Journal of Autism and Developmental Disorders最新文献

Synchronous positive affect (SPA) is a key element of parent-child interaction quality which is related to favorable developmental outcomes. Children with autism spectrum disorder (ASD) and their parents tend to show less SPA compared to other populations. The current study explored changes in SPA made by parents and their children with ASD following the Preschool-Based Early Start Denver Model (PB-ESDM) intervention. Thirty children receiving PB-ESDM and 23 receiving treatment-as-usual (TAU) were assessed pre- and post- intervention using microanalysis of video-recorded parent-child interactions, in which SPA was quantified. Results showed a significant increase in SPA among children receiving PB-ESDM who had lower pre-treatment adaptive functioning. These findings suggest that SPA may serve as a sensitive treatment outcome measure for children with poorer adaptive functioning, who often struggle to show significant changes on standardized measures. The study's modest sample and non-randomized design are noted as limitations.

Anxiety is commonly experienced by autistic people and impacts on quality of life and social participation. New anxiety interventions are required to effectively meet the needs of autistic people. Personalised Anxiety Treatment-Autism (PAT-A©) is a bespoke, modular approach to treating anxiety in up to 12 sessions. This study explored the feasibility and acceptability of delivering PAT-A© in the UK National Health Service (NHS). A single-blind randomised controlled trial design. Thirty-four autistic adults were recruited via clinical services and randomised to receive either PAT-A© or enhanced treatment as usual (CCSP). Outcome assessments relating to anxiety, quality of life and related constructs were completed at baseline, immediately post intervention; and at 3 and 12 months. Seventy-one percent of the PAT-A© group and 65% of the CCSP met diagnostic threshold for at least three anxiety disorders. Retention was good across both groups, with 82% (N = 14/17) completing the full course of PAT-A© and 71% (N = 12/17) attending both psychoeducational sessions in CCSP. 94% in PAT-A© and 82% in CCSP completed some follow up assessment 3 months post-intervention. Thematic analysis of interview data revealed that many participants valued the personalised approach, developed transferable skills and experienced positive changes to their anxiety. Participants were willing to be recruited and randomised, PAT-A© was feasible to deliver in the NHS and the trial methods and materials were acceptable. Our findings indicate that a fully powered clinical and cost-effectiveness trial of PAT-A© is warranted.

The COVID-19 pandemic has strained the resources of the world's healthcare systems. Most individuals with neurodevelopmental disabilities (NDDs) experience significant mental health issues and face substantial barriers in accessing appropriate supports which have been exacerbated during the pandemic. It is unknown the extent to which COVID-19 impacted the demand for and effectiveness of inpatient care for those with NDDs. The impact of COVID-19 on the number of admissions of youth with NDDs to pediatric inpatient psychiatry units, as well as their functioning and length of stay during the first two years of the pandemic was analyzed using Bayesian structural time series models. Admission data of youth with NDDs from four pediatric inpatient units in Alberta, Canada (n = 2144) was examined. Inpatient admissions of youth with NDDs significantly increased following the onset of the pandemic. Compared to the period prior to the pandemic, patients with NDDs had significantly worse overall functioning and received fewer days of treatment. These findings highlight the need for increased resources to support the mental health needs of this vulnerable population and are consistent with other studies in the general population examining the utilization of inpatient psychiatric units during the pandemic.

This study investigated how the school experiences and personal characteristics of youth with Intellectual Disabilities (ID) contribute to their longitudinal trajectories of anxiety. To this end, we relied on a sample of 390 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged from 11 to 22 (M = 15.70), and recruited in Canada (n = 140) and Australia (n = 250). Across three yearly time points, all participants completed self-report measures of anxiety, school climate, and victimization. Our results revealed a slight normative decrease in anxiety over time and showed that experiences of school victimization were associated with higher levels of anxiety (initially and momentarily) and increases in victimization were accompanied by increases in anxiety over time. Perceptions of attending a school that fosters security and promotes learning also tended to be accompanied by lower levels of anxiety (initially and momentarily). Momentary increases in perceptions of attending a school that fosters positive peer interactions were associated with momentary decreases in anxiety, whereas momentary increases in perceptions of attending a school characterized by positive teacher-student relationships and an equitable treatment of all students both led to small momentary increases in anxiety once all other components of student school experiences were considered. The theoretical and practical implications of these results are discussed.

Autistic adults experience disproportionate rates of co-occurring mental health problems. Psychotherapy has been recognized as an appropriate treatment approach, but evidence is limited. Researchers used a qualitative research paradigm to explore the experiences of mental health providers who provide psychotherapy to autistic adults. The Enhanced Critical Incident Technique was used to interview 13 mental health providers regarding perceptions of facilitating therapy with autistic adults. This research highlights challenges to providing psychotherapy to autistic adults while also illuminating ways that mental health providers have worked to ameliorate such challenges and create positive experiences in therapy. This research also contrasts therapy for autistic adults relative to the general population. Practice recommendations and suggestions for future research are offered.

SATB2-associated syndrome (SAS) is a genetic syndrome characterised by intellectual disability, severe speech delay, and palatal and dental problems. Behaviours that challenge (BtC) are reported frequently; however, there is limited research on specific forms of BtC and the correlates of these behaviours. The current study explores correlates of well-defined BtC, self-injury, aggression, and property destruction, in SAS. Eighty-one parents/caregivers of individuals with SAS (53.1% male, Mage 10.12 years) completed questionnaire measures of health, behavioural, emotional, and autism characteristics. Individuals with SAS were grouped based on caregiver responses to the presence or absence of self-injury, aggression, and property destruction on the Challenging Behaviour Questionnaire. Rates of self-injury, aggression and property destruction were 42%, 77% and 49%, respectively. Between-group comparisons were conducted to compare characteristics between behaviour groups. Significantly differing characteristics were entered into separate hierarchical logistic regressions for each form of BtC. Behavioural comparisons indicated variation in the characteristics associated with each behaviour. All hierarchical logistic regression models were significant (p < .001): self-injury (χ²(5) = 38.46, R² = 0.571), aggression (χ²(4) = 25.12, R² = 0.414), property destruction (χ²(4) = 23.70, R² = 0.346), explaining between 34.6% and 57.1% of the variance in behaviour presence. This is the first study to identify correlates of self-injury, aggression, and property destruction in SAS. Variability in the characteristics associated with each behaviour highlights the importance of specificity when examining BtC. Understanding correlates of specific forms of BtC has important implications for informing SAS-associated pathways to behavioural outcomes and the implementation of tailored behavioural interventions.

This research investigated the impact popular novels have on knowledge about and attitudes towards Autism Spectrum Disorder (ASD), compared to that of traditional college textbooks. Study 1 found that participants in the novel condition chose fewer correct and fewer incorrect responses to questions about ASD. Participants did not differ in their desired social distance from individuals with ASD. Study 2 found that participants in the novel and textbook conditions both showed the same amount of learning, with higher scores on the post-test assessment of knowledge than the pre-test. Participants in the novel condition showed significant improvement in their attitudes towards individuals with ASD after reading, while those in the textbook condition showed more negative attitudes after reading the textbook chapter. These findings add to our understanding of the potential of popular fiction to impact consumers' knowledge about ASD while improving our attitudes towards individuals with ASD. These findings also raise concerns about traditional educational material used to teach about ASD.

Purpose: Disorders on the autism spectrum have characteristics that can manifest as difficulties with communication, executive functioning, daily living, and more. These challenges can be mitigated with early identification. However, diagnostic criteria has changed from DSM-IV to DSM-5, which can make diagnosing a disorder on the autism spectrum complex. We evaluated machine learning to classify individuals as having one of three disorders of the autism spectrum under DSM-IV, or as non-spectrum.

Methods: We employed machine learning to analyze retrospective data from 38,560 individuals. Inputs encompassed clinical, demographic, and assessment data.

Results: The algorithm achieved AUROCs ranging from 0.863 to 0.980. The model correctly classified 80.5% individuals; 12.6% of individuals from this dataset were misclassified with another disorder on the autism spectrum.

Conclusion: Machine learning can classify individuals as having a disorder on the autism spectrum or as non-spectrum using minimal data inputs.

The present study was designed to examine autistic and non-autistic young adults' lived experience in psychosexual development and sex education and to solicit recommendations on how to improve sex education programs. Participants included 10 autistic young adults and 10 non-autistic young adults aged 18 to 24 years. The two groups were matched for sex and education level. One-on-one semi-structured interviews were conducted. Participants' responses were analyzed using comparative interpretative phenomenological analysis. Four superordinate themes emerged: (1) "Who am I as a sexual being"; (2) Making sense of psychosexual development; (3) Sources of information; and (4) "Dear developers of sex education programs". Most autistic participants shared feelings of intense anxiety about romantic and sexual relationships, in part due to anticipated difficulties in social communication. Interestingly, although interview questions mostly focused on sex and adolescence, issues surrounding romantic relationships and their links to current self-concept were prominent themes in many autistic participants' responses, suggesting that autism-friendly sex education programs need to address issues related to romance and should target not only adolescents but also young adults. Also, autistic participants learned from peer interactions within the autistic community, highlighting the importance of facilitating peer exchanges and continuous learning beyond completing a program. Regarding delivery format, autistic participants valued concreteness and a mixed-sex small-group setting, and recommended using visual cues, real life examples, and role play. Autistic individuals have unmet psychosexual educational needs. Further research may consider their needs, lived experience, and recommendations when developing new autism-friendly sex education programs.

We examined receipt of general early intervention services and autism-specific specialized services across demographic groups among toddlers with autism diagnoses who were receiving Part C Early Intervention (EI). Latent class analysis (n = 508) identified five demographically distinct subgroups associated with intersecting marginalization and privilege. Analyses of longitudinal parent interviews (n = 225) revealed service receipt disparities across these demographically distinct latent classes; children from White, U.S. born, English-proficient parents with incomes above poverty level received more EI services (M = 12.0 h/week) than other subgroups, with children from Latiné immigrant families receiving the fewest hours (M = 6.9 h/week). Across all groups, average intervention hours were 8.8 h/week. Despite early identification, racial, ethnic, and other sociodemographic disparities were evident in receipt of Part C Early Intervention services, indicating the need to address barriers to equitable care.