Autism最新文献

Evidence supporting the association between breastfeeding patterns and autism is inconsistent. This study examined sociodemographic and birth factors related to breastfeeding duration and subsequent autism spectrum disorder (autism) diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition, compared to a neurotypically developing cohort, based on electronic health records. Demographics, feeding preferences, and breastfeeding duration as reported by parents during routine baby wellness visits were analyzed for a cohort of 11,766 (1.9%) children with autism spectrum disorder diagnosis and a random subsample of 12,000 (2.03%) neurotypically developing children. Autism spectrum disorder diagnosis was based on a national autism registry and assigned after electronic health records were completed. Preterm, very low birth weight, multiple births, and complex medical comorbidities were excluded. Infants subsequently diagnosed with autism were breastfed for an average of 5.0 months, 1.5 months shorter than neurotypically developing. Fewer autism spectrum disorder infants were exclusively breastfed in the first year of life. Two-way analysis of variance indicated a significant effect of socioeconomic status and autism spectrum disorder on breastfeeding duration, and a significant interaction of socioeconomic status with autism spectrum disorder. Shorter breastfeeding duration among infants with subsequent autism spectrum disorder was confirmed, calling for closer monitoring for autism traits in infants with breastfeeding difficulties. These challenges were independent of birth parameters; however, they were influenced by socioeconomic factors.Lay AbstractThis study found that infants later diagnosed with autism were breastfed for a shorter duration than their typically developing peers, with differences influenced by socioeconomic status. These findings highlight the importance of monitoring breastfeeding challenges as a potential early indicator of autism, particularly in families of mid-range socioeconomic status.

Mothers of autistic children often face unique emotional and financial challenges, contributing to heightened stress, poorer mental health and increased interparental conflict. This study examined interparental conflict over a 10-year period (child ages 4-14 years) among mothers of autistic children. The objectives were to: (1) compare interparental conflict levels between mothers of autistic and non-autistic children; (2) identify distinct interparental conflict trajectories among mothers of autistic children; and (3) examine the relationship between interparental conflict trajectories and mothers' psychological distress when their children were age 14 years. Data were drawn from six waves of the Longitudinal Study of Australian Children. There were 333 mothers of autistic children and 8145 mothers of non-autistic children. Mothers of autistic children reported significantly greater interparental conflict than mothers of non-autistic children, peaking at child ages 4-5 years. Two interparental conflict trajectories were identified for mothers of autistic children: consistently low and persistently elevated, with the latter associated with greater psychological distress. These results highlight the importance of tailored support for mothers of autistic children to reduce interparental conflict and improve maternal well-being, ultimately strengthening overall family functioning.Lay AbstractMothers raising autistic children often deal with more emotional and financial stress than mothers of non-autistic children, which can lead to more frequent interparental conflict. This study looked at how interparental conflict changed over 10 years, from when children were 4 to 14 years old. Researchers analysed data from a large, longitudinal Australian study of children. They compared two groups: 333 mothers of autistic children and 8145 mothers of non-autistic children. The study aimed to: (1) examine differences in interparental conflict between the two groups, (2) identify distinct patterns of interparental conflict among mothers of autistic children and (3) explore how these patterns related to mothers' psychological distress when their children were 14 years old. Mothers of autistic children experienced more interparental conflict than mothers of non-autistic children, particularly when their children were 4 to 5 years old. Two distinct interparental conflict patterns emerged among mothers of autistic children: one group experienced consistently low interparental conflict, while the other reported persistently elevated interparental conflict. Mothers in the persistently elevated interparental conflict group also reported greater psychological distress compared to those in the consistently low interparental conflict group. These results highlight the need for more personalised support for mothers of autistic children to help reduce interparental conflict and improve maternal well-being.

When an autistic person requires inpatient mental health support, they should be supported in mainstream services with reasonable adjustments. However, there is a lack of research into how autistic service users find their admissions to mental health wards. Ten United Kingdom-based autistic adults took part in semi-structured interviews to explore their experiences of being a mental health inpatient. These results were analysed using reflexive thematic analysis (RTA) and four themes were developed: 'I'm not mental health, I'm not autism, I'm just me', 'All the noise. All the people. All the unpredictability', 'You work out how to survive', and 'It's the usual set up, all the decisions had been made'. Results highlighted a negative overall appraisal of inpatient admissions, with specific difficulties in a lack of nuanced autism understanding, sensory environments, unpredictability and a felt sense of powerlessness. Findings indicate further autism training is required for staff working on inpatient wards, as well as changes to sensory environments that could benefit neurodivergent populations. These changes should detail how to put in place reasonable adjustments throughout a person's admission. Decisions around these factors should be made in collaboration with experts-by-experience to ensure effective intervention.Lay AbstractAt times, autistic adults who experience mental health difficulties may need to be supported in inpatient mental health care to manage risks to themselves and others. When this is the case, these adults should be able to access mainstream mental health services, and those supporting them should put in place reasonable adjustments to support their autistic needs. The researcher interviewed 10 UK-based autistic adults who had spent time in NHS England inpatient mental health wards to find out about their experiences. All participants found their time on mental health wards difficult, and there were some common reasons for this, including: autism needs not being recognised or understood, the environment of the ward not fitting their needs, and feeling as though they had no power to make changes in their care. This suggests that changes need to be made to how inpatient mental health care is delivered to autistic service users.

This study aimed to identify guiding principles to underpin assessment and diagnosis of autism to improve the quality, consistency and accuracy of services provided to individuals and their families. An online survey and focus groups were used to capture community perspectives of members of the Australian autistic and autism communities. A total of 871 individuals participated across the research activities, including autistic individuals (n = 253), parents of autistic individuals (n = 344), practitioners (n = 325) and members of organisations with an interest in the assessment and/or diagnosis of autism (n = 115). Three overarching themes, encompassing 15 codes, representing the principles that should underpin practice across the assessment and diagnostic process were developed (a) placing the person at the centre of the process; (b) understanding and valuing the whole person and (c) improving quality and access. Assessment and diagnosis for autism should go beyond diagnostic decision-making to include understanding of individual needs and identifying support pathways. The principles identified serve as a first step to guiding practitioners in their approach, ensuring they work in ways that promote best practice, reflect the perspectives of autistic people and engender meaningful outcomes for individuals and families that are independent of receiving a diagnostic label.Lay AbstractThis study looked to identify principles of practice that could help make autism assessments and diagnoses better for autistic people and their families. To do this, the researchers asked people from the autism community in Australia to share their thoughts through an online survey and focus groups. A total of 871 people took part. This included autistic adults, parents of autistic children, professionals like psychologists and speech pathologists and people from autism-related organisations. From what people said, three main ideas stood out: (a) putting people at the centre of the process, (b) looking at the whole person and (c) improving quality and access to services. The study found that getting a diagnosis is just one part of the process. It is also important to use the assessment to help people understand themselves better and find the right support. The principles highlighted in this study can help guide professionals to do a better job when assessing autism. They encourage practices that are respectful, person-focused and based on what autistic people and their families say is important. This can lead to better outcomes for everyone, no matter whether a diagnosis is given or not.

This study investigated whether parental emotion-regulation difficulties are prospectively associated with increased emotion-regulation challenges in autistic children and adolescents and explored the underlying mechanisms and behavioral implications of these potential intergenerational associations. Over three time points (T1, T2, T3) spanning 2 years, 363 parents of autistic children and adolescents from Hong Kong provided questionnaire data. Path analyses revealed that parental emotion-regulation difficulties at T1 were associated with greater negative emotional expressiveness at T2, which in turn was linked to increased emotion-regulation difficulties and more internalizing and externalizing problems in autistic children and adolescents at T3. Importantly, these findings indicate that when parents have difficulty regulating their emotions and express negativity, their autistic children and adolescents are more likely to face emotion-regulation challenges and exhibit behavior problems. This underscores the need to support parents in regulating their emotions and optimizing their emotional expressiveness. Clinicians and policymakers should help parents strengthen their emotion regulation and enhance their emotional well-being by building coping strategies and fostering supportive environments. By promoting parents' emotional wellness, we may also improve psychological adjustment and behavioral outcomes for their autistic children and adolescents.Lay abstractParents of autistic children and adolescents often experience high levels of parenting stress and face challenges in managing their own negative emotions. These emotional struggles can impact their autistic children and adolescents during everyday interactions, potentially intensifying the emotional and behavioral difficulties they experience. This study examined whether parents' emotion-regulation patterns are longitudinally linked to the development of emotion regulation in their autistic children and adolescents. The findings revealed that when parents had difficulty regulating their emotions and frequently expressed negative emotions, their autistic children and adolescents were more likely to face emotion-regulation challenges and experience personal distress and interpersonal difficulties. This underscores the importance of supporting parents in regulating their emotions and optimizing their emotional expressiveness. Clinicians and policymakers should assist parents in strengthening their emotion regulation and enhancing their emotional well-being by building coping strategies and fostering supportive environments. By promoting parents' emotional wellness, we may also improve psychological adjustment and behavioral functioning for their autistic children and adolescents.

Caregivers' adjustment to their child's autism diagnosis has important implications for child and caregiver outcomes. However, there has been substantial variability in definitions and measurement of caregiver adjustment to autism diagnosis. This study reports a systematic review of measures of caregivers' adjustment to their child's autism diagnosis, and the effectiveness of intervention for caregiver adjustment. A systematic review (PROSPERO CRD42023463196) was conducted according to PRISMA guidelines. Adjustment was defined as caregivers' psychological response to their child's autism diagnosis. Database searches yielded 6345 unique articles, which were title and abstract screened. Full text screening was completed for 428 articles. Mixed Methods Appraisal Tool (MMAT) was used to assess study quality. The review identified 78 articles, which included 42 measures of adjustment and eight interventions targeting adjustment, four of which produced significant improvement in adjustment. Study quality was mostly adequate. The review identified a need for consensus on defining and measuring caregiver adjustment. The review also identified the need for fathers, caregivers who are autistic, and caregivers of adults to be more included in adjustment research. There is preliminary evidence for interventions supporting adjustment, but further research is needed.Lay abstractThe process of understanding and accepting a child's diagnosis of autism, known as adjustment, is important for the ongoing well-being of autistic people and their caregivers. The way that researchers have defined and measured adjustment has not been consistent. This article reports a systematic review aiming to identify how adjustment has been defined and measured in published research. The review also aimed to identify interventions that have targeted caregiver adjustment and see whether they are effective. The review identified 78 articles, which included 42 measures of adjustment and eight interventions. Four of the interventions demonstrated significant benefits for adjustment. There is a need for further research to develop a consensus regarding definition and measurement of adjustment, so that adjustment can be measured more consistently across studies. There is also a need for research looking at whether existing interventions for autism have benefits for caregiver adjustment, and to conduct more rigorous evaluations of any new adjustment interventions that are developed.

Students with autism spectrum disorder have an impact on their social, communication, and behavioral skills. Existing studies primarily focus on autism detection and diagnosis but lack effective approaches for predicting autism spectrum disorder levels and linking them to personalized educational strategies. This research aims to develop an autism-level categorization and a tailored education plan recommendation system for autistic students. The proposed methodology involves collecting a data set with attributes such as verbal ability, social interaction, sensory sensitivity, and attention span for students with autism spectrum disorder. These features are preprocessed and used to train a TabNet model to categorize the autism level. The system recommends a personalized education plan through a web application, based on prediction. This study uniquely integrates autism spectrum disorder-level prediction with education planning, achieving an accuracy of 99.37% and precision of 98.91% using the Autism Spectrum Classification for Education Planning data set. This shows the proposed model effectively categorizes autism levels and provides an education plan recommendation system for autistic students.Lay abstractAutism spectrum disorder (ASD) is a critical neurodevelopmental disorder affecting the social and communication skills of autistic students. People with autism spectrum disorder can have different levels of support needs in daily life; understanding these levels is important for providing a correct educational plan for autistic students. We develop a system that predicts the level of support needed for a student and then recommends a personalized educational plan. The system uses information such as the student's verbal communication skills, social interaction abilities, sensory sensitivity, and attention span. After predicting the level, the system applies a predefined set of rules to suggest specific teaching methods. These are utilized in matching the abilities and needs of the autistic students to study effectively. We developed an interactive web application that enables parents or teachers to input a student's details and obtain both the support level and personalized learning suggestions. The outcome indicates that the method combines early and correct autism spectrum disorder-level prediction with practical teaching methods, making education more personalized and effective for autistic students.

Autistic youth experience high rates of self-harm and suicidal ideation, and substantial barriers to adequate mental health care. Research suggests that mental health services may not meet the needs of autistic individuals, though autistic youth experiencing self-harm and suicidal ideation are underrepresented in this literature. The present study aimed to explore experiences of self-harm, suicidal ideation and mental health care among a sample of autistic youth recruited through two Australian government-funded youth mental health services. Online interviews with seven autistic participants aged 15-23 years were transcribed and thematically analysed using a reflexive approach. Four themes and two subthemes were generated: (1) social rejection as risk, and connection as protection; (2) overwhelming emotions can lead to self-harm and hinder help-seeking; (3) feeling (mis)understood and (in)adequately accommodated by clinicians (comprising two subthemes related to poor understanding and accommodation of autism within mental health services); and (4) safety planning can feel like a box-ticking exercise. These findings highlight the importance of social connectedness as a protective factor against self-harm and suicidal ideation for autistic youth, and the necessity of improving understanding and accommodation of autism in mental health care settings and suicide interventions.Lay abstractAutistic people under the age of 25 experience high rates of self-harm and suicidal thoughts. Previous research has found that mental health care provided by professionals like psychologists might not meet the needs of autistic people. However, this research has usually focused on autistic adults, so less is known about the experiences of younger autistic people. In this study, we spoke with seven autistic young people aged between 15 and 23 years, and asked about their experiences of self-harm, suicidal thoughts and mental health care. Many participants had experienced social rejection or bullying, which contributed to their self-harm and suicidal thoughts. However, positive relationships with family, friends and others were a source of support when they were struggling. Self-harm was described as a way to cope with strong negative emotions, but many participants found it hard to talk about or describe those emotions, which made it difficult to get support. The help they received from psychologists for their self-harm and suicidal thoughts was impacted by how well the psychologist understood autism, and whether they were willing to accommodate the participants' individual needs and preferences. Participants had created suicide safety plans as part of the mental health care they received, but many felt like they had to do this just for the sake of doing it, rather than creating a plan that was truly helpful.