Journal of Autism and Developmental Disorders最新文献

The study described the sleep characteristics (SC) of children/adolescents with Autism Spectrum Disorder (ASD), and examined their association with medication use, support level, chronotype, probable sleep bruxism (PSB), anxiety, salivary levels of cortisol (SalC) and melatonin (SalM). Methods: Following anamnesis and dental examination, anxiety was assessed using the SCARED questionnaire. The SCs were determined by two age-appropriate questionnaires, and the percentage of negative SCs (%Neg) was recorded. Saliva samples were collected to measure SalC and SalM levels. The sample comprised 85 ASD patients aged 2-16 years, of whom 80%, 50.6% were classified as support level 2, 83.5% used medication, 84.7% had an afternoon chronotype, 72.9% presented PSB, and 48.2%, anxiety. The mean %Neg was significantly higher in patients using medication (49.29 ± 15.88; p = 0.03) and those requiring more support (level 1: 41.57 ± 14.45; level 2: 50.78 ± 15.54; level 3: 55.11 ± 23.44; p = 0.019). Patients with anxiety showed a higher %Neg (51.31 ± 16.33) than those without anxiety (43.65 ± 15.79). The mean SalC and SalM levels were 13.29 ± 13.39 and 299.91 ± 241.77, respectively.. In children aged 2-6 years, one rhythmicity SC and two separation-related SCs were associated with SalC (p < 0.05); lower SalM levels were found in patients who "slept alone" (p = 0.02). In older patients, "moving while sleeping" was associated with lower SalC (p = 0.05), and three additional SCs were linked to reduced SalM levels (p < 0.05). The presence of negative SCs in ASD patients was more common in those taking medication, requiring more support, and presenting anxiety. Furthermore, SalC and SalM levels were associated with specific SCs, especially among individuals aged (7-16).

Baby schema refers to physical features perceived as cute, known to trigger attention, induce positive emotions, and prompt social interactions. Given the reduced visual attention to social stimuli observed in individuals on the autism spectrum, the current study examines whether the sensitivity to baby schema is also affected. We expected that the looking time towards cute-featured stimuli would vary with symptom severity levels and would be associated with social affect. Ninety-four children (31 typically developing; 63 diagnosed with autism spectrum disorder - ASD) aged 20-83 months (M = 49.63, SD = 13.59) completed an eye-tracking visual exploration task. Autistic participants were separated into two groups based on symptom severity: children with high autism severity symptoms (HS ASD; N = 23) and low-moderate autism symptoms (LMS ASD; N = 40). Animals and neutral objects were simultaneously presented on the screen along with either human babies (condition 1) or adults (condition 2). The results indicated that visual attention oriented to cute-featured stimuli varied with autism symptom severity: only LMS and TD groups spend more time looking at cute-featured stimuli (babies; animals) than neutral objects. Moreover, children with higher severity in the social affect domain spent less time on the stimuli depicting cute than non-cute stimuli. These findings suggest that autism symptom severity and social skills are linked to variations in visual attention to cute stimuli. Implications of baby schema sensitivity are discussed in relation to the development of social competencies and play, responsiveness to robot-based interventions, as well as appraised relevance in autistic children.

Previous studies have used cluster analysis to address the diagnostic heterogeneity of autism spectrum disorder, but have been limited by identifying subgroups solely on the basis of core autism symptoms. The present study aimed to identify sleep phenotypes and their clustering with core autism symptoms in youth diagnosed with autism. 1397 patients (1-17y, M = 6.1 ± 3.3y; M IQ = 88.5 ± 27.2; 81.2% male, 89.0% white) with autism. Principal component analysis (PCA) was performed on 10 sleep items from the Pediatric Behavior Scale. Latent class analyses (LCA) determined phenotypes characterized by core autism symptoms and sleep clusters, accounting for age, sex, Intelligence Quotient (IQ), and medication use.PCA identified three distinct sleep clusters (disturbed sleep, insufficient sleep and hypersomnolence) explaining 48.4% of the variance. LCA revealed four phenotypes based on core ASD symptoms and sleep clusters. Compared to Class 1 (54.8%) as the reference group, Class 2 (26.3%) had a similar degree of sleep problems, higher IQ and milder autism symptoms, less problems with selective attention/fearlessness; Class 3 (14.5%) was characterized by insufficient and disturbed sleep, perseveration and somatosensory disturbance, and higher medication use, while Class 4 (4.4%) was by hypersomnolence, problems with social interactions, and higher medication use.We found four distinct clustering of core autism symptoms and sleep problems differing in their sleep profiles as well as in relation to clinical characteristics, demographics, internalizing/externalizing symptoms, and functional outcomes. Our findings underscore the heterogeneity of autism based on sleep-wake problems, advocating for personalized therapeutic interventions targeting nighttime sleep and daytime alertness.

We aimed to compare sleep problems in autistic and non-autistic adults with co-occurring depression and anxiety. The primary research question was whether autism status influences sleep quality, after accounting for the effects of depression and anxiety. We hypothesized that autistic adults would report higher levels of depression, anxiety, and sleep problems compared to non-autistic adults, after controlling for these covariates. We recruited 208 adults (109 non-autistic, 99 autistic) through a crowdsourcing platform, Prolific. Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the Generalized Anxiety Disorder 7-item scale. Statistical analyses included Mann-Whitney U tests to compare group scores and a generalized linear model to assess the effect of autism status on sleep problems while controlling for depressive and anxiety symptoms. Autistic adults reported significantly higher levels of depressive and anxiety symptoms compared to non-autistic adults. However, after controlling for depression and anxiety, autism status alone did not have a statistically significant effect on overall sleep quality. The findings suggest that while autistic adults experience more severe sleep problems, these issues are closely related to higher levels of depression and anxiety rather than autism status itself. This study contributes to the understanding of sleep difficulties in autistic individuals, highlighting the importance of addressing co-occurring mental health conditions. Further research should explore the specific factors that exacerbate sleep problems in this population.

The aim of the study was to evaluate the significance of the severity of autistic traits, behavioural difficulties, prosocial behaviour and temperamental characteristics in children for parental self-efficacy and parental satisfaction in two groups of parents: parents of autistic children, and parents of neurotypical children. Data come from 145 parents of autistic children and 239 parents of neurotypical children. Using hierarchical multiple regression analyses, the analysis explored the role of child characteristics in prediction of parental self-efficacy and parental satisfaction. The regression model tested explained 21% variation in parental self-efficacy and 27% variation in parental satisfaction in parents of autistic children and 3% of variation of results with respect to parental self-efficacy and 17% variation in parental satisfaction in parents of neurotypical children. In both groups, parental self-efficacy and parental satisfaction were negatively correlated with such child characteristics as severity of behavioural difficulties, severity of autistic traits and emotionality as also positively related to the child's prosocial behaviour. These findings may suggest that particularly useful mental health prevention programs for parents should combine two elements: developing parents' abilities of effectively coping with children's behavioural difficulties and working on attribution processes and negative convictions about parenthood.

Although affective irritability is a common and concerning problem for autistic youth, limited research has examined relations among core autism characteristics and irritability. Therefore, this study investigated potential associations among types of restricted/repetitive behaviors (RRBs) and social communication challenges and irritability in autistic children and adolescents. Participants were 107 autistic youth recruited from a university-based autism clinical research program. Two hierarchical multiple regressions were conducted with Affective Reactivity Index as the dependent variable. Covariates were entered at step 1, followed by the independent variables of interest at step 2. For the first model, independent variables of interest were Repetitive Behavior Scale-Revised subscales: stereotyped behavior, self-injurious behavior, compulsive behavior, ritualistic behavior, sameness behavior, and restricted behavior. For the second model, independent variables of interest were Social Responsiveness Scale, Second Edition subscales: social awareness, social cognitive, social communication, and social motivation. Irritability was significantly associated with several categories of RRBs (i.e., insistence on sameness, stereotypic behavior, and restricted interests/activities). Nonetheless, irritability was not associated with categories of social communication and interaction challenges in autistic youth. Results from this study indicated differing associations between core autism characteristics and affective irritability. Findings highlight the importance of differentiating types of restricted, repetitive behaviors and social communication and interaction challenges in conceptualizing mental health concerns in autistic youth.

The mean diagnosis age of autism was about 5 years in Taiwan. Whether the delayed diagnosis of autism (≥ 6 years) was associated with parental severe mental disorders remained unknown. The parents of 22,859 autistic individuals and 228,590 age- and sex-matched nonautistic individuals were assessed for the presence of severe mental disorders (schizophrenia, bipolar disorder, major depressive disorder, alcohol use disorder, and substance use disorder). The timing of autism diagnosis was classified into three age categories: < 6 years, 6-11 years, and ≥ 12 years. Logistic regression models were used to examine associations between parental severe mental disorders and these age categories of autism diagnosis. Parental schizophrenia and substance use disorders were associated with the delayed diagnosis of autism, both diagnosis at ≥ 12 years (odds ratio [OR]: 2.14; 1.57) and at 6-11 years (1.87; 1.38). Parental bipolar disorder and major depressive disorder were also associated with the delayed diagnosis of autism, especially diagnosis at 6-11 years (OR 1.98; 1.86). Our findings underscore the need for clinicians to monitor the neurodevelopmental conditions of offspring born to parents with severe mental disorders during the early stages of their life.

Decision-making under unpredictable conditions can cause discomfort in autistic persons due to their preference for predictability. Decision-making impairments might furthermore be associated with a dysregulation of sex and stress hormones. This prospective, cross-sectional study investigated decision-making in 32 autistic participants (AP, 14 female) and 31 non-autistic participants (NAP, 20 female) aged 18-64 years. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under ambiguity and under risk with known outcome probabilities, respectively. Cortisol, estradiol, and testosterone serum levels were related to decision-making performance. Groups did not differ in overall IGT and CRT performance, but compared with NAP, AP preferred less profitable card decks with predictable outcomes while avoiding those with unpredictable outcomes. AP required more time to reach decisions compared to NAP. Additionally, AP without comorbid depression performed significantly worse than NAP in the IGT. Estradiol and cortisol concentrations were significant predictors of CRT scores in NAP, but not in AP. The study results imply that AP are 'risk-averse' in decision-making under ambiguity as they avoided choice options with unpredictable losses in comparison to NAP. Our findings highlight the intolerance for uncertainty, particularly in ambiguous situations. Thus, we recommend being as transparent and precise as possible when interacting with autistic individuals. Future research should explore decision-making in social situations among individuals with ASD, factoring in person-dependent variables such as depression.

Purpose: To investigate associations between possible sleep bruxism (PSB) and sleep disorders in children/adolescents with autism spectrum disorder (ASD) as well as parental perceived stress.

Methods: A cross-sectional study was conducted involving children/adolescents with ASD five to 19 years of age and their parents at a public institution that supports disabled people in the city of João Pessoa in Northeast Brazil. The parents answered a form addressing sociodemographic characteristics and medical data (schooling, income, age, sex, support level and use of medications). PSB was recorded based on the reports of the parents. Parental stress was investigated using the Perceived Stress Scale (PSS-10). Sleep disorders in the children/adolescents were investigated using the Sleep Disturbance Scale for Children (SDSC). Data analysis involved descriptive, bivariate and Poisson regression analyses (95% CI; p < 0.05).

Results: Fifty children/adolescents with ASD participated in the study. Boys accounted for 84.0% of the sample (n = 42). PSB in the children/adolescents was reported by 28.0% of the parents. The mean parental PSS-10 score was 20.3 ± 8.5 and the mean SDSC score was 48.8 ± 17.5. The adjusted Poisson model revealed associations between PSB and higher levels of perceived stress of the parents (PR = 1.05; 95% CI: 1.01-1.09), sleep breathing disorders (PR = 1.14; 95%CI: 1.05-1.24) and sleep-wake transition disorders (PR = 1.16; 95%CI: 1.00-1.36; p = 0.044).

Conclusion: The occurrence of PSB in children and adolescents with ASD was associated with higher levels of parental stress, higher scores for sleep breathing disorders and sleep-wake transition disorders.

Silent pauses may serve communicative purposes such as demarcating boundaries between discourse units in language production. Previous research has shown that autistic children differ in their pausing behavior from typically-developing (TD) peers, however, the factors behind this difference remain underexplored. The current study was aimed at comparing the use of silent pauses in the narrative production of autistic children and age-matched TD children, and also to identify possible relations between pausing behavior and the children's language and executive function abilities. According to the study's findings, the autistic children did not differ from their TD peers in the use of grammatical pauses, however, the former tended to produce significantly less syntactically complex narratives than the TD group, which increased the likelihood that the autistic group would pause appropriately at phrasal boundaries. Though we have found low rates of ungrammatical silent pauses and omitted pauses in obligatory discourse contexts across both groups, autistic children with lower cognitive flexibility tended to use more ungrammatical pauses than their peers with higher cognitive flexibility scores. Also, the autistic group tended to omit obligatory silent pauses more often as their narration became more complex. The results demonstrate that syntactic complexity in narrative production modulated autistic children's pausing behavior, and that structurally simple narrations boosted the autistic group's appropriate use of grammatical pauses. The overall findings also demonstrate the importance of studying silent pauses in the narrative discourse of autistic children, and also highlight the links between silent pauses and the children's syntactic and cognitive skills.