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Time is of the essence: Age at autism diagnosis, sex assigned at birth, and psychopathology. 时间是关键:自闭症诊断年龄、出生时的性别分配和精神病理学。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-11-01 Epub Date: 2024-05-09 DOI: 10.1177/13623613241249878
Jessica V Smith, Goldie A McQuaid, Gregory L Wallace, Emily Neuhaus, Andrea Lopez, Allison B Ratto, Allison Jack, Alexis Khuu, Sara J Webb, Alyssa Verbalis, Kevin A Pelphrey, Lauren Kenworthy

Lay abstract: Previous research has shown that girls/women are diagnosed later than boys/men with autism. Individuals who are diagnosed later in life, especially girls/women, have greater anxious and depressive symptoms. Previous research has been limited due to narrow inclusionary criteria for enrollment in studies. The present study uses two samples-one clinic-based, large "real-world" sample and another research-based sample with strict criteria for autism diagnosis-to understand the relationships between diagnostic age, sex assigned at birth, and symptoms of anxiety/depression. In both samples, those who were diagnosed later had greater anxious/depressive symptoms, and anxiety was not predicted by sex. In the clinic-based but not research-based sample, those assigned female at birth were diagnosed later than those assigned male at birth. In the clinic-based sample only, individuals assigned female at birth and who were later diagnosed experienced greater symptoms of anxiety/depression compared to those assigned male who benefited from earlier diagnostic timing. Within the research-based sample, those assigned female at birth had greater depressive symptoms than those assigned male. These findings highlight the importance of timely identification of autism, especially for girls/women who are often diagnosed later. Community-based samples are needed to better understand real-world sex-based and diagnostic age-based disparities in mental health.

内容提要:以往的研究表明,女孩/女性比男孩/男性更晚被诊断出患有自闭症。晚期确诊的患者,尤其是女孩/女性,焦虑和抑郁症状更为严重。以往的研究由于纳入研究的标准较窄而受到限制。本研究使用了两个样本--一个是以诊所为基础的大型 "真实世界 "样本,另一个是以研究为基础的、有严格自闭症诊断标准的样本--来了解诊断年龄、出生时的性别分配与焦虑/抑郁症状之间的关系。在这两个样本中,被诊断较晚的人焦虑/抑郁症状更严重,而焦虑并不受性别的影响。在以诊所为基础而非以研究为基础的样本中,出生时被分配为女性的人比出生时被分配为男性的人诊断较晚。仅在诊所样本中,与因诊断时间较早而获益的男性患者相比,出生时被分配为女性且诊断时间较晚的患者的焦虑/抑郁症状更为严重。在以研究为基础的样本中,出生时被分配为女性的人比被分配为男性的人有更严重的抑郁症状。这些研究结果突显了及时发现自闭症的重要性,尤其是对于那些通常较晚才被诊断出来的女孩/女性。我们需要基于社区的样本,以更好地了解现实世界中基于性别和诊断年龄的心理健康差异。
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引用次数: 0
'It's not always textbook social anxiety': A survey-based study investigating the nature of social anxiety and experiences of therapy in autistic people. 这并不总是教科书上的社交焦虑":一项基于调查的研究,调查自闭症患者社交焦虑的性质和治疗经历。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-11-01 Epub Date: 2024-05-14 DOI: 10.1177/13623613241251513
Alexander C Wilson, Fiona Gullon-Scott

Lay abstract: The nature of social anxiety has been widely researched in non-autistic people. This existing research has allowed therapists to develop effective therapy for social anxiety in non-autistic people. Meanwhile, some research suggests that autistic people may have different experiences of anxiety compared to non-autistic people. In addition, there is some evidence that modified therapy may help autistic people with social anxiety, although we also know that many autistic people feel failed by existing mental health services.This article provides a detailed picture of social anxiety in autistic people. This includes similarities and differences compared to non-autistic people. In terms of similarities, people often described feeling afraid that others would judge them, and this would have negative consequences. In terms of differences, autistic people commonly reported a clash between their traits and their social environment, which caused them distress and discomfort. This included factors only rarely reported by non-autistic people (such as struggling with too much sensory stimulation or inaccessible forms of communication and encountering discrimination for these problems). Based on this, we propose a 'distinct' model of social anxiety with particular relevance to autistic people. In addition, many participants reported negative experiences in therapy for social anxiety. They thought therapists wrongly viewed their fears of social situations as irrational and ungrounded. They thought therapists did not adapt the therapy process in an individualised way and did not understand neurodiversity or recognise neurodivergence.Standard approaches for social anxiety may not always suit autistic people, so this needs further exploration. We highlight several practical recommendations for therapists offering therapy for social anxiety to autistic people.

内容提要:对非自闭症患者社交焦虑的本质进行了广泛的研究。现有的研究使治疗师能够针对非自闭症患者的社交焦虑症开发出有效的疗法。与此同时,一些研究表明,与非自闭症患者相比,自闭症患者可能有不同的焦虑体验。此外,有证据表明,改良疗法可以帮助自闭症患者缓解社交焦虑,尽管我们也知道,许多自闭症患者感到现有的心理健康服务很失败。本文详细介绍了自闭症患者的社交焦虑,包括与非自闭症患者的异同。就相似之处而言,自闭症患者经常描述他们害怕别人对他们评头论足,从而产生负面影响。在差异方面,自闭症患者通常表示他们的特质与社会环境之间存在冲突,这给他们造成了困扰和不适。这其中包括非自闭症患者很少提到的因素(如与过多的感官刺激或无法接触的交流方式作斗争,以及因这些问题而遭受歧视)。在此基础上,我们提出了一个与自闭症患者特别相关的 "独特 "社交焦虑模型。此外,许多参与者表示在社交焦虑的治疗过程中有负面的经历。他们认为治疗师错误地将他们对社交场合的恐惧视为非理性和无根据的。他们认为治疗师没有以个性化的方式调整治疗过程,不了解神经多样性,也没有认识到神经差异性。治疗社交焦虑的标准方法可能并不总是适合自闭症患者,因此这需要进一步探讨。我们强调了治疗师为自闭症患者提供社交焦虑治疗的几项实用建议。
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引用次数: 0
The impact of educational and medical systems on autistic children from multilingual American homes: A systematic review. 教育和医疗系统对来自多语言美国家庭的自闭症儿童的影响:系统回顾。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-11-01 Epub Date: 2024-04-10 DOI: 10.1177/13623613241242839
Hyejung Kim, Diana Baker, Sunyoung Kim, Cong Liu, Kelley Cook

Lay abstract: Research has found that autistic children can navigate multilingual schools and communities without harming their language skills or school success. However, they may encounter specific challenges within the United States, where educational and healthcare systems are insufficiently equipped to meet their needs. This review examined 46 US-based studies on the topic and findings reveal persistent deficit-based ideas about multilingualism and autism (e.g., professionals recommending that autistic students only speak and learn in English) accompanied by patterns of unequal identification of autism among multilingual children. These findings highlight issues of disproportionality and inadequate access to educational and healthcare resources. However, recent studies indicate that incorporating a child's native language in education not only enhances learning and behavioral outcomes but also boosts cognitive functions like problem-solving and planning. Taken as a whole, current research suggests that intentionally addressing linguistic diversity will allow educational and medical systems to better serve autistic children.

内容提要:研究发现,自闭症儿童可以在多语言学校和社区中游刃有余,而不会损害他们的语言技能或学业成就。然而,在美国,他们可能会遇到特殊的挑战,因为美国的教育和医疗保健系统不足以满足他们的需求。本综述研究了 46 项关于该主题的美国研究,研究结果表明,关于多语言和自闭症的赤字观念(例如,专业人士建议自闭症学生只说英语和用英语学习)持续存在,同时多语言儿童中自闭症的识别率也不平等。这些发现凸显了教育和医疗资源不均衡和获取不足的问题。然而,最近的研究表明,在教育中融入儿童的母语不仅能提高学习和行为成果,还能增强认知功能,如解决问题和制定计划。总体而言,目前的研究表明,有意识地解决语言多样性问题将使教育和医疗系统更好地服务于自闭症儿童。
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引用次数: 0
Neurodiversity paradigms and their development across cultures: Some reflections in East Asian contexts. 神经多样性范式及其在不同文化中的发展:东亚背景下的一些思考。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-11-01 Epub Date: 2024-10-06 DOI: 10.1177/13623613241285678
Tomoya Hirota, Keun-Ah Cheon, Meng-Chuan Lai
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引用次数: 0
Considerations for effective dissemination of evidence-based early intervention approaches. 有效传播循证早期干预方法的考虑因素。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-11-01 Epub Date: 2024-05-05 DOI: 10.1177/13623613241253117
Sophia R D'Agostino, Kyle M Frost, Katherine Pickard

Lay abstract: Dissemination, or the widespread sharing of information, is important for moving research evidence into community practice. Early intervention programs for young autistic children have not yet been widely disseminated to the early childhood workforce. This letter describes factors that may support or prevent dissemination to community-based settings, such as packaging and branding early intervention approaches. We argue that an increased focus on dissemination research is needed.

内容提要:传播或广泛共享信息对于将研究证据转化为社区实践非常重要。针对自闭症幼儿的早期干预计划尚未在儿童早期工作者中广泛传播。这封信描述了可能支持或阻碍向社区环境传播的因素,如早期干预方法的包装和品牌。我们认为,需要更加重视传播研究。
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引用次数: 0
The Neurodiversity Attitudes Questionnaire: Development and Initial Validation. 神经多样性态度问卷:开发与初步验证。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-11-01 Epub Date: 2024-04-28 DOI: 10.1177/13623613241245756
Rachel K Schuck, Sunghee Choi, Kaitlynn Mp Baiden, Patrick Dwyer, Mirko Uljarević

Lay abstract: Neurodiversity refers to the idea that brain differences (including disabilities) are valuable and should be accepted. Attitudes toward neurodiversity can have real-life impacts on the lives of neurodivergent people (those whose brains do not fit society's "standard"). These impacts can include effects on daily interactions, as well as how professionals such as teachers and doctors deliver services to neurodivergent people. In order to identify negative attitudes toward neurodiversity and potentially improve them, we first need to measure these attitudes. This article describes the development of the Neurodiversity Attitudes Questionnaire (NDAQ). NDAQ development included revision of questionnaire items based on feedback from experts and neurodivergent people, systematically evaluating the way participants responded to questionnaire items, and analysis of how the NDAQ items are grouped into different factors. A preliminary analysis with 351 individuals mostly living in the United States who were currently working or planning to work in a helping profession (e.g. doctors, teachers, therapists, and so on) indicates that the NDAQ measures attitudes toward neurodiversity, is well understood by participants, and fits a five-factor structure. While the NDAQ represents the first instrument designed to specifically assess attitudes toward the broad idea of neurodiversity, further work is still needed.

内容提要:神经多样性是指大脑差异(包括残疾)是有价值的,应该被接受。对神经多样性的态度会对神经变异者(大脑不符合社会 "标准 "的人)的生活产生实际影响。这些影响包括对日常互动的影响,以及教师和医生等专业人员如何为神经变异者提供服务。为了识别人们对神经多样性的消极态度并加以改进,我们首先需要对这些态度进行测量。本文介绍了神经多样性态度问卷 (NDAQ) 的开发过程。NDAQ 的开发包括根据专家和神经多 样性人士的反馈意见对问卷项目进行修订,系统评估参与者对问卷项目的反应方式,以及分析 NDAQ 项目如何被归类为不同的因素。通过对 351 名主要生活在美国,目前正在或计划从事帮助性职业(如医生、教师、治疗师等)的人进行初步分析,结果表明 NDAQ 能够测量人们对神经多样性的态度,参与者能够很好地理解,并且符合五因素结构。虽然 NDAQ 是首个专门用于评估对神经多样性这一广泛概念的态度的工具,但仍需开展进一步的工作。
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引用次数: 0
Validating the Child Behavior Checklist 1.5-5 as a screening tool for autism spectrum disorder. 验证儿童行为检查表 1.5-5 作为自闭症谱系障碍筛查工具的有效性。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-10-29 DOI: 10.1177/13623613241293088
Norton Kitanishi, Daniela Bordini, Marcos V V Ribeiro, Cristiane Silvestre Paula, Helena Brentani, Joana Portelese, Pamela J Surkan, Silvia S Martins, Jair de Jesus Mari, Paola Matiko Martins Okuda, Sheila C Caetano

Lay abstract: Early identification of Autism Spectrum Disorder is very important, especially in low and middle-income countries, where access to resources is often limited. The Child Behavior Checklist 1.5-5 is a tool that has been used to help identify children with autism spectrum disorder through specific behavior patterns. However, its effectiveness in low- and middle-income country settings has not been thoroughly studied. This research focused on evaluating the Child Behavior Checklist 1.5-5 as a screening tool for autism spectrum disorder among Brazilian children. The study involved 1292 children aged 3-5 years from the general population and 70 children with autism spectrum disorder aged 1-5 years. Using advanced statistical methods, the study tested how well the Child Behavior Checklist identified children with autism spectrum disorder and how reliable it was in this context. The findings showed that the Child Behavior Checklist 1.5-5 performed well in identifying autism spectrum disorder, with high reliability and consistency in the results. Although one item in each of the autism spectrum problems and withdrawn syndrome subscales did not perform as strongly, the overall tool was effective. In summary, the Child Behavior Checklist 1.5-5 proves to be a reliable and valid tool for early autism spectrum disorder screening in Brazilian children. This can help ensure that more children in low- and middle-income country settings are identified early and receive the necessary support and interventions to help them thrive. Future research should continue to test this tool in different contexts to confirm its usefulness across various populations.

内容提要:早期识别自闭症谱系障碍非常重要,尤其是在中低收入国家,因为这些国家获得的资源往往有限。儿童行为核对表 1.5-5 是一种通过特定行为模式帮助识别自闭症谱系障碍儿童的工具。然而,该工具在中低收入国家环境中的有效性尚未得到深入研究。本研究重点评估了儿童行为核对表 1.5-5 作为自闭症谱系障碍筛查工具在巴西儿童中的应用情况。研究涉及 1292 名 3-5 岁的普通儿童和 70 名 1-5 岁的自闭症谱系障碍儿童。研究采用先进的统计方法,测试了儿童行为量表对自闭症谱系障碍儿童的识别能力和可靠性。研究结果表明,儿童行为检查表 1.5-5 在识别自闭症谱系障碍方面表现良好,结果具有高度可靠性和一致性。虽然自闭症谱系障碍和孤僻综合症子量表中各有一个项目表现不佳,但总体而言,该工具还是有效的。总之,儿童行为核对表 1.5-5 被证明是一种可靠有效的工具,可用于巴西儿童自闭症谱系障碍的早期筛查。这有助于确保更多中低收入国家的儿童及早得到识别,并接受必要的支持和干预,帮助他们茁壮成长。未来的研究应继续在不同环境中测试该工具,以确认其在不同人群中的实用性。
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引用次数: 0
'It's designed for someone who is not me': A reflexive thematic analysis of the unmet healthcare support needs in UK autistic adults aged 65 years and over. 这是为不是我的人设计的":对英国 65 岁及以上自闭症成人未得到满足的医疗保健支持需求的反思性专题分析。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-10-29 DOI: 10.1177/13623613241291081
Hassan Mansour, Amy Gillions, Jude Brown, Anoushka Pattenden, Susan Hartley, Sarifa Patel, Stephanie James, Martin Styles, Will Mandy, Joshua Stott, Elizabeth O'Nions

Lay abstract: Autistic people often face both physical and mental health challenges throughout their lives, which can lead to a higher risk of premature death due to health inequalities. However, we know very little about the healthcare experiences of autistic older adults. In this study, we talked with 19 autistic adults aged 65 years or above living in the United Kingdom. We found these main themes: (1) A lifetime of being misunderstood; (2) Autistic people falling between the gaps; (3) Processing autism diagnosis in later life; (4) Concerns about service pressures and scarce resources; (5) Lack of continuity of care, empathy and understanding; (6) Anxiety, alexithymia and sensory overload; and (7) Reduced social support and concerns for the future. Themes show that autistic older adults face unique healthcare access challenges because services don't consider their lifelong experiences of social exclusion. Participants also worried about age-related decline coupled with reduced social support, which makes it harder for them to get support. To address these challenges, healthcare services should provide more targeted support, make policies and funding consistent, and improve healthcare provision by providing staff training. Importantly, they must also speak with autistic older adults so they can advocate for their current and future care.

内容提要:自闭症患者一生中常常面临身体和心理健康的双重挑战,这可能会导致他们因健康不平等而过早死亡的风险更高。然而,我们对自闭症老年人的医疗保健经历知之甚少。在这项研究中,我们与 19 名居住在英国、年龄在 65 岁或以上的自闭症成年人进行了交谈。我们发现了以下主要主题:(1)终生被误解;(2)自闭症患者被夹在中间;(3)晚年生活中对自闭症诊断的处理;(4)对服务压力和资源稀缺的担忧;(5)缺乏持续护理、同情和理解;(6)焦虑、自闭症和感官超负荷;以及(7)社会支持减少和对未来的担忧。这些主题表明,患有自闭症的老年人在获得医疗服务方面面临着独特的挑战,因为医疗服务没有考虑到他们终生被社会排斥的经历。参与者还担心与年龄相关的衰退以及社会支持的减少,这使得他们更难获得支持。为了应对这些挑战,医疗服务机构应提供更有针对性的支持,使政策和资金保持一致,并通过提供员工培训来改善医疗服务的提供。重要的是,他们还必须与患有自闭症的老年人进行交流,以便他们能够为自己当前和未来的护理工作进行宣传。
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引用次数: 0
Prevalence, incidence, and characteristics of autism spectrum disorder among children in Beijing, China. 中国北京儿童自闭症谱系障碍的患病率、发病率和特征。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-10-29 DOI: 10.1177/13623613241290388
Yanan Zhao, Feng Lu, Ruoxi Ding, Dawei Zhu, Rong Zhang, Siwei Sun, Ping He, Xiaoying Zheng

Lay abstract: It is the first study to explore the prevalence, incidence, and co-occurring conditions of autism spectrum disorder for the preschoolers in China. The prevalence and incidence of autism spectrum disorder has increased in recent decades. Autism spectrum disorder has become an important public concern worldwide. In this study, all hospital confirmed cases had an associated diagnosis (International Classification of Diseases, 10th revision (ICD-10) codes: F84.0, 84.5, F84.9). In total, 4457 children aged 4-6 years were identified as having autism spectrum disorder. In 2021, 1 in 95 children aged 6 years, 1 in 115 children aged 5 years, and 1 in 130 children aged 4 years were estimated to have autism spectrum disorder in Beijing. The incidence was 0.11% in 2019 and increased to 0.18% in 2021. There has been a great emphasis on the importance of early autism spectrum disorder diagnosis in large cities in China.

内容提要:该研究首次探讨了中国学龄前儿童自闭症谱系障碍的患病率、发病率和共病情况。近几十年来,自闭症谱系障碍的患病率和发病率呈上升趋势。自闭症谱系障碍已成为全世界公众关注的重要问题。在本研究中,所有医院确诊病例均有相关诊断(《国际疾病分类》第 10 次修订版(ICD-10)代码:F84.0、F84.5、F84.6、F84.7):F84.0、84.5、F84.9)。共有 4457 名 4-6 岁儿童被确认患有自闭症谱系障碍。据估计,2021 年北京每 95 名 6 岁儿童中就有 1 名、每 115 名 5 岁儿童中就有 1 名、每 130 名 4 岁儿童中就有 1 名患有自闭症谱系障碍。2019 年的发病率为 0.11%,2021 年将增至 0.18%。自闭症谱系障碍早期诊断的重要性在中国大城市得到了高度重视。
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引用次数: 0
The to be, or not to be, of acting autistic. 自闭症的 "要 "与 "不要"。
IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-10-29 DOI: 10.1177/13623613241290270
Michelle Dean, Anders Nordahl-Hansen

Lay abstract: Autistic characters are becoming more common in film and television, and a growing number of production companies are making efforts to hire autistic actors to play autistic characters. The purpose of this study is to learn about the experiences of professional autistic actors who have played autistic characters in professional media productions. We also explored autistic actors' impressions of the autistic characters they have seen on screen. We interviewed nine professional autistic actors, who discussed their experiences as professional actors playing autistic characters. Interviews revealed the following themes, including (1) the advantages and disadvantages of disclosing autism, (2) professional networks, and (3) windows and mirrors. Throughout the interviews, the actors discussed instances when they needed to identify as being autistic to take advantage of autism-focused employment opportunities, and other instances when they felt more comfortable not identifying as autistic. Actors' professional support networks were knowledgeable about autism and advocated for the inclusion and employment of autistic actors. They appreciated the growing number of autistic characters on screen but hoped more production companies invest in authentic casting initiatives. Actors compel production companies to move away from overplayed stereotypical and misleading portrayals. The actors' recommendations for future autistic characterizations are described.

内容提要:自闭症角色在影视作品中越来越常见,越来越多的制作公司开始努力聘用自闭症演员来扮演自闭症角色。本研究旨在了解专业自闭症演员在专业媒体作品中扮演自闭症角色的经历。我们还探讨了自闭症演员对他们在银幕上看到的自闭症角色的印象。我们采访了九位专业自闭症演员,让他们谈谈作为专业演员扮演自闭症角色的经历。访谈揭示了以下主题,包括 (1) 公开自闭症的利弊,(2) 职业网络,以及 (3) 窗户和镜子。在整个访谈过程中,演员们讨论了他们需要表明自己是自闭症患者以利用以自闭症为重点的就业机会的情况,以及他们觉得不表明自己是自闭症患者更自在的其他情况。演员的专业支持网络对自闭症有一定的了解,并倡导包容和雇用自闭症演员。他们对银幕上越来越多的自闭症角色表示赞赏,但希望更多的制片公司投资于真实的选角举措。演员们迫使制片公司摒弃过度渲染的刻板印象和误导性描述。演员们还对未来自闭症角色的塑造提出了建议。
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引用次数: 0
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Autism
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