Journal of Autism and Developmental Disorders最新文献

This systematic review and meta-analysis aimed to assess and compare the prevalence of dental caries in children and adolescents with and without ASD and identify associated factors. Following the PRISMA guidelines, a comprehensive literature search was conducted across multiple databases, yielding 2,103 studies, from which 25 met inclusion criteria. The primary outcome measure was caries prevalence, analyzed through clinical assessments. Risk of bias was evaluated using an adapted Newcastle-Ottawa Scale. Statistical analysis was performed with Review Manager, using random-effects models to account for heterogeneity, which was assessed with I². Meta-analyses revealed no significant differences between groups for most caries indicators, such as DMFT and dmft indices. However, the mean Caries Per Surface (DMFS) index was significantly higher in ASD patients, suggesting greater caries severity. Our study found a significant difference in dental caries severity between children and adolescents with Autism Spectrum Disorder (ASD) and those without ASD, through the DMFS index.

Purpose: PEERS^® for Preschoolers (P4P) is a parent-assisted social skills program for young autistic children, which has shown benefits for child and family functioning (Park et al. in Focus Autism Other Dev Disabil 38(2):80-89, 2023; Tripathi et al. in J Autism Dev Disord 52:2610-2626, 2022; Tripathi et al. in Autism 28(2):390-402, 2024). However, investigation into predictors of P4P program response have yet to be thoroughly explored. The current study aimed to explore the impact of parenting stress and social responsiveness on program outcomes in P4P.

Methods: Participants included 74 preschool-aged children with historical autism diagnoses and their parents who enrolled in the 16-week P4P program. Predictors of interest were assessed through the Parenting Stress Inventory, 4th Edition, Short Form (PSI-4 SF; Abidin, in Parenting stress index. Psychological Assessment Resources, 2012) and Social Responsiveness Scale, 2nd Edition (SRS-2; Constantino & Gruber, in Social responsiveness scale, second edition (SRS-2). Western Psychological Services, 2008).

Results: Results indicated significant improvements on all outcomes following P4P, including child social skills, problem behaviors, social engagement, social responsiveness, and parenting stress. Baseline parenting stress and child social responsiveness did not predict program completion. In regression models controlling for pre-scores on the respective outcomes, neither PSI-4 SF nor SRS-2 scores predicted post-scores.

Conclusion: Overall, results are encouraging in its implication that the P4P can benefit autistic preschoolers and their parents with varying degrees of social responsiveness and parenting stress, respectively, upon entry.

Missed appointments are detrimental to the healthcare system and to the clients themselves. Autistic youth may be particularly impacted due to unique service needs and limited services available within the system. To date, there is limited literature specific to treatment attendance in autistic populations receiving behavioral services. This study examines prevalence, predictors of, and reasons for missed appointments in an outpatient clinic specializing in addressing behavioral concerns. This retrospective case review examines missed appointments in a sample of 306 autistic youths from an outpatient clinic from 2019 to 2022. An average of 5.2 appointments were cancelled and 9.0 were completed, resulting in an average individual cancellation rate of 38%. Statistically significant predictors of no shows and patient cancellations were younger age and a post-COVID appointment. The most common reasons for missed appointments was sickness, scheduling conflict, insurance authorization issues, and family emergency. Missed appointments may be common in outpatient behavioral settings for autistic youth. Resolving issues related to cancellations (e.g., sleep concerns), identifying families in need of targeted support strategies (e.g., assistance and flexibility with scheduling, transportation support), and advocating for systemic change may help meet the multifaceted needs of this population.

Family accommodation (FA) is a term describing the change in behavior seen in parents and caregivers as they attempt to effect change in their child or adolescent's anxious behavior-usually by allowing avoidance, attempting distraction, or attempting to manage distress. FA has been well-documented in children and adolescents with anxiety and obsessive-compulsive disorders; however, there has been less summarized on the degree to which autistic youth and families engage in accommodation. This review aims to establish the phenomenology of FA in autistic youth related to comorbid anxiety, obsessive-compulsive disorders, and restricted and repetitive behaviors (RRBs). This review also aims to summarize how FA is currently addressed in treatment within this population. Using PRISMA guidelines, peer-reviewed articles were included if (a) participants included caregivers of autistic youth, (b) there was a clearly delineated autism participant group, and (c) at least one quantitative outcome measure of FA was included. Seventeen articles were included in the review. Several themes emerged including (1) high rates of FA in autistic youth across OCD, anxiety, and RRBs, (2) some form of parental involvement in treatment, and (3) decreased rates of FA post-treatment. Overall, family accommodation appears to be present to at least the same degree, if not more so, in families of anxious autistic children and adolescents as their non-autistic but anxious counterparts. Family accommodation also often appears to be an important consideration with treatments for anxiety and OCD in autistic youth.

Even when perceived as highly qualified, job candidates with autism spectrum disorder (ASD) are less likely to be hired after a job interview than their neurotypical (NT) counterparts. However, when NT individuals receive training about neurodiversity and are aware of an ASD diagnosis, preliminary evidence suggests hiring outcomes for candidates with ASD are significantly more positive, at least when training occurs immediately before evaluation. This study examined whether the benefits of neurodiversity training coupled with diagnostic disclosure extend to the general population and persist over time. Participants included undergraduate students and individuals from the general U.S. population recruited through Prolific. They completed neurodiversity training either two weeks or two months before reviewing taped interviews of job candidates with and without ASD. They rated candidates on several social dimensions (e.g., trustworthiness, likeability, awkwardness) and indicated how likely they were to hire each candidate. Although candidates with ASD were rated less favorably on some social characteristics (e.g., awkwardness, similarity) relative to NT candidates, they were rated similarly on other dimensions (e.g., trustworthiness), and at both delays were just as likely to be hired as NT candidates. These findings suggest that evaluators who engage in neurodiversity training and receive diagnostic information about ASD candidates are favorably inclined to hire ASD candidates, and this positive disposition towards ASD candidates persists for several months after neurodiversity training.

Young people with autism have support needs related to self-determination that are currently not adequately addressed in Spain. This study aimed to assess the effectiveness, implementation, and acceptability of a program to support self-determination for young adults with autism in Spain. A multicenter, mixed methods randomized controlled trial (RCT) study was conducted (2020-2022). Young adults with autism between 17 and 30 years of age were recruited, and 40 were randomly assigned to the intervention or waiting-list group. Quantitative and qualitative data on outcomes relating to self-determination, program implementation and acceptability were collected at baseline, during, and after the intervention using several tools, including the SDI: SR and focus groups. Joint displays were used to integrate the quantitative and qualitative results for a comprehensive evaluation of the program. The quantitative results revealed no significant differences between the intervention and waiting list groups but indicated positive impacts on agentic actions and overall self-determination as reported by participants and caregivers. The qualitative results expanded the quantitative results by identifying personal and contextual barriers and facilitators of self-determination while offering deeper insights into the quantitative outcomes. Implementation fidelity was high, and the qualitative data provided areas for improvement and identified challenges and best practices. Program acceptability was high, and the group format proved useful. Our study provides the first empirical evidence of an intervention designed to promote self-determination in individuals with autism in Spain, but further research is needed. This trial was retrospectively registered at www.clinicaltrial.org (NCT05938751) on January 1^st, 2023.

Challenges with social communication and social interaction are a defining characteristic of autism spectrum disorder (ASD). These challenges frequently interfere with making friendships, securing and maintaining employment, and can lead to co-occurring conditions. While face-to-face clinical interventions with trained professionals can be helpful in improving social conversation, they can be costly and are unavailable to many, particularly given the high prevalence of ASD and lack of professional training. The purpose of this study was to assess whether an AI program using a Large Language Model (LLM) would improve verbal empathetic responses during social conversation. Autistic adolescents and adults, 11-35 years of age, who were able to engage in conversation but demonstrated challenges with empathetic responses participated in this study. A randomized clinical trial design was used to assess the effects of the AI program (Noora) compared to a waitlist control group. Noora asks participants to respond to leading statements and provides feedback on their answers. In this study, participants were asked to respond to 10 statements per day 5 days per week for 4 weeks for an expected total of 200 trials. Pre- and post-intervention conversation samples were collected to assess generalization during natural conversation. Additionally pre- and post-intervention questionnaires regarding each participant's comfort during social conversation and participants' satisfaction with the AI program were collected. The results of this study demonstrated that empathetic responses could be greatly improved by using an AI program for a short period of time. Participants in the experimental group showed statistically significant improvements in empathetic responses, which generalized to social conversation, compared to the waitlist control group. Some participants in the experimental group reported improved confidence in targeted areas and most reported high levels of satisfaction with the program. These findings suggest that AI using LLMs can be used to improve empathetic responses, thereby providing a time- and cost-efficient support program for improving social conversation in autistic adolescents and adults.

This study investigated the mechanisms underlying disordered eating of autistic adults, by investigating associations between eating disorder (ED) symptoms and autistic traits; autism-specific atypical eating; alexithymia; interoception; and body image in autistic and non-autistic participants. Autistic adults (n = 196) and non-autistic adults (n = 206) completed online self-report measures assessing ED pathology, atypical eating, body image dissatisfaction, interoception, alexithymia, and autistic traits. Structural Equation Modelling tested a theoretical model of the relationships between these variables, and whether these relationships were moderated by autism diagnosis. Autistic adults self-reported higher ED pathology than non-autistic adults. The proposed model and the strength of the relationship between body image and ED pathology did not differ between the autistic and non-autistic groups. Atypical eating (not related to over-evaluation of weight/shape), however, was only associated with ED pathology in the autistic group. Both traditional and additional factors, including eating disturbances not driven by weight/shape concern, appear to contribute to ED pathology in autism.

The extent to which autistic students are provided with autonomy-support, structure and involvement during the teacher-student interaction has been under-researched. Few studies have focused on autistic secondary school students and even fewer have used observations to analyze their interactions. In this research, we aimed to understand the interaction dynamics between autistic students and their teachers in the Netherlands and Mexico; two countries committed to inclusive education. Six teacher-student dyads from five mainstream secondary schools in the Netherlands and seven teacher-student dyads from one school in Mexico participated. We used a fine-grained observational method to describe the classroom interactions, systematically coded from the lens of Self-Determination Theory. To study the interaction as a whole and co-occurring teacher and student behaviors (rather than breaking it down into separate parts), we used State Space Grids. Teacher-student interactions varied widely. In general, Dutch and Mexican teachers provided much structure in the classroom, which (in many cases) coincided with the active engagement of autistic students. At the same time, autistic students in both countries received little autonomy-support. However, when these students received autonomy-support, they responded with more engagement. In contrast, both engaged and disengaged student behaviors occurred when the teacher showed involvement. The desired patterns of interaction were not observed in all teacher-student pairs. Our findings indicate that teachers in both countries are missing opportunities to be autonomy-supportive. This contextual factor was minimally observed in the teacher-student interactions, particularly when compared to the levels of structure and involvement provided during lessons.

Purpose: Autistic children and their families from heritage-language-speaking homes are underrepresented in empirical research and would benefit from receiving care tailored to their linguistic and cultural needs. Board Certified Behavior Analysts (BCBAs) commonly support autistic children in the United States but have reported limited knowledge and training in how to support bilingual children, their families, nor the bilingual staff who support them. The following research question was addressed: Do BCBA leaders in autism care who complete an asynchronous online professional development training demonstrate (a) increased knowledge, (b) improved self-efficacy, and (c) improved attitudes toward supporting multilingual Applied Behavior Analysis (ABA) staff and recipients of multilingual ABA services compared to BCBA leaders in a waitlist-control group?

Method: Part of a larger sequential exploratory mixed methods study, this randomized waitlist control trial measured the impacts of a professional development training related to autism and multilingualism in ABA care on BCBAs' knowledge, self-efficacy, and attitudes. Social validity data were also collected and analyzed using descriptive statistics.

Results: The training significantly increased the intervention group's knowledge and reported self-efficacy compared to participants in the waitlist control group but had no significant effect on participants' attitudes. In addition, participants perceived the training as socially valid.

Conclusion: Implications highlight the need for more attention on professional development research for autism providers, to examine pre-service training, and for clinical leaders to examine their workplace environment to promote effective and fair practices.