There is a lack of representation of racially diverse individuals who are multilingual from low-income households in autism research. This calls into question the generalizability of research findings derived from predominantly White, English-speaking samples. In this article, we bring forth an important argument about why we as an autism field should work to expand representation in research samples. We also discuss strategies that can be used to work toward this goal. We detail the recruitment and retention of 94 Spanish-English bilingual Latinx (primarily Mexican and Central American) families from low-income households across a large urban city and its surrounding communities in the United States for an assessment validation study. We use the method of this study as an example of how to engage and include underrepresented populations in autism research, describing the efforts that were implemented to engage families and community-based organizations serving this population. We conclude the report by summarizing culturally sensitive strategies researchers can use to engage populations of different races and ethnicities from low-income households in their own research studies, in hopes of increasing representation in the autism science field and ensuring that research findings are applicable across populations, including those who have been historically underrepresented.Lay AbstractIndividuals of different races and identities from low-income households and their families are not adequately represented in research. This makes it difficult to know whether autism research findings apply to traditionally underserved individuals of color, since participants included in studies are usually White and speak English. We use our own study, where we successfully recruited 94 Spanish-English bilingual participants who are from Mexico and Central America but are currently living in the United States in low-income households for an assessment study, as an example to describe the strategies that were helpful to recruit participants with these sociodemographic characteristics. We end the article by discussing strategies that are culturally appropriate for researchers to consider when working with autistic populations of color who are from predominantly low-income households and their families.
Neurodevelopmental conditions (NDC) are highly heritable. Obstetric complications (OC) have been studied as potential predictors for NDC, although results are inconsistent. Inconsistencies might be related to biases such as family confounders. While some studies using sibling and twin designs have examined the association between OC and NDC, this body of research remains limited, and findings to date remain inconsistent. We used a case-control sibling study including children aged 6-17 years across five groups: those diagnosed with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), co-occurring ASD + ADHD, their unaffected siblings and a comparison group without NDC. For analytic purposes, we created a combined NDC group including all individuals with ASD, ADHD or both. Participants were recruited between 2021 and 2022 from a tertiary hospital in Spain. We examined the association of NDC and OC using single predictors and cumulative OC. The study adheres to the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines. A total of 238 participants were included (NDC = 117, unaffected siblings = 82, comparison group = 39). We found that NDC individuals showed more neonatal complications than the comparison group (β = 1.73, 95% CI = 1.00-2.98, p = 0.04), which remained significant in the sibling analysis (β = 1.43, 95% CI = 1.02-2.00, p = 0.04). This study supports that the cumulative neonatal complications, rather than specific factors, are associated with increased likelihood of being diagnosed with NDC, beyond familial confounding. Results highlight the neonatal period as a relevant window of vulnerability.Lay AbstractThe role of complications during pregnancy in neurodevelopmental disorders: a sibling studyThis study examined the association between complications during pregnancy and autism, attention-deficit/hyperactivity disorder and the combination of both conditions. We compared children with these conditions and their siblings, as well as a group comparison without diagnosed neurodevelopmental disorders. We gathered information through parents' interviews. We found that children with autism or attention-deficit/hyperactivity disorder presented more problems in the first 4 weeks of the child's life than their siblings and the group of comparison. We did not find that children with these conditions present more complications during pregnancy. In addition, we observed that the probability of being diagnosed with these conditions is increased due to cumulative problems rather than specific problems.
This study aimed to identify sensory subtypes in preschool children on the autism spectrum in Japan and examine their associations with participation and family functioning. A total of 264 caregivers of preschool children aged 3-6 years on the autism spectrum participated in the study. Data were collected from 56 child development centers and medical institutions across Japan. Sensory features were assessed using the Japanese version of the Short Sensory Profile, and five sensory subtypes were identified: Taste/Smell Sensitive, Extremely Atypical, Mixed Sensory, Gravitational Insecurity and Motor Difficulty, and Adaptive. These subtypes were associated with distinct participation restrictions, such as activities of daily living (ADL)-related challenges in the Mixed Sensory group, leisure-related difficulties in the Taste/Smell Sensitive group, and limitations across all domains in the Extremely Atypical group. Significant differences in family functioning were also observed in domains related to interaction with the external environment of the family, with the Extremely Atypical group showing support needs. These findings underscore the importance of developing tailored intervention strategies for each sensory subtype.Lay abstractThis study examined the impact of differences in sensory processing on the daily lives of preschool children with autism spectrum disorder in Japan, as well as how these differences influence their families. Caregivers of children aged 3-6 years from 56 centers and medical institutions took part in the study. Through a questionnaire, we identified five sensory types among the children: those sensitive to taste and smell, those with highly unusual sensory responses, those with a mix of sensory challenges, those struggling with balance and movement, and those with more adaptive sensory responses. Each sensory type encountered specific challenges in daily activities. For example, children with mixed sensory challenges had difficulties with basic tasks such as eating or dressing, while those sensitive to taste and smell faced challenges in leisure activities. Children with highly unusual sensory responses experienced difficulties in all areas of daily life. These challenges also impacted family dynamics, especially in how families engaged with their surroundings. Families of children with highly unusual sensory responses often required additional support. Our findings emphasize the necessity for personalized support and intervention strategies tailored to each child's unique sensory subtype, which can enhance their participation in daily activities and promote their family's well-being.
This study examines how multilingual caregivers use their linguistic resources to support their autistic children's language development, challenging historical narratives recommending therapists use only one language, English. Using a critical language socialization framework in which multilingualism is considered a practice that transcends linguistic competence, we analyzed 108 videos from five Spanish-dominant, Mexican heritage families. Findings showed that (1) families flexibly used their linguistic resources in daily interactions; (2) home activity settings predicted language use in distinct ways, transportation activities provided fewer constraints for interlocutors to use decontextualized language, language for abstract reasoning and prediction; and (3) variability in maternal scaffolding strategies influenced children's decontextualized language. We recommend the implementation of asset-based interventions designed to leverage the strengths of multilingual autistic children and their families.Lay AbstractMexican heritage bilingual mothers of autistic children use a variety of language practices when talking with their children. We asked mothers to video record their language interactions with their autistic child over 10 days. Specifically, we analyzed the verbal language practices parents and children used during daily routine activities (e.g. meals). Historically, therapists have recommended that multilingual families only use English when talking with their autistic children, so as not to confuse them and interfere with their development. It is important to understand how multilingual parents use this non-empirical advice. In our sample, we found that mothers used a variety of language strategies including Spanish, English, describing and labeling their environment, action directions (directing a child to perform an action), close-ended questions (e.g. what color is this?), open-ended questions (e.g. How does the radio work?), and abstract reasoning to interact with their children. These strategies varied across activity settings. In particular, transportation was an important setting for children to use abstract language. Mothers' verbal strategies influenced children's language output, including children's use of abstract reasoning and prediction, one of the most complex language strategies.
Black caregivers of children with autism express that there are gaps in both knowledge and acceptance of disabilities within their communities. This lack of information and resources provided to Black communities can lead to tensions within families regarding autism diagnoses and how to support individuals with autism in their families. As part of a larger qualitative study, 23 Black caregivers of children with autism shared their experiences with the messages received from family members about their child's autism diagnosis. Two overarching themes emerged regarding family messaging: Lack of Understanding and Denial of Autism and Supportive Acceptance and Inclusion. Six subthemes were identified that highlight the nuance within the messaging content. These findings can inform strategies to develop culturally tailored interventions to support Black caregivers in navigating the range of messages received from family members when their child receives a diagnosis of autism. Further research should build on these findings to investigate how directly this family messaging links to broader messaging in Black culture regarding autism, as well as how both family and cultural messaging may interact with factors such as awareness or use of autism resources, attitudes toward research, and long-term social and behavioral outcomes for Black children with autism.Lay abstractBlack caregivers of children with autism say there are gaps in knowledge and acceptance of disabilities in their communities. This lack of information and resources can cause tensions in families about autism diagnoses and how to support their children. This study talked to 23 Black caregivers to learn about their experiences with the messages they received about their child's autism diagnosis from family members. We found two main themes: Lack of Understanding and Denial of Autism, and Supportive Acceptance and Inclusion. Within these themes, parents shared different experiences, like family members denying autism exists, not wanting to learn about it, or being very supportive and inclusive. Black caregivers also talked about the emotional toll the negative messages take on them. This work is important because it can help create culturally tailored support for Black caregivers of children with autism, so that they can engage with family members in more supportive ways. Future research should look at how these messages affect the use of autism resources, attitudes toward research, and long-term outcomes for Black children with autism.

