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Corbett BA, Key AP, Klemencic ME, Muscatello RA, Jones D, Pilkington J, Burroughs C, Vandekar S. Investigating Social Competence in a Pilot Randomized Clinical Trial of a Theatre-Based Intervention Enhanced for Adults with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06214-0. [PMID: 38109034 PMCID: PMC11182891 DOI: 10.1007/s10803-023-06214-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by challenges in social competence that persist in adulthood, yet few treatment options exist. A pilot randomized clinical trial (RCT) of a peer-mediated, theatre-based intervention with established efficacy in youth with ASD was examined in autistic adults. The final sample consisted of forty-seven 18-to-40-year-old participants randomized to the experimental (EXP N = 23) or waitlist control (WLC N = 24) condition. A multimodal, social interdependent model was employed to examine social competence changes in brain (incidental face memory (IFM) using event-related potentials), cognition (Wechsler Memory Scale-III), behavior (Contextual Assessment of Social Skills) and function (Social Responsiveness Scale (SRS); Adaptive Behavior Assessment Scale (ABAS) Social Composite). Using analysis of covariance in which pretest was controlled in the model, posttest between-group differences were observed on IFM (p = 0.016, η2 = 0.139, d = 0.79) and several social and adaptive functional (SRS, ABAS) outcomes in social communication and interaction (SCI) (p = 0.019, η2 = 0.121, d = -00.45), communication (p = 0.044 η2 = 0.09, d = -00.31), and motivation (p = 0.001, η2 = 0.229, d = -0.79) domains. At two-month follow-up, gains in social motivation remained (p = 0.041, η2 = 0.100, d = -0.77). The results offer preliminary support for a unique theatre-based social skills intervention for autistic adults who have few treatment options to enhance social competence. The trial was pre-registered with ClinicalTrials.gov (Identifier: NCT04349644).
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA.
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark E Klemencic
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Dorita Jones
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, TN, USA
| | - Jennifer Pilkington
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Burroughs
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
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Li Y, Zhou F, Li R, Gu J, He J. Exploring the correlation between genetic transcription and multi-temporal developmental autism spectrum disorder using resting-state functional magnetic resonance imaging. Front Neurosci 2023; 17:1219753. [PMID: 37456995 PMCID: PMC10339831 DOI: 10.3389/fnins.2023.1219753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction The present investigation aimed to explore the neurodevelopmental trajectory of autism spectrum disorder (ASD) by identifying the changes in brain function and gene expression associated with the disorder. Previous studies have indicated that ASD is a highly inherited neurodevelopmental disorder of the brain that displays symptom heterogeneity across different developmental periods. However, the transcriptomic changes underlying these developmental differences remain largely unknown. Methods To address this gap in knowledge, our study employed resting-state functional magnetic resonance imaging (rs-fMRI) data from a large sample of male participants across four representative age groups to stratify the abnormal changes in brain function associated with ASD. Partial least square regression (PLSr) was utilized to identify unique changes in gene expression in brain regions characterized by aberrant functioning in ASD. Results Our results revealed that ASD exhibits distinctive developmental trajectories in crucial brain regions such as the default mode network (DMN), temporal lobe, and prefrontal lobes during critical periods of neurodevelopment when compared to the control group. These changes were also associated with genes primarily located in synaptic tissues. Discussion The findings of this study suggest that the neurobiology of ASD is uniquely heterogeneous across different ages and may be accompanied by distinct molecular mechanisms related to gene expression.
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Groenendijk ER, Van Heijst BFC, Geurts HM. Short report: A co-designed psychoeducation for older autistic adults-a multiple case study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:1163-1169. [PMID: 36519752 PMCID: PMC10115925 DOI: 10.1177/13623613221138691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There are currently no old-age specific interventions for autistic adults. Therefore, in this explorative study, we examined the possible effects of a co-designed psychoeducation program for older autistic adults (55+ years), with a multiple case study design ( N = 9, age 56–73 years; Netherlands Trial Register (code Trial NL5670)). For each participant, also a person close to them (a proxy) participated. This allowed us to calculate a discrepancy score regarding autistic traits and cognitive challenges. The main hypothesis was that our program, delivered after general psychoeducation, would result in a discrepancy reduction between self and proxy reports. However, contrary to our hypothesis, we observed neither intervention effects on our primary outcome measures (discrepancy scores) nor the secondary outcome measures (mastery, self-efficacy, self-esteem, self-stigmatization, quality of life, and hope and future perspectives). Thus, despite co-designing the current intervention, the results were not promising. However, the positive feedback and suggestions of the participants make developing an improved version of a specific psychoeducation program for older autistic adults still a worthwhile pursuit. Lay abstract After receiving an autism diagnosis by a clinician, psychoeducation (i.e. information regarding autism) is often offered. However, older autistic adults (55+ years) may need specific information about the challenges they face in daily life as they are in a specific life phase. A psychoeducation program for this specific age group does not exist yet. We first developed such a program together with autistic adults and clinicians working with autistic people, after which we tested the program with nine autistic adults (56–73 years) and someone close to them (so-called proxy). Before testing the program, we determined together with autistic older adults what they thought should be the outcome of this intervention in order to state whether it was, indeed, a useful intervention. Earlier studies found that autistic people often think differently about their own autistic characteristics than their proxy. A reduction of this difference could increase mutual understanding. Therefore, the main hypothesis was that the program would decrease this difference with respect to autistic characteristics and cognitive challenges (e.g. memory problems). Another hypothesis was that the program would have a positive impact on a series of other factors, such as self-esteem. The results showed that the program did neither decrease the difference in insight nor the other tested factors. Nonetheless, we believe it is important to keep on working on a psychoeducation program for older autistic adults, because participants informed us the program had still helped them in certain ways and they gave helpful feedback for improvements of the program.
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Affiliation(s)
- ER Groenendijk
- University of Amsterdam, The Netherlands
- HSK Group, The Netherlands
| | - BFC Van Heijst
- University of Amsterdam, The Netherlands
- Dr. Leo Kannerhuis (Youz/Parnassiagroup), The Netherlands
| | - HM Geurts
- University of Amsterdam, The Netherlands
- Dr. Leo Kannerhuis (Youz/Parnassiagroup), The Netherlands
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Yarar EZ, Roestorf A, Spain D, Howlin P, Bowler D, Charlton R, Happé F. Aging and autism: Do measures of autism symptoms, co-occurring mental health conditions, or quality of life differ between younger and older autistic adults? Autism Res 2022; 15:1482-1494. [PMID: 35790084 DOI: 10.1002/aur.2780] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022]
Abstract
Previous research has indicated that autistic adults experience higher rates of co-occurring mental health difficulties and poorer quality of life (QoL) than their non-autistic peers. Little is known, however, about these aspects in older age or whether younger and older autistic adults experience similar patterns This cross-sectional study investigated potential age-related effects on autism symptoms, self-reported mental health, and QoL in younger and older autistic adults (n = 79, aged 19-71 years) compared to a non-autistic control group (n = 57) matched for gender, age and IQ. Results showed that autistic adults had higher levels of self-reported autism symptoms and poorer QoL than controls. There were no significant age effects on autism symptoms or on most self-rated mental health symptoms. However, significantly more autistic adults in the younger versus older group scored above the clinical threshold for anxiety, somatoform disorders and eating disorders. Older autistic adults rated social QoL as significantly better than younger autistic adults; there was no significant age difference in the control group. Self-reported QoL was best predicted by self-ratings of severity of depressive symptoms in both groups. Further research is needed to track autism and co-occurring mental health symptomatology across the lifespan, so that service provision can be tailored accordingly. LAY SUMMARY: Young autistic adults have reported more psychological difficulties and poorer quality of life (QoL) than the general population. We investigated whether these difficulties continue into older age. Autism symptoms and mental health problems were common in autistic adults, with no difference between age groups, except for anxiety, physical and eating problems. Although QoL was poorer in both younger and older autistic compared to non-autistic adults, older autistic adults reported better social QoL than those who were younger.
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Affiliation(s)
- Esra Zıvralı Yarar
- Department of Psychology, Social Sciences University of Ankara, Ankara, Turkey
| | | | - Debbie Spain
- Visiting Postdoctoral Clinical Researcher, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Dermot Bowler
- Department of Psychology, City, University of London, London, England
| | - Rebecca Charlton
- Department of Psychology, Goldsmiths University of London, London, England
| | - Francesca Happé
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
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Mason D, Stewart GR, Capp SJ, Happé F. Older Age Autism Research: A Rapidly Growing Field, but Still a Long Way to Go. AUTISM IN ADULTHOOD 2022; 4:164-172. [PMID: 36605971 PMCID: PMC9645679 DOI: 10.1089/aut.2021.0041] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background There is a paucity of research involving older autistic people, as highlighted in a number of systematic reviews. However, it is less clear whether this is changing, and what the trends might be in research on autism in later life. Methods We conducted a broad review of the literature by examining the number of results from a search in three databases (PubMed, Embase, PsycINFO) across four age groups: childhood, adolescence, adulthood, and older age. We also examined the abstracts of all the included articles for the older age group and categorized them under broad themes. Results Our database search identified 145 unique articles on autism in older age, with an additional 67 found by the authors (hence, the total number of articles in this review is 212). Since 2012, we found a 392% increase in research with older autistic people, versus 196% increase for childhood/early life, 253% for adolescence, and 264% for adult research. We identify 2012 as a point at which, year-on-year, older age autism research started increasing, with the most commonly researched areas being cognition, the brain, and genetics. However, older adult research only accounted for 0.4% of published autism studies over the past decade. Conclusions This increase reflects a positive change in the research landscape, although research with children continues to dominate. We also note the difficulty of identifying papers relevant to older age autism research, and propose that a new keyword could be created to increase the visibility and accessibility of research in this steadily growing area.
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Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Address correspondence to: David Mason, MSc, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom
| | - Gavin Robert Stewart
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Address correspondence to: Gavin Robert Stewart, PhD, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom
| | - Simone Josephine Capp
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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6
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van den Heuvel RM, Wensing M, Geurts HM, Teunisse JP. The Social Support Network of Adults with an Autism Spectrum Condition: An Exploration Using the Network in Action-Questionnaire. J Autism Dev Disord 2022; 53:1974-1988. [PMID: 35182260 PMCID: PMC10123042 DOI: 10.1007/s10803-022-05467-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
Abstract
Actively involving the network during treatment, as recommended in Autism Spectrum Condition (ASC) guidelines, can be facilitated with the Network in Action-Questionnaire (NiA-Q), which identifies the current and potential sources of social support. The aims of this study were to (1) examine the factor structure of the NiA-Q and (2) to explore the self- and proxy-report on the social network. Before the start of treatment in a mental health institution, 193 adults with an ASC diagnosis and 84 proxies completed the NiA-Q. Factor analysis showed two factors: positive social support and interpersonal distress. Self- and proxy-report on the NiA-Q did not differ for most variables, except for social network wishes. The NiA-Q provides a basis for network involvement and strengthening.
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Affiliation(s)
- Rinske M van den Heuvel
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands. .,HAN University of Applied Sciences, Nijmegen, The Netherlands. .,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - Michel Wensing
- General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Hilde M Geurts
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan-Pieter Teunisse
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
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7
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Parchomiuk M. Old Age in Adults with ASD: Psychosocial Aspects—a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-020-00229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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8
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Lodi-Smith J, Rodgers JD, Marquez Luna V, Khan S, Long CJ, Kozlowski KF, Donnelly JP, Lopata C, Thomeer ML. The Relationship of Age with the Autism-Spectrum Quotient Scale in a Large Sample of Adults. AUTISM IN ADULTHOOD 2021; 3:147-156. [PMID: 34169231 DOI: 10.1089/aut.2020.0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: The historical focus on autism as a childhood disorder means that evidence regarding autism in adulthood lags significantly behind research in other age groups. Emerging studies on the relationship of age with autism characteristics do not target older adult samples, which presents a barrier to studying the important variability that exists in life span developmental research. This study aims to further our understanding of the relationship between the Autism-Spectrum Quotient Scale and age in a large adult sample. Methods: The present study examines the relationship of Autism-Spectrum Quotient Scale (AQ) scores with age in 1139 adults, ages 18-97 years. Participants came from three distinct samples-a sample of primarily students, a sample of MTurk participants, and a sample of primarily community dwelling older adults. The majority of the participants did not self-report an autism diagnosis (91%), were female (67%), and identified as White (81%). Participants completed the AQ primarily via online surveys. Researchers scored the AQ following six common scoring practices. Results: Results of preregistered analyses indicate that autism characteristics measured by the AQ are not strongly associated with age (r values from -0.01 to -0.11). Further findings indicate that the measurement of autism characteristics is consistent across age into late life using both multiple groups and local structural equation modeling approaches to measurement invariance (comparative fit indices = 0.82-0.83, root mean square error = 0.06) as well as reliability analysis. Finally, demographic and autism-related variables (sex, race, self-identified autism spectrum disorder diagnosis, and degree of autism characteristics) did not moderate the relationship between age and autism characteristics. Conclusion: These results suggest that self-reports of autism characteristics using the AQ do not vary strongly by age in this large age-representative sample. Findings suggest that the AQ can potentially serve as a useful tool for future research on autism across the life span. Important limitations on what we can learn from these findings point toward critical avenues for future research in this area. Lay summary Why was this study done?: Self-report questionnaires of autism characteristics are a potentially important resource for studying autism in adulthood. This study sought to provide additional information about one of the most commonly used self-report questionnaires, the Autism-Spectrum Quotient Scale (AQ), across adulthood.What was the purpose of this study?: This study intended to determine if there is a relationship between scores on the AQ and age. Researchers also worked to identify which of the multiple different ways of scoring the AQ worked best across adulthood.What did the researchers do?: Researchers collected data from over a thousand participants aged 18-97 years. Participants from three different age groups completed online surveys to self-report their levels of autism characteristics on the AQ. Researchers tested the relationship between AQ scores and age with six different commonly used ways to calculate AQ scores. Researchers used multiple statistical techniques to evaluate various measurement properties of the AQ.What were the results of the study?: The results indicate that autism characteristics measured by the AQ are not strongly associated with age. Along with that, there is evidence that certain approaches to measuring of autism characteristics are consistent across age into late life and do not vary with demographic and autism-related factors.What do these findings add to what was already known?: These results add to the growing evidence that self-reports of autism characteristics using the AQ in general samples are not strongly associated with age across adulthood. These findings also provide guidance about ways of scoring the AQ that work well through late life.What are potential weaknesses in the study?: While the AQ has a degree of relationship with autism diagnoses, this is far from perfect and has not been evaluated in the context of aging research. Therefore, findings from the present research must be carefully interpreted to be about autism characteristics not diagnoses. The sample was also limited in a number of other ways. As in any studies including a broad age range of individuals, the oldest participants are likely quite healthy, engaged individuals. This may particularly be the case given the higher mortality rates and health challenges seen with autism. Similarly, as with any self-report research, this research is limited to those individuals who could answer questions about their autism characteristics. The sample was also predominantly White and nonautistic. Finally, the research was limited to one point in time and so cannot tell us about how autism characteristics may change across adulthood.How will these findings help autistic adults now or in the future?: These findings support the potential for the AQ to be a useful tool for future research on autism in adulthood. For example, researchers can use measures such as the AQ to study how autism characteristics change over time or are associated with aging-related issues such as changes in physical health and memory. Such research may be able to provide a better understanding of how to support autistic individuals across adulthood.
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Affiliation(s)
- Jennifer Lodi-Smith
- Department of Psychology, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Jonathan D Rodgers
- Department of Psychology, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Valeria Marquez Luna
- Department of Psychology, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Sarah Khan
- Department of Psychology, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Caleb J Long
- Department of Psychology, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Karl F Kozlowski
- Department of Kinesiology, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - James P Donnelly
- Department of Counseling and Human Services, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Christopher Lopata
- Department of Teacher Education, Institute for Autism Research, Canisius College, Buffalo, New York, USA
| | - Marcus L Thomeer
- Department of Teacher Education, Institute for Autism Research, Canisius College, Buffalo, New York, USA
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Characteristics of Older Autistic Adults: a Systematic Review of Literature. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00238-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Geurts HM, Agelink van Rentergem JA, Radhoe T, Torenvliet C, Van der Putten WJ, Groenman AP. Ageing and heterogeneity regarding autism spectrum conditions: a protocol paper of an accelerated longitudinal study. BMJ Open 2021; 11:e040943. [PMID: 33789848 PMCID: PMC8016100 DOI: 10.1136/bmjopen-2020-040943] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Autism spectrum conditions (ASC) develop early in life and are thought to last a lifetime. However, ASC research has two major knowledge gaps that hinder progression in understanding the concept of ASC and in providing proper support for autistic adults: (1) the majority of knowledge about ASC mainly stems from childhood studies so little is known about older autistic adults and (2) while it is broadly recognised that ASC is a heterogeneous condition, we do not yet understand the differences in trajectories leading to their future outcome. We aim to fill both knowledge gaps. METHODS AND ANALYSIS A multistage overlapping cohort design assessing (cognitive) ageing in ASC is designed to obtain an accelerated longitudinal data set. Data, including a multitude of questionnaires, diagnostics and cognitive tests, are collected over four waves within a 10-year time frame. This will provide information regarding actual changes in quality of life, co-occurring health conditions and cognition as well as the possibility to test external validity and temporal stability in newly formed behavioural subtypes. Participants consist of three groups of adults aged 20-90 years: (1) with a clinical diagnosis of ASC, (2) with a clinical diagnosis of attention deficit hyperactivity disorder (ADHD) but no ASC, (3) no ASC/ADHD (ie, comparison group). The sample size differs between waves and instruments. Detailed analysis plans will be preregistered in AsPredicted or at the Open Science Framework. ETHICS AND DISSEMINATION Ethical approval for this study was obtained from the ethical review board of the Department of Psychology of the University of Amsterdam (wave 1 2011-PN-1952 and 2013-PN-2668, wave 2 2015-BC-4270, waves 3 and 4 2018-BC-9285). In line with the funding policies of the grant organisation funding this study, future papers will be published open access.
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Affiliation(s)
- Hilde M Geurts
- Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz), Amsterdam, The Netherlands
| | | | - Tulsi Radhoe
- Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wikke J Van der Putten
- Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Leo Kannerhuis (Youz), Amsterdam, The Netherlands
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11
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Zıvralı Yarar E, Howlin P, Charlton R, Happé F. Age-Related Effects on Social Cognition in Adults with Autism Spectrum Disorder: A Possible Protective Effect on Theory of Mind. Autism Res 2020; 14:911-920. [PMID: 33067894 DOI: 10.1002/aur.2410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 08/13/2020] [Accepted: 09/29/2020] [Indexed: 11/06/2022]
Abstract
Impaired social cognition has been suggested to underlie the social communication difficulties that define autism spectrum disorder (ASD). In typical development, social cognition may deteriorate in older age, but age effects in ASD adults have been little explored. In the present study, we compared groups of younger and older adults with and without ASD (n = 97), who completed a set of social cognition tasks assessing theory of mind (ToM), and self-report measures of empathy and alexithymia. While typically developing (TD) younger adults outperformed elderly TD and younger ASD participants, younger and older ASD adults did not differ in their ToM performance, and the elderly ASD and TD groups performed equivalently. By contrast, ASD adults reported lower empathy scores and higher levels of alexithymia symptoms compared to TD adults regardless of age. The difference between ASD and TD groups in self-reported empathy scores was no longer significant when alexithymia was covaried (with the exception of the Perspective Taking subscore). Results suggest a possible age-protective effect on ToM in the ASD group. In addition, empathy difficulties appear to be associated with alexithymia rather than ASD per se. Possible interpretations are discussed, and future directions for autism aging research are proposed. LAY SUMMARY: People with autism spectrum disorder (ASD) have difficulties with social understanding. Some age-related studies in typical development have shown a decline in social understanding in older age. We investigated whether a similar pattern is present in adults with ASD. We found that understanding what someone is thinking was not worse in older versus younger autistic adults. Also, we reported further evidence suggesting that emotional empathy difficulties were related to difficulties with understanding one's own emotions rather than with autism itself. Autism Res 2021, 14: 911-920. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Esra Zıvralı Yarar
- Department of Psychology, Social Sciences University of Ankara, Ankara, Turkey
| | - Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rebecca Charlton
- Department of Psychology, Goldsmiths University of London, London, UK
| | - Francesca Happé
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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12
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Pagni BA, Walsh MJM, Rogers C, Braden BB. Social Cognition in Autism Spectrum Disorder Across the Adult Lifespan: Influence of Age and Sex on Reading the Mind in the Eyes Task in a Cross-sectional Sample. Front Integr Neurosci 2020; 14:571408. [PMID: 33013336 PMCID: PMC7498724 DOI: 10.3389/fnint.2020.571408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/18/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Approximately 50,000 U.S. teens with autism spectrum disorder (ASD) become adults every year, however little is known regarding how age influences social cognition and if men and women with ASD are differentially impacted across the adult lifespan. Social cognition declines non-linearly with age in neurotypical (NT) adults. Moreover, sex differences have been observed on RME tasks in NT adults but not adults with ASD, although aging effects have been largely ignored. Objective: This cross-sectional study examined the influence of age and sex on social cognition in adults with ASD compared to NT adults. Methods: The Reading the Mind in the Eyes (RME) task was administered to evaluate the theory of mind abilities in 95 adults with ASD and 82 NT adults ages 18–71 years. The main effects of diagnosis, age, and sex, as well as two-way and three-way interaction were modeled using linear and quadratic aging terms in a multiple regression analysis. Results: A main effect of diagnosis was observed, indicating poorer performance in adults with ASD relative to NT adults. Age and sex interactions were nonsignificant. Discussion: We replicated previous findings of reduced theory of mind (ToM) abilities in adults with ASD, compared to NT adults. While interactions were nonsignificant, visual inspection of quadratic age curves indicated the possibility of unique ToM trajectories in men and women with and without ASD that should be investigated in larger longitudinal studies.
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Affiliation(s)
- Broc A Pagni
- Autism Brain Aging Laboratory, Arizona State University, College of Health Solutions, Tempe, AZ, United States
| | - Melissa J M Walsh
- Autism Brain Aging Laboratory, Arizona State University, College of Health Solutions, Tempe, AZ, United States
| | - Carly Rogers
- Autism Brain Aging Laboratory, Arizona State University, College of Health Solutions, Tempe, AZ, United States
| | - B Blair Braden
- Autism Brain Aging Laboratory, Arizona State University, College of Health Solutions, Tempe, AZ, United States
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13
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Wijker C, Leontjevas R, Spek A, Enders-Slegers MJ. Effects of Dog Assisted Therapy for Adults with Autism Spectrum Disorder: An Exploratory Randomized Controlled Trial. J Autism Dev Disord 2020; 50:2153-2163. [PMID: 30900194 PMCID: PMC7261269 DOI: 10.1007/s10803-019-03971-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Effective treatments of highly prevalent stress-related outcomes such as depression and anxiety are understudied in adults with autism spectrum disorder (ASD). A randomized controlled trial with baseline, post-intervention, and 10-week follow-up, that explores the effects of animal assisted therapy (AAT) was conducted. In total, 53 adults with ASD with normal to high intelligence were randomized in an intervention (N = 27) versus waiting list control group (N = 26). The remarkable adherence to the therapy program by study participants and the program's clinically relevant effects indicate that AAT with dogs can be used to reduce perceived stress and symptoms of agoraphobia, and to improve social awareness and communication in adults with ASD with normal to high intelligence.
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Affiliation(s)
- Carolien Wijker
- GGZ Oost Brabant, P.O. Box 3, 5427 ZG, Boekel, The Netherlands. .,Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands.
| | - Ruslan Leontjevas
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands.,Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands
| | | | - Marie-Jose Enders-Slegers
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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14
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Horwitz EH, Schoevers RA, Greaves-Lord K, de Bildt A, Hartman CA. Adult Manifestation of Milder Forms of Autism Spectrum Disorder; Autistic and Non-autistic Psychopathology. J Autism Dev Disord 2020; 50:2973-2986. [PMID: 32052317 PMCID: PMC7374470 DOI: 10.1007/s10803-020-04403-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We compared the presence of autistic and comorbid psychopathology and functional impairments in young adults who received a clinical diagnosis of Pervasive Developmental Disorders Not Otherwise Specified or Asperger’s Disorder during childhood to that of a referred comparison group. While the Autism Spectrum Disorder group on average scored higher on a dimensional ASD self- and other-report measure than clinical controls, the majority did not exceed the ASD cutoff according to the Autism Diagnostic Observation Schedule. Part of the individuals with an ASD diagnosis in their youth no longer show behaviors that underscribe a clinical ASD diagnosis in adulthood, but have subtle difficulties in social functioning and a vulnerability for a range of other psychiatric disorders.
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Affiliation(s)
- E H Horwitz
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. .,GGZ Friesland, Leeuwarden, The Netherlands.
| | - R A Schoevers
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | | | - A de Bildt
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - C A Hartman
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, University Psychiatric Center, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Walsh MJM, Baxter LC, Smith CJ, Braden BB. Age Group Differences in Executive Network Functional Connectivity and Relationships with Social Behavior in Men with Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2019; 63:63-77. [PMID: 32405319 PMCID: PMC7220036 DOI: 10.1016/j.rasd.2019.02.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Research suggests adults with autism spectrum disorder (ASD) may use executive functions to compensate for social difficulties. Given hallmark age-related declines in executive functioning and the executive brain network in normal aging, there is concern that older adults with ASD may experience further declines in social functioning as they age. In a male-only sample, we hypothesized: 1) older adults with ASD would demonstrate greater ASD-related social behavior than young adults with ASD, 2) adults with ASD would demonstrate a greater age group reduction in connectivity of the executive brain network than neurotypical (NT) adults, and 3) that behavioral and neural mechanisms of executive functioning would predict ASD-related social difficulties in adults with ASD. METHODS Participants were a cross-sectional sample of non-intellectually disabled young (ages 18-25) and middle-aged (ages 40-70) adult men with ASD and NT development (young adult ASD: n=24; middle-age ASD: n=25; young adult NT: n=15; middle-age NT: n=21). We assessed ASD-related social behavior via the self-report Social Responsiveness Scale-2 (SRS-2) Total Score, with exploratory analyses of the Social Cognition Subscale. We assessed neural executive function via connectivity of the resting-state executive network (EN) as measured by independent component analysis. Correlations were investigated between SRS-2 Total Scores (with exploratory analyses of the Social Cognition Subscale), EN functional connectivity of the dorsolateral prefrontal cortex (dlPFC), and a behavioral measure of executive function, Tower of London (ToL) Total Moves. RESULTS We did not confirm a significant age group difference for adults with ASD on the SRS-2 Total Score; however, exploratory analysis revealed middle-age men with ASD had higher scores on the SRS-2 Social Cognition Subscale than young adult men with ASD. Exacerbated age group reductions in EN functional connectivity were confirmed (left dlPFC) in men with ASD compared to NT, such that older adults with ASD demonstrated the greatest levels of hypoconnectivity. A significant correlation was confirmed between dlPFC connectivity and the SRS-2 Total Score in middle-age men with ASD, but not young adult men with ASD. Furthermore, exploratory analysis revealed a significant correlation with the SRS-2 Social Cognition Subscale for young and middle-aged ASD groups and ToL Total Moves. CONCLUSIONS Our findings suggest that ASD-related difficulties in social cognition and EN hypoconnectivity may get worse with age in men with ASD and is related to executive functioning. Further, exacerbated EN hypoconnectivity associated with older age in ASD may be a mechanism of increased ASD-related social cognition difficulties in older adults with ASD. Given the cross-sectional nature of this sample, longitudinal replication is needed.
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Affiliation(s)
- Melissa J. M. Walsh
- Department of Speech and Hearing Science, Arizona State University, 976 S Forest Mall, Tempe, AZ 85281
| | - Leslie C. Baxter
- Department of Neuroimaging Research, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ 85013
| | - Christopher J. Smith
- Southwest Autism Research & Resource Center, 2225 N 16th Street, Phoenix, AZ 85006
| | - B. Blair Braden
- Department of Speech and Hearing Science, Arizona State University, 976 S Forest Mall, Tempe, AZ 85281
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16
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Roestorf A, Bowler D, Deserno M, Howlin P, Klinger L, McConachie H, Parr J, Powell P, Van Heijst B, Geurts H. "Older Adults with ASD: The Consequences of Aging." Insights from a series of special interest group meetings held at the International Society for Autism Research 2016-2017. RESEARCH IN AUTISM SPECTRUM DISORDERS 2019; 63:3-12. [PMID: 31275429 PMCID: PMC6559228 DOI: 10.1016/j.rasd.2018.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/18/2018] [Accepted: 08/25/2018] [Indexed: 05/21/2023]
Abstract
A special interest group (SIG) entitled "Older Adults with ASD: The Consequences of Aging" was held at the International Society for Autism Research (INSAR) annual meetings in 2016 and 2017. The SIG and subsequent meetings brought together, for the first time, international delegates who were members of the autistic community, researchers, practitioners and service providers. Based on aging autism research that is already underway in UK, Europe, Australia and North America, discussions focussed on conceptualising the parameters of aging when referring to autism, and the measures that are appropriate to use with older adults when considering diagnostic assessment, cognitive factors and quality of life in older age. Thus, the aim of this SIG was to progress the research agenda on current and future directions for autism research in the context of aging. A global issue on how to define 'aging' when referring to ASD was at the forefront of discussions. The 'aging' concept can in principle refer to all developmental transitions. However, in this paper we focus on the cognitive and physical changes that take place from mid-life onwards. Accordingly, it was agreed that aging and ASD research should focus on adults over the age of 50 years, given the high rates of co-occurring physical and mental health concerns and increased risk of premature death in some individuals. Moreover, very little is known about the cognitive change, care needs and outcomes of autistic adults beyond this age. Discussions on the topics of diagnostic and cognitive assessments, and of quality of life and well-being were explored through shared knowledge about which measures are currently being used and which background questions should be asked to obtain comprehensive and informative developmental and medical histories. Accordingly, a survey was completed by SIG delegates who were representatives of international research groups across four continents, and who are currently conducting studies with older autistic adults. Considerable overlap was identified across different research groups in measures of both autism and quality of life, which pointed to combining data and shared learnings as the logical next step. Regarding the background questions that were asked, the different research groups covered similar topics but the groups differed in the way these questions were formulated when working with autistic adults across a range of cognitive abilities. It became clear that continued input from individuals on the autism spectrum is important to ensure that questionnaires used in ongoing and future are accessible and understandable for people across the whole autistic spectrum, including those with limited verbal abilities.
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Affiliation(s)
- A. Roestorf
- The Ageing with Autism Project, Autism Research Group, Department of Psychology, City, University of London, United Kingdom
| | - D.M. Bowler
- The Ageing with Autism Project, Autism Research Group, Department of Psychology, City, University of London, United Kingdom
| | - M.K. Deserno
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| | - P. Howlin
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Brain and Mind Centre, The University of Sydney, Australia
| | - L. Klinger
- University of North Carolina at Chapel Hill, TEACCH Autism Program, Department of Psychiatry, USA
| | - H. McConachie
- Institute of Health and Society, Newcastle University, United Kingdom
| | - J.R. Parr
- Institute of Neuroscience, Newcastle University, United Kingdom
| | - P. Powell
- Georgia Institute of Technology, School of Psychology, Atlanta, GA, USA
| | - B.F.C. Van Heijst
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| | - H.M. Geurts
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
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17
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Kuiper MWM, Verhoeven EWM, Geurts HM. Stop Making Noise! Auditory Sensitivity in Adults with an Autism Spectrum Disorder Diagnosis: Physiological Habituation and Subjective Detection Thresholds. J Autism Dev Disord 2019; 49:2116-2128. [PMID: 30680585 PMCID: PMC6483953 DOI: 10.1007/s10803-019-03890-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Auditory sensitivities are common among people with autism spectrum disorder diagnoses (ASD). As underlying factors are unknown, we examined whether ASD adults (NASD = 33; NTypically Developing = 31; 25-45 years; IQ > 70): (1) habituated slower to auditory stimuli; (2) had lower auditory detection thresholds; and (3) whether these mechanisms related to self-reported auditory sensitivities. Two auditory stimuli (tone, siren) were repeated, whilst skin conductance responses were recorded to measure habituation. Detection thresholds were measured by stepwise reductions in tone volume. We found no evidence in favor of our hypotheses, but ASD adults did rate the auditory stimuli as more arousing. Based on explorative analyses, we argue that studying the strength of physiological responses to auditory stimuli is needed to understand auditory sensitivities.
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Affiliation(s)
- Marieke W M Kuiper
- Dr. Leo Kannerhuis, Autism Expert Centre, Department of Research, Development & Innovation, Houtsniplaan 1, 6865 XZ, Doorwerth, The Netherlands.
- University of Amsterdam, Faculty of Social and Behavioural Sciences, Dutch Autism & ADHD Research Center, Brain and Cognition, Nieuwe Achtergracht 129, 1001 NK, Amsterdam, The Netherlands.
| | - Elisabeth W M Verhoeven
- Dr. Leo Kannerhuis, Autism Expert Centre, Department of Research, Development & Innovation, Houtsniplaan 1, 6865 XZ, Doorwerth, The Netherlands
| | - Hilde M Geurts
- Dr. Leo Kannerhuis, Autism Expert Centre, Department of Research, Development & Innovation, Houtsniplaan 1, 6865 XZ, Doorwerth, The Netherlands
- University of Amsterdam, Faculty of Social and Behavioural Sciences, Dutch Autism & ADHD Research Center, Brain and Cognition, Nieuwe Achtergracht 129, 1001 NK, Amsterdam, The Netherlands
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Agelink van Rentergem JA, Lever AG, Geurts HM. Negatively phrased items of the Autism Spectrum Quotient function differently for groups with and without autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1752-1764. [PMID: 30818972 PMCID: PMC6728748 DOI: 10.1177/1362361319828361] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The Autism Spectrum Quotient is a widely used instrument for the detection of autistic
traits. However, the validity of comparisons of Autism Spectrum Quotient scores between
groups may be threatened by differential item functioning. Differential item functioning
entails a bias in items, where participants with equal values of the latent trait give
different answers because of their group membership. In this article, items of the Autism
Spectrum Quotient were studied for differential item functioning between different groups
within a single sample (N = 408). Three analyses were conducted. First,
using a Rasch mixture model, two latent groups were detected that show differential item
functioning. Second, using a Rasch regression tree model, four groups were found that show
differential item functioning: men without autism, women without autism, people 50 years
and younger with autism, and people older than 50 years with autism. Third, using
traditional methods, differential item functioning was detected between groups with and
without autism. Therefore, group comparisons with the Autism Spectrum Quotient are at risk
of being affected by bias. Eight items emerged that consistently show differences in
response tendencies between groups across analyses, and these items were generally
negatively phrased. Two often-used short forms of the Autism Spectrum Quotient, the AQ-28
and AQ-10, may be more suitable for group comparisons.
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Affiliation(s)
| | - Anne Geeke Lever
- 1 University of Amsterdam, The Netherlands.,2 Dutch Autism & ADHD Research Center, The Netherlands
| | - Hilde M Geurts
- 1 University of Amsterdam, The Netherlands.,2 Dutch Autism & ADHD Research Center, The Netherlands.,3 Dr. Leo Kannerhuis, The Netherlands
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Abbott P, Happé FG, Charlton RA. Exploratory Study of Executive Function Abilities Across the Adult Lifespan in Individuals Receiving an ASD Diagnosis in Adulthood. J Autism Dev Disord 2018; 48:4193-4206. [PMID: 29980900 PMCID: PMC6223764 DOI: 10.1007/s10803-018-3675-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Little is known about cognition in autism spectrum disorder (ASD) across adulthood. We examined executive function abilities and autism traits in 134 adults receiving a first diagnosis of ASD. Participants aged 18–75 years with abilities in the normal range were assessed on executive function and self-report autism traits. Results suggest that for some abilities relying on speed and sequencing (Trails A and B; Digit Symbol), late-diagnosed individuals with ASD may demonstrate better performance than typical age-norms. On other executive measures (Digit Span, Hayling and Brixton tests) age-related correlations were similar to typical age-norms. Different domains of executive function may demonstrate different trajectories for ageing with ASD, with patterns of slower, accelerated or equivalent age-related change being observed across different measures.
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Affiliation(s)
| | - Francesca G Happé
- Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rebecca A Charlton
- Department of Psychology, Goldsmiths University of London, New Cross, London, SE14 6NW, UK.
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