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.
Anxiety is one of the most prevalent mental health challenges in autistic children, yet there is limited evidence on effective tools to measure treatment outcomes. Previous research with non-autistic children has found that the Child Anxiety Impact Scale, Parent Version achieved good diagnostic accuracy when measuring treatment outcomes and performed better than a commonly used symptom measure. However, this has not been evaluated for autistic children. The present study examined the psychometric properties of the Child Anxiety Impact Scale, Parent Version in autistic children and compared its utility against other anxiety symptom measures, to detect treatment outcomes as assessed by a gold-standard diagnostic interview, the Anxiety and Related Disorders Interview Schedule, Child Version, Parent Interview with the Autism Spectrum Addendum. Data were used from 212 children (aged 7-13 years) who participated in a randomised controlled trial. Receiver-operating characteristic curve analyses were conducted, and subsequent subgroup analyses were conducted using DeLong tests. Results demonstrated that the Child Anxiety Impact Scale, Parent Version had strong psychometric properties, with total scores significantly outperforming other measures in predicting post-treatment recovery from anxiety diagnoses. These findings have implications for future choices of treatment outcome measures in research and clinical practice.Lay abstractStudy on the utility of anxiety scales to detect anxiety diagnostic treatment outcomes in autistic childrenWhy was the study done? The importance of having valid and reliable anxiety measures for autistic children has been highlighted as a research priority by professionals and people with lived experience. Yet, while anxiety has been frequently assessed in autistic children, we do not currently know much about how well commonly used anxiety measures work, especially parent reports, in this context. This has significant implications for care planning and resource allocation for autistic children who experience significant anxiety problems.What did the researchers do? The research team studied data collected in a previously published multi-centred randomised controlled trial (RCT) testing an adapted cognitive behavioural therapy for anxiety (Wood et al., 2020) to better understand how different anxiety measures did, compared to gold-standard anxiety diagnostic assessments, in detecting treatment outcomes. They focused in particular on the Child Anxiety Impact Scale, Parent Version (CAIS-P).What did the researchers find? This study found that the CAIS-P did better than conventional anxiety symptom measures in detecting treatment outcomes for anxiety problems in autistic children.What do the findings mean? This study adds to the current evidence base to inform choices of measurement of anxiety problems in the context of autism.
This study investigates the relationships between family dynamics, parental psychological distress, and functional impairment in Turkish autistic children. We recruited 100 families, including children aged 6-12 years diagnosed with autism and their parents. Autism severity was measured using the Childhood Autism Rating Scale. Parents completed validated tools, including the Brief Symptom Inventory and Weiss Functional Impairment Rating Scale-Parent Form, while mothers also completed the Multidimensional Perceived Social Support Scale and Marital Adjustment Test. Mothers reported higher functional impairment in their children (M = 0.90, SD = 0.50) than fathers (M = 0.82, SD = 0.46, p = 0.020). Maternal distress was significantly associated with greater functional impairment (β = 0.242, p = 0.028), while stronger marital relationships were linked to lower levels of impairment (β = -0.323, p = 0.001). Autism symptom severity and comorbid conditions were not significantly associated with functional impairment. These findings suggest that maternal mental health and marital satisfaction are related to functional impairments in autistic children. While fathers often have less direct caregiving roles, their supportive presence may also be important. These findings highlight the need for longitudinal studies to clarify whether reducing caregiver stress and supporting family resilience are linked to improved outcomes in autistic children.Lay AbstractRaising autistic children presents unique daily challenges for families. This study explored how family relationships and parents' mental health are linked to the daily functioning of autistic children in Türkiye. We included 100 families with children aged 6-12 years who had been diagnosed with autism. Mothers often reported more challenges in their child's daily life compared to fathers. Higher levels of maternal stress were associated with greater difficulties in children's daily functioning. In contrast, stronger and more supportive marriages were associated with fewer reported challenges. These results suggest that family dynamics and caregiver well-being are closely related to how autistic children experience daily life. Supporting parental mental health and strengthening family relationships may help promote better outcomes for autistic children and their families.
Masking may entail the suppression of autistic traits by autistic individuals. Thus far, research indicates a negative impact of autistic masking on mental health, but this is largely based on retrospective surveys. In this study, we used ecological momentary assessment to examine real-time associations between social context (i.e. presence of (non-)autistic others), masking, and perceived stress in everyday life among a sample of autistic adults. Ecological momentary assessment data were collected via a smartphone application for 87 autistic individuals (58 females; M age = 48; age range: 17-68). In line with the hypotheses, repeated measures analyses of variance and linear mixed models indicated that (1) participants reported masking significantly less when they were alone compared with when others were present, (2) participants masked significantly more when non-autistic others were present compared with autistic others, and (3) more masking was associated with a concurrent higher level of perceived stress. Autistic adults reported they could be more themselves among autistic peers and reduced masking was associated with reduced stress. These ecological momentary assessment study findings provide ecological validity to the potential stressful impact of masking in the daily lives of autistic adults.Lay abstractAutistic people may try to hide their autistic traits in order to fit in. This is called autistic masking. Survey research suggests that autistic masking may have a negative effect on the mental well-being of autistic people. Yet, survey research has limitations, because people may not remember or may not accurately report how much they masked and how they felt in the past. Therefore, in this study, we asked autistic adults to use a smartphone app to report with whom they were (with or without autistic people), if they could be themselves (degree of masking), and how stressed they felt during the past 4 h. Participants reported this information multiple times over a period of 28 days. In total, 87 autistic adults participated (58 females; age range: 17-68). In line with our expectations, (1) participants masked less when they were alone compared with when others were present, (2) participants masked more when non-autistic others were present compared with autistic others, and (3) more masking was linked with the experience of more stress in the same moment. Autistic adults reported they could be more themselves among other autistic individuals. Also, less masking was associated with less stress. Our study shows the everyday reality of stress during masking experienced by autistic adults.

