Autism最新文献

Elopement is a common and dangerous behavior among autistic children. Behavioral treatments can reduce elopement, but most evidence comes from small-N evaluations in specialized settings with strategies varying across studies. The current study compared the efficacy of the caregiver-mediated function-based elopement treatment to parent education program (PEP) in a 16-week randomized clinical trial of 76 autistic children (age = 4-12 years). Function-based elopement treatment involves 12 weekly appointments aimed at improving safety, identifying the function of elopement, and implementing subsequent function-based treatment strategies. No group differences were observed on the Aberrant Behavior Checklist-Hyperactivity (primary outcome). Significant improvement from baseline to endpoint in function-based elopement treatment compared to parent education program participants was observed for secondary outcomes, including caregiver ratings of safety measures (p < 0.01), severity of elopement based on the Elopement Questionnaire (p < 0.01), and caregiver-collected data on elopement (p < 0.01). The Clinical Global Impression-Improvement Scale (CGI-I) rated by a treatment-blind evaluator found 31.6% of function-based elopement treatment participants improved compared to 2.6% in parent education program (p = 0.001). Improvements were maintained at a 28-week follow-up. Attrition was 5.26%, and no significant adverse events were deemed related to treatment. Function-based elopement treatment was superior to parent education program on elopement-specific outcomes and appears safe and acceptable.Lay AbstractMany autistic children exhibit wandering or running away from supervision (i.e. elopement), which can include leaving the house in the middle of the night or getting lost from a parent in a crowded location. Elopement can result in injury when the child is not supervised and is incredibly stressful for parents. Research suggests that behavioral intervention can help with elopement. However, most studies include only a few children. In addition, treatment strategies differ across studies, making it difficult to compare outcomes. The function-based elopement treatment has compiled strategies across different studies to build a 12-session treatment manual that can be followed by clinicians. The manual guides the therapist on the delivery of parent-training strategies to improve the child's safety and reduce elopement. We compared function-based elopement treatment to a control condition where parents met weekly with a clinician for more general parent training. Children whose parents received function-based elopement treatment showed greater improvement in elopement than children whose parents received more general parent education. This result suggests that the treatment works. Further study is needed to move function-based elopement treatment into clinical practice.

Observations of parent-child play with toys are often used to assess interactions between parents and non-autistic as well as autistic children, but some research indicates that play without toys may elicit more positive interactions than play with toys. The first goal of the study was to examine whether this is true in the case of autistic preschoolers by comparing their play with their parents with versus without toys. The second goal was to compare mother- and father-child interactions. Seventy-eight autistic preschooler boys were observed interacting in counterbalanced mother- and father-child play with or without toys, and interactions were coded using the Emotional Availability scales. Results revealed that for both mothers and fathers scores on all of the EA scales in the play episode without toys were higher than scores in the episode with toys. Also, almost no differences were found between children's interactions with their mothers and fathers in both play with or without toys. Both findings broaden our understanding of the early social experiences of autistic children with their parents.Lay AbstractResearchers that study the development of young children often observe them playing with their parents with toys. However, a few studies and clinical experience suggest that the interactions between parents and children are often more positive when they play without toys. The first goal of the study was to find out if this is true for autistic preschoolers. We observed 78 children playing with each of their parents, and compared their play with and without toys. The second goal of the study was to compare mother- and father-child interactions to discover if they are similar or different from one another. We measured the emotional quality of parent-child interactions using scales that measure the behavior of both parents and children toward one another. We studied only boys because autism may present differently in girls. We discovered that both parents' and children's behavior were more positive when they were playing without toys compared to when they were playing with toys. Also, when we compared the emotional quality of how children played with their mothers and their fathers we found almost no differences, both in how the parents and the children behaved. The findings are important because they can guide researchers, clinicians, and parents to include both play with toys and play without toys in studies, interventions, and daily life. They also emphasize the importance of fathers, because although the fathers in the study were somewhat less involved in everyday caregiving with their children compared to mothers, they had interactions with the children that were as positive as those children had with their mothers. Importantly, we do not know if the findings apply to autistic girls as well.

The purpose of this study was to explore and document the migratory motivations and reasonings of Mexican mothers of autistic children pursuing autism services in the United States. The study was guided by the overarching research question, "What are the experiences of mothers living in the U.S./Mexico border while seeking services for their autistic children, and what social and financial resources influence their decisions?". Following a Community-Based Participatory Research approach, we collaborated with organizations and stakeholders in the development of qualitative research materials while also supporting the purposeful recruitment of caregivers who: (1) had lived in the U.S./Mexico border and moved to the United States to pursue autism services, or (2) were currently living in the U.S./Mexico border and were looking to pursue autism services in the United States. Eleven mothers participated in a two-part semi-structured interview protocol alongside a demographic form. Findings outline three global themes that describe the dynamic process of pursuing autism services and migrating to the United States: (1) stage of constant contrast between Mexico and the United States, (2) active pursuit of autism services in the United States, and (3) potential pathways to immigration. The global themes provide a systemic analysis and reflection of the current autism service system in Mexico while also highlighting the gaps in service coordination for first-generation immigrant families.Lay abstractThis study aimed to understand why Mexican mothers of autistic children move to the United States to seek autism services. Using a method that involved the community, we worked with local partners to create research materials and find caregivers for the study. We focused on mothers who had either moved from the U.S./Mexico border to the United States for autism services or were planning to do so. Eleven mothers participated by completing a two-part interview and a demographic form. The results highlight three main themes that explain the complex reasons and motivations behind their decision to seek autism services in the United States: (1) stage of constant contrast between Mexico and the United States, (2) active pursuit of autism services in the United States, and (3) potential pathways to immigration. These findings also highlight the differences in autism services between the United States and Mexico and the challenges faced by immigrant families trying to get the care their children need.

Families of autistic youth often support their children's transition from adolescence to adulthood. During this time, families learn to navigate the complex shift from school-based to adult disability services. For Latinx (vs non-Latinx White) families of autistic youth, transition is especially difficult because of the systemic barriers (e.g. language) Latinx families face when accessing services. Unfortunately, few interventions aim to improve the transition among Latinx families of autistic transition-aged youth. This study examines the effectiveness, feasibility, and acceptability of the ASISTIR (Apoyando a nueStros hIjo/as con autiSmo obTener servIcios de tRansición; Supporting our Children with Autism to Obtain Transition Services) program, a six-session program for Latinx families of autistic youth, with respect to increasing: school-based transition planning and adult disability services knowledge, empowerment, and advocacy. Twenty-nine participants were included in this single-group, intervention study. After completing the program, participants demonstrated significantly improved: knowledge of school-based transition planning and adult disability services, advocacy, and empowerment. In addition, participants were highly satisfied with the program, based on the formative and summative evaluations and individual interviews. Implications for research and practice are discussed.Lay abstractTo support Latinx families of autistic youth navigate school-based transition services and adult disability services, we provided a family advocacy program entitled, ASISTIR (Apoyando a nueStros hIjo/as con autiSmo obTener servIcios de tRansición; Supporting our Children with Autism to Obtain Transition Services). The ASISTIR program consisted of six, two-hour sessions and included the following topics: school-based transition planning, person-centered planning, Supplemental Security Income, Vocational Rehabilitation, and Home and Community-Based Medicaid Waiver. Twenty-nine Latinx family members completed the cohort-based ASISTIR program. After participating family members demonstrated increased knowledge of school-based transition planning and adult disability services. Participants also demonstrated increased empowerment and advocacy.

On average, groups of autistic individuals are more likely than groups of non-autistic individuals to exhibit unconventional conversational behaviours. We examined autistic and non-autistic children's social impressions of unconventional responding, as well as actual conversational behaviours in the same participants. Across two studies, 36 autistic and 36 non-autistic matched 9-13-year-olds listened to conversational vignettes which manipulated the relevance and timing of responses produced by the speaker. They then rated the speaker's social desirability. We also measured the content and latency of the same children's conversational responses. Autistic children aligned with their non-autistic peers in indicating that they were less likely to befriend, or enjoy interacting with, a speaker who provided off-topic or delayed responses. However, the same autistic children provided more off-topic, and fewer topic-continuing, conversational responses than their non-autistic counterparts. These findings suggest that displaying unconventional conversational behaviours may act as a barrier to friendship or inclusion for autistic children, even when socialising with other autistic peers.Lay abstractDuring a conversation, on average, autistic individuals are often more likely than non-autistic people to provide an off-topic comment and/or to pause for longer before providing a response. One possible explanation for this is that autistic individuals prefer, or are more tolerant of, unconventional communication styles. To explore this possibility, we investigated whether autistic and non-autistic 9-13-year-olds find off-topic or delayed responding a deterrent to friendship or interaction. Participants listened to scripted conversations and then rated social desirability statements, such as 'I would enjoy chatting to the [target speaker]'. We also examined the prevalence of these behaviours in children's own conversational responses. We found that autistic children were just as likely as non-autistic children to dis-prefer unconventional conversational responding. Both groups indicated that they were less likely to want to be friends with the speaker, or to chat with them, when they provided off-topic or delayed responses. However, despite their judgements of others, the same autistic children were more likely to provide off-topic responses themselves than their non-autistic peers, as well as giving fewer on-topic responses which facilitate back-and-forth conversation. Overall, this is problematic for autistic children, as our findings suggest that the tendency to exhibit unconventional conversational behaviours will have negative social consequences, even when interacting with other autistic peers.

Some parents experience concerns relating to their child's development and seek clinical assessments for their child's behaviour. We sought to understand the concerns that led parents to seek a general clinical assessment where some children were diagnosed with autism spectrum disorder. We conducted a systematic review to identify the types of parent concerns that drives parents to seek professional help for their child's development. Database searching identified 7587 records, where 10 studies (9 cohorts) met our inclusion criteria. Parent reported concerns were categorised using the coding schemes of included studies described as autism spectrum disorder-specific (i.e. communication, social or stereotyped behaviour concerns) or non-autism spectrum disorder-specific concerns (i.e. behaviour/temperament, developmental, medical, sensory or motor concerns). The most reported parental concerns prior to an assessment were speech and language, social and behavioural. Concerns were also reported relating to parent understandings of an autism spectrum disorder diagnosis and the positive and negative implications surrounding the autism spectrum disorder diagnosis. Data were reported descriptively due to variations in study design and data analyses. Additional rigorous research on parent concerns prior to a diagnostic autism spectrum disorder assessment is required to capture what drives parents to seek professional help to support their child's development.Prospero registration number: CRD42022307436Lay abstractWhen a parent has concerns about their child's development, there is a lag between seeking and receiving health information. When waiting, parents may speculate about a possible diagnosis of autism spectrum disorder, but it is unclear what types of concerns might drive this speculation. To determine the types of concerns parents may have before their child is assessed, we conducted a systematic review that explored parent concerns before an autism spectrum disorder assessment. Our aim was to determine the types of concerns that might drive parents to seek medical help for their child's development. Four online databases were searched and 10 articles reporting on 9 studies matched our inclusion criteria. In these cohorts, parents reported autism spectrum disorder-specific concerns (i.e. communication, social or stereotyped behaviour concerns) or non-autism spectrum disorder-specific concerns (i.e. behaviour/temperament, developmental, medical, sensory or motor concerns). Some parents also reported on their positive and negative thoughts of a potential autism spectrum disorder diagnosis and what the diagnosis would mean to them. The most reported parental concerns before an assessment were speech and language, social and behavioural. To understand the types of concerns parents have once they seek medical help, further research into how families speculated a possible autism spectrum disorder is recommended.

Employment contributes to well-being, yet many autistic people who want to work face barriers to meaningful employment. Much research focuses solely on employment rates, rather than taking a more holistic view of professional trajectories and occupational experiences. We conducted semi-structured interviews with 18 autistic adults to explore their experiences of, and perspectives on, career success. Our participants highlighted the overarching importance of finding fulfilment in one's career. Using reflexive thematic analysis, we identified five additional key themes: (1) volatile career journeys, (2) the need for continuing career support, (3) the impact (positive or negative) of social interactions, (4) the important role of organisations and (5) the catastrophic impact of poor experiences. Our findings highlight the importance of tailored, lifelong employment support and inclusive workplaces in enabling autistic people to thrive at work. Enabling autistic career fulfilment requires moving beyond entry-level hiring to foster sustainable, fulfilling employment for all autistic people.Lay abstractMany autistic people want to work but have trouble finding jobs they like and can stick with. Most research tries to help more autistic people get jobs, but does not look at whether those jobs are fulfilling, or how people progress once they start working. We spoke to 18 autistic people about their experiences at work, and their ideas about success at work. Participants said finding fulfilment in their careers was key. We found five common 'themes' across the interviews. First, autistic people's careers often take unexpected turns. For example, many participants only got diagnosed as adults, which sometimes changed their work plans. Second, autistic people might need ongoing help with their career, including help with finding jobs they would enjoy and be good at, and advice on how to progress in their job. Third, getting along with others at work is really important. Having supportive colleagues helped our participants thrive, but workplace bullying forced some to leave their jobs. Fourth, workplaces need to be welcoming to everybody. Adjustments and understanding managers helped, but many of our participants' workplaces were not inclusive. Finally, bad work experiences can be devastating for mental health and well-being and negative experiences like bullying led some participants to quit working entirely. Our findings show that lifelong support tailored to each person and welcoming workplaces are important for autistic people to thrive at work. It is not enough to just hire autistic people - we need to help them have jobs they like and can stick with long-term.