1
|
Girolamo T, Ghali S, Larson C. Sentence Production and Sentence Repetition in Autistic Adolescents and Young Adults: Linguistic Sensitivity to Finiteness Marking. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2297-2315. [PMID: 38768078 PMCID: PMC11253802 DOI: 10.1044/2024_jslhr-24-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential language variation. One promising method is strategic scoring, which has good clinical utility for identifying language impairment in nonautistic school-age children across variants of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults. METHOD Thirty-one diverse autistic adolescents and adults with language impairment (ALI; n = 15) and without language impairment (ASD; n = 16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals-Fifth Edition. Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness marking across utterances and morphosyntactic structures. RESULTS Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI < ASD). DISCUSSION Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential language variation in finiteness marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25822336.
Collapse
Affiliation(s)
- Teresa Girolamo
- School of Speech, Language, and Hearing Sciences, Center for Autism and Developmental Disorders, San Diego State University, CA
| | - Samantha Ghali
- Child Language Doctoral Program, The University of Kansas, Lawrence
| | - Caroline Larson
- Department of Speech, Language, and Hearing Sciences, Interdisciplinary Neuroscience Program, University of Missouri, Columbia
| |
Collapse
|
2
|
Girolamo T, Escobedo A, Butler L, Larson CA, Campos I, Greene-Pendelton K. Social drivers of health in communicative outcomes of racially and ethnically minoritized autistic adolescents and adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.17.24309053. [PMID: 38947098 PMCID: PMC11213112 DOI: 10.1101/2024.06.17.24309053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Despite their importance, little is known about how social drivers of health shape communicative outcomes in autism. Even less is known when considering the intersection of race and language impairment. An understanding of factors in communicative outcomes is key for characterizing developmental trajectories and informing supports. This cross-sectional observational study examined the role of social drivers of health in communicative outcomes of racially and ethnically minoritized autistic adolescents and adults. Participants ages 13 to 30 (N = 73) completed a behavioral assessment protocol, including language and nonverbal cognitive skills, as well as social drivers of health (sense of community, unmet services, barriers to services). Correlational analyses revealed associations between social drivers of health on social communication impairment and real-world communication. Generalized linear mixed-effects modeling revealed that language predicted real-world communication, but sense of community predicted social communication impairment. Findings point to the importance of assessing both individual differences and social drivers of health in outcomes in autism research. Future work should focus on social drivers of health in larger-scale analyses of outcomes in minoritized autistic individuals during the transition to adulthood, considering supports that align with service eligibility and person-centered outcomes.
Collapse
|
3
|
Liu F, Begeer S, Hoekstra RA, Wang C, Scheeren AM. Autistic adults in China and the Netherlands: Proxy-reported community integration and life satisfaction. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241258182. [PMID: 38864577 DOI: 10.1177/13623613241258182] [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: 06/13/2024]
Abstract
LAY ABSTRACT Even though there are about 10 million Chinese autistic individuals, we know little about autistic adults in China. This study examined how well young autistic adults in China integrate into their communities (such as having a job, living independently and having friends) and how satisfied they are with their lives as reported by their caregivers. We compared them to autistic adults with similar characteristics (such as high support needs) from the Netherlands. We included 99 autistic adults in China and 109 in the Netherlands (18-30 years). In both countries, autistic adults were reported to have a hard time fitting into their communities. They often had no work, did not live on their own and had few close friends. Also, in both countries, caregivers reported that autistic adults felt low satisfaction with their life. Chinese adults were less satisfied with their life than Dutch adults, as indicated by their caregivers. This could be because of a lack of support for autistic adults in China, higher parental stress in Chinese caregivers, or general cross-country differences in happiness. Only in the Dutch group, younger compared with older adults fitted better into their communities, and adults without additional psychiatric conditions were reported to have higher life satisfaction. Country was a significant predictor of independent living only, with Dutch participants more likely living in care facilities than Chinese participants. In conclusion, our study shows that autistic adults with high support needs generally face similar challenges in both China and the Netherlands.
Collapse
Affiliation(s)
- Fangyuan Liu
- Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
| | - Sander Begeer
- Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
| | | | | | - Anke M Scheeren
- Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
| |
Collapse
|
4
|
Grosman HE, Aragon-Guevara D, McQuaid GA, Wallace GL, Lee NR. Academic learning challenges and links to vocational outcomes in young autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241255774. [PMID: 38864310 DOI: 10.1177/13623613241255774] [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: 06/13/2024]
Abstract
LAY ABSTRACT Finding a job can be hard for autistic adults. No studies have been completed that look into whether having difficulties learning and troubles finding a job are related in this population. The current study did so by evaluating the Learning Needs Screening Tool, a measure of learning challenges used in vocational rehabilitation settings, or places meant to help people find work. A total of 401 autistic adults completed this study online. Specifically, the study evaluated (a) the characteristics of the Learning Needs Screening Tool, including the relationships between questions that ask about similar learning challenges, and (b) the ability of the measure to relate to real-world outcomes that are associated with learning difficulties, namely prior special education receipt and difficulties finding a job. Evaluation of the questions asked on the Learning Needs Screening Tool revealed that they were highly related and that learning difficulties fell into different categories. Fifty-six percent of the people in the study showed learning challenges on the measure. People who were identified as having learning difficulties on the Learning Needs Screening Tool had higher rates of receiving special education services in the past and lower rates of current employment. These results suggest that the Learning Needs Screening Tool may help to identify autistic job seekers who have learning difficulties and may have more challenges finding a job.
Collapse
|
5
|
Patti MA, Croen LA, Dickerson AS, Joseph RM, Ames JL, Ladd-Acosta C, Ozonoff S, Schmidt RJ, Volk HE, Hipwell AE, Magee KE, Karagas M, McEvoy C, Landa R, Elliott MR, Mitchell DK, D'Sa V, Deoni S, Pievsky M, Wu PC, Barry F, Stanford JB, Bilder DA, Trasande L, Bush NR, Lyall K. Reproducibility between preschool and school-age Social Responsiveness Scale forms in the Environmental influences on Child Health Outcomes program. Autism Res 2024; 17:1187-1204. [PMID: 38794898 PMCID: PMC11186723 DOI: 10.1002/aur.3147] [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] [Received: 01/05/2024] [Accepted: 04/12/2024] [Indexed: 05/26/2024]
Abstract
Evidence suggests core autism trait consistency in older children, but development of these traits is variable in early childhood. The Social Responsiveness Scale (SRS) measures autism-related traits and broader autism phenotype, with two age-dependent forms in childhood (preschool, 2.5-4.5 years; school age, 4-18 years). Score consistency has been observed within forms, though reliability across forms has not been evaluated. Using data from the Environmental Influences on Child Health Outcomes (ECHO) program (n = 853), preschool, and school-age SRS scores were collected via maternal report when children were an average of 3.0 and 5.8 years, respectively. We compared reproducibility of SRS total scores (T-scores) and agreement above a clinically meaningful cutoff (T-scores ≥ 60) and examined predictors of discordance in cutoff scores across forms. Participant scores across forms were similar (mean difference: 3.3 points; standard deviation: 7), though preschool scores were on average lower than school-age scores. Most children (88%) were classified below the cutoff on both forms, and overall concordance was high (92%). However, discordance was higher in cohorts following younger siblings of autistic children (16%). Proportions of children with an autism diagnoses were also higher among those with discordant scores (27%) than among those with concordant scores (4%). Our findings indicate SRS scores are broadly reproducible across preschool and school-age forms, particularly for capturing broader, nonclinical traits, but also suggest that greater variability of autism-related traits in preschool-age children may reduce reliability with later school-age scores for those in the clinical range.
Collapse
Grants
- UH3OD023285 NIH ECHO Program, funded by the office of the Director, NIH
- UG3 OD023342 NIH HHS
- UH3OD023288 NIH ECHO Program, funded by the office of the Director, NIH
- U24OD023319 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023244 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023313 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023305 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023275 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023328 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023342 NIH ECHO Program, funded by the office of the Director, NIH
- U2C OD023375 NIH HHS
- UH3OD023271 NIH ECHO Program, funded by the office of the Director, NIH
- U24OD023382 NIH ECHO Program, funded by the office of the Director, NIH
- UH3OD023249 NIH ECHO Program, funded by the office of the Director, NIH
- U2COD023375 NIH ECHO Program, funded by the office of the Director, NIH
- UH3 OD023342 NIH HHS
Collapse
Affiliation(s)
- Marisa A Patti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Robert M Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis, Sacramento, California, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, MIND Institute, University of California Davis, Sacramento, California, USA
| | - Heather E Volk
- Wendy Klag Center for Autism and Developmental Disabilities Research, Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kelsey E Magee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margaret Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Cindy McEvoy
- Department of Pediatrics, Papé Pediatric Research Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Rebecca Landa
- Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael R Elliott
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Daphne Koinis Mitchell
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Viren D'Sa
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sean Deoni
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Michelle Pievsky
- Department of Psychiatry and Human Behavior, Hasbro Children's Hospital, Providence, Rhode Island, USA
| | - Pei-Chi Wu
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Fatoumata Barry
- Bradley-Hasbro Research Center and the Department of Pediatrics, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Joseph B Stanford
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Deborah A Bilder
- Department of Psychiatry, University of Utah Huntsman Mental Health Institute, Salt Lake City, Utah, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
6
|
Girolamo T, Birmingham M, Patel K, Ghali S, Campos I, Greene-Pendelton K, Canale R, Larson C, Sterling A, Shogren KA. Self-determination in minoritized autistic adolescents and adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.02.24306799. [PMID: 38746405 PMCID: PMC11092698 DOI: 10.1101/2024.05.02.24306799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Self-determination plays an important role in outcomes in autism and shows intersectional disparities. Yet, little is known about the role of individual differences or social drivers of health in the development of self-determination. Understanding these factors is key for developing effective supports. This mixed-methods convergent study examined self-determination in racially and ethnically minoritized autistic individuals and caregivers. Participants ages 13 to 30 ( N = 73) varying widely in language and cognitive ability and caregivers ( n =52) completed the Self-Determination Inventory. Autism traits and sense of community predicted caregiver report of self-determination, and autism traits and language predicted self-report of self-determination, consistent with DisCrit and Diversity Science. Self-Determination Inventory interviews of a subset of participants ( n = 13) and caregivers ( n = 9) were analyzed using inductive thematic analysis. Themes pointed to the role of the intersection of race and disability in shaping self-determination. Altogether, findings point to the importance of these frameworks, environmental influences, and multi-informant perspectives in characterizing self-determination. Future work should focus on the impact of environmental factors in self-determination in minoritized autistic individuals during the transition to adulthood.
Collapse
|
7
|
Oosting DR, Howard MS, Carter AS. Reciprocal Associations Between Language Ability and Social Functioning Development in Pre-verbal Autistic Children. J Autism Dev Disord 2024; 54:1643-1655. [PMID: 36719605 DOI: 10.1007/s10803-023-05906-x] [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: 01/17/2023] [Indexed: 02/01/2023]
Abstract
Longitudinal research on language abilities and social functioning in young children suggests that gains in one domain affect gains in the other. However, few studies have examined inter-relations of language and social functioning jointly among young children diagnosed with autism spectrum disorder (ASD). Pre-verbal toddlers with ASD are a group of particular clinical relevance, given that greater language abilities at school entry have been associated with positive long-term adjustment in many areas, including adaptive and social functioning. Reduced attention to and engagement in social interactions among autistic toddlers who are not yet speaking may interfere with language development concurrently and over time. The present study examined reciprocal associations between language ability and social functioning over a 2-year period across three time points in a sample of 90 pre-verbal autistic toddlers using cross-lagged panel analyses conducted in MPlus. Cross-lagged panel analyses revealed significant within-timepoint synchronous correlations, within-domain autoregressive paths over time, and as hypothesized, reciprocal significance in all cross-lagged paths. For very young pre-verbal children with ASD, language ability and social functioning appear to exert concurrent and cascading developmental influences on one another. Targeting both language and social functioning simultaneously may enhance intervention efficacy for very young pre-verbal children with ASD.
Collapse
Affiliation(s)
- Devon R Oosting
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Mya S Howard
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA.
| |
Collapse
|
8
|
Kiehl I, Pease R, Hackmann C. The adult experience of being diagnosed with autism spectrum disorder: A qualitative meta-synthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1060-1074. [PMID: 38360530 DOI: 10.1177/13623613231220419] [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] [Indexed: 02/17/2024]
Abstract
LAY ABSTRACT There is little research looking at the experience of individuals diagnosed with autism spectrum disorder as adults. Adults diagnosed with autism spectrum disorder face different challenges than children, and more research is needed to better understand those challenges. For this review, autistic and non-autistic researchers looked at research on the experience of receiving a diagnosis of autism spectrum disorder as an adult. We looked for themes in people's experience leading up to diagnosis, going through the diagnostic process, and living their life after diagnosis. We analyzed 24 studies and found three overarching themes that captured thirty-two themes describing the experience of diagnosis. The three overarching themes expressed issues with identity and relationships before and after the diagnosis and identified that the diagnosis of autism spectrum disorder in adulthood impacted people's adaptation to and assimilation (i.e. the making sense of and internalizing the diagnosis) of autism spectrum disorder. While the diagnostic process itself was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences and had effects on identity and self-esteem. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the impact of the diagnosis on people's identity and choices about telling others about their diagnosis, and whether and how people want to make adaptations, should be discussed and thought through in the process of diagnosis.
Collapse
Affiliation(s)
- Ingrid Kiehl
- Massachusetts General Hospital, USA
- McLean Hospital, USA
- Harvard Medical School, USA
| | - Ruby Pease
- Norfolk and Suffolk Foundation Trust, UK
| | - Corinna Hackmann
- Norfolk and Suffolk Foundation Trust, UK
- The University of East Anglia, UK
| |
Collapse
|
9
|
Blume J, Dhanasekara CS, Kahathuduwa CN, Mastergeorge AM. Central Executive and Default Mode Networks: An Appraisal of Executive Function and Social Skill Brain-Behavior Correlates in Youth with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:1882-1896. [PMID: 36988766 DOI: 10.1007/s10803-023-05961-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/30/2023]
Abstract
Atypical connectivity patterns have been observed for individuals with autism spectrum disorders (ASD), particularly across the triple-network model. The current study investigated brain-behavior relationships in the context of social skills and executive function profiles for ASD youth. We calculated connectivity measures from diffusion tensor imaging using Bayesian estimation and probabilistic tractography. We replicated prior structural equation modeling of behavioral measures with total default mode network (DMN) connectivity to include comparisons with central executive network (CEN) connectivity and CEN-DMN connectivity. Increased within-CEN connectivity was related to metacognitive strengths. Our findings indicate behavior regulation difficulties in youth with ASD may be attributable to impaired connectivity between the CEN and DMN and social skill difficulties may be exacerbated by impaired within-DMN connectivity.
Collapse
Affiliation(s)
- Jessica Blume
- Department of Human Development and Family Sciences, Texas Tech University, P.O. Box 41230, Lubbock, TX, 79409-1230, USA.
| | | | - Chanaka N Kahathuduwa
- Department of Psychiatry and Neurology, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Ann M Mastergeorge
- Department of Human Development and Family Sciences, Texas Tech University, P.O. Box 41230, Lubbock, TX, 79409-1230, USA
| |
Collapse
|
10
|
Marcilla-Jorda M, Grande C, Coelho V, Rubio-Belmonte C, Moro-Ipola M. Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework. J Autism Dev Disord 2024:10.1007/s10803-024-06337-y. [PMID: 38613593 DOI: 10.1007/s10803-024-06337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 04/15/2024]
Abstract
Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.
Collapse
Affiliation(s)
| | - Catarina Grande
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto, University of Porto, Porto, Portugal
| | - Vera Coelho
- Department of Social and Behavioral Sciences, Universidade da Maia, Maia, Portugal
- Center for Psychology at University of Porto, University of Porto, Porto, Portugal
| | | | - Micaela Moro-Ipola
- Faculty of Health Sciences, Universitat Jaume I, Castello de la Plana, Spain.
| |
Collapse
|
11
|
Li G, Zarei MA, Alibakhshi G, Labbafi A. Teachers and educators' experiences and perceptions of artificial-powered interventions for autism groups. BMC Psychol 2024; 12:199. [PMID: 38605422 PMCID: PMC11010416 DOI: 10.1186/s40359-024-01664-2] [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] [Received: 07/21/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Artificial intelligence-powered interventions have emerged as promising tools to support autistic individuals. However, more research must examine how teachers and educators perceive and experience these AI systems when implemented. OBJECTIVES The first objective was to investigate informants' perceptions and experiences of AI-empowered interventions for children with autism. Mainly, it explores the informants' perceived benefits and challenges of using AI-empowered interventions and their recommendations for avoiding the perceived challenges. METHODOLOGY A qualitative phenomenological approach was used. Twenty educators and parents with experience implementing AI interventions for autism were recruited through purposive sampling. Semi-structured and focus group interviews conducted, transcribed verbatim, and analyzed using thematic analysis. FINDINGS The analysis identified four major themes: perceived benefits of AI interventions, implementation challenges, needed support, and recommendations for improvement. Benefits included increased engagement and personalized learning. Challenges included technology issues, training needs, and data privacy concerns. CONCLUSIONS AI-powered interventions show potential to improve autism support, but significant challenges must be addressed to ensure effective implementation from an educator's perspective. The benefits of personalized learning and student engagement demonstrate the potential value of these technologies. However, with adequate training, technical support, and measures to ensure data privacy, many educators will likely find integrating AI systems into their daily practices easier. IMPLICATIONS To realize the full benefits of AI for autism, developers must work closely with educators to understand their needs, optimize implementation, and build trust through transparent privacy policies and procedures. With proper support, AI interventions can transform how autistic individuals are educated by tailoring instruction to each student's unique profile and needs.
Collapse
Affiliation(s)
- Guang Li
- School of History, Capital Normal University, Beijing, China
| | | | | | - Akram Labbafi
- Maraghe Branch, PhD Candidate of English Language Teaching, Islamic Azad University, Teheran, Iran
| |
Collapse
|
12
|
Sohl K, Oberweiser C, Ranum E, Oberweiser C, Cornell W. A Pediatrician's Practical Guide for Navigating Transition to Adulthood with Autistic Youth and Their Caregivers. Pediatr Clin North Am 2024; 71:315-326. [PMID: 38423723 DOI: 10.1016/j.pcl.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
When pediatricians, autistic people, and their families carefully consider and plan for the transition from pediatric care to adult care, there are better outcomes for patients. Pediatricians see their patients over time and are uniquely positioned to help prepare for the changes that come with the transition through adolescents to adulthood. Although programs such as Got Transition offer some guidance on how to navigate the transition from pediatric care to adult care, there is less information on how to help those on the autism spectrum and their families transition to adulthood in other ways.
Collapse
Affiliation(s)
- Kristin Sohl
- Department of Pediatrics, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA; ECHO Autism Communities, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA.
| | | | - Elly Ranum
- Department of Pediatrics, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA
| | - Charles Oberweiser
- Schlief School of Accountancy, Stephen F. Austin State University, 1936 North Street, Nacogdoches, TX, USA
| | - Wendy Cornell
- ECHO Autism Communities, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA; Department of Special Education, College of Education and Human Development, 611 Conley Avenue, Columbia, MO 65211, USA
| |
Collapse
|
13
|
Eigsti IM. The Autism Constellation and Neurodiversity: Long-Term and Adult Outcomes in Autism Spectrum Disorder. Pediatr Clin North Am 2024; 71:327-341. [PMID: 38423724 PMCID: PMC10914322 DOI: 10.1016/j.pcl.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Research on autistic adults suggests significant heterogeneity in outcomes. A significant proportion of individuals struggle with intellectual disability and limited communication skills. Of the 67% who have age-appropriate cognitive skills, around half are expected to attain a college education, and 25% are likely to hold a full-time job. Outcomes have been improving over time, in part because of earlier diagnosis and earlier intervention. Indeed, an estimated 10% to 20% are expected to lose all symptoms of autism by adolescence.
Collapse
Affiliation(s)
- Inge-Marie Eigsti
- Connecticut Autism and Language Lab (CALL), University of Connecticut; Cognitive Neuroscience of Communication T32 Training Program; Institute for the Brain and Cognitive Sciences; Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269, USA.
| |
Collapse
|
14
|
Zhong C, Rando J, Patti MA, Braun JM, Chen A, Xu Y, Lanphear BP, Yolton K, Croen LA, Fallin MD, Hertz-Picciotto I, Newschaffer CJ, Lyall K. Gestational thyroid hormones and autism-related traits in the EARLI and HOME studies. Autism Res 2024; 17:716-727. [PMID: 38436527 DOI: 10.1002/aur.3115] [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] [Received: 05/25/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Thyroid hormones are essential for neurodevelopment. Few studies have considered associations with quantitatively measured autism spectrum disorder (ASD)-related traits, which may help elucidate associations for a broader population. Participants were drawn from two prospective pregnancy cohorts: the Early Autism Risk Longitudinal Investigation (EARLI), enrolling pregnant women who already had a child with ASD, and the Health Outcomes and Measures of the Environment (HOME) Study, following pregnant women from the greater Cincinnati, OH area. Gestational thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured in mid-pregnancy 16 (±3) weeks gestation serum samples. ASD-related traits were measured using the Social Responsiveness Scale (SRS) at ages 3-8 years. The association was examined using quantile regression, adjusting for maternal and sociodemographic factors. 278 participants (132 from EARLI, 146 from HOME) were included. TSH distributions were similar across cohorts, while FT4 levels were higher in EARLI compared to HOME. In pooled analyses, particularly for those in the highest SRS quantile (95th percentile), higher FT4 levels were associated with increasing SRS scores (β = 5.21, 95% CI = 0.93, 9.48), and higher TSH levels were associated with decreasing SRS scores (β = -6.94, 95% CI = -11.04, -2.83). The association between TSH and SRS remained significant in HOME for the 95% percentile of SRS scores (β = -6.48, 95% CI = -12.16, -0.80), but not EARLI. Results for FT4 were attenuated when examined in the individual cohorts. Our results add to evidence that gestational thyroid hormones may be associated with ASD-related outcomes by suggesting that relationships may differ across the distribution of ASD-related traits and by familial likelihood of ASD.
Collapse
Affiliation(s)
- Caichen Zhong
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Juliette Rando
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Marisa A Patti
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Joseph M Braun
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lisa A Croen
- Kaiser Permanente Northern California, Oakland, California, USA
| | - M Daniele Fallin
- Emory Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, California, USA
| | - Craig J Newschaffer
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
- College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
15
|
Girolamo T, Ghali S, Larson C. Sentence production and sentence repetition in autistic adolescents and young adults: Linguistic sensitivity to finiteness-marking. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.26.24304924. [PMID: 38586015 PMCID: PMC10996725 DOI: 10.1101/2024.03.26.24304924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Purpose Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential dialectal variation. One promising method is strategic scoring (Oetting et al., 2016), which has good clinical utility for identifying language impairment in nonautistic school-age children across dialects of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults. Method Thirty-one diverse autistic adolescents and adults with language impairment (ALI; n=15) and without language impairment (ASD; n=16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals-5th Ed (Wiig et al., 2013). Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness-marking across utterances and morphosyntactic structures. Results Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI < ASD). Discussion Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential dialectal variation in finiteness-marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed.
Collapse
|
16
|
Saban-Bezalel R, Ben-Itzchak E, Zachor DA. Friendship in Autism Spectrum Disorder Is Related to Diverse Developmental Changes Between Toddlerhood and Adolescence. J Autism Dev Disord 2024:10.1007/s10803-024-06284-8. [PMID: 38456995 DOI: 10.1007/s10803-024-06284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Follow-up studies of children diagnosed with autism spectrum disorder (ASD) in early childhood that focus on friendship formation during adolescence are scarce. The present study focused on exploring characteristics possibly related to the ability to establish friendships during adolescence among children diagnosed with ASD in toddlerhood. METHODS The cohort included 43 participants who underwent comprehensive assessments during toddlerhood and adolescence. Participants were divided into two groups [Friendship(+)/Friendship(-)] based on (1) adolescent social insight as assessed by professionals and (2) parental and adolescent self-reports regarding having or not having friends. No differences in IQ, ASD symptoms, or adaptive behavior during early childhood were found between the two groups. RESULTS Different and better changes in social communication, adaptive socialization, and daily living skills were observed for the Friendship(+) group. Adolescents with ASD in the Friendship(+) group exhibited greater social independence. Attention-deficit/hyperactivity disorder incidence, anxiety symptom severity, and placement in mainstream or special education classes did not differ between the two groups. CONCLUSION This long-term study highlights that for children with ASD, longitudinal growth in social communication and adaptive functioning is possible, highly important for and related to the development of the complex ability to establish friendship.
Collapse
Affiliation(s)
- Ronit Saban-Bezalel
- Bruckner Center for Autism Research, Department of Communication Disorders, Ariel University, Ariel, Israel.
| | - Esther Ben-Itzchak
- Bruckner Center for Autism Research, Department of Communication Disorders, Ariel University, Ariel, Israel
| | - Ditza A Zachor
- The Autism Center/ALUT, Department of Pediatrics, Sackler Faculty of Medicine, Shamir (Assaf Harofeh) Medical Center, Tel Aviv University, Zerifin, 70300, Israel
| |
Collapse
|
17
|
Bordini D, Moya AC, Asevedo GRDC, Paula CS, Brunoni D, Brentani H, Caetano SC, Mari JDJ, Bagaiolo L. Exploring the Acquisition of Social Communication Skills in Children with Autism: Preliminary Findings from Applied Behavior Analysis (ABA), Parent Training, and Video Modeling. Brain Sci 2024; 14:172. [PMID: 38391746 PMCID: PMC10886593 DOI: 10.3390/brainsci14020172] [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] [Received: 09/28/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
Social communication skills, especially eye contact and joint attention, are frequently impaired in autism spectrum disorder (ASD) and predict functional outcomes. Applied behavior analysis is one of the most common evidence-based treatments for ASD, but it is not accessible to most families in low- and middle-income countries (LMICs) as it is an expensive and intensive treatment and needs to be delivered by highly specialized professionals. Parental training has emerged as an effective alternative. This is an exploratory study to assess a parental intervention group via video modeling to acquire eye contact and joint attention. Four graded measures of eye contact and joint attention (full physical prompt, partial physical prompt, gestural prompt, and independent) were assessed in 34 children with ASD and intellectual disability (ID). There was a progressive reduction in the level of prompting required over time to acquire eye contact and joint attention, as well as a positive correlation between the time of exposure to the intervention and the acquisition of abilities. This kind of parent training using video modeling to teach eye contact and joint attention skills to children with ASD and ID is a low-cost intervention that can be applied in low-resource settings.
Collapse
Affiliation(s)
- Daniela Bordini
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04017-030, SP, Brazil
| | - Ana Cláudia Moya
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04017-030, SP, Brazil
| | | | - Cristiane Silvestre Paula
- Human Development Sciences Program, Mackenzie Presbyterian University (UPM), Sao Paulo 01302-907, SP, Brazil
| | - Décio Brunoni
- Human Development Sciences Program, Mackenzie Presbyterian University (UPM), Sao Paulo 01302-907, SP, Brazil
| | - Helena Brentani
- Psychiatry Institute, University of São Paulo (USP), Sao Paulo 01246-904, SP, Brazil
| | - Sheila Cavalcante Caetano
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04017-030, SP, Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04017-030, SP, Brazil
| | - Leila Bagaiolo
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04017-030, SP, Brazil
- Gradual-Behavioral Intervention Group, Sao Paulo 05458-000, SP, Brazil
| |
Collapse
|
18
|
MacKenzie KT, Beck KB, Eack SM, Zeglen KN, Conner CM, Mazefsky CA. Developing a Measure of Key Adult Outcomes in Adults with Developmental Disabilities: Conceptual Model and Item Generation of the REALS (Relationships, Employment, Autonomy, and Life Satisfaction). J Autism Dev Disord 2024:10.1007/s10803-023-06219-9. [PMID: 38291244 DOI: 10.1007/s10803-023-06219-9] [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: 12/09/2023] [Indexed: 02/01/2024]
Abstract
Employment, social relationships, and autonomy are priorities to people with intellectual and developmental disabilities (IDDs). However, few validated measures exist to systematically assess these key adult outcomes in this population. This research includes first steps to develop self- and proxy report measures of life outcomes for adults with IDDs-the Relationships, Employment, Autonomy, and Life Satisfaction (REALS). A literature search identified existing adult outcome measures, and comparison of their domains informed initial conceptual model development. External consultants revised the model, and items were generated. Autistic adults (n = 15), adults with other IDDs (n = 7), caregivers of autistic adults (n = 13), and caregivers of adults with other IDDs (n = 10) completed in-depth cognitive interviews to assess comprehension of items and response categories, factors influencing how participants respond to items, and the inclusiveness of the item pool. A final conceptual model was generated with three subdomains (social relationships, employment, and autonomy), including assessment of life satisfaction within each domain. Cognitive interviews revealed that response set restructuring and item-level revisions were needed to capture the complexity of adult life and make the measure more accessible across a range of abilities. This study developed a conceptual model of relationships, work, and autonomy specific to adults with IDDs. Future work will involve collecting data from 800 + self-reporters with IDDs and 800 + caregivers of adults with IDDs to conduct psychometric analyses. Improving measurement in this area is critical to better understanding the needs of adults with IDDs and improving services available to them.
Collapse
Affiliation(s)
| | - Kelly B Beck
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shaun M Eack
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- University of Pittsburgh, School of Social Work, Pittsburgh, PA, USA
| | | | - Caitlin M Conner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
19
|
Hickey EJ, DaWalt LS, Hong J, Taylor JL, Mailick MR. Trajectories of Competitive Employment of Autistic Adults through Late Midlife. Healthcare (Basel) 2024; 12:265. [PMID: 38275545 PMCID: PMC10815573 DOI: 10.3390/healthcare12020265] [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] [Received: 10/29/2023] [Revised: 01/02/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study's aims were to provide a fine-grained analysis of competitive employment patterns, to determine whether there was age-related change, and to test whether trajectories differed between those with and without intellectual disability (ID). Using an accelerated longitudinal design, trajectories of hours of competitive employment were estimated from young adulthood through late midlife in a community-based cohort (n = 341; 1327 observations). Results indicated a significant curvilinear trajectory of age-related change in hours of competitive employment, with differences between those with and without ID. For those without ID, the number of competitive employment hours increased from young adulthood until early midlife, then leveled off and decreased into late midlife. For those with ID, engagement in competitive employment was low throughout. Although competitive employment is just one option for vocational engagement, it is a goal often articulated by autistic adults who seek entry into the general workforce. The present research reveals their degree of engagement in the competitive workforce across the decades of adulthood.
Collapse
Affiliation(s)
- Emily J. Hickey
- University Center for Excellence in Developmental Disabilities, Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA;
| | - Leann Smith DaWalt
- University Center for Excellence in Developmental Disabilities, Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA;
| | - Jinkuk Hong
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA; (J.H.); (M.R.M.)
| | - Julie Lounds Taylor
- Pediatrics and Psychiatry & Behavioral Science, Vanderbilt University Medical Center, 1211 Medical Center Dr., Nashville, TN 37232, USA;
| | - Marsha R. Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI 53705, USA; (J.H.); (M.R.M.)
| |
Collapse
|
20
|
Bateman KJ, Wilson SE, Ingvarsson E, Doucette J, Therrien W, Nevill R, Mazurek M. Snack Talk: Effects of a Naturalistic Visual Communication Support on Increasing Conversation Engagement for Adults with Disabilities. Behav Anal Pract 2023; 16:1085-1099. [PMID: 38076735 PMCID: PMC10700260 DOI: 10.1007/s40617-023-00775-3] [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: 01/06/2023] [Indexed: 02/08/2023] Open
Abstract
Adults with intellectual and developmental disabilities frequently experience poor life outcomes, with individuals reporting lower levels of social support, relationships, gainful employment, and satisfaction in their quality of life. To ameliorate these outcomes, social skills and social communication interventions aligned with the needs of adults are warranted. This study examined the efficacy of Snack Talk, a supplemental naturalistic visual communication support, with five adults with intellectual and developmental disabilities. Snack Talk was implemented during the midday mealtime, with the goal of increasing conversation engagement. A withdrawal design across participants was used. Results demonstrated increases in conversation engagement and showed meaningful gains for participants in the intervention and postintervention phase compared to baseline.
Collapse
Affiliation(s)
- Katherine J. Bateman
- The Haring Center for Inclusive Education, College of Education, University of Washington, Box 357925, 1981 NE Columbia Road, Seattle, WA 98195 USA
| | | | | | | | - William Therrien
- Curriculum, Instruction and Special Education; School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Rose Nevill
- Curriculum, Instruction and Special Education; School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| | - Micah Mazurek
- Curriculum, Instruction and Special Education; School of Education and Human Development, University of Virginia, Charlottesville, VA USA
| |
Collapse
|
21
|
Hong J, DaWalt LS, Taylor JL, Haider A, Mailick M. Autism through midlife: trajectories of symptoms, behavioral functioning, and health. J Neurodev Disord 2023; 15:36. [PMID: 37919643 PMCID: PMC10623813 DOI: 10.1186/s11689-023-09505-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND This study describes change in autism symptoms, behavioral functioning, and health measured prospectively over 22 years. Most studies tracking developmental trajectories have focused on autism during childhood, although adulthood is the longest stage of the life course. A robust understanding of how autistic people change through midlife and into older age has yet to be obtained. METHODS Using an accelerated longitudinal design with 9 waves of data, developmental trajectories were estimated from adolescence through midlife and into early old age in a community-based cohort (n = 406). The overall aim was to determine whether there were age-related increases or decreases, whether the change was linear or curvilinear, and whether these trajectories differed between those who have ID and those who have average or above-average intellectual functioning. Subsequently, the slopes of the trajectories were evaluated to determine if they differed depending on age when the study began, with the goal of identifying possible cohort effects. RESULTS There were significant trajectories of age-related change for all but one of the measures, although different measures manifested different patterns. Most autism symptoms improved through adulthood, while health worsened. An inverted U-shaped curve best described change for repetitive behavior symptoms, activities of daily living, maladaptive behaviors, and social interaction. For these measures, improved functioning was evident from adolescence until midlife. Then change leveled off, with worsening functioning from later midlife into early older age. Additionally, differences between autistic individuals with and without ID were evident. Although those who have ID had poorer levels of functioning, there were some indications that those without ID had accelerating challenges in their aging years that were not evident in those with ID - increases in medications for physical health problems and worsening repetitive behaviors. CONCLUSIONS Meeting the needs of the increasingly large population of autistic adults in midlife and old age requires a nuanced understanding of life course trajectories across the long stretch of adulthood and across multiple domains. Given the heterogeneity of autism, it will be important not to generalize across sub-groups, for example those who are minimally verbal and those who have above-average intellectual functioning.
Collapse
Affiliation(s)
- Jinkuk Hong
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI, 53705, USA.
| | - Leann Smith DaWalt
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI, 53705, USA
| | - Julie Lounds Taylor
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Aasma Haider
- Lawrence University, 711 E. Boldt Way, Appleton, WI, 54911, USA
| | - Marsha Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI, 53705, USA
| |
Collapse
|
22
|
Jayashankar A, Aziz-Zadeh L. Disgust Processing and Potential Relationships with Behaviors in Autism. Curr Psychiatry Rep 2023; 25:465-478. [PMID: 37672122 PMCID: PMC10627949 DOI: 10.1007/s11920-023-01445-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE OF REVIEW While there are reports of differences in emotion processing in autism, it is less understood whether the emotion of disgust, in particular, plays a significant role in these effects. Here, we review literature on potential disgust processing differences in autism and its possible associations with autistic traits. RECENT FINDINGS In autism, there is evidence for differences in physical disgust processing, pica behaviors, attention away from other's disgust facial expressions, and differences in neural activity related to disgust processing. In typically developing individuals, disgust processing is related to moral processing, but modulated by individual differences in interoception and alexithymia. Autistic individuals may experience atypical disgust, which may lead to difficulty avoiding contaminants and affect socio-emotional processing. In autism, such outcomes may lead to increased occurrences of illness, contribute to gastrointestinal issues, diminish vicarious learning of disgust expression and behaviors, and potentially contribute to differences in processes related to moral reasoning, though further research is needed.
Collapse
Affiliation(s)
- Aditya Jayashankar
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, 90089, USA.
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, 90089, USA.
| | - Lisa Aziz-Zadeh
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, 90089, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, 90089, USA
| |
Collapse
|
23
|
Rodriguez‐Perez M, Kennedy M, Barker ED, Kreppner J, Solerdelcoll M, Sonuga‐Barke EJ. The adult outcome of childhood quasi-autism arising following extreme institutional deprivation. J Child Psychol Psychiatry 2023; 64:1292-1302. [PMID: 36782398 PMCID: PMC10476691 DOI: 10.1111/jcpp.13767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND Rutter and colleagues' seminal observation that extended early life exposure to extreme institutional deprivation can result in what he termed quasi-autism (QA), informed both our understanding of the effects of adversity on development and the nature of autism. Here we provide the first detailed analysis of the adult outcomes of the group of institutionally deprived-then-adopted children identified as displaying QA. METHODS Twenty-six adult adoptees identified with QA in childhood (Childhood QA+) were compared to 75 adoptees who experienced extended institutional deprivation (>6 months) but no QA (Childhood QA-), and 116 adoptees exposed to Low/No institutional deprivation. The outcomes were child-to-adult developmental trajectories of neuro-developmental symptoms (autism, attention-deficit/hyperactivity disorder (ADHD), disinhibited social engagement (DSE) and cognitive impairment), adult functioning, life satisfaction and mental health. RESULTS Childhood QA+ was associated with elevated and persistent trajectories of broad-based autism-related difficulties, ADHD and DSE symptoms and low IQ, as well as adult mental health difficulties and functional impairment, including high rates of low educational attainment and unemployment. Life satisfaction and self-esteem were unaffected. Autism-related communication problems, in particular, predicted negative adult outcomes. Childhood QA+ was still associated with poor outcomes even when ADHD, DSE and IQ were controlled. CONCLUSIONS Early and time-limited institutional deprivation has a critical impact on adult functioning, in part via its association with an early established and persistent variant of autism, especially related to communication difficulties. Apparent similarities and differences to non-deprivation related autism are discussed.
Collapse
Affiliation(s)
- Maria Rodriguez‐Perez
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Mark Kennedy
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Edward D. Barker
- Department of Psychology, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Jana Kreppner
- Centre for Innovation in Mental Health, School of PsychologyUniversity of SouthamptonSouthamptonUK
| | - Mireia Solerdelcoll
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Edmund J.S. Sonuga‐Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Child and Adolescent PsychiatryAarhus UniversityAarhusDenmark
| |
Collapse
|
24
|
Soylu F, May K, Kana R. White and gray matter correlates of theory of mind in autism: a voxel-based morphometry study. Brain Struct Funct 2023; 228:1671-1689. [PMID: 37452864 DOI: 10.1007/s00429-023-02680-5] [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: 06/07/2022] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by difficulties in theory of mind (ToM) and social communication. Studying structural and functional correlates of ToM in the brain and how autistic and nonautistic groups differ in terms of these correlates can help with diagnosis and understanding the biological mechanisms of ASD. In this study, we investigated white matter volume (WMV) and gray matter volume (GMV) differences between matching autistic and nonautistic samples, and how these structural features relate to age and ToM skills, indexed by the Reading the Mind in the Eyes (RMIE) measure. The results showed widespread GMV and WMV differences between the two groups in regions crucial for social processes. The autistic group did not express the typically observed negative GMV and positive WMV correlations with age at the same level as the nonautistic group, pointing to abnormalities in developmental structural changes. In addition, we found differences between the two groups in how GMV relates to ToM, particularly in the left frontal regions, and how WMV relates to ToM, mostly in the cingulate and corpus callosum. Finally, GMV in the left insula, a region that is part of the salience network, was found to be crucial in distinguishing ToM performance between the two groups.
Collapse
Affiliation(s)
- Firat Soylu
- Educational Psychology Program, The University of Alabama, Tuscaloosa, USA.
| | - Kaitlyn May
- Educational Psychology Program, The University of Alabama, Tuscaloosa, USA
| | - Rajesh Kana
- Department of Psychology, & the Center for Innovative Research in Autism, University of Alabama, Tuscaloosa, USA
| |
Collapse
|
25
|
Thurman W, Heitkemper E, Hutson T, Preston A, Hecht J. "The System Tends to Scoop You Up and Spit You Out and They're Done With You": The Intersection of Intellectual/Developmental Disability and Homelessness From the Perspectives of Service Providers. QUALITATIVE HEALTH RESEARCH 2023; 33:1017-1029. [PMID: 37550990 PMCID: PMC10494477 DOI: 10.1177/10497323231186880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
People with intellectual and developmental disabilities (IDD) experience elevated risk for poor health and social outcomes in adulthood and are at risk for experiencing homelessness and housing instability. Although the exact prevalence of IDD among homeless populations is unknown, a small body of literature related to the intersection of IDD and homelessness suggests differential health needs and service use patterns, with a need for targeted health and social services. In this study, we explore the perceptions and experiences of 18 homeless or disability service providers about (a) their clients at the intersection of IDD and homelessness and (b) their role and the services provided at the intersection of IDD and homelessness. Participants struggled to provide appropriate, accessible services for this population, owing to lack of training and awareness of specific needs, fragmented systems, and inadequately funded healthcare and housing support. Our findings also reveal that clients at this intersection have high contact with public systems, which places them at risk for losing their right to self-determination. Recommendations center on systems transformation to facilitate the ability of providers to collaborate and to make data-driven decisions to deliver person-centered care.
Collapse
Affiliation(s)
- Whitney Thurman
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | | | - Tara Hutson
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Angela Preston
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Jonathan Hecht
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
26
|
Mason D, Milner V, Clark L, Kelly E, Pyefinch R, Happé F. Autistic People and Moving Home: A Systematic Review. AUTISM IN ADULTHOOD 2023; 5:236-247. [PMID: 37663439 PMCID: PMC10468557 DOI: 10.1089/aut.2022.0016] [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: 11/19/2022]
Abstract
Background While many studies have examined where and with whom autistic people live, very few have looked at autistic people's experience of moving home. Choosing where to live, and being able to move residence, could be important for autonomy, and we therefore undertook a systematic review to identify studies about autistic adults' experience of moving home. Methods We entered search terms relevant to autism and moving home into six databases and Google Scholar. After screening the titles and abstracts, we identified a final set of articles and screened the full text. We then checked the reference lists for potentially relevant articles; then, we conducted a search for articles that cited our final set of articles. Three raters assessed each included article for methodological quality. Results The search strategy identified a total of 311 articles (initial search, ancestry searching, articles from other sources). After deduplication, we screened a total of 165 articles for eligibility. A final set of seven articles was identified. Our narrative synthesis of the articles suggests that both autistic people and the relatives of autistic people think living independently is a source of positive personal development. However, autistic people reported that poor employment prospects impacted on their financial independence and hence independent living. Parents highlighted concerns about their offspring's personal care, safety, and the difficulty of navigating the housing system for those autistic people with co-occurring intellectual disability. Conclusions Taken together, our review suggests that autistic people and those who care for them have a positive view of independent living and are aware of the barriers to achieving this. Our review highlights a gap in the understanding of autistic adults' experience of moving home. We briefly describe our ongoing research project [the "Moving (as an) Autistic Person" project] exploring autistic people's experiences of moving house.
Collapse
Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Victoria Milner
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lauren Clark
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Emily Kelly
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebekah Pyefinch
- 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
| |
Collapse
|
27
|
Justus SA, Mirjalili S, Powell PS, Duarte A. Neural reinstatement of context memory in adults with autism spectrum disorder. Cereb Cortex 2023; 33:8546-8556. [PMID: 37106572 PMCID: PMC10321090 DOI: 10.1093/cercor/bhad139] [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] [Received: 11/18/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is associated with episodic memory impairment. However, episodic memories include a variety of contextual details, and it is difficult to solely rely on behavioral data to assess how specifically (i.e. event-specific reinstatement) an event is remembered. We applied encoding-retrieval representational similarity (ERS) analysis to EEG data to assess event-specific ERS for object-context associations in a sample of 34 adults (17 with, 17 without ASD). Participants studied objects presented alongside 2 contextual features: scene/color, and attention was directed toward one object-context relationship. At retrieval, memory was assessed for the object and both contexts. Behavioral results revealed no group differences in item or context memory performance. ERS results revealed group temporal differences in reinstatement. Results may indicate differences in both encoding (i.e. fewer perceptual details) and retrieval (i.e. ineffectively skipping through memory fragments) in ASD and should be further investigated in studies modulating the perceptual detail required for memory decisions. Results highlight the utility of ERS as a methodology used to evaluate episodic reinstatement even in the absence of behavioral differences in memory performance.
Collapse
Affiliation(s)
- Sidni A Justus
- Department of Psychological Science, Kennesaw State University, 402 Bartow Ave NW, Kennesaw, GA 30144, United States
| | - Soroush Mirjalili
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, United States
| | - Patrick S Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333, United States
| | - Audrey Duarte
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, United States
| |
Collapse
|
28
|
Antolini G, Colizzi M. Where Do Neurodevelopmental Disorders Go? Casting the Eye Away from Childhood towards Adulthood. Healthcare (Basel) 2023; 11:healthcare11071015. [PMID: 37046942 PMCID: PMC10094062 DOI: 10.3390/healthcare11071015] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Neurodevelopmental disorders (NDDs) encompass a group of complex conditions with onset during the early developmental period. Such disorders are frequently associated with a number of neuropsychiatric features, the most prevalent ones being autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, communication and specific learning disorders, and motor disorders. These conditions are characterized by wide genetic and clinical variability, and although they were previously conceptualized as childhood-limited disorders, NDDs are progressively being recognized as persistent conditions with a potentially relevant impact on the quality of life and overall functioning during adult life. In addition, emerging evidence seems to point towards the hypothesis of a neurodevelopmental continuum, according to which NNDs could portray different time-dependent outcomes, depending on the severity of the altered brain development. Despite representing lifelong phenotypes, they are often not promptly identified and/or managed in adulthood. In this regard, specific guidelines on clinical and therapeutic approaches for these conditions have not yet been delineated. In this view, future research investigations should be encouraged to broaden available knowledge, characterize the clinical course of NDDs across an individual’s lifespan, and better understand the patterns of aging-related concerns in adults with an NDD diagnosis. Additionally, considering the difficulties many young adults encounter while transitioning from childhood to adult mental health services, new, specific programs should be developed and existing programs should be implemented to improve the transition process and for the management of NDDs in adulthood.
Collapse
Affiliation(s)
- Giulia Antolini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy
| | - Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| |
Collapse
|
29
|
Guo D, Yang X, Gao M, Chen X, Tang Y, Shen L, Li K, Shi L. Deficiency of Autism-Related Gene Dock4 Leads to Impaired Spatial Memory and Hippocampal Function in Mice at Late Middle Age. Cell Mol Neurobiol 2023; 43:1129-1146. [PMID: 35635601 DOI: 10.1007/s10571-022-01233-4] [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: 02/25/2022] [Accepted: 05/12/2022] [Indexed: 11/25/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that lasts lifelong and causes noticeably higher premature mortality. Although the core symptoms and other behavioral deficits of ASD can persist or be deteriorated from early development to old age, how aging affects the behaviors and brain anatomy in ASD is largely unknown. DOCK4 is an ASD risk gene highly expressed in the hippocampus, and Dock4 knockout (KO) mice display ASD-like behaviors in adulthood (4- to 6-month-old). In this study, we evaluated the behavioral and hippocampal pathological changes of late-middle-aged (15- to 17-month-old) Dock4 male KO mice. Aged Dock4 KO mice continuously showed similar social deficit, elevated anxiety, and disrupted object location memory as observed in the adulthood, when compared to their wild-type (WT) littermates. Notably, Dock4 KO mice displayed an age-related decline of hippocampal dependent spatial memory, showing decreased spatial memory in Barnes maze than their WT littermates at late middle age. Morphological analysis from WT and Dock4 KO littermates revealed that Dock4 deficiency led to decreased mature neurons and oligodendrocytes but increased astrocytes in the hippocampus of late-middle-aged mice. Together, we report that ASD-like behaviors mostly persist into late-middle age in Dock4 KO mice, with specific alterations of spatial memory and hippocampal anatomy by age, thus providing new evidence for understanding age differences in behavioral deficits of ASD.
Collapse
Affiliation(s)
- Daji Guo
- Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China.
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China.
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China.
| | - Xiaoman Yang
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Ming Gao
- Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
| | - Xiaoqing Chen
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Yanping Tang
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Lingling Shen
- Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
| | - Keshen Li
- Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China.
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China.
| | - Lei Shi
- JNU-HKUST Joint Laboratory for Neuroscience and Innovative Drug Research, College of Pharmacy, Jinan University, Guangzhou, 510632, Guangdong, China.
| |
Collapse
|
30
|
Tincani M, Ji H, Upthegrove M, Garrison E, West M, Hantula D, Vucetic S, Dragut E. Vocational Interventions for Individuals with ASD: Umbrella Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2023. [DOI: 10.1007/s40489-023-00368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
|
31
|
Smit S, Hopper J. Love, Joy, and a Lens of Childhood Trauma: Exploring Factors That Impact the Mental Health and Well-Being of Autistic Parents via Iterative Phenomenological Analysis. AUTISM IN ADULTHOOD 2023; 5:63-75. [PMID: 36941861 PMCID: PMC10024273 DOI: 10.1089/aut.2021.0101] [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: 11/12/2022]
Abstract
Background The autistic community have called for an increase in autism research exploring the lifespan experiences of autistic people. Researchers have notably neglected the parenting experiences of autistic adults. We aimed to study the factors that impact the mental health of autistic parents. We also explored the possible influence of childhood trauma. Methods Nine autistic parents took part in remote semi-structured interviews. We used participants' chosen communication modalities during interviews to facilitate accessibility. We carried out data analysis using the principles of Iterative Phenomenological Analysis, a qualitative approach where meaning is co-constructed by both the participant's interpretation of their personal experience and the researcher's subjective interpretation. Results We identified three superordinate themes: Identity and Purpose; Looking Through a Lens of Trauma; and External Factors. Our participants described intimate connections with their children, who were sources of love and joy. Their childhood trauma influenced their parenting experiences. They experienced extreme empathy, perfectionism, and a drive to protect their children from the same trauma. We found that professionals' acceptance and awareness of autism was essential for positive outcomes during interactions with participants. Participants also experienced pervasive sensory overload from their environments, related to a loss of trusted coping mechanisms when they became parents. Conclusions Our study draws attention to the influence of childhood trauma on the parenting experience of autistic adults. We reveal an unexplored long-term impact of childhood trauma resulting from a lack of support and othering of autistic children. Professionals should consider that autistic parents may be parenting through a lens of historical trauma. Professionals should be trained in trauma-informed approaches for providing support. Researchers should investigate this phenomenon to explore how this knowledge can be used to inform practise. Researchers should also investigate wider systemic and societal issues that have an impact on the mental health of autistic parents.
Collapse
Affiliation(s)
- Simone Smit
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jeremy Hopper
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| |
Collapse
|
32
|
Poustka L. Autismus-Spektrum-Störungen. Monatsschr Kinderheilkd 2023. [DOI: 10.1007/s00112-023-01700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
|
33
|
Yon-Hernández JA, Canal-Bedia R, Wojcik DZ, García-García L, Fernández-Álvarez C, Palacio-Duque S, Franco-Martín MA. Executive functions in daily living skills: A study in adults with autism spectrum disorder. Front Psychol 2023; 14:1109561. [PMID: 37113122 PMCID: PMC10127455 DOI: 10.3389/fpsyg.2023.1109561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Adults with autism and adults with schizophrenia show difficulties in adaptive skills, especially those related to daily functioning. Some studies suggest that adaptive skills are associated with deficits in executive functions (EF), while others indicate that intelligence quotient (IQ) might also play a role. Literature suggests that autistic symptoms further affect adaptive skills. The interest of the current study, therefore, was to explore to what extent IQ, EFs as well as core autistic symptoms predict adaptive skills. Methods To do this, 25 controls, 24 adults with autism, and 12 with schizophrenia were assessed on IQ (Wechsler Adult Intelligence Scale), and executive functioning. The EF was measured with neuropsychological tasks (inhibition, updating, and task switching) and with the Dysexecutive-Spanish Questionnaire (DEX-Sp) which assessed everyday life EF problems. Core ASD symptoms were measured using the Autism Diagnostic Observation Schedule, the Autism Spectrum Quotient-Short version (AQ-S), and the Repetitive Behavior Questionnaire - 3 (RBQ-3). Results The results indicated EF difficulties in both, autism and schizophrenia. The IQ explained a high percentage of the variance found in adaptive skills, but only in the autism group. We can conclude, therefore, that high IQ is associated with low adaptive skills levels and EFs affect adaptive functioning in people with autism; however, this does not explain the difficulties in adaptive functioning in the schizophrenia group. Core features of autism assessed with self-report questionnaires (but not the ADOS-2) predicted low scores on the adaptive skills, only in the autism group. Discussion Both EF measures predicted adaptive skills scores in autism, but not in schizophrenia. Our results suggest that different factors affect the adaptive functioning in each disorder. For instance, the EFs should be a central focus for improvement, especially for individuals with autism.
Collapse
Affiliation(s)
- Jo A. Yon-Hernández
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Ricardo Canal-Bedia
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- *Correspondence: Ricardo Canal-Bedia,
| | - Dominika Z. Wojcik
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | | | - Clara Fernández-Álvarez
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Stefanny Palacio-Duque
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A. Franco-Martín
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Zamora Hospital (Complejo Asistencial de Zamora), Zamora, Spain
| |
Collapse
|
34
|
Tsiplova K, Ungar WJ, Szatmari P, Cost K, Pullenayegum E, Duku E, Volden J, Smith IM, Waddell C, Zwaigenbaum L, Bennett TA, Elsabbagh M, Georgiades S, Zaidman-Zait A. Measuring the association between behavioural services and outcomes in young children with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 132:104392. [PMID: 36493738 DOI: 10.1016/j.ridd.2022.104392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) receive a wide range of services. AIMS To examine the association between behavioural services received by children with ASD between ages 2 and 5 years and outcomes during primary school years. METHODS A total of 414 preschool-aged children diagnosed with ASD were enrolled at five Canadian sites and were assessed within four months of diagnosis (T1), six months later (T2), 12 months later (T3), at school entry (T4), and then annually (T5-T8) to 11 years of age. The association between the receipt of behavioural services during T1 to T3 and T8 outcomes related to adaptive behaviour and behavioural problems was modelled using linear regressions adjusted for immigrant status, family income, child's age at diagnosis, site, sex assigned at birth, and baseline (T1) outcome. RESULTS Children who received behavioural services during at least one time period from T1 to T3 did not have significantly different outcomes at T8 than children who did not receive any behavioural services. IMPLICATIONS Pre-school use of behavioural services was not found to affect outcomes during later childhood. Numerous challenges accompany studies of the association between pre-school service use and later outcomes in a heterogeneous ASD sample. Recommendations for study design are provided.
Collapse
Affiliation(s)
- Kate Tsiplova
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
| | - Peter Szatmari
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Katherine Cost
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, 8205 114 Street, 3-48 Corbett Hall, Edmonton, Alberta T6G 2G4, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850 University Avenue, P. O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada; Autism Research Centre, IWK Health Centre, 4th Floor Link Building, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Room 2435, 515 West Hastings Street Vancouver, British Columbia V6B 5K, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue Edmonton, Alberta T6G 1C9, Canada
| | - Teresa A Bennett
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education, Constantiner School of Education, Tel Aviv University, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel; The School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| |
Collapse
|
35
|
Abstract
PURPOSE OF REVIEW The goal of this paper is to provide an overview of profiles of adaptive behavior in autism spectrum disorder and highlight the importance of these everyday skills in optimizing self-sufficiency throughout life. RECENT FINDINGS Research has clearly confirmed that adaptive deficits exist in ASD, particularly in social skills. These impairments are highly associated with co-occurring conditions such as executive functioning impairments, psychiatric conditions, and even psychosis. There tends to be a discrepancy between intellectual capacity and adaptive functioning, particularly in autistic individuals without cognitive and language delays, with this gap widening between childhood and adulthood. Although cognition and language skills are associated with good outcome in ASD, they are insufficient in the absence of intact adaptive behavior. There is a critical need to emphasize the importance of adaptive functioning in diagnostic evaluations and treatment/intervention programs to ensure that every autistic individual has the potential for success.
Collapse
|
36
|
Lee JYS, Whittingham K, Mitchell AE. Childhood experiences of being parented, adult attachment, psychological inflexibility, social engagement, and mental health of autistic adults. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 130:104343. [PMID: 36152473 DOI: 10.1016/j.ridd.2022.104343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/15/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Autistic adults have an increased risk of poor mental health. Although parental care and overprotection in childhood influence later attachment and mental health in the general adult population, this has not been investigated in the autistic population. Likewise, the roles of psychological inflexibility and social engagement in influencing mental health outcomes for autistic adults have yet to be examined. AIMS To examine if retrospectively recalled childhood experiences of parental care and overprotection, as well as current adult attachment, psychological inflexibility and social engagement are associated with mental health in autistic adulthood. Further, to examine mediators of the association between parental care and overprotection and mental health in autistic adults. METHODS AND PROCEDURES A community-recruited convenience sample of 126 Australian autistic adults completed an online survey assessing childhood experiences of parental care and overprotection and current adult attachment, psychological inflexibility, social engagement, and mental health. OUTCOMES AND RESULTS Linear regressions showed that psychological inflexibility was the strongest predictor of depression, anxiety, and stress, followed by attachment anxiety (depression, anxiety) and attachment avoidance (anxiety, stress). Mediation analyses revealed that psychological inflexibility and attachment anxiety mediated the associations between parental care and overprotection and mental health outcomes in autistic adulthood. CONCLUSIONS AND IMPLICATIONS Psychological inflexibility and adult attachment (anxious and avoidant attachment) are important to understanding mental health of autistic adults. Psychological inflexibility and attachment anxiety mediate associations between recalled childhood experiences of parental care and overprotection and mental health in autistic adulthood.
Collapse
Affiliation(s)
- Jia Ying Sarah Lee
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Amy E Mitchell
- School of Psychology, The University of Queensland, Brisbane, Australia; School of Nursing and Midwifery, Griffith University, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| |
Collapse
|
37
|
Prigge MBD, Bigler ED, Lange N, Morgan J, Froehlich A, Freeman A, Kellett K, Kane KL, King CK, Taylor J, Dean DC, King JB, Anderson JS, Zielinski BA, Alexander AL, Lainhart JE. Longitudinal Stability of Intellectual Functioning in Autism Spectrum Disorder: From Age 3 Through Mid-adulthood. J Autism Dev Disord 2022; 52:4490-4504. [PMID: 34677753 PMCID: PMC9090201 DOI: 10.1007/s10803-021-05227-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 12/02/2022]
Abstract
Intelligence (IQ) scores are used in educational and vocational planning for individuals with autism spectrum disorder (ASD) yet little is known about the stability of IQ throughout development. We examined longitudinal age-related IQ stability in 119 individuals with ASD (3-36 years of age at first visit) and 128 typically developing controls. Intelligence measures were collected over a 20-year period. In ASD, Full Scale (FSIQ) and Verbal (VIQ) Intelligence started lower in childhood and increased at a greater rate with age relative to the control group. By early adulthood, VIQ and working memory stabilized, whereas nonverbal and perceptual scores continued to change. Our results suggest that in individuals with ASD, IQ estimates may be dynamic in childhood and young adulthood.
Collapse
Affiliation(s)
- Molly B D Prigge
- Department of Radiology and Imaging Sciences, Radiology Research, University of Utah, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA.
| | - Erin D Bigler
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
- Department of Neurology, University of California-Davis, Davis, CA, USA
| | - Nicholas Lange
- Department of Psychiatry, Harvard School of Medicine, Boston, MA, USA
| | - Jubel Morgan
- Department of Radiology and Imaging Sciences, Radiology Research, University of Utah, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA
| | - Alyson Froehlich
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Abigail Freeman
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Kristina Kellett
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Karen L Kane
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Carolyn K King
- Department of Radiology and Imaging Sciences, Radiology Research, University of Utah, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA
| | - June Taylor
- Department of Radiology and Imaging Sciences, Radiology Research, University of Utah, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA
| | - Douglas C Dean
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, Radiology Research, University of Utah, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA
| | - Jeff S Anderson
- Department of Radiology and Imaging Sciences, Radiology Research, University of Utah, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA
| | - Brandon A Zielinski
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Andrew L Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Janet E Lainhart
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
38
|
Roestorf A, Howlin P, Bowler DM. Ageing and autism: A longitudinal follow-up study of mental health and quality of life in autistic adults. Front Psychol 2022; 13:741213. [PMID: 36081725 PMCID: PMC9447441 DOI: 10.3389/fpsyg.2022.741213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 06/29/2022] [Indexed: 12/27/2022] Open
Abstract
Background Poor mental health is known to adversely affect functional abilities, social isolation, and quality of life (QoL). It is, therefore, crucial to consider the long-term impacts of mental health conditions as autistic adults grow older. Objectives To explore, in a group of community-based autistic adults, the extent of: (i) autistic traits, co-occurring physical and mental health conditions; (ii) age-related differences in those conditions, and changes over time; and (iii) their impact on everyday living and QoL. Method About Sixty-eight autistic adults (aged 19–80 years) participated in the first study (T1); 49 participants from T1 took part in a follow-up at T2 (mean retest interval 2.4 years). Standardised self-report measures of autistic traits, mental health, and QoL were completed at both time points. Results Over two-thirds (71%) of autistic adult participants experienced at least one co-occurring condition, and over a third (37%) met the criteria for three or more co-occurring conditions. Mental and physical health difficulties were related to autistic traits and difficulties in everyday life and were consistent predictors of poor QoL at T1 and T2. Conclusion Mental health difficulties in autism persisted into older age and did not improve over time. These findings have important implications for mental health provision for autistic adults in older age.
Collapse
Affiliation(s)
- Amanda Roestorf
- Autism Research Group (ARG), Department of Psychology, City, University of London, London, United Kingdom
- *Correspondence: Amanda Roestorf,
| | - Patricia Howlin
- Department of Clinical Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dermot M. Bowler
- Autism Research Group (ARG), Department of Psychology, City, University of London, London, United Kingdom
| |
Collapse
|
39
|
Intensive behavioural interventions based on applied behaviour analysis (ABA) for young children with autism: A cost-effectiveness analysis. PLoS One 2022; 17:e0270833. [PMID: 35972929 PMCID: PMC9380934 DOI: 10.1371/journal.pone.0270833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background The economic and social costs of autism are significant. This study evaluates the cost-effectiveness of early intensive Applied Behaviour Analysis (ABA)-based interventions for autistic pre-school children in the UK. Methods A de novo economic analysis was developed in Microsoft Excel comparing early intensive ABA-based interventions compared with treatment as usual (TAU). The analysis used 15.5-year time horizon, with costs and benefits discounted a 3.5%. The model structure was based on cohort structure to capture changes in adaptive behaviour and cognitive ability over time. The analysis was informed by an individual patient data (IPD) meta-analysis of available evidence. Results Adopting a public sector perspective, early intensive ABA-based therapies were associated with greater incremental costs and greater benefits. When pessimistic assumptions were made regarding the long-term effects of treatment incremental costs were £46,103 and incremental quality-adjusted life years (QALYs) were 0.24, resulting in an incremental cost-effectiveness ratio (ICER) of £189,122 per quality-adjusted life year (QALY). When optimistic assumptions were made about long-term effects, incremental costs were £39,233 with incremental benefits of 0.84 QALYs. The resulting ICER was £46,768 per QALY. Scenario analyses emphasised the importance of assumptions made regarding adult outcomes and type of school attended, both of which significantly affect the results of the analysis. Conclusions The results of this economic analysis suggest that early intensive ABA-based interventions are unlikely to represent value for money, based on a £20,000 to £30,000 per QALY threshold typically adopted to inform UK healthcare funding decisions. However, important gaps in the available evidence, limit the strength of the conclusions that can be drawn from the presented analysis. Further research, focusing on the trajectory of autistic children following intervention is likely to be highly beneficial to resolving some of these uncertainties.
Collapse
|
40
|
Rødgaard E, Jensen K, Miskowiak KW, Mottron L. Representativeness of autistic samples in studies recruiting through social media. Autism Res 2022; 15:1447-1456. [PMID: 35809003 PMCID: PMC9541916 DOI: 10.1002/aur.2777] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/20/2022] [Indexed: 12/30/2022]
Abstract
Survey-based research with recruitment through online channels is a convenient way to obtain large samples and has recently been increasingly used in autism research. However, sampling from online channels may be associated with a high risk of sampling bias causing findings not to be generalizable to the autism population. Here we examined autism studies that have sampled on social media for markers of sampling bias. Most samples showed one or more indicators of sampling bias, in the form of reversed sex ratio, higher employment rates, higher education level, lower fraction of individuals with intellectual disability, and later age of diagnosis than would be expected when comparing with for example population study results from published research. Findings from many of the included studies are therefore difficult to generalize to the broader autism population. Suggestions for how research strategies may be adapted to address some of the problems are discussed. LAY SUMMARY: Online surveys offer a convenient way to recruit large numbers of participants for autism research. However, the resulting samples may not fully reflect the autism population. Here we investigated the samples of 36 autism studies that recruited participants online and found that the demographic composition tended to deviate from what has been reported about the autism population in previous research. The results may thus not be generalizable to autism in general.
Collapse
Affiliation(s)
| | - Kristian Jensen
- Department of Psychiatry and AddictologyUniversité de MontréalMontrealQuebecCanada
| | - Kamilla Woznica Miskowiak
- Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
- Psychiatric Centre CopenhagenRigshospitaletCopenhagenDenmark
| | - Laurent Mottron
- Department of Psychiatry and AddictologyUniversité de MontréalMontrealQuebecCanada
- Centre de Recherche du CIUSSS‐NIMHôpital Rivière‐des‐PrairiesMontréalQuebecCanada
| |
Collapse
|
41
|
Waldman J, McPaul A, Jahoda A. A comparison of the content and nature of worries of autistic and neurotypical young people as they transition from school. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:667-678. [PMID: 35893767 PMCID: PMC10074755 DOI: 10.1177/13623613221111313] [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: 11/16/2022]
Abstract
LAY ABSTRACT Autistic young people experience higher levels of anxiety than neurotypical young people. Having worries is part of feeling anxious. This makes it surprising that very little research has looked at the kind of worries autistic young people have. Leaving school, in particular, can be a worrying time for young people. Twenty-two autistic young people and 22 neurotypical young people who were at mainstream secondary schools agreed to take part in the study. They were between 16 and 18 years of age. They were asked to sort through a series of pictures, showing the different types of worries that young people might experience. They were then asked to pick out their four main worries and say how much they thought about each worry and how upset the worry made them. They also completed a questionnaire about their level of anxiety. There were similarities and differences between the autistic and neurotypical young people's worries. Both groups worried about failing and how they might get on in further education. The autistic young people were more worried about change and friendships. Work and money were particular concerns for the neurotypical young people. The autistic young people said that they found their worries more upsetting than the neurotypical young people. Having a better understanding of autistic young people's worries at important points in their lives might mean that more timely help and support can be given to them. Simply knowing what to ask young autistic school leavers about may help them to express unspoken concerns.
Collapse
Affiliation(s)
- Jack Waldman
- University of Glasgow, Gartnavel Royal Hospital, UK
| | | | | |
Collapse
|
42
|
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: 6] [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.
Collapse
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
| |
Collapse
|
43
|
Cameron LA, Tonge BJ, Howlin P, Einfeld SL, Stancliffe RJ, Gray KM. Social and community inclusion outcomes for adults with autism with and without intellectual disability in Australia. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:655-666. [PMID: 35677963 PMCID: PMC9328353 DOI: 10.1111/jir.12953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 04/12/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Research suggests that adults with autism tend to have poor outcomes. Outcomes have mostly been defined using summary outcome ratings, with less focus on specific outcomes such as employment, living situation, social satisfaction, loneliness, and friendships. This study aimed to explore social and community outcomes, including employment, education, living arrangements, friendships, and social satisfaction, for autistic adults with and without intellectual disability. METHOD Eighty-four adults with autism (mean age 34.2 years, SD = 4.5; 67% with co-occurring intellectual disability), recruited as children and adolescents, participated in the current study. Adult social and community inclusion outcomes were explored through interview and questionnaire, both parent/carer-report and self-report. RESULTS Participants predominantly lived with family or in supported accommodation, did not pursue higher education, and mostly participated in day activity programmes. Most had limited friendships as reported by parents/carers; however, self-report data (n = 28) indicated that adults were largely satisfied with their social relationships. Overall outcome was poor for 57%, and good/very good for 34%. Adults with intellectual disability generally had poorer outcomes. CONCLUSION Autistic adults encountered numerous difficulties in leading an independent life. Adults with co-occurring intellectual disability were most likely to experience difficulties; however, outcomes ranged from poor to very good for adults without intellectual disability. Discrepancies in parent/carer-report and self-reported experiences of friendships highlight the need to ensure individual experiences are captured in addition to parent/carer-report. Appropriate resources and programmes are crucial for adults with autism to support them to have the choice to live independently.
Collapse
Affiliation(s)
- L. A. Cameron
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - B. J. Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
| | - P. Howlin
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - S. L. Einfeld
- Brain and Mind CentreUniversity of SydneySydneyNew South WalesAustralia
| | - R. J. Stancliffe
- Centre for Disability Research and PolicyUniversity of SydneySydneyNew South WalesAustralia
| | - K. M. Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
| |
Collapse
|
44
|
Powell K, Macari S, Brennan-Wydra E, Feiner H, Butler M, Goncalves Fortes D, Boxberger A, Torres-Viso M, Morgan C, Lyons M, Chawarska K. Elevated symptoms of executive dysfunction predict lower adaptive functioning in 3-year-olds with autism spectrum disorder. Autism Res 2022; 15:1336-1347. [PMID: 35388596 PMCID: PMC9253075 DOI: 10.1002/aur.2715] [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] [Received: 08/23/2021] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/06/2022]
Abstract
Executive functioning (EF) deficits co-occur frequently with autism spectrum disorder (ASD) and have a long-term detrimental impact on quality of life of children and their families. Timely identification of risk for EF vulnerabilities may hasten access to early intervention and alleviate their long-term consequences. This study examines (1) if EF deficits are elevated in toddlers with ASD compared to nonautistic siblings of children with ASD, typically developing (TYP) toddlers, and toddlers with atypical developmental presentation; and (2) if EF deficits have a detrimental effect on adaptive functioning in ASD. Participants were recruited between September 2014 and October 2019 and included 73 toddlers with ASD, 33 nonautistic siblings of children with ASD, 35 toddlers with atypical development, and 28 TYP toddlers matched on chronological age (M = 39.01 months, SD = 3.11). EF deficits were measured using the BRIEF-P; adaptive skills were measured using the VABS-II. Whenever appropriate, analyses were controlled for MSEL verbal and nonverbal developmental quotient, ADOS-2 autism severity scores, and sex. Analyses revealed that toddlers with ASD exhibited elevated BRIEF-P scores across all domains compared to each of the three comparison groups. Higher BRIEF-P scores were associated with lower adaptive social, communication, and daily living skills while controlling for symptom severity, verbal and nonverbal functioning, and sex. In conclusion, marked vulnerabilities in EF are already present in 3-year-old toddlers with ASD and are predictive of the level of adaptive functioning in ASD. EF vulnerabilities in toddlers should be targeted for intervention to improve long-term outcomes in ASD. LAY SUMMARY: Many children with autism experience vulnerabilities in executive functioning (EF), which may include challenges with inhibition, working memory, cognitive flexibility, and planning. The study shows that these vulnerabilities can already be detected at age three and that their presence is linked with lower social, communication, and daily living skills. Screening children with ASD for EF challenges and helping those who have difficulties may improve their long-term outcomes.
Collapse
Affiliation(s)
- Kelly Powell
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Suzanne Macari
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Emma Brennan-Wydra
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Hannah Feiner
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Maureen Butler
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Diogo Goncalves Fortes
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Alexandra Boxberger
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Mariana Torres-Viso
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Chelsea Morgan
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Megan Lyons
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Yale University School of Medicine, Yale Child Study Center, New Haven, Connecticut, USA
| |
Collapse
|
45
|
Lin YJ, Chiu YN, Wu YY, Tsai WC, Gau SSF. Developmental Changes of Autistic Symptoms, ADHD Symptoms, and Attentional Performance in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2022:10.1007/s10803-022-05445-x. [PMID: 35420295 DOI: 10.1007/s10803-022-05445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 12/01/2022]
Abstract
This study followed up ADHD/autistic symptoms and attentional performance in children/adolescents with ASD and typically developing ones (TD) over 5-7 years. The participants were stratified by age at baseline into child (< 12 years) and adolescent (12-19 years) groups. ADHD symptoms, especially hyperactivity, and attentional functions significantly improved during follow-up, more in children than in adolescents, in both ASD and TD. Significantly more omission errors and perseverations were noted in ASD than TD through the follow-up. Children with ASD had more improvement in reaction time while adolescents with ASD had less improvement in commission errors and detectability than TD. No correlation of attentional functions and ADHD symptoms in ASD implied different neural mechanisms of ADHD symptoms between ASD and ADHD.
Collapse
Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.,Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Yu-Yu Wu
- YuNing Psychiatry Clinic, Taipei, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan. .,Department of Psychology, Graduate Institute of Epidemiology, and Preventive Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
46
|
Saulnier CA, Klaiman C. Assessment of adaptive behavior in autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Celine A. Saulnier
- Neurodevelopmental Assessment & Consulting Services Decatur Georgia USA
- Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA
| | - Cheryl Klaiman
- Department of Pediatrics, Marcus Autism Center Emory University School of Medicine, Children's Healthcare of Atlanta Atlanta Georgia USA
| |
Collapse
|
47
|
Demizu Y, Matsumoto J, Yasuda Y, Ito S, Miura K, Yamamori H, Fujimoto M, Hasegawa N, Ishimaru K, Hashimoto R. Relationship between autistic traits and social functioning in healthy individuals. Neuropsychopharmacol Rep 2022; 42:226-229. [PMID: 35365959 PMCID: PMC9216356 DOI: 10.1002/npr2.12249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/06/2022] Open
Abstract
AIM Social functioning is influenced by various factors. Autistic traits could be one of the factors that affect social functioning. METHODS In the present study, the relationship between autistic traits and social functioning among 755 healthy individuals was analyzed. Autistic traits were assessed with the autism-spectrum quotient. Social functioning was assessed by the social functioning scale and the social activity assessment. RESULTS The Autism-Spectrum Quotient total score was significantly negatively correlated with the social functioning scale total and all subscales of the social functioning scale. All subscales of the Autism-Spectrum Quotient except attention to detail were significantly negatively correlated with the social functioning scale total score. However, the Autism-Spectrum Quotient was not correlated with the social activity assessment, which indicates labor functioning. CONCLUSION Autistic traits of healthy individuals had a negative impact on situations in real life through social functioning for daily life-sustaining. The effect was not enough to affect labor functioning as indicated by working hours in healthy individuals. These findings should also be examined in individuals with autism spectrum disorder in future studies.
Collapse
Affiliation(s)
- Yuria Demizu
- Department of Developmental and Clinical Psychology, The Division of Human Developmental Sciences, Graduate School of Humanity and Sciences, Ochanomizu University, Tokyo, Japan.,Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Junya Matsumoto
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Life Grow Brilliant Mental Clinic, Medical Corporation Foster, Osaka, Japan
| | - Satsuki Ito
- Department of Developmental and Clinical Psychology, The Division of Human Developmental Sciences, Graduate School of Humanity and Sciences, Ochanomizu University, Tokyo, Japan.,Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Hidenaga Yamamori
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan.,Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - Michiko Fujimoto
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naomi Hasegawa
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Keiichiro Ishimaru
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.,Faculty of Core Research, Ochanomizu University, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| |
Collapse
|
48
|
Dialogic Priming and Dynamic Resonance in Autism: Creativity Competing with Engagement in Chinese Children with ASD. J Autism Dev Disord 2022; 53:2458-2474. [PMID: 35355175 DOI: 10.1007/s10803-022-05505-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 10/18/2022]
Abstract
A growing body of research has focused on the relationship between priming and engagement through dialogue (e.g. Tantucci and Wang in Appl Linguist 43(1):115-146, 2022; Mikulincer et al. in Cognit Emotion 25:519-531, 2011). The present study addresses this issue also in relation to creativity and provides a new applied model to measure intersubjective engagement in ASD vs neurotypical populations' speech. We compared two balanced corpora of naturalistic Mandarin interaction of typically developing children and children diagnosed with ASD (cf. Zhou and Zhang in Xueqian jiaoyu yanjiu [Stud Preschool Educ] 6:72-84, 2020). We fitted a mixed effects linear regression showing that in both neurotypical and ASD populations, dialogic priming significantly correlates with engagement and with whether the child could creatively re-use the original input to produce a new construction. What we found is that creativity and intersubjective engagement are in competition in children with ASD in contrast with the neurotypical population. This finding points to a relatively impeded ability in ASD to re-combine creatively a priming input during the here-and-now of a dialogic event.
Collapse
|
49
|
Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 258] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | | | | |
Collapse
|
50
|
Dempsey EE, Moore C, Johnson SA, Stewart SH, Smith IM. Moral Foundations Theory Among Autistic and Neurotypical Children. Front Psychol 2022; 12:782610. [PMID: 35095668 PMCID: PMC8795511 DOI: 10.3389/fpsyg.2021.782610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals' moral inclinations using Haidt's framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children's moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children's moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children.
Collapse
Affiliation(s)
| | - Chris Moore
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Shannon A. Johnson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Sherry H. Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Isabel M. Smith
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Autism Research Centre, IWK Health, Halifax, NS, Canada
| |
Collapse
|