Journal of Autism and Developmental Disorders最新文献

The purpose of this study was to: (1) confirm the factor structure of a therapist-report measure of adaptations to an autism evidence-based intervention (EBI), (2) identify predictors of adaptation types, and (3) examine associations of adaptation types with observed therapist fidelity. Participants included a subset of therapists (N = 70; 31.4% Hispanic), autistic children (N = 79; ages 5-13 years; 57.0% Hispanic), and their caregivers (N = 77; 54.5% Hispanic), who participated in the training condition of a community effectiveness trial of An Individualized Mental Health Intervention for Autism (AIM HI). Families reported demographics and completed assessments of child functioning and caregiver strain at baseline. Therapists submitted video recordings of psychotherapy sessions during EBI training, which were later coded for fidelity by independent raters. Therapists completed the Adaptations to Evidence-Based Practices Scale at the end of the 6-month training period. Multi-level confirmatory factor analysis yielded two adaptation types consistent with prior research: Augmenting and Reducing/Reordering adaptations. In multi-level models, higher Augmenting adaptations were associated with lower child cognitive functioning (B= -0.01, p < .05), higher child autism characteristics (B = 0.01, p < .05), and Non-Hispanic White caregiver ethnicity (B = - 0.17, p < .01). Higher Reducing/Reordering adaptations were associated with Non-Hispanic White caregiver race/ethnicity only (B = - 0.33, p < .01). There were no significant associations between therapist-reported adaptations and observed fidelity. This study further supports Augmenting and Reducing/Reordering as distinct subtypes of adaptations with unique predictors. Therapists likely adapt AIM HI to tailor the EBI to individual client needs and do so in ways that do not appear to interfere with fidelity. Trial Registration ClinicalTrials.gov identifier NCT02416323.

This systematic review expands the current knowledge about Peer-Mediated Interventions (PMIs) for children with Autism Spectrum Disorder, focusing exclusively on primary school age (6-12 years). The study has three aims: (1) describing the main features of the PMI programs; (2) discussing the PMIs efficacy on autistic children's social skills; (3) analyzing whether the PMIs were coherent with the bio-psycho-social model promoted by the International Classification of Functioning, Disability and Health (ICF) classification system, by referring to the person-environment interaction and to the concepts of body functions and structures, environmental factors, and activity and participation. The systematic review followed the PRISMA-P method. The literature search was conducted in August 2024 through PsycInfo, PsycArticles, Education Source, and PubMed databases. A total of 558 articles were generated; 1 study was later added. Twenty-four articles were finally included. Most of the studies used a multiple baseline design across subjects and proved to be effective. Yet, only 5 studies included a follow-up assessment, which showed contrasting results. PMIs partly fit the ICF bio-psycho-social vision, even if they were not designed for this purpose. Our analysis arises from the belief that systematically including the perspective of individual-environment interaction could better guarantee the intervention efficacy.

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.

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.

Despite increasing autism prevalence rates across racial and ethnic groups, research has traditionally overlooked the influence of culture on developmental diagnostic conversations. Addressing this gap in research is crucial to understanding and mitigating potential disparities in diagnostic experiences, especially among Black caregivers. Black caregivers encounter frustration and discrimination during the diagnostic process, citing dismissiveness and a lack of cultural competence from healthcare providers. To address these issues, this study centers the perspectives of Black caregivers as they participate in a developmental diagnostic program for toddlers under three years of age. This retrospective qualitative study, conducted exclusively by a Black research team, involved nineteen Black caregivers of thirteen toddlers as they participated in semi-structured interviews conducted by a multidisciplinary clinical team. The research team employed a conceptual content analysis to examine caregivers' descriptions of their children's behaviors and characteristics, as well as the factors and experiences associated with their descriptions. Caregivers provided distinct descriptions of behaviors and characteristics in the categories of language and communication, learning, and temperament, associating them with situational and dispositional factors and experiences. The findings offer valuable insights for implementing culturally responsive diagnostic practices. Additionally, these results may enhance the quality of caregiver-provider interactions during developmental assessment, leading to earlier and more accurate diagnoses for Black children.

This study examined the relationship between empathy, prosocial behaviour, social interactions and early psychopathological symptoms (internalising and externalising behaviours) in children with autism spectrum disorder (ASD) and typically developing (TD) children. A total of 506 parents of children aged 18-48 months participated in this study. The parents of 92 children with ASD and 414 neurotypical children completed the Empathy Questionnaire, the Child Prosocial Behaviour Questionnaire, and the Emotional and Social Development Questionnaire. The results confirmed the direct relationship between empathy and prosocial behaviour in both groups. However, the findings showed a different pattern of the indirect relationship between empathy and prosociality through the social dimensions in the children with ASD compared to their typically developing peers. In the children with ASD, there was only one significant indirect path from empathy to prosocial behaviour - through internalising behaviours (anxiety). Anxiety also played a moderating role in this relationship. The higher the anxiety, the stronger the relationship between empathy and prosociality. In the neurotypical group, social interactions were a significant mediator, strengthening the relationship between empathy and prosocial behaviour. Externalising behaviours weakened this relationship. Intergroup and gender differences were also examined. These findings may have practical implications for social skills training programmes based on behavioural interventions by highlighting the importance of prosocial behaviour for social interaction and protection against psychopathological problems in children with autism and typically developing children.

Cognitive style refers to how individuals perceive their environment and solve problems. Among various cognitive styles documented, verbal and visual styles, including object versus spatial cognition, have been widely studied. "Thinking in pictures" is often associated with autism and characterized by enhanced performance and autonomy of certain perceptual areas. This study aimed to characterize the cognitive style of autistic individuals, focusing on this visual "thinking in pictures" style. We assessed 43 autistic and 42 non-autistic adults using the Object Spatial Imagery Verbal Questionnaire to evaluate three dimensions of their cognitive style: visual object, visual spatial, and verbal. Using a cluster analysis, we identified cognitive style profiles. We then examined manifestations of cognitive style within these profiles, including mental imagery abilities (with the Mental Rotation Test), the vividness of mental images (with the Vividness of Visual Imagery Questionnaire), language abilities (with the Mill Hill vocabulary test), and synesthetic experiences. Our results revealed three distinct cognitive profiles: a visual profile characterized by significant mental imagery and vivid mental images, a visuo-spatial profile associated with strong abilities to manipulate mental images but lower vividness of mental images, and a verbal profile with lower spatial imagery and manipulation abilities. While all profiles were observed in autistic individuals, the visual cognitive profile was the most common. Additionally, we found synesthesia to be more prevalent in the autistic population compared to the non-autistic population. This study confirms that, while not exclusive, a visual cognitive style is prevalent among autistic individuals.

Many autistic individuals may desire support and services primarily in the areas of adaptive functioning and social well-being throughout their lifetime. There is a need for community-informed and person-centered social programs targeted for autistic adolescents and adults. New technology, such as virtual reality (VR), is being researched to assess the feasibility of providing therapeutic services to autistic individuals. This qualitative study aims to better understand and explore the perceptions of parents and autistic adolescents regarding social development and thoughts around social skills interventions delivered through technologies such as VR. Eight autistic adolescents between the ages of 12 to 17, and five parents participated across five focus groups. The focus group interviews were semi-structured, and qualitative data analysis was conducted through an open thematic approach and inductive coding process. Seven primary themes with sub-themes were identified throughout the focus group interview discussions: Social Skills of the participating autistic adolescents as reported by their parents and by self-report, Family Dynamics affecting social relationships within the family, Social Skills Goals both groups hoped to develop and improve, the existence and quality of In-Person vs. Online Friendships, Experience/Comfort With Technology, Openness to Virtual Environments, and Concerns for Virtual Environments. Researchers identified these themes across both parent and adolescent focus groups. This study provides guidance to the research community on investigating different innovative approaches for offering a social program that is supported by autistic individuals.

The experiences of special education teachers in Saudi Arabia are quite different from the experiences of their counterparts from other countries as they work in a unique culture and educational system. The educational system in Saudi Arabia is gender segregated, and the Saudi Arabian Ministry of Education (MoE) provides an equal budget, salaries, and subsidies and implements the same policies and uses the same curriculum regardless of the location, size of the city, or the number of students. This country's unique characteristics may influence special education teachers' experiences, which raises the need to investigate and understand the experiences of Saudi special education teachers. We sought to understand the experiences of special education teachers in Saudi Arabia, focusing on teaching communication skills to autistic students. We conducted semi-structured interviews with 13 Saudi special education teachers to gain deeper insights into the experiences of these teachers within the Saudi context. The themes that emerged from the interviews revolved around evaluating and teaching communication skills, the role of the Saudi MoE, and the perceived challenges and needs related to teaching communication skills. Building on our findings, we propose a set of recommendations for special education teachers and the Saudi MoE.