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Ambrose K, Simpson K, Adams D. The relationship between social and academic outcomes and anxiety for children and adolescents on the autism spectrum: A systematic review. Clin Psychol Rev 2021; 90:102086. [PMID: 34598053 DOI: 10.1016/j.cpr.2021.102086] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 12/28/2022]
Abstract
Anxiety is the most common co-occurring condition in children on the autism spectrum but the potential impacts of anxiety on social and academic outcomes of children on the autism spectrum have not been systematically examined. In this review, 50 studies were identified that explore the relationship between anxiety and scores on social or academic measures in children on the autism spectrum. Social competence was frequently measured, and the findings of these studies were mixed. While other social constructs have received little attention, associations were found between anxiety and victimisation, and anxiety and social relationships. Only three studies focused on the impact of anxiety on scores on academic measures, highlighting the need for further research in this area. Anxiety was most frequently measured using subscales from broader behavioural instruments, which may not capture the range of anxiety symptoms of children on the autism spectrum. Future studies that include multi-informant methodologies and proportional representation of females and children with intellectual disability will further knowledge of the impact of anxiety in children on the spectrum.
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Affiliation(s)
- Kathryn Ambrose
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia.
| | - Kate Simpson
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia
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2
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Popow C, Ohmann S, Plener P. Practitioner's review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2021; 35:113-134. [PMID: 34160787 PMCID: PMC8429404 DOI: 10.1007/s40211-021-00395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/15/2021] [Indexed: 11/14/2022]
Abstract
Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders.
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Affiliation(s)
- Christian Popow
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Susanne Ohmann
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Paul Plener
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
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3
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Dellapiazza F, Audras-Torrent L, Michelon C, Baghdadli A. Clinical characteristics of children with ASD and comorbid ADHD: Association with social impairment and externalizing and internalizing behaviours. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103930. [PMID: 33690105 DOI: 10.1016/j.ridd.2021.103930] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are frequently occurring conditions that are often associated (ASD + ADHD). However, there are few comparative studies concerning the clinical presentation in patients formally diagnosed with both ASD and ADHD. Here, we aimed to 1) compare social impairment and externalizing/internalizing behavioural problems across four groups of children: ASD + ADHD, ASD alone, ADHD alone, and typical development and 2) examine their bidirectional relationship with ASD and/or ADHD symptoms. METHODS This study included 186 participants from 6 to 12 years of age: single ASD (n = 98), ASD + ADHD (n = 29), single ADHD (n = 28), and TD (n = 31). RESULTS The results showed that children in the ASD + ADHD and single ASD groups had a higher level of social impairment than those in the single ADHD group. In addition, children in the single ADHD group presented a greater attention deficit than those in the single ASD group. Externalizing /internalizing behaviours were more frequent in all groups with neuro-developmental disorders than in typical development. In addition, externalizing behavioural problems were related to ADHD severity in the ASD + ADHD and single ADHD groups, whereas internalizing behaviours were related to ASD severity. CONCLUSIONS These findings highlight the specific needs of children who have both ASD and ADHD and underscore the necessity of individualizing their interventions.
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Affiliation(s)
- Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France; Faculté de Médecine, Université de Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
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4
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Kildahl AN, Bakken TL, Matre EAW, Hellerud JMA, Engebretsen MH, Helverschou SB. Case study: identification of anxiety and subsequent intervention in an adolescent male with autism, severe intellectual disability and self-injurious behaviour. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 67:327-338. [PMID: 34552728 PMCID: PMC8451636 DOI: 10.1080/20473869.2020.1850160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 11/07/2020] [Accepted: 11/07/2020] [Indexed: 05/12/2023]
Abstract
Introduction: Anxiety disorders are highly prevalent in individuals with autism spectrum disorder (ASD), but knowledge is limited regarding identification and treatment of these disorders in individuals with ASD and more severe levels of intellectual disability (ID). The current case study aims to explore and describe the inpatient, psychiatric assessment in an adolescent male with ASD, severe ID and self-injurious behaviour (SIB) who was diagnosed with a co-occurring anxiety disorder. The study further aims to explore the implications of this diagnosis for subsequent intervention and care, including management of SIB. Materials and methods: Case study including multimodal, psychiatric assessment and subsequent intervention. Results: Following changes in care strategies attempting to incorporate the understanding of anxiety/trauma as contributing to SIB, a reduction of SIB was observed, and this reduced frequency was maintained when the patient was discharged from the inpatient setting. Conclusions: Though no causal inferences are possible, these experiences indicate that further research is needed regarding possible associations between SIB and anxiety in individuals with ASD, including implications for treatment. Experiences from the current case further indicate that it is possible to recognize and diagnose anxiety disorder in complex cases involving ASD, severe ID, limited verbal language skills, and severe SIB.
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Affiliation(s)
- Arvid Nikolai Kildahl
- Regional Section Mental Health, Intellectual Disabilities/Autism, Oslo University Hospital, Oslo, Norway
- NevSom Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Oslo, Norway
| | - Trine Lise Bakken
- Regional Section Mental Health, Intellectual Disabilities/Autism, Oslo University Hospital, Oslo, Norway
| | | | | | - Maria Hagen Engebretsen
- Regional Section Mental Health, Intellectual Disabilities/Autism, Oslo University Hospital, Oslo, Norway
| | - Sissel Berge Helverschou
- NevSom Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Oslo, Norway
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5
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Den houting J, Adams D, Roberts J, Keen D. An exploration of autism‐specific and non‐autism‐specific measures of anxiety symptomatology in school‐aged autistic children. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12174] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jacquiline Den houting
- Autism Centre of Excellence, School of Educational and Professional Studies, Griffith University, Brisbane, Queensland, Australia,
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia,
| | - Dawn Adams
- Autism Centre of Excellence, School of Educational and Professional Studies, Griffith University, Brisbane, Queensland, Australia,
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia,
| | - Jacqueline Roberts
- Autism Centre of Excellence, School of Educational and Professional Studies, Griffith University, Brisbane, Queensland, Australia,
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia,
| | - Deb Keen
- Autism Centre of Excellence, School of Educational and Professional Studies, Griffith University, Brisbane, Queensland, Australia,
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia,
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6
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Blacher J, Baker BL. Collateral Effects of Youth Disruptive Behavior Disorders on Mothers' Psychological Distress: Adolescents with Autism Spectrum Disorder, Intellectual Disability, or Typical Development. J Autism Dev Disord 2019; 49:2810-2821. [PMID: 29071563 DOI: 10.1007/s10803-017-3347-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Disruptive behavior disorders were assessed in 160 youth aged 13 years, with Autism Spectrum Disorder (ASD, n = 48), intellectual disability (ID, n = 28), or typical development (TD, n = 84). Mothers' reported collateral effects on their psychological adjustment were related to both youth disability status and clinical level behavior disorders. More youth with ASD or ID had clinical level behavior disorders than their TD peers, and their mothers reported significantly higher personal stress and psychological symptoms, as well as lower positive impact of the youth on the family. The youth's clinical level behavior disorders accounted for these differences more than the diagnostic status. Mothers high in dispositional optimism reported the lowest stress and psychological symptoms in relationship to youth behavior challenges.
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Affiliation(s)
- Jan Blacher
- Graduate School of Education, University of California, UCR, Sproul Hall, Riverside, CA, 92521, USA.
| | - Bruce L Baker
- Department of Psychology, University of California, Los Angeles (UCLA), Franz Hall, Los Angeles, CA, 90095, USA
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7
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Høyland AL, Nærland T, Engstrøm M, Torske T, Lydersen S, Andreassen OA. Atypical event-related potentials revealed during the passive parts of a Go-NoGo task in autism spectrum disorder: a case-control study. Mol Autism 2019; 10:10. [PMID: 30873274 PMCID: PMC6402134 DOI: 10.1186/s13229-019-0259-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 02/08/2019] [Indexed: 12/19/2022] Open
Abstract
Background The core features of autism spectrum disorder (ASD) are easily recognizable in non-structured clinical and real-life situations. The features are often difficult to capture in structured laboratory settings, and the results from tests do not necessarily reflect symptom severity. We investigated neurophysiological processing in the passive parts of a cued Go-NoGo task, using the active parts of the test as a comparator. Methods Forty-nine adolescents diagnosed with ASD and 49 typically developing (TD) adolescents (age 12–21 years) were included. Daily life executive function was assessed with the Behavior Rating Inventory of Executive Function (BRIEF). We applied a visual cued Go-NoGo task and recorded event-related potentials (ERPs). We investigated occipital N1, a component related to early perception of visual stimuli, and P3a, a fronto-central component related to switching of attention, in the passive and active parts of the test. Results During the passive parts, the ASD group had statistically significantly longer N1 latency (p < 0.001, Cohens d = 0.75) and enhanced amplitude of P3a (p = 0.002, Cohens d = 0.64) compared to the TD, while no significant differences were observed in the active parts. Both components correlated significantly with the Behavioral Regulation Index of the BRIEF (partial correlation r = 0.35, p = 0.003). Conclusion Delayed N1 response, indicating altered visual perception, and enhanced P3a response, indicating increased neural activation related to attention allocation, were found during the passive parts of a Go-NoGo task in ASD participants. These abnormal ERP signals in the non-structured settings were associated with everyday executive function, suggesting that neurophysiolocal measures related to atypical control of alertness and “hyper-awareness” underlie daily life dysfunction in ASD. Assessments during passive settings have a potential to reveal core neurobiological substrates of ASD. Electronic supplementary material The online version of this article (10.1186/s13229-019-0259-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne L Høyland
- 1Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergata 46, N-7030 Trondheim, Norway.,2Department of Pediatrics, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Terje Nærland
- 3NevSom, Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway.,4NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo, Norway
| | - Morten Engstrøm
- 5Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,6Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tonje Torske
- 7Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Stian Lydersen
- 1Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Klostergata 46, N-7030 Trondheim, Norway
| | - Ole A Andreassen
- 4NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo, Oslo, Norway.,8Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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8
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Vogan VM, Leung RC, Safar K, Martinussen R, Smith ML, Taylor MJ. Longitudinal Examination of Everyday Executive Functioning in Children With ASD: Relations With Social, Emotional, and Behavioral Functioning Over Time. Front Psychol 2018; 9:1774. [PMID: 30364134 PMCID: PMC6191468 DOI: 10.3389/fpsyg.2018.01774] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 09/03/2018] [Indexed: 11/13/2022] Open
Abstract
Executive functioning (EF) deficits are well-documented in Autism Spectrum Disorder (ASD), yet little is known about the longitudinal trajectory of "everyday" EF and links to social, emotional and behavioral outcomes in ASD. This study examined the profile of everyday EF utilizing parent-reported measures over 2 years, and explored whether prior estimates of EF were related to later co-morbid psychopathology and social functioning in 39 children with ASD and 34 typically developing (TD) children (ages 7-14 years). According to parent reports, children with ASD had impaired scores of EF in all domains at both time points, and showed no significant improvement across 2 years, compared to controls. Regression analyses showed that prior estimates of behavior regulation difficulties at time 1 uniquely predicted later emotional (i.e., symptoms of anxiety/depression) and behavioral (i.e., oppositionality/aggressiveness) problems in children with ASD 2 years later. Furthermore, an improvement of metacognitive skills predicted a reduction of social difficulties over 2 years in ASD. These results imply that EF may be a potential target of intervention for preventing and reducing co-morbid psychopathology and promoting social competence in youth with ASD. Furthermore, the findings that EF related to behavior is more critical for later emotional and behavioral functioning, whereas EF related to cognition is more critical for social functioning, indicates that it may be beneficial to tailor treatment. Future studies investigating the effectiveness of EF-based interventions in improving the cognitive, psychological and social outcomes in ASD are of high priority.
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Affiliation(s)
- Vanessa M Vogan
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada
| | - Rachel C Leung
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Kristina Safar
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rhonda Martinussen
- Institute of Child Study, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Mary Lou Smith
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Margot J Taylor
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
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9
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Menezes M, Robinson L, Sanchez MJ, Cook B. Depression in Youth with Autism Spectrum Disorders: a Systematic Review of Studies Published Between 2012 and 2016. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2018. [DOI: 10.1007/s40489-018-0146-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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10
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Torske T, Nærland T, Øie MG, Stenberg N, Andreassen OA. Metacognitive Aspects of Executive Function Are Highly Associated with Social Functioning on Parent-Rated Measures in Children with Autism Spectrum Disorder. Front Behav Neurosci 2018; 11:258. [PMID: 29375332 PMCID: PMC5767603 DOI: 10.3389/fnbeh.2017.00258] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 12/19/2017] [Indexed: 12/27/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is characterized by social dysfunction. Even though executive dysfunction has been recognized as important in understanding ASD, the findings are inconsistent. This might be due to different definitions of executive function (EF), which part of EF that has been studied, structured vs. unstructured tasks, inclusion of different moderators (age, IQ, sex) and different diagnostic categories within the spectrum. The main finding is that people with ASD have more EF difficulties than normal controls and more difficulties on open-end tasks than on structured cognitive tasks. Since some EF difficulties may not be observable in a laboratory setting, informant measures might have higher ecological validity than neuropsychological tests. Evidence suggests that executive dysfunctions are associated with social impairments, but few studies have investigated the details of this relationship, and it remains unclear what types of EF deficits are relevant for the social problems of individuals with ASD. Here we investigated which EF domains were associated with various domains of social function on parent-rated measures. A total of 86 children and adolescents with a diagnosis of ASD were included and tested for general cognitive abilities. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Social Responsiveness Scale (SRS). Multiple regression analysis revealed significant associations between SRS scores and age, sex, total IQ and the BRIEF indexes. The Metacognition Index from the BRIEF added significantly to the prediction of the SRS total score and the subscales Social Communication, Social Motivation and Autistic Mannerisms. The findings suggest that metacognitive aspects of EF are of particular importance for social abilities in children and adolescents with ASD. Earlier research has shown that typically developing (TD) children have a different relationship between EF and social function than children with ASD. They found that in TD children the EF domain related to behavioral regulation was most important to social function. The results from the current study may have implications for understanding the cognitive components of the social problems that define ASD, and may be relevant in developing more targeted clinical EF interventions related to core ASD dysfunctions.
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Affiliation(s)
- Tonje Torske
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Terje Nærland
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway.,NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Merete G Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Nina Stenberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, University of Oslo and Oslo University Hospital, Oslo, Norway
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11
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Munkhaugen EK, Torske T, Gjevik E, Nærland T, Pripp AH, Diseth TH. Individual characteristics of students with autism spectrum disorders and school refusal behavior. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:413-423. [PMID: 29241346 DOI: 10.1177/1362361317748619] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study compared social, executive, emotional, and behavioral characteristics of students with autism spectrum disorder who did and did not display school refusal behavior. The participants were 62 students with autism spectrum disorder without intellectual disability aged 9-16 years attending inclusive schools. Parents first completed questionnaires assessing social and executive functioning as well as emotional and behavioral problems. They then documented their child's school refusal behavior for a period of 20 days. Compared to students without school refusal behavior (n = 29), students with school refusal behavior (n = 33) were significantly less socially motivated; displayed more deficits in initiating tasks or activities, in generating ideas, responses, or problem-solving strategies; and displayed more withdrawn and depressive symptoms. Assessing social and executive functioning, as well as emotional problems, may help professionals provide tailored interventions for students with autism spectrum disorder and school refusal behavior, which will further be valuable in recognizing characteristics associated with school refusal behavior.
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12
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Andersen PN, Hovik KT, Skogli EW, Øie MG. Severity of Autism Symptoms and Degree of Attentional Difficulties Predicts Emotional and Behavioral Problems in Children with High-Functioning Autism; a Two-Year Follow-up Study. Front Psychol 2017; 8:2004. [PMID: 29184527 PMCID: PMC5694568 DOI: 10.3389/fpsyg.2017.02004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/02/2017] [Indexed: 12/27/2022] Open
Abstract
Children with autism often struggle with emotional and behavioral problems (EBP). This study investigated whether level of autism symptoms, attention problems or verbal IQ at baseline can predict EBP 2 years later in children with High-Functioning Autism (HFA). Thirty-four participants with HFA and 45 typically developing children (TD) (ages 9-16) were assessed with parent ratings of EBP, autism symptoms, attention problems, and a test of verbal IQ. The amount of autism symptoms and degree of attention problems at baseline significantly predicted EBP at follow-up, whereas verbal IQ did not. The findings from this study emphasize the importance of assessing and understanding the consequences of autism symptoms and attention problems when treating EBP in children with HFA. Furthermore, interventions aimed at improving ASD symptoms may positively affect the prevalence of EBP in children with HFA.
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Affiliation(s)
- Per N. Andersen
- Department of Education and Social Work, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Kjell T. Hovik
- Division of Mental Health Care, Innlandet Hospital Trust, Sanderud, Norway
| | - Erik W. Skogli
- Division of Habilitation and Rehabilitation, Innlandet Hospital Trust, Lillehammer, Norway
| | - Merete G. Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
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13
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Havdahl KA, von Tetzchner S, Huerta M, Lord C, Bishop SL. Utility of the Child Behavior Checklist as a Screener for Autism Spectrum Disorder. Autism Res 2015; 9:33-42. [PMID: 26140652 DOI: 10.1002/aur.1515] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 05/29/2015] [Accepted: 06/13/2015] [Indexed: 11/07/2022]
Abstract
The Child Behavior Checklist (CBCL) has been proposed for screening of autism spectrum disorders (ASD) in clinical settings. Given the already widespread use of the CBCL, this could have great implications for clinical practice. This study examined the utility of CBCL profiles in differentiating children with ASD from children with other clinical disorders. Participants were 226 children with ASD and 163 children with attention-deficit/hyperactivity disorder, intellectual disability, language disorders, or emotional disorders, aged 2-13 years. Diagnosis was based on comprehensive clinical evaluation including well-validated diagnostic instruments for ASD and cognitive testing. Discriminative validity of CBCL profiles proposed for ASD screening was examined with area under the curve (AUC) scores, sensitivity, and specificity. The CBCL profiles showed low discriminative accuracy for ASD (AUC 0.59-0.70). Meeting cutoffs proposed for ASD was associated with general emotional/behavioral problems (EBP; mood problems/aggressive behavior), both in children with and without ASD. Cutoff adjustment depending on EBP-level was associated with improved discriminative accuracy for school-age children. However, the rate of false positives remained high in children with clinical levels of EBP. The results indicate that use of the CBCL profiles for ASD-specific screening would likely result in a large number of misclassifications. Although taking EBP-level into account was associated with improved discriminative accuracy for ASD, acceptable specificity could only be achieved for school-age children with below clinical levels of EBP. Further research should explore the potential of using the EBP adjustment strategy to improve the screening efficiency of other more ASD-specific instruments.
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Affiliation(s)
- K Alexandra Havdahl
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, New York.,Lovisenberg Diaconal Hospital, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | | | - Marisela Huerta
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, New York
| | - Catherine Lord
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, New York
| | - Somer L Bishop
- Department of Psychiatry, University of California San Francisco, California
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14
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Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents with Autism Spectrum Disorder. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.jecm.2014.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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