1
|
Chen YJ, Sideris J, Watson LR, Crais ER, Baranek GT. Developmental Impacts of Early Sensory Patterns on School-Age Adaptive, Maladaptive, and Participation Outcomes in Autistic and Non-autistic Children. J Autism Dev Disord 2024:10.1007/s10803-024-06494-0. [PMID: 39095674 DOI: 10.1007/s10803-024-06494-0] [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: 07/15/2024] [Indexed: 08/04/2024]
Abstract
Early sensory differences may cascade into later social-communication difficulties in autism, yet their impacts on broader functional outcomes have remained understudied. This study aimed to conduct a comprehensive investigation into the longitudinal impacts of sensory patterns, including sensory hyperresponsiveness, hyporesponsiveness, and sensory repetitions/seeking behavior, on various school-age outcome domains among a community sample of children with autistic and non-autistic conditions. We prospectively followed 1,517 children with caregiver-reported sensory questionnaires across three timepoints from infancy to school age. A subsample (n = 389; 88 with reported autism diagnosis/concerns) was further assessed with adaptive, maladaptive and participation outcome measures at age 6-7. Structural equation modeling approaches were used to evaluate the multivariate associations between latent growth parameters (i.e., intercepts and slopes) of sensory patterns and school-age outcomes. Increasing sensory hyperresponsiveness was directly associated with poorer adaptive/maladaptive outcomes and indirectly with lower participation in activities with higher functional demands across settings at school age. Elevated sensory hyporesponsiveness was associated with lower adaptive functioning, more externalizing problems, and lower classroom participation. Trajectories of sensory patterns accounted for more unique variances in adaptive functioning and participation in daily life settings with higher functional and environmental demands among autistic children compared to their non-autistic peers.
Collapse
Affiliation(s)
- Yun-Ju Chen
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street CHP 133, Los Angeles, CA, 90089, USA.
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - John Sideris
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street CHP 133, Los Angeles, CA, 90089, USA
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda R Watson
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health SciencesDivision of Speech and Hearing Sciences, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth R Crais
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health SciencesDivision of Speech and Hearing Sciences, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Grace T Baranek
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street CHP 133, Los Angeles, CA, 90089, USA
- Program for Early Autism Research, Leadership and Service (PEARLS), University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
2
|
Simpson K, Adams D. Parent-reported environmental factors and strategies to support home and community participation in children on the autism spectrum. Disabil Rehabil 2024; 46:3970-3979. [PMID: 37772748 DOI: 10.1080/09638288.2023.2261843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Participating in home and community activities can be influenced by environmental factors and parent strategies. Children on the autism spectrum are reported to participate less in home and community activities than their neurotypical peers. Little is known about environmental factors that may influence their participation, and ways parents support their child's participation. MATERIALS AND METHODS Parents of children on the autism spectrum aged 5-6 years (n = 72) and 10-11 years (n = 94) completed the Participation and Environment Measure for Children and Youth. This study reports on the perceived support, barriers, and resources in the home and the community environment. Parents reported strategies they used to support their child's participation in home and the community. RESULTS Home environmental factors were identified as more supportive by the parents of younger children. The sensory quality of activities and social demands were factors identified as making community participation harder for both groups. Parents used a range of different strategies in the home and the community to support their child's participation. CONCLUSIONS Identifying environmental barriers and supports to participation can assist in developing interventions to support meaningful participation in activities for children on the autism spectrum.Implications for rehabilitationSkills required for the activity and preferences of children on the autism spectrum are important considerations when supporting their participation in activities.When exploring a child's level of participation, it may be helpful to ask parents about what their child can do with or without their support.The sensory quality of the environment is a consideration when supporting the participation of children on the autism spectrum in community activities.As sensory processing is an individual experience, the impact of sensory elements of the environment may differ for individuals.
Collapse
Affiliation(s)
- Kate Simpson
- School of Education and Professional Studies, Autism Centre of Excellence, Griffith University, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Brisbane, Australia
| | - Dawn Adams
- School of Education and Professional Studies, Autism Centre of Excellence, Griffith University, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Brisbane, Australia
| |
Collapse
|
3
|
Iwanaga Y, Tanaka G, Maruta M, Shiozu H, Kawanaka M, Iwanaga R. Participation Patterns and Associated Factors in Japanese Children With Autism. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241237741. [PMID: 38491761 DOI: 10.1177/15394492241237741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND Children's participation is an important outcome for children, families, and rehabilitation. OBJECTIVES We compared participation patterns (home and community) of 6- to 12-year-old Japanese children with autism and children with typical development (TD) and explored the associations of participation with familial, environmental, and child-related factors. METHOD Twenty-five mothers of children with autism and 21 mothers of TD children completed a survey covering their child's participation and environment, family empowerment, autism symptoms, sensory processing, behavior, and demographic characteristics. RESULTS Children with autism showed restricted home and community participation. Home involvement was associated with family empowerment and the children's age, whereas home frequency was linked to environmental supportiveness and household income. CONCLUSION Japanese children with autism need appropriate support to address decreased participation. Occupational therapists may focus on family empowerment and the child's environment to facilitate the home participation of children with autism.
Collapse
Affiliation(s)
- Yuto Iwanaga
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
- Nagasaki City Disability Welfare Center, Japan
| | - Goro Tanaka
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
| | - Michio Maruta
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
| | | | - Mizuho Kawanaka
- Nagasaki University, Graduate School of Biomedical Sciences, Japan
| | | |
Collapse
|
4
|
Donoso J, Rattray F, de Bildt A, Tillmann J, Williams P, Absoud M, Totsika V. Association of cognitive and adaptive skills with internalizing and externalizing problems in autistic children and adolescents. Autism Res 2024; 17:596-609. [PMID: 38031634 DOI: 10.1002/aur.3056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
The presence of an intellectual disability (ID) alongside autism is considered to increase the risk for mental health and behavior problems in children and adolescents. Existing evidence is restricted by looking at ID as a categorical classification. The study aimed to examine the association of cognitive and adaptive behavior skills with internalizing and externalizing problems in a large sample of autistic children and adolescents, across a wide range of cognitive skills. Participants were 2759 children and adolescents aged between 4 and 18 years recruited as part of the Simons Simplex Collection (SSC), of whom 709 (approximately 25%) had ID. Multiple regression models examined associations of internalizing and externalizing problems with cognitive and adaptive skills (communication, daily living, and socialization skills). Cognitive skills were not associated with externalizing problems but were associated with more internalizing problems in autistic children without ID (Cog β: 0.126). All adaptive skill domains were inversely associated with externalizing (Communication β: -0.145; Daily-Living β: -0.132; Socialization β: -0.289) and internalizing problems (Communication β: -0.074; Daily-Living β: -0.064; Socialization β: -0.213) in those without ID. Daily living (β: -0.158) and socialization skills (β: -0.104) were inversely correlated with externalizing problems in autistic children with ID, while only socialization problems (β: -0.099) were associated with internalizing problems in this group. Socialization skills were systematically associated with internalizing and externalizing problems across all levels of cognitive functioning. Supporting social skills development may benefit all aspects of child mental health, while recognizing that children with higher cognitive skills are more vulnerable to internalizing problems might assist with earlier identification of these problems.
Collapse
Affiliation(s)
- Javiera Donoso
- Division of Psychiatry, University College London, London, UK
| | - Fiona Rattray
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
| | - Julian Tillmann
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Penny Williams
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Michael Absoud
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
- Millenium Institute for Care Research (MICARE), Santiago, Chile
| |
Collapse
|
5
|
Ambrose K, Simpson K, Adams D. Using Q-sort method to explore autistic students' views of the impacts of their anxiety at school. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241231607. [PMID: 38390716 DOI: 10.1177/13623613241231607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
LAY ABSTRACT Many autistic students experience anxiety, but there is little research that explores how anxiety might affect autistic students in the school environment. In this study, 45 autistic students, aged 7 to 17 years, completed an online sorting activity to tell us how anxiety impacts them at school. The students were given 21 statements about possible social and academic effects of anxiety (for example, 'When I'm worried it's hard to start my schoolwork' or 'When I'm worried I talk less to my friends or other students'), and sorted them based on how much they agreed each statement was true for them. The three statements most highly rated as being impacted by anxiety were difficulties related to schoolwork. By comparing the information provided by students, six smaller groups of students were identified who sorted the statements in a similar order. These groups show that anxiety affects different autistic students in different ways, including missing school or activities, communicating less with friends and teachers and finding it harder to complete schoolwork. This online sorting activity enabled autistic students themselves to report how anxiety affects them at school. The results suggest that it is important to provide individualised support for autistic students who experience anxiety at school, to reduce the impact of their anxiety on their participation, communication and interactions, and schoolwork. Further research about the effects of anxiety on the academic outcomes of autistic students is also needed.
Collapse
Affiliation(s)
- Kathryn Ambrose
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kate Simpson
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Dawn Adams
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| |
Collapse
|
6
|
Li B, Heyne D, Scheeren A, Blijd-Hoogewys E, Rieffe C. School participation of autistic youths: The influence of youth, family and school factors. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231225490. [PMID: 38311864 DOI: 10.1177/13623613231225490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
LAY ABSTRACT School-aged youths have a basic human right to participate in educational and recreational activities at school. Yet, autistic youths are at high risk of being excluded from school and from school-based activities. It is important to understand how this occurs, to ensure that all autistic youths have opportunities to participate in school activities that are equal to the opportunities of their non-autistic peers. The present study investigated multiple influences on the school participation of autistic youths, including youth factors (age and autistic traits), family factors (parent education level and parental self-efficacy for supporting their child's schoolwork) and school factors (the impact of problems autistic youths experienced with the physical and social environments of school). Using an online survey, we gathered the views and experiences of the parents of 200 autistic youths aged between 4 and 16 years, in the Netherlands. We found that among the factors, only the impact of problems that autistic youths experienced with the physical environment of school was associated with their school participation. In particular, autistic youths who experienced greater difficulties with the physical environment of school had lower levels of school participation. Our findings highlight the pressing need to modify school environments to better accommodate the needs of autistic youths so that they can participate easily and comfortably.
Collapse
Affiliation(s)
- Boya Li
- Leiden University, The Netherlands
- Delft University of Technology, The Netherlands
| | | | | | | | - Carolien Rieffe
- Leiden University, The Netherlands
- University of Twente, The Netherlands
- University College London, UK
| |
Collapse
|
7
|
Adams D, Ambrose K, Simpson K, Malone S, Dargue N. The relationshipbetween anxiety and social outcomes in autistic children and adolescents: A meta-analysis. Clin Child Fam Psychol Rev 2023; 26:706-720. [PMID: 37606793 PMCID: PMC10465686 DOI: 10.1007/s10567-023-00450-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/23/2023]
Abstract
Anxiety is one of the most frequently reported co-occurring conditions for autistic children and adolescents. The relationship between anxiety and social outcomes in autistic youth has been the focus of a range of studies, with mixed results. This meta-analysis aimed to identify the strength of the association between anxiety and a frequently researched social outcome (social competence) in autistic young people and whether that association is influenced by individual or research design factors. A previous preregistered systematic review was updated with a search of the same three databases (CINAHL, ERIC, and PsycINFO) as the original review. Through this, 20 studies with sufficient data on a neurotypically-defined measure of social competence and anxiety were identified. Results were synthesised using a mixed effects model. The meta-analysis on 2,321 participants (from 22 samples) highlighted wide heterogeneity in results. The findings show that anxiety has a significant, small negative impact on social competence (d = - 0.48; 95% CI = - 0.71, - 0.26), meaning that as scores on measures of anxiety increase, scores on measures of social competence decrease. This relationship between anxiety and social competence was moderated by age, becoming weaker as age increased. Whilst this is an important finding for supporting mental health and well-being of autistic young people, the large amount of variance left unexplained suggests that multiple factors, including the use of measures designed for neurotypical people and the potential impact of camouflaging on such measures, need to be considered in future designs.
Collapse
Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia.
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia.
- Autism CRC, Brisbane, Australia.
| | - Kathryn Ambrose
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Autism CRC, Brisbane, Australia
| | - Kate Simpson
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Autism CRC, Brisbane, Australia
| | - Stephanie Malone
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
| | - Nicole Dargue
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
| |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW To summarize recent findings regarding anxiety and trauma-related disorders in children diagnosed with autism spectrum disorder (autism), focusing on the distinct ways in which these conditions may be expressed, as well as advances in evidence-based assessment and treatment. RECENT FINDINGS Current findings suggest both anxiety and trauma-related disorders may be more prevalent, yet more complicated to address in autistic relative to non-autistic children. Overlapping symptoms and distinct manifestations of these disorders pose challenges for the accurate identification, assessment, and treatment of anxiety and trauma-related disorders in autistic children. Emerging evidence recommends adapting traditional assessment and treatment approaches to better meet the needs of autistic children. Recent research suggests autism-centered conceptualizations, which accommodate complexity in how anxiety and trauma-related disorders are experienced and expressed by autistic people, are needed to enhance the psychiatric care of this population.
Collapse
|