Autism最新文献

Lay abstract: What is already known?In the United States, the COVID-19 Pandemic caused many autistic adults to be fearful and worried about their health. There is a lot of research that says that when autistic adults experience health distress it can worsen their mental health. We do not know, however, what might explain how experiencing health distress negatively affects mental health. Because of this, our participatory action research team wanted to understand if there are strengths-based processes that help us understand the relationship between health distress and mental health concerns.What does this paper add?We examined among 281 autistic adults how a strengths-based construct from acceptance and commitment therapy called psychological flexibility might explain the relationship between health distress and mental health concerns. We found that for adults that had more values progress, doing the things that mattered to them, was associated with better mental health even while experiencing health distress. We also found that values obstruction, getting stuck on uncomfortable thoughts and feelings and trying to avoid them, explained worse mental health for autistic adults experiencing health distress.Implications for research and practice?The findings of this study provide initial support that psychological flexibility can explain the relationship between health distress and mental health concerns among autistic adults. Interventions that seek to improve psychological flexibility, like acceptance and commitment therapy, might be useful in improving autistic adults' mental health while they are experiencing health distress.

Lay abstract: Autistic people experience more mental health conditions like depression or anxiety than non-autistic people. They are also more likely to experience difficulties in accessing mental health supports Clinicians have published suggestions on how to improve therapy for autistic people. However, whether these ways to adapt (i.e. adaptations) therapy for autistic people are seen as helpful by autistic people themselves has not been investigated. We recruited 130 autistic adults to complete an online survey. They rated 55 adaptations to therapy from "Not at all helpful" to "Extremely helpful." We also asked for ideas of additional adaptations. Adaptations classified as neurodiversity affirming (e.g. having a therapist that embraces differences in brains and provides support to affirm neurodivergent identity) were rated highest. Approximately half of adaptations were rated positively at a group level. However, for almost every adaptation at least one person rated it as not at all helpful and at least one rated it as extremely helpful. Additional adaptations were around general good practice, financial cost, neurodiversity-affirming practices, practical, sensory/environmental, structure, and therapy style/techniques. Our findings add how helpful autistic people themselves rate adaptations to therapy and similarities and differences to clinicians. This is important to consider how these perspectives can differ. Findings also identify additional suggestions that clinicians could use in their practice and ideas for future research. Findings can help autistic adults in advocating for adaptations to therapy that address their needs by providing a list of possible adaptations. Furthermore, findings may help clinicians to better support their autistic clients.

Lay abstract: Autistic individuals have described facing unfair or discriminatory treatment across settings, such as in school and at work. However, there have been few studies examining how widespread or prevalent discrimination is against autistic individuals. We aimed to fill that gap by examining how prevalent or common it is for autistic youth to experience discrimination based on race or ethnicity, sexual orientation or gender identity, and health condition or disability. We compared rates of discrimination against autistic youth to youth without developmental differences/diagnoses and youth with other developmental differences (i.e. youth diagnosed with attention-deficit/hyperactivity disorder [ADHD], learning disability, and speech/language disorders). We analyzed data from the 2021-2022 National Survey of Children's Health, which is a nationwide survey on which parents report about aspects of their children's lives. We found that autistic youth experience higher rates of discrimination based on race or ethnicity and sexual orientation or gender identity compared to youth who are typically developing and do not have a diagnosis (such as a speech or language disorder). Importantly, they also face significantly more discrimination due to their disability than youth with other diagnoses, such as ADHD, and youth without a developmental diagnosis. These results show that autistic youth are at risk for experiencing discriminatory treatment. Our study should motivate researchers, policymakers, and community members to address this critical issue.

Lay abstract: What do we already know about emotion regulation in autism?We know that many autistic children, youth, and adults experience difficulties regulating emotions. Existing research has focused mainly on the differences in emotion regulation capabilities between autistic and non-autistic individuals, the relationships between autistic traits and emotion regulation, and how emotion regulation relates to other outcomes, such as social skills and mental health.What does this paper add?We want to take a new approach to review the existing emotion regulation research through the lens of a specific theoretical model: the extended process model of emotion regulation. Professor James Gross developed this model. It consists of four emotion regulation phases: identification, selection, implementation, and monitoring.Our review revealed specific areas within these emotion regulation phases that could significantly impact the emotion regulation experiences of autistic individuals. We also outline the gaps in the research and propose avenues for future investigation.Implications for practiceBy deepening our understanding of emotion regulation in autistic individuals through the proposed future research, researchers and clinicians can pave the way for the development of tailored support programs. These programs will directly target specific emotion regulation mechanisms, offering a much-needed individualized support approach.

Lay abstract: Genetic testing is recommended by various professional organizations as part of clinical guidelines during the evaluation of autism spectrum disorder (ASD) and other neurodevelopmental disorders. However, previous studies demonstrate that rates of genetic testing are low. This study aimed to identify the rates of genetic testing within a large university healthcare network and factors that may be associated with higher or lower rates. Researchers reviewed over 7500 electronic health records of patients who were evaluated for ASD or other neurodevelopmental disorders. Some factors that were recorded include patient demographics (race, gender, insurance, zip code), ordered but not completed tests, genetic test results and reasons for declining genetic tests if noted, and other known barriers to genetic testing such as blood draws and specialties of providers seen by patients. Statistical analysis was conducted to determine associations between rates of genetic testing and different factors recorded in our database. Our results demonstrate that less than half of patients received at least one indicated genetic test, while a smaller percentage received recommended genetic tests. While sex assigned at birth and gender did not impact whether a patient received at least one indicated genetic test, race and insurance did. Our review reveals that genetic testing is not sufficiently offered by physicians, and we have identified multiple obstacles that prevent patients from receiving genetic testing which must be further investigated.

Lay abstract: Many children with autism struggle with movement difficulties, yet the causes of these difficulties remain unclear. One possible explanation is atypical motor planning and integration of visual and motoric information. Before performing a goal-directed movement, the brain creates a prediction of the movement based on visual and sensory information and previous experience, forming a "blueprint" of the motor steps needed to achieve the goal. This process is called motor planning. During movement, adjustments to the plan can be made through feedback mechanisms. This longitudinal study aimed to examine the development of motor planning in children with autism and typically developing children over early school-age (7-9 years). The children performed a sequential manual peg-rotation task, which involved grasping, rotating, and placing a peg, while detailed measures of movement were collected. Task end-goal difficulty varied, and the goal was either initially occluded or fully visible. The results revealed that children with autism showed atypical motor planning development compared with typically developing peers, and these differences became more pronounced as the children grew older. As the typically developing children matured, they appeared to rely more on initial visual information, which assisted them in motor planning. However, this facilitation did not occur for children with autism. These findings suggest that the differences in motor planning seen in children with autism may be linked to atypical visuomotor integration, highlighting the need for individualized interventions. Furthermore, it is crucial to consider developmental aspects to fully understand motor planning in children with autism.

Lay abstract: In the past decade, autistic children have increasingly enrolled in general schools worldwide. However, most insights into their educational experiences come from educators and parents. There is a gap in understanding autistic children's perspectives on their educational experiences. The limited evidence from autistic children primarily focuses on middle school and reveals complex feelings of loneliness, anxiety and being misunderstood by teachers and peers. Moreover, research to date has not examined the full-time period of general education, which is needed to understand the cumulative developmental trajectory from elementary through high school. To address these gaps, this study investigated the lived experiences of 10 autistic individuals (ages 19-25 years) who had completed their entire school journey in general education settings. This study utilised in-depth interviews and a visual technique called the 'Blob Tree' to elicit their stories. The findings indicated that during primary school, participants felt overwhelmed and confused by the school environment. The transition to middle school, where they received an autism diagnosis, marked a period of significant instability, social insecurity and loneliness. Interestingly, the participants gained confidence during high school, accepted their autism and developed a more positive self-image. These findings emphasise the importance of learning the longitudinal self-perspective of autistic individuals through creative methods like the 'Blob Tree' technique. Furthermore, the study highlights the crucial role of effective support services during school transitions, particularly from experts in inclusive education. It underscores the need to create environments within general schools that are more inclusive to support autistic students better.

Lay abstract: This study aimed to examine whether an acceptance and commitment therapy (ACT)-based parenting program, incorporating topics of emotional and stress management, parenting skills training, autism-related education, and self-care learning, could be successfully implemented, well-received, and beneficial for parents of children with autism. We randomly assigned 40 parents to either participate in the eight-session ACT-based parenting program or receive usual care only. The program was found to be feasible, with many parents willing to participate and complete the sessions. The parents also reported high satisfaction with the program and found it beneficial, according to satisfaction surveys and interviews. The results showed that parents who participated in the ACT-based parenting program had significant improvements in several outcomes compared to parents in usual-care-only group, including reduced parenting stress, decreased depressive and anxiety symptoms, and increased confident in their parenting abilities. Their autistic children showed fewer emotional and behavioral problems after the intervention. Based on these findings, we conclude that the ACT-based parenting program is feasible and acceptable and has promising effects for parents of autistic children. In the future, larger studies should be conducted to further explore its effectiveness for different groups of parents caring for children with autism or other neurodevelopmental conditions.

Lay abstract: The Autism Stigma and Knowledge Questionnaire (ASK-Q) was developed to assess autism knowledge across cultural contexts. The current study aimed to examine cultural equivalence of the measure using a large, international database. These analyses identified 18 items in need of examination for removal or revision. A team of autism experts recommended several additional changes to reduce stigma and increase cross-cultural sensitivity and accuracy of the items on the measure. These changes resulted in a briefer measure with maintained statistical support.