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Accardo AL, Neely LC, Pontes NMH, Pontes MCF. Bullying Victimization is Associated with Heightened Rates of Anxiety and Depression Among Autistic and ADHD Youth: National Survey of Children's Health 2016-2020. J Autism Dev Disord 2024:10.1007/s10803-024-06479-z. [PMID: 39034347 DOI: 10.1007/s10803-024-06479-z] [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: 07/07/2024] [Indexed: 07/23/2024]
Abstract
Autistic youth and youth with ADHD have heightened rates of bullying victimization, anxiety, and depression. The purpose of this research is to use nationally representative US data to 1) estimate the prevalence of anxiety and depression among bullied neurodivergent youth and 2) investigate whether the association between bullying victimization and anxiety or depression is significantly greater among autistic youth and youth with ADHD. For this research, we used five years of data (2016-2020) from the nationally representative National Survey of Children's Health (NSCH), youth ages 12-17 years (n = 71,973). Data were analyzed with R and the R survey package to estimate average marginal percentages, risk differences, and additive interactions as recommended by STROBE guidelines. The study identified heightened anxiety and depression among bullied autistic or ADHD youth. Results also showed that the increase in the rate of anxiety or depression associated with bullying victimization was significantly greater among autistic youth and youth with ADHD relative to non-autistic non-ADHD youth; interactions were significant among both male and female youth. Autistic youth, youth with ADHD, and youth with co-occurring autism and ADHD are particularly vulnerable to bullying victimization and associated depression and anxiety. Future research is needed to understand why the association between bullying victimization and depression/anxiety is significantly greater among autistic and non-autistic ADHD youth. Recommendations include exploring school-wide anti-stigma initiatives to stop the reciprocal bullying-anxiety/depression cycle, routine bullying and mental health screening of autistic and ADHD youth, and clinical management of bullied autistic and ADHD youth with anxiety or depression.
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Affiliation(s)
- Amy L Accardo
- College of Education, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
| | - Leslie C Neely
- Department of Educational Psychology, The University of Texas at San Antonio, 501 W. Cesar E. Chavez Blvd, San Antonio, TX, 78207, USA
| | - Nancy M H Pontes
- School of Nursing, Rutgers University, 530 Federal Street, Camden, NJ, 08102, USA
| | - Manuel C F Pontes
- Rohrer College of Business, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
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2
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Nuske HJ, Smith T, Levato L, Bronstein B, Sparapani N, Garcia C, Castellon F, Lee HS, Vejnoska SF, Hochheimer S, Fitzgerald AR, Chiappe JC, Nunnally AD, Li J, Shih W, Brown A, Cullen M, Hund LM, Stahmer AC, Iadarola S, Mandell DS, Hassrick EM, Kataoka S, Kasari C. Building Better Bridges: Outcomes of a Community-Partnered New School Transition Intervention for Students on the Autism Spectrum. J Autism Dev Disord 2024:10.1007/s10803-024-06285-7. [PMID: 38865033 DOI: 10.1007/s10803-024-06285-7] [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: 02/12/2024] [Indexed: 06/13/2024]
Abstract
New school transitions can be challenging for students on the autism spectrum. No published, evidence-based interventions exist to support families and teachers of students transitioning to elementary and secondary school during this critical period. Using Community Partnered Participatory Research, we developed Building Better Bridges (BBB), a caregiver coaching intervention that includes training on effective school communication, educational rights, advocacy, and child preparation strategies. We compared BBB (n = 83) to a module/resources-only comparison (n = 87) in a four-site randomized controlled trial in racially and ethnically diverse, under-resourced communities. In our intent-to-treat analysis, caregivers and teachers in BBB rated students' transitions to the new classroom as more positive, relative to the comparison group. Results suggest this low-cost intervention can improve the transition process for families and students at high risk of poor transitions.
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Affiliation(s)
- Heather J Nuske
- Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Tristram Smith
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Lynne Levato
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Briana Bronstein
- Center for Education, College of Health & Human Services, Widener University, Chester, PA, USA
| | - Nicole Sparapani
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Consuelo Garcia
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Fernanda Castellon
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Hyon Soo Lee
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Sarah F Vejnoska
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Samantha Hochheimer
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Amber R Fitzgerald
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jenny C Chiappe
- Teacher Education Division, Special Education, College of Education, California State University, Dominguez Hills, Carson, CA, USA
| | - Amanda Dimachkie Nunnally
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jennica Li
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Wendy Shih
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Ashlee Brown
- Professional Development and Research, Early Learning Services, Elwyn, Philadelphia, PA, USA
| | - Michelle Cullen
- Special Education Department, Rochester City School District, Rochester, NY, USA
| | - Lisa M Hund
- Health Resources and Services Administration, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Rockville, MD, USA
| | - Aubyn C Stahmer
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Suzannah Iadarola
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - David S Mandell
- Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Sheryl Kataoka
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Connie Kasari
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
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McMaughan DJ, Lewis C, McGehee A, Noreen D, Parker E, Criss MM. Meaningful Social Inclusion and Mental Well-Being Among Autistic Adolescents and Emerging Adults: Protocol for a Community-Based Mixed Methods Study. JMIR Res Protoc 2024; 13:e52658. [PMID: 38483470 PMCID: PMC10979331 DOI: 10.2196/52658] [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: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND In the United States, autistic people face high rates of co-occurring mental illnesses and premature death due to self-harm, which are indicators of threats to mental well-being. Social inclusion may enhance mental well-being and resilience among autistic people. According to Simplican and colleague's (2015) model of social inclusion for people with intellectual and developmental disabilities, social inclusion is an interaction between community participation and interpersonal relationships. There is limited research on social inclusion that includes the integration of interpersonal relationships and community participation among autistic people or the impact of social inclusion on the well-being of autistic people. Additionally, little evidence exists regarding how autistic people prefer to be included in the community or form interpersonal relationships. OBJECTIVE The long-term objective of this project is to improve social inclusion factors to support the mental well-being of autistic people. This protocol describes a community-based, mixed methods pilot study to develop a definition of meaningful social inclusion for autistic people and to understand the relationship between meaningful social inclusion and mental well-being among autistic adolescents and emerging adults. METHODS The project uses a community-based, sequential mixed methods design with a formative phase (Phase 1) that informs a survey phase (Phase 2) and concludes with a process evaluation of the community engagement process (Phase 3). During Phase 1, we will recruit 10 community partners (autistic adults and stakeholders) and conduct sharing sessions to cocreate a definition of meaningful social inclusion and a survey of meaningful social inclusion and well-being. During Phase 2, we will recruit 200 participants (100 autistic adolescents and emerging adults and 100 caregivers) to complete the survey. We will examine whether meaningful social inclusion predicts well-being given sociodemographic factors using ordered logistic regression, with well-being categorized as low, medium, and high. During Phase 3, the community partners from Phase 1 will complete a survey on their experiences with the project. RESULTS Ethics approval was obtained for this project in March 2023. We have recruited community partners and started the Phase 1 focus groups as of September 2023. Phase 2 and Phase 3 have not yet started. We expect to complete this study by March 2025. CONCLUSIONS Using a community-based, mixed methods approach, we intended to develop a definition of meaningful social inclusion for autistic people and understand the role meaningful social inclusion plays in the well-being of autistic people. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52658.
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Affiliation(s)
- Darcy Jones McMaughan
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Casey Lewis
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Amy McGehee
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Dani Noreen
- Neurodiversity Unbound, Aurora, CO, United States
| | - Elliot Parker
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Michael M Criss
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
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Wright N, Courchesne V, Pickles A, Bedford R, Duku E, Kerns CM, Bennett T, Georgiades S, Hill J, Richard A, Sharp H, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children. Psychol Med 2023; 53:7707-7719. [PMID: 37381780 PMCID: PMC10755241 DOI: 10.1017/s0033291723001599] [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] [Received: 12/29/2021] [Revised: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.
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Affiliation(s)
- N. Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - V. Courchesne
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - A. Pickles
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - R. Bedford
- Department of Psychology, University of Bath, Bath, UK
| | - E. Duku
- McMaster University, Hamilton, Canada
| | - C. M. Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | | | | | - J. Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - A. Richard
- IWK Health Centre, Autism Research Centre, Halifax, Canada
| | - H. Sharp
- Department of Primary Care and Mental Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - I. M. Smith
- Dalhousie University and IWK Health, Halifax, Canada
| | | | | | | | - P. Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - M. Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Pathways Team
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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Marion A, Bowman K, Thomas G, Harrison AJ. A mixed method examination: how stigma experienced by autistic adults relates to metrics of social identity and social functioning. Front Psychiatry 2023; 14:1243618. [PMID: 37965369 PMCID: PMC10640997 DOI: 10.3389/fpsyt.2023.1243618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
A recent meta-analysis reveals almost half of autistic individuals experience some form of victimization in their lifetime, including bullying and other forms of stigma. Research among caregivers of autistic individuals demonstrates that stigma can have a long-lasting impact on other aspects of a social identity, such as self-esteem, but less research has specifically examined this among autistic adults themselves, in spite of research suggesting these are likely constructs that contribute to the internalization of stigma and subsequent mental health consequences. The current study used a mixed method approach to assess the relation between stigma and several components of social identity and social functioning. More specifically, among 45 autistic young adults, three dimensions of self-reported stigma (discrimination, disclosure, and positive aspects) were examined in relation to self-esteem, self-efficacy, social satisfaction and adaptive social functioning. Quantitative analyses revealed higher reported discriminative and disclosure stigma were significantly associated with lower self-efficacy. Increased experience with all types of stigma were associated with lower social satisfaction. Greater reported disclosure stigma was also associated with lower self-esteem. Qualitative interviewing among eight autistic young adults helped to better understand the nature of stigma and the impact of these experiences. Thematic analysis of the qualitative data revealed that all of the participants experienced stigma in the form of exclusion or isolation and that a majority also experienced verbal bullying. Many of the negative interactions came from educators, peers, and family members. Most participants indicated that these stigmatizing interactions directly contributed to decreased social satisfaction, diminished self-efficacy, and lowered self-esteem. A greater understanding of the negative consequences of stigma can inform efforts to increase awareness and acceptance of autism.
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Affiliation(s)
- Alex Marion
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Karrah Bowman
- Department of Educational Psychology, University of Georgia, Athens, GA, United States
| | - Gina Thomas
- Department of Educational Psychology, University of Georgia, Athens, GA, United States
| | - Ashley J. Harrison
- Department of Educational Psychology, University of Georgia, Athens, GA, United States
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Hotez E, Giwa Onaiwu M. A Neurodiversity-Oriented Approach to Address Autism Wandering as a "Problem Behavior" in Pediatrics. Cureus 2023; 15:e40862. [PMID: 37492814 PMCID: PMC10363653 DOI: 10.7759/cureus.40862] [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: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023] Open
Abstract
Pediatricians are frequently tasked with addressing autism "problem behaviors," including wandering, defined as leaving the safety of a responsible person's care or a safe area (alternatively referred to as elopement). In the following commentary, we - as autism researchers and individuals with lived experience - discuss the prevalence and public health consequences of wandering. We conceptualize wandering in the context of "problem behaviors" for autistic individuals and describe the current state of the evidence on wandering prevention and intervention. We emphasize that pediatricians have a unique opportunity to optimize their efforts to address wandering - as well as related "problem behaviors" - utilizing a neurodiversity orientation. This will allow them to enact approaches that address the potential upstream mechanisms underlying wandering to make these efforts more effective and provide critical assistance to families. In this manuscript, we provide recommendations to pediatricians to more effectively address the mechanisms underlying and exacerbating these challenges to improve the health, well-being, and quality of life of autistic children and their families. In particular, we recommend that pediatricians focus efforts toward 1) addressing the link between chronic stress and "problem behaviors"; 2) engaging individuals, caregivers, and families as experts in their health and development; and 3) collaborating with the systems and sectors relevant to autistic individuals and their families.
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Affiliation(s)
- Emily Hotez
- General Internal Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
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Tone EB, Henrich CC. Peer victimization and social confidence in youth with disabilities. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2023. [DOI: 10.1016/j.appdev.2023.101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Liu TL, Chen YL, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Chou WJ, Yen CF. Adolescent-Caregiver Agreement Regarding the School Bullying and Cyberbullying Involvement Experiences of Adolescents with Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3733. [PMID: 36834428 PMCID: PMC9961965 DOI: 10.3390/ijerph20043733] [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: 01/11/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
School bullying and cyberbullying victimization and perpetration are prevalent in adolescents with autism spectrum disorder (AASD). However, the levels of adolescent-caregiver agreement regarding the bullying involvement of AASD and the factors associated with these levels remain to be evaluated. In the present study, we evaluated the levels of adolescent-caregiver agreement on the school bullying and cyberbullying involvement experiences of AASD and the factors associated with the levels of agreement. This study included 219 dyads of AASD and their caregivers. The school bullying and cyberbullying involvement experiences of the participating AASD were assessed using the School Bullying Experience Questionnaire and the Cyberbullying Experiences Questionnaire, respectively. Attention-deficit/hyperactivity disorder, oppositional defiant disorder (ODD), depressive and anxiety symptoms, and autistic social impairment were also assessed. AASD and their caregivers had poor to fair levels of agreement regarding the school bullying and cyberbullying victimization and perpetration experiences of AASD. Severe inattention, hyperactivity-impulsivity, ODD, depressive and anxiety symptoms, and autistic social impairment were associated with high levels of adolescent-caregiver agreement. When assessing the bullying involvement experiences of AASD, mental health professionals should obtain information from multiple sources. In addition, the factors influencing the levels of agreement should be considered.
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Affiliation(s)
- Tai-Ling Liu
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Lung Chen
- Department of Psychology, Asia University, Taichung 41354, Taiwan
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98105, USA
| | - Hsing-Chang Ni
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
| | - Chiao-Fan Lin
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Hsiang-Lin Chan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Yi-Hsuan Hsieh
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan
| | - Liang-Jen Wang
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Kaohsiung Medical Center, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Min-Jing Lee
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Wen-Jiun Chou
- School of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Kaohsiung Medical Center, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Leno VC, Wright N, Pickles A, Bedford R, Zaidman-Zait A, Kerns C, Zwaigenbaum L, Duku E, Bennett T, Georgiades S, Smith IM, Richards A, Vaillancourt T, Szatmari P, Elsabbagh M. Longitudinal associations between early childhood irritability and adolescent depression symptoms in autistic children are mediated by peer relationships but not educational engagement. Dev Psychopathol 2023; 36:1-11. [PMID: 36700357 PMCID: PMC7615659 DOI: 10.1017/s0954579422001316] [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] [Indexed: 01/27/2023]
Abstract
In the general population, irritability is associated with later depression. Despite irritability being more prevalent in autistic children, the long-term sequelae are not well explored. We tested whether irritability in early childhood predicted depression symptoms in autistic adolescents, and whether associations could be explained by difficulties in peer relationships and lower educational engagement. Analyses tested the longitudinal associations between early childhood irritability (ages 3-5) and adolescent depression symptoms (age 14) in a prospective inception cohort of autistic children (N = 390), followed from early in development shortly after they received a clinical diagnosis. Mediators were measured in mid-childhood (age 10) by a combination of measures, from which latent factors for peer relationships and educational engagement were estimated. Results showed early childhood irritability was positively associated with adolescent depression symptoms, and this association remained when adjusting for baseline depression. A significant indirect pathway through peer relationships was found, which accounted for around 13% of the association between early childhood irritability and adolescent depression, suggesting peer problems may partially mediate the association between irritability and later depression. No mediation effects were found for education engagement. Results highlight the importance of early screening and intervention for co-occurring irritability and peer problems in young autistic children.
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Affiliation(s)
- Virginia Carter Leno
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Nicola Wright
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Psychology, Manchester Metropolitan University, United Kingdom
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Rachael Bedford
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Psychology, University of Bath, United Kingdom
| | | | - Connor Kerns
- University of British Columbia, Vancouver, Canada
| | | | - Eric Duku
- McMaster University, Hamilton, Ontario, Canada
| | | | | | - Isabel M. Smith
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Annie Richards
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ontario, Canada
| | - Peter Szatmari
- University of Toronto, Canada
- Centre for Addiction and Mental Health, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Quebec, Canada
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McMaughan DJD, Jones JL, Mulcahy A, Tucker EC, Beverly JG, Perez-Patron M. Hospitalizations Among Children and Youth With Autism in the United States: Frequency, Characteristics, and Costs. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:484-503. [PMID: 36454617 DOI: 10.1352/1934-9556-60.6.484] [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: 12/20/2020] [Accepted: 03/15/2022] [Indexed: 06/17/2023]
Abstract
National estimates of hospitalization diagnoses and costs were determined using the 2016 HCUP Kids' Inpatient Database. Children and youth with autism were hospitalized over 45,000 times at over $560 million in costs and 260,000 inpatient days. The most frequent principal diagnoses for hospitalizations of children and youth with autism were epilepsy, mental health conditions, pneumonia, asthma, and gastrointestinal disorders, which resulted in almost $200 million in costs and 150,000 inpatient days. Mental health diagnoses accounted for 24.8% of hospitalizations, an estimated $82 million in costs, and approximately 94,000 inpatient days. Children and youth with autism were more likely hospitalized for epilepsy, mental health diagnoses, and gastrointestinal disorders, and less likely for pneumonia and asthma compared to other children and youth.
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11
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Fredrick SS, Nickerson AB, Sun L, Rodgers JD, Thomeer ML, Lopata C, Todd F. ASD Symptoms, Social Skills, and Comorbidity: Predictors of Bullying Perpetration. J Autism Dev Disord 2022:10.1007/s10803-022-05612-0. [PMID: 35678945 DOI: 10.1007/s10803-022-05612-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
Abstract
Children with ASD are more likely to be involved in bullying compared to typically developing peers; however, studies rarely examine bullying perpetration and the contributing factors among this population. The primary aim of this study was to examine the extent to which parent-reported ASD symptoms, social skills, and comorbid externalizing and internalizing symptoms predicted bullying perpetration in a sample of 390 children with ASD without intellectual disability. Findings from hierarchical regression analyses indicated that social skill deficits, externalizing symptoms (i.e., hyperactivity, aggression, and conduct problems), and depressive symptoms were associated with higher likelihood of bullying perpetration, while severity of ASD symptoms and anxiety were not significant predictors. Further research is needed to better understand bullying perpetration among children with ASD.
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Affiliation(s)
- Stephanie S Fredrick
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, State University of New York, Buffalo, NY, USA.
| | - Amanda B Nickerson
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Lucia Sun
- Alberti Center for Bullying Abuse Prevention, University at Buffalo, State University of New York, Buffalo, NY, USA
| | | | - Marcus L Thomeer
- Institute for Autism Research, Canisius College, Buffalo, NY, USA
| | | | - Fable Todd
- Institute for Autism Research, Canisius College, Buffalo, NY, USA
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Estabillo JA, Moody CT, Poulhazan SJ, Adery LH, Denluck EM, Laugeson EA. Efficacy of PEERS® for Adolescents via Telehealth Delivery. J Autism Dev Disord 2022; 52:5232-5242. [PMID: 35624224 PMCID: PMC9137447 DOI: 10.1007/s10803-022-05580-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 11/16/2022]
Abstract
PEERS® for Adolescents is an evidence-based social skills intervention for autistic youth and adolescents with other social challenges. The efficacy and effectiveness of PEERS® are well established; however, limited data on PEERS® via telehealth delivery exist. The current study aimed to examine the efficacy of PEERS® for Adolescents via telehealth and compare outcomes between telehealth and in-person modalities. Thirty-one adolescents (Mage = 13.77, SD = 2.14) participated in telehealth groups, and outcomes were compared with 212 adolescents (Mage = 14.02, SD = 2.00) from in-person groups. Findings demonstrate PEERS® for Adolescents via telehealth results in significant improvements in social skills knowledge, social responsiveness, overall social skills and problem behaviors, and social engagement. Telehealth outcomes are relatively equivalent to in-person delivery.
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Affiliation(s)
- Jasper A Estabillo
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA. .,Department of Psychology, University of California, Los Angeles, CA, USA.
| | - Christine T Moody
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Solene J Poulhazan
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Laura H Adery
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Elizabeth M Denluck
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,College of Education School Psychology Program, University of Oregon, Eugene, OR, USA
| | - Elizabeth A Laugeson
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
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Lu HH, Chen DR, Chou AK. The school environment and bullying victimization among seventh graders with autism spectrum disorder: a cohort study. Child Adolesc Psychiatry Ment Health 2022; 16:22. [PMID: 35292070 PMCID: PMC8925143 DOI: 10.1186/s13034-022-00456-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/05/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is strong evidence to support the association between bullying and the onset of mental health conditions in students with ASD (autism spectrum disorder). In Taiwan, the seventh grade marks the first year of middle school, following elementary school. This period is also when peers tend to perform bullying behaviours to establish status among the peer group. Therefore, seventh grade is considered one of the most challenging times for students with ASD due to several changes within the school environment and the developmental changes that arise at this age. This study aims to assess the association between the school environment and bullying victimization among students with autism spectrum disorder (ASD) enrolled in regular classes in their first year of middle school. METHODS Data were obtained from the Special Needs Education Longitudinal Study database located in the Survey Research Data Archive of Academia Sinica. The analysis included one hundred eighty-four seventh graders with ASD who were in regular classes across Taiwan. The primary variables under study were whether the participants had experienced social exclusion, insults or teasing, extortion, or sexual harassment over the past semester. RESULTS Participants with a higher positive friendship quality (P = 0.027) and who had received more peer support upon encountering difficulties in school (P = 0.041) were less likely to experience social exclusion. Participants with a higher positive friendship quality (P = 0.001) and a more positive classroom learning environment (P = 0.031) were less likely to have experienced insults or teasing. However, participants with more friends were more likely to be extorted (P = 0.015) and sexually harassed (P = 0.001) than those with fewer friends. Furthermore, participants in regular classes on a part-time basis were 2.59 times more likely to report sexual harassment than those in regular classes on a full-time basis (P = 0.021). CONCLUSIONS This study suggests that a supportive school environment reduces the likelihood that seventh-graders with ASD will be bullied. Clinicians should consider the association between the school environment and bullying victimization among adolescents with ASD in regular classes during their first year of middle school.
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Affiliation(s)
- Hsin-Hui Lu
- grid.411641.70000 0004 0532 2041Department of Psychology, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Duan-Rung Chen
- Institute of Health Behaviors and Community Sciences, National Taiwan University, Room 636, No 17, Xu-Zhou Road, Taipei 100, Taipei, Taiwan.
| | - An-Kuo Chou
- grid.19188.390000 0004 0546 0241Department of Pediatrics, National Taiwan University Hsin-Chu Hospital, Hsinchu, Taiwan
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Liu TL, Wang PW, Hsiao RC, Ni HC, Liang SHY, Lin CF, Chan HL, Hsieh YH, Wang LJ, Lee MJ, Chou WJ, Yen CF. Multiple types of harassment victimization in adolescents with autism spectrum disorder: Related factors and effects on mental health problems. J Formos Med Assoc 2022; 121:2161-2171. [DOI: 10.1016/j.jfma.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 12/27/2021] [Accepted: 03/09/2022] [Indexed: 10/31/2022] Open
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Tripathi I, Estabillo JA, Moody CT, Laugeson EA. Long-Term Treatment Outcomes of PEERS ® for Preschoolers: A Parent-Mediated Social Skills Training Program for Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:2610-2626. [PMID: 34302574 PMCID: PMC9114088 DOI: 10.1007/s10803-021-05147-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 12/02/2022]
Abstract
Although parent-assisted social skills interventions may reduce early social challenges in preschool-aged children with autism spectrum disorder (ASD), limited research has explored whether intervention gains maintain several years after treatment. This study examined the durability of PEERS® for Preschoolers, a parent-mediated social skills training program for preschool-aged children with ASD and other social challenges. Twenty-nine parents reported on child and family outcomes 1–5 years following treatment. Results demonstrated maintenance of treatment gains on measures of ASD-related social impairments including social communication, social responsiveness, social motivation, and peer engagement. Post-treatment improvements in problem behaviors and parenting stress were not maintained at long-term follow-up. Implications of these results are discussed.
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Affiliation(s)
- Isita Tripathi
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA. .,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Jasper A Estabillo
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychology, University of California, 1264 Franz Hall, Los Angeles, CA, 90095-1759, USA
| | - Christine T Moody
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, 300 UCLA Medical Plaza, Los Angeles, CA, 90095-6967, USA
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Weiss JA, Robinson S, Riddell RP, Flora D. Understanding Stability and Change in Perceived Social Support in Parents of Autistic Children and Adolescents. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:679974. [PMID: 36188809 PMCID: PMC9397722 DOI: 10.3389/fresc.2021.679974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/30/2021] [Indexed: 12/28/2022]
Abstract
Parents of children with autism often have their own support needs. Informal social support can be an important component of managing parenting-related stressors. We know very little about the factors that lead to higher levels of perceived social support or the potential reciprocal relationship social support has with other factors in parents of children with autism. The current longitudinal study examined the reciprocal relations of perceived social support and parent stress and child behavior problems across a 1-year period, using three time points. There was remarkable stability in variables over time. Baseline perceived social support significantly predicted changes in child behavior and parent stress at the 6-month time point, but neither of those variables significantly predicted social support. This study adds to our understanding of social support and clarifies how perceived social support relates to other factors longitudinally.
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Affiliation(s)
- Jonathan A. Weiss
- Developmental Disabilities and Mental Health Laboratory, Department of Psychology, York University, Toronto, ON, Canada
- *Correspondence: Jonathan A. Weiss
| | - Suzanne Robinson
- Developmental Disabilities and Mental Health Laboratory, Department of Psychology, York University, Toronto, ON, Canada
- Roncesvalles Psychology Clinic, Toronto, ON, Canada
| | - Rebecca Pillai Riddell
- Opportunities to Understanding Childhood Hurt Laboratory, Department of Psychology, York University, Toronto, ON, Canada
| | - David Flora
- Quantitative Methods, Department of Psychology, York University, Toronto, ON, Canada
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Social Anxiety in Victimization and Perpetration of Cyberbullying and Traditional Bullying in Adolescents with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115728. [PMID: 34073617 PMCID: PMC8198472 DOI: 10.3390/ijerph18115728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
Victimization and perpetration of cyberbullying and traditional bullying are prevalent among adolescents with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The aims of this study were to examine the role of social anxiety in victimization and perpetration of cyberbullying and traditional bullying in adolescents with ASD and ADHD in Taiwan. A total of 219 adolescents with ASD and 287 adolescents with ADHD aged 11–18 years and their caregivers were recruited from the child psychiatry outpatient clinics into this study. The associations of social anxiety with victimization and perpetration of cyberbullying and traditional bullying were examined using logistic regression analysis. The results indicated that after the effects of sex, age, and autistic social impairment were controlled, social anxiety increased the risk of being a victim of cyberbullying (Odds Ratios (OR) = 1.048; 95% Confidence Interval (CI): 1.013–1.084), a victim of traditional bullying (OR = 1.066; 95% CI: 1.036–1.097), and a perpetrator of traditional bullying (OR = 1.061; 95% CI: 1.027–1.096) in adolescents with ASD. After the effects of sex, age, and ADHD symptoms were controlled for, social anxiety increased the risk of being a victim of traditional bullying in adolescents with ADHD (OR = 1.067; 95% CI: 1.039–1.096). Social anxiety was significantly associated with several forms of bullying involvement in adolescents with ASD and ADHD and warrants being considered into prevention and intervention programs for bullying involvement.
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Scott M, Sedgewick F. 'I have more control over my life': A qualitative exploration of challenges, opportunities, and support needs among autistic university students. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2021; 6:23969415211010419. [PMID: 36440371 PMCID: PMC9685136 DOI: 10.1177/23969415211010419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Autistic people are known to experience more mental health issues than non-autistic people, and the same is true among university students. These difficulties can have long-term consequences, such as dropping out of university and unemployment. Understanding the challenges autistic students face can help institutions to better support this group, while allowing celebration of the opportunities higher education offers. METHODS 12 autistic university students took part in semi-structured interviews about their mental health, the impact of university on their mental health, and their experiences of support while in higher education. Interviews were subject to thematic analysis. RESULTS Three key themes were identified from autistic student accounts: Relationships, Independence, and Support. While each of these encompassed positive and negative elements, Relationships were described as tying everything together - when these were supportive, things went well, but when they were characterized by stigmatizing attitudes, students experienced much greater difficulties at university. CONCLUSIONS Autistic students can and do thrive at university, as shown by many of our participants. However, all faced significant challenges with their mental health at times, and experienced varying levels of support. Improving autism knowledge among staff, with emphasis on enabling better relationships, would make a significant difference to the autistic student experience.
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Affiliation(s)
- Matthew Scott
- School of Education, University of Bristol, UK; School of Psychology, University of Cardiff, UK
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