of emotion labelling, and intense negative emotions were associated with impaired emotion control. However, the association between lack of emotional awareness-'I have no emotion'-and impaired emotion control was only evident in ASC individuals. Our study highlights a nuanced facet of emotional processing in the ASC population. Further research is needed to gain a deeper understanding of the complex relationship between ED and alexithymia in autism.

Autism Spectrum Disorder (ASD) is on the rise worldwide with an increasing acknowledgement that its continuum of care to enhance participation should be multidisciplinary. The International Classification of Functioning, Disability, and Health (ICF) and its derivatives ICF - Children and Youth (ICF - CY) and ICF Core Sets have been increasingly used among health professionals to enhance communication and documentation of outcomes. This study aimed at investigating the comprehensiveness of the ICF - CY and ICF Core Sets with regard to occupational therapy goals and the extent of participation representation in these goals. Forty occupational therapists working with children with ASD stated their most common three long-term goals. The goals were then mapped to the ICF - CY two level classification. The percentage of goals reflecting "Participation" was calculated. The overlap between ICF - CY and the ICF ASD Core Sets was assessed. A total of 155 goals were extracted, of which only seven (4.5%) related to sensory processing were not linked to the ICF - CY categories. 35.1% of the total linked goals were regarded as reflecting "Participation". 84.5% of ICF - CY categories overlapped with the ICF ASD Core Sets. Categories related to hand function, and taking care of body parts were found to be lacking in the ICF ASD Core Sets. The ICF - CY and the ICF ASD Core Sets may be feasible clinical tools for children with ASD, however, they may not be sufficient to cover occupational therapy goals. Goals also need to be modified to better reflect participation.

Over the past ten years, there has been a significant improvement in the sensibility and specificity of the earlier diagnosis of ASD. However, parenting traits were relatively explored among children with different disabilities. We aimed to clarify the characteristics of parent-child interaction among children with ASD and DLD, compared with children not diagnosed with a disability. The study recruited 280 children aged 1.5-3.9 years (30 children with ASD, 48 children with DLD, and 202 TD children) and their primary caregivers. Parent-child interaction was measured based on video recordings and observation. One-way ANOVA was used for the comparison of IRS-C scores among the three groups, and the t-test was used for pairwise comparisons; effect size was also calculated. Children's age and sex were further considered as grouping category in our analyses. All comparison models were adjusted by demographic background (i.e. child age and sex, sibling, main caregiver, mother education, and family annual income). Children with ASD showed the lowest level of general social competence compared to children with DLD (d = 1.298, P < 0.001) and TD group (d = 1.833, P < 0.001). Children with DLD showed less responsiveness (d = 0.780, P < 0.001) and less empathy (d = 0.706, P < 0.001) than TD children. Caregivers of children with ASD also showed the lowest level of parenting attributes relative to caregivers of children with DLD (d = 0.978, P < 0.001) and caregivers of TD children (d = 0.860, P < 0.001). The child- and parent-related traits also varied by child age and sex. We posit that parent-child interaction necessitates greater attention with respect to early screening and identification.

There is no validated screening measure for children with high-functioning autism spectrum disorder (ASD) in Korea. The purpose of the present study was (1) to examine the reliability and validity of the Korean version of the Autism Spectrum-Child (K-AQ-Child); (2) to find the optimal cut-off value of the K- AQ-Child in the Korean population. A total of 144 children aged 4-11 years (male 80.6%, mean age = 7.05 ± 1.75) were recruited in this study, with 72 in the high-functioning ASD group and 72 in the non-clinical Control group. The Cronbach's alpha coefficient of the K-AQ-child was 0.962, showing excellent internal consistency. For discriminant validity, the ASD group scored significantly higher than the Control group on the total score and all the scores of the subdomains of the K-AQ-Child after controlling for sex. Significant positive correlation between total scores of the K-AQ-Child and the K-SCQ was found. The optimal cut-off value of 58.5 yielded a sensitivity of 0.931 and specificity of 0.986. K-AQ-Child is a valid and reliable measure to quantify autistic traits and identify the high-risk individuals for further diagnostic evaluation in intellectually capable children aged 4-11 years. It would be useful for both clinical practice and research purposes.Clinical Trial Registration The trial was registered at the Clinical Research Information Service (CRIS) of Republic of Korea (Registration Number: KCT0008907).

Most studies in children with autism spectrum disorder (ASD) support a decrement in imitation performance. Factors related to visual attention and motor execution have been proposed to explain this phenomenon in ASD. However, studies investigated imitation with various methods, leading to inconsistent findings. Here, we examine imitation performance related to visual attention and motor execution. We focused on the imitation of meaningful and meaningless gestures, consistently reported as more affected than imitation of actions with objects in ASD. The imitation eye-tracking task consisted of a video of an actor demonstrating gestures and prompting children to imitate them. The demonstrations comprised meaningful and meaningless hand gestures, and meaningless facial gestures. We measured the fixation duration to the actor' face during child-directed speech and gesture demonstrations. We video-recorded children to assess their performance. Our sample comprised 100 participants (3.55 ± 1.11 years old), including 84 children with ASD. The ASD and typically developing groups displayed the same visual attention toward gesture demonstrations, although children with ASD spent less time looking at the face during facial stimuli. Visual exploration of actors' gestures did not influence imitation performance. Imitation of meaningful gestures was associated with less severe autistic symptoms, whereas imitation of meaningless gestures was correlated with higher non-verbal cognitive and fine-motor skills. These findings contribute to a better understanding of the complexity of imitation. We delineated the distinct nature of imitation of meaningful and meaningless gestures in children with ASD. We discuss clinical implications in relation to assessment and intervention programs.

Studying Autism Spectrum Disorder (ASD) heterogeneity in biologically homogeneous samples may increase our knowledge of ASD etiology. Fragile X syndrome (FXS), Angelman syndrome (AS), Tuberous Sclerosis Complex (TSC), and Neurofibromatosis type 1 (NF1) are monogenic disorders with high a prevalence of ASD symptomatology. This study aimed to identify ASD symptom profiles in a large group of children and adolescents (0;9-28 years) with FXS, AS, TSC, and NF1. Data on ASD symptomatology (Autism Diagnostic Observation Scale (ADOS-2) & Social Responsiveness Scale (SRS-2)) were collected from children and adolescents with FXS (n = 54), AS (n = 93), TSC (n = 112), and NF1 (n = 278). To identify groups of individuals with similar ASD profiles, we performed two latent profile analyses. We identified a four-profile model based on the ADOS-2, with a (1) 'Non-spectrum symptom profile', (2) 'Social Affect symptom profile', (3)'Restricted/Repetitive Behaviors symptom profile', and (4)'ASD symptom profile'. We also identified a four-profile model based on the SRS, with a (1)'Non-clinical symptom profile', (2)'Mild symptom profile', (3)'Moderate symptom profile', and (4)'Severe symptom profile'. Although each syndrome group exhibited varying degrees of severity, they also displayed heterogeneity in the profiles in which they were classified. We found distinct ASD symptom profiles in a population consisting of children and adolescents with FXS, AS, TSC, and NF1. Our study highlights the importance of a personalized approach to the identification and management of ASD symptoms in rare genetic syndromes. Future studies should aim to include more domains of functioning and investigate the stability of latent profiles over time.

Increased head circumference is an established finding in autism spectrum disorder (ASD); however, it is unclear when this increase occurs, if it persists and whether it manifests across the whole ASD spectrum. Head circumference is a strong predictor of brain size and can therefore provide key insights into brain development in ASD. We used data from the Avon Longitudinal Study of Parents and Children to compare head circumference trajectories from birth to 15 years in children with an ASD diagnosis (N = 78, controls = 6,404) or elevated autistic traits as measured using the Social Communication Disorder Checklist (N = 639, controls = 6,230). Exploratory analyses were conducted in those with ASD and co-morbid cognitive learning needs (CLN). Children with an ASD diagnosis had larger head circumference from birth across childhood and adolescence compared to controls in univariable (B = 0.69, 95% confidence interval [CI]: 0.28-1.09, p = 0.001) and multivariable models (B = 0.38, 95% CI: 0.003-0.75, p = 0.048). Differences were more marked in those with co-morbid CLN. Children with elevated autistic traits had significantly smaller head circumference compared to controls. There was weak evidence of group differences when height was included as a covariate. Head circumference trajectories in ASD deviate from control children and persist until adolescence. Autistic traits were associated with smaller head circumference, suggesting distinct growth trajectories between clinical cases from those with non-clinical traits.

This study examined the recurrence rate of autism in siblings at elevated likelihood (EL) and the predictive validity of the Q-CHAT and ADOS-2 at 14 and 24 months (m) for a clinical best estimate (CBE) autism diagnosis at 3 years. 331 EL-siblings (47.9% girls) from the prospective longitudinal EuroSibs study underwent ADOS-2 assessments and caregivers completed the Q-CHAT at 14 m and 24 m. At 3 years CBE was determined using DSM-5 criteria. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated. Autism recurrence rate was 25.7% [95% CI (21.1, 30.6)]. Q-CHAT sensitivity was 31.8% [95% CI (21.4, 43.6)] at 14 m and 30.6% [95% CI (20.7, 41.7)] at 24 m. Specificity was 81.2% [95% CI (75.4, 86.2)] at 14 m and 94.8% [95% CI (91.2, 97.2)] at 24 m. PPV was 35.6% [95% CI (24.2, 48.2)] at 14 m and 66.7% [95% CI (49.8, 81.1)] at 24 m. NPV was 78.5% [95% CI (72.6, 83.7)] and 79.9% [95% CI (74.7, 84.6)] respectively. ADOS-2 demonstrated a of 64.3% [95% CI (45.9, 80.2)] and 69.3% [95% CI (58.4, 79.0)] and a specificity of 71.1% [95% CI (60.3, 80.4)] and 68.7% [95% CI (62.5, 74.5)] at 14 m and 24 m respectively. PPV was 45% [95% CI (30.3, 60.4)] at 14 m and 41.9% [95% CI (33.5, 50.7)] at 24 m. NPV was 84.4% [95% CI (74.2, 91.8)] at 14 m and 87.3% [95% CI (81.9, 91.6)] at 24 m. Q-CHAT and ADOS-2 at 14 m and 24 m can aid in early differentiation between EL-siblings who need further assessment and those who do not, but neither has sufficient sensitivity and PPV for standalone CBE diagnosis prediction.

Children with Autism Spectrum Disorder (ASD) experience increased hospitalizations as compared to the general population, particularly in the context of mental health crises. Given the unique needs of children with ASD and behavioral health needs that can either lead to or emerge during hospitalization, an understanding of hospital experiences is critical. To date, research on caregiver experiences in acute care medical hospital settings is limited. Therefore, the purpose of this qualitative study was to investigate caregiver experiences with inpatient care for children with ASD and behavioral health needs, including factors and practices that impacted or were desirable for care. Two focus groups were conducted with a total of 12 parents of children with ASD admitted to a large pediatric hospital. Data were analyzed using interpretive description. Emerging themes pointed to the child, family, and staff factors and practices that intersect to influence hospitalization experiences. Child factors included the child's communication, sensory, behavioral, medical, and safety needs. Family factors included the family's relationship with the healthcare team, own needs, and advocacy experiences. Staff factors included staff communication practices, comfort, and knowledge when providing care. Overall, this research demonstrates the complexity of factors and practices that impact the behavioral health hospitalization experience for children with ASD and their caregivers. Experiences varied widely and were guided by the unique needs of each child. Findings point to care practices that can be adopted to best meet the needs of all stakeholders during hospitalization and offer implications for future educational initiatives.