Journal of Autism and Developmental Disorders最新文献

Purpose: Many genes have been identified in autism spectrum disorder (ASD). Yet how many adults with ASD receive recommended genetic testing and their outcomes is unknown. We investigated the percentage of adults with ASD with documented genetic testing in our ASD specialty clinic and the percentage with positive findings.

Methods: Adults were identified through search of our data repository and ASD diagnoses confirmed using record review by psychiatrists specializing in ASD. Patients were included (N = 630) who had at least one visit with a qualifying clinician between 5/1/2010 and 12/15/2020. Data were collected through manual retrospective record review.

Results: Only 41% of the adults with ASD (261/630) had a documented history of genetic testing. Genetic testing was declined by patients or families for 11% of records and not recorded in 47%. Mean (SD; range) age for the 261 adults was 28.5 (5.3; 22-58) years; 26% were female and 73% had intellectual disability (ID). The genetic testing method was recorded in 91% (238). Only 54% of these patients had testing using a recommended method (chromosomal array, autism/ID sequencing panel, or exome sequencing). Few adults received testing with sequencing technologies. A genetic cause of ASD was found in 28%.

Conclusion: ASD-related genetic testing is underutilized in adults with ASD. Nearly half of the adults in our sample lacked documentation of genetic testing. Adults with ASD may benefit from having their genetic testing history reviewed in the clinic and the recommended testing performed.

Purpose: While mentoring programs have many positive social-emotional outcomes for youth, the benefits of mentoring are not yet well understood for autistic youth, a population that frequently seeks social and mental health supports. The current pilot randomized clinical trial study aims to examine (1) the acceptability of the Autism Mentorship Program (AMP) and (2) the preliminary effectiveness of AMP in improving mentees' well-being and reducing symptoms of mental health problems.

Methods: Participants included 24 autistic youth, 24 caregivers of autistic youth, and 12 autistic adults. Youth (ages 14-18) were randomized to AMP or services-as-usual (SAU), with 13 randomized into AMP. AMP included 23 weekly online mentoring sessions during which autistic mentors and autistic adolescents met in 1-to-1 meetings and discussed topics related to social-emotional learning or shared interests or engaged in an activity of their choosing. Youth, caregivers and autistic mentors completed pre- and post-program assessments related to satisfaction, mental health, and psychosocial outcomes. Analyses focused on descriptive trends and effect sizes due to limited power.

Results: Participants in AMP reported high program satisfaction and strong mentoring relationships. Compared to youth in SAU, AMP youth showed improvements in self-esteem, satisfaction with self, perceived social support, and engagement, with small to moderate effect sizes. Mentees also reported trends toward reduced anxiety and depression.

Conclusion: AMP is a feasible, acceptable, and potentially effective identity-affirming program for autistic adolescents. Findings support further evaluation in larger trials to establish its utility as a scalable, community-based mental health support within autistic communities.

Purpose: Research has indicated an increase of adults being referred for first-time autism assessment though there are limited tools designed to assess autism in adulthood. Concerns have arisen regarding higher rates of camouflaging in adulthood-diagnosed adults and how this may restrict clinicians' ability to observe all autistic traits during assessments with an unfamiliar person. The Brief Observation of Symptoms of Autism (BOSA), derived from the Autism Diagnostic Observation Schedule-2 (ADOS-2), was developed during the COVID-19 pandemic. The BOSA focuses on a 12- to 14-minute interaction with a familiar other and has shown promise as an adapted tool. Due to the short duration and limited materials, the BOSA may be useful as a supplemental measure for first-time diagnosis of adolescents or adults, or as a brief method to characterize research participants.

Methods: The study sought to explore the utility of the BOSA and its correspondence to the ADOS-2 with a sample of forty-two adolescents and adults who completed the ADOS-2 and BOSA within the same visit at an autism lab within a university in New Jersey.

Results: Sensitivity and specificity of the ADOS-2 Modules 3 and 4 and BOSA F2 were comparable. The instruments yielded highly similar classifications and item scores. Differences in some item scores highlight limitations of very brief observations and suggest potential areas for refinement of the BOSA.

Conclusion: The BOSA may provide an additional context in which to consider diagnostic features when assessing adolescents and adults and offers a feasible option for sample characterization in research.

The aim was to investigate trait social anxiety and social evaluative stress in autistic children and adolescents and Specific Learning Disorders (SLD). This was done by evaluating behavioral, subjective, and autonomic responses to the Trier Social Stress Test (TSST). Study 1 included 280 children and adolescents: 60 autistic without intellectual disability (ID), 70 SLD, and 150 non-diagnosed (ND) peers. Study 2 involved 55 participants: 15 autistic without ID, 15 SLD, and 20 ND. The sample was predominantly male. In Study 1, behavioral (quality of public speech) and subjective (valence, arousal, perceived competence, and worries) aspects of social stress were examined. Study 2 expands upon the first study, as physiological responses to social stress were also measured. Trait social anxiety was investigated using both parents' and children's reports in the two studies. Parents of autistic participants and with SLD reported higher trait social anxiety in their children than the parents of ND. No differences emerged from the participants' self-reports, though those autistic and with SLD were assigned lower scores in the public speech quality than ND. Autistic children and adolescents reported lower arousal and higher perceived competence than ND, while those with SLD reported a lower perception of competence. Autistic participants had a decreased cardiac reactivity across the TSST when compared to SLD and ND. Our findings show unique patterns of responses within each group, confirming that the combined investigation of trait anxiety and social stress responses could be a valuable insight in research and clinical practice.

This research aimed to translate the original English version of the Psy-Flex, a scale of psychological flexibility, into Chinese and to test its psychometric properties among parents of children with autism spectrum disorder (ASD). Two phases were conducted: (1) translation from English to Chinese (Psy-Flex-C), followed by a semantic equivalence evaluation between two versions, a pre-test, and an evaluation of the Psy-Flex-C in terms of face validity with 20 parents of autistic children, and content validity of the Psy-Flex-C with eight experts. (2) A cross-sectional study with 248 parents of autistic children was conducted for validation, and a subgroup of 50 participants was randomly selected to assess the test-retest reliability at a 2-week interval. The Psy-Flex-C showed satisfactory semantic equivalence with the original version and demonstrated adequate internal consistency (Cronbach's α = 0.84) and test-retest stability (weighted kappa statistic = 0.88). Concurrent validity was supported by a moderate correlation between the Psy-Flex-C and the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (Pearson's r = 0.54, p < 0.01). The Psy-Flex-C showed a significant mean score difference between parents with high and low parenting stress (t = 5.43, p < 0.001). Similar to the original scale, confirmatory factor analysis showed the best fitting one-factor structure of the Psy-Flex-C (X²/df = 1.62, p = 0.13, RMSEA = 0.05, GFI = 0.99, CFI = 0.99, TLI = 0.98, SRMR = 0.023). The Psy-Flex-C can be a reliable and valid instrument to self-report psychological flexibility in parents of children with ASD. Future research is recommended to test the Psy-Flex-C using diverse samples from different cultures and contexts to enhance its generalizability.

Given the diverse nature of the autism spectrum and the complex, context-dependent nature of Social Functioning (SF), this study aims to delineate profiles of SF in young people with autism. Using a multi-method approach, it aims to gain a comprehensive understanding of social difficulties in people with ASD. This study also examines the co-occurrence of mental health issues within these profiles, which can exacerbate social impairments. This understanding is essential for designing interventions and support systems tailored to the specific needs of people with ASD. 49 autistic individuals aged 12 to 30, without intellectual disability were recruited. A combination of measures was used to thoroughly assess SF. Latent profile analysis was employed to identify distinct profiles of social functioning. A control group of 60 non-autistic people served as a reference for these profiles. Mental health difficulties were evaluated through clinical interviews and questionnaires. Two profiles of SF were identified, illustrating two ways of managing the cost of social interactions. Compared to controls, one was more socially withdrawn, spending more time alone, while the other spent a similar amount of time alone but interacted less with others. A different prevalence of mental health problems was observed within these profiles. This study highlighted two SF profiles in young people with ASD, revealing different approaches to managing social interactions. These results show that people with ASD do not have uniform strengths and difficulties of SF, and that mental health problems exert a significant influence on different aspects of SF.

Challenging behaviors of young autistic children remain a major parenting challenge for many of their family members, including caregivers. Caregivers from underrepresented cultural or linguistic backgrounds may experience exacerbated difficulties related to challenging behaviors due to limited access to culturally sustaining and responsive interventions. Evidence-based behavior parent training programs, such as RUBI, are highly effective in increasing caregivers' capacity in preventing and responding to these behaviors in naturalistic settings using behavior analytic principles. Therefore, the purpose of this study was to examine the effectiveness, acceptability, and feasibility of the culturally adapted RUBI program with underserved families. We conduct a convergent mixed-methods study using a pilot randomized controlled trial with a waitlist control group and focus group interviews with 31 Korean families of young children with or suspected of autism. The Korean RUBI underwent rigorous cultural adaptation using the Cultural Adaptation Checklist, including the use of multiple community advisory boards to inform cultural adaptation. Both quantitative and qualitative findings revealed significant improvements in parents' confidence and knowledge in behavioral principles and decrease in severity of challenging behaviors, which suggest clinical utility of RUBI in an underrepresented, low-resourced community. A culturally adapted intervention for a different population can be perceived as a newly constructed intervention. This study provides insight on the systematic process of cultural adaptation of an established autism intervention and effectiveness, feasibility, and acceptability of RUBI.