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Bennett T, Drmic I, Gross J, Jambon M, Kimber M, Zaidman-Zait A, Andrews K, Frei J, Duku E, Georgiades S, Gonzalez A, Janus M, Lipman E, Pires P, Prime H, Roncadin C, Salt M, Shine R. The Family-Check-Up® Autism Implementation Research (FAIR) Study: protocol for a study evaluating the effectiveness and implementation of a family-centered intervention within a Canadian autism service setting. Front Public Health 2024; 11:1309154. [PMID: 38292388 PMCID: PMC10826514 DOI: 10.3389/fpubh.2023.1309154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Prevalence rates of emotional and behavior problems (EBP) in autistic children and youth are high (40-70%), and often cause severe and chronic impairment. Furthermore, autistic children are also more likely to experience family "social-ecological" adversity compared to neurotypically developing peers, including social isolation, child maltreatment, caregiver mental illness, and socioeconomic risk. These family stressors increase the risk of co-occurring EBP among autistic children and can often impede access to evidence-based care, thus amplifying long-term health inequities for autistic children and their caregivers. In the current autism services landscape, there are few scalable, evidence-based programs that adequately address these needs. The Family Check-Up (FCU®) is a brief, strength-based, and tailored family-centered intervention that supports positive parenting and explicitly assesses the social determinants of child and family mental health within an ecological framework. Studies have demonstrated long-term positive child and caregiver outcomes in other populations, but the FCU® has not been evaluated in families of autistic children and youth. Therefore, we aimed to evaluate FCU® implementation within an established, publicly funded Autism Program in Ontario, Canada, with delivery by autism therapists, to demonstrate sustainable effectiveness within real-world settings. Methods In this study, we outline the protocol for a hybrid implementation-effectiveness approach with two key components: (1) A parallel-arm randomized controlled trial of N = 80 autistic children/youth (ages 6-17 years) and high levels of EBP and their caregivers. Primary and secondary outcomes include child EBP, and caregiver well-being and parenting. (2) A mixed methods implementation study, to describe facilitators and barriers to implementation of the FCU® within an autism service setting. Discussion Scalable, ecologically focused family-centered interventions offer promise as key components of a public health framework aimed at reducing mental health inequities among autistic children, youth, and their caregivers. Results of this study will inform further program refinement and scale-up.
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Affiliation(s)
- Teresa Bennett
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Irene Drmic
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Julie Gross
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Marc Jambon
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | | | - K. Andrews
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Julia Frei
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - E. Duku
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Magdalena Janus
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - E. Lipman
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Paulo Pires
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Heather Prime
- Department of Psychology, York University, Toronto, ON, Canada
| | - Caroline Roncadin
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Mackenzie Salt
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Rebecca Shine
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
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Mirenda P, Zaidman-Zait A, Cost KT, Smith IM, Zwaigenbaum L, Duku E, Kerns C, Georgiades S, Vaillancourt T, Elsabbagh M, Bennett T, Szatmari P. Educators Describe the "Best Things" About Students with Autism at School. J Autism Dev Disord 2024; 54:1-17. [PMID: 36315320 DOI: 10.1007/s10803-022-05761-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
This study examined educators' descriptions of the positive character traits of students with autism spectrum disorder at ages 7-8 and 10-11, using an adapted version of the Values in Action (VIA) Classification of Strengths. The most commonly endorsed strengths at both age intervals were kindness, specific skills, self-regulation, and perseverance. Higher scores for challenging behavior were associated with a lower likelihood of endorsement for Happiness and Courage traits. Higher autism symptom severity scores were associated with a lower likelihood of endorsement for Courage traits. Few significant differences were found for endorsement of trait categories by students' educational placement or the type of curriculum they received. Results may have implications for student-teacher relationships, educational assessments, and school-based interventions that emphasize strengths and resilience.
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Affiliation(s)
- Pat Mirenda
- University of British Columbia, 2125 Main Mall, V6T 1Z4, Vancouver, BC, Canada.
| | | | | | | | | | - Eric Duku
- McMaster University, Hamilton, Canada
| | - Connor Kerns
- University of British Columbia, 2125 Main Mall, V6T 1Z4, Vancouver, BC, Canada
| | | | | | - Mayada Elsabbagh
- McGill University/Montreal Children's Hospital, Montreal, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
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Beauchamp MLH, Rezzonico S, Bennett T, Duku E, Georgiades S, Kerns C, Mirenda P, Richard A, Smith IM, Szatmari P, Vaillancourt T, Waddell C, Zaidman-Zait A, Zwaigenbaum L, Elsabbagh M. The Influence of Bilingual Language Exposure on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum. J Autism Dev Disord 2023; 53:4577-4590. [PMID: 36222993 PMCID: PMC10628039 DOI: 10.1007/s10803-022-05678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
We examined the narrative abilities of bilingual and monolingual children on the autism spectrum (AS), whether bilinguals presented stronger social and pragmatic language abilities compared to monolinguals, and the link between narrative, social, and pragmatic language abilities.The narrative, social, and pragmatic language skills of school-aged bilinguals (n = 54) and monolinguals (n = 80) on the AS were assessed using normed measures. Language exposure was estimated through a parent questionnaire.Bilinguals performed similarly to monolinguals on measures of narrative, social, and pragmatic language skills. However, balanced bilinguals performed better on a nonliteral language task.Overall, results indicate that bilingual children on the AS can become as proficient in using language as monolinguals and may enjoy a bilingual advantage.
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Affiliation(s)
| | | | | | - Eric Duku
- McMaster University, Hamilton, Canada
| | | | - Connor Kerns
- University of British Columbia, Vancouver, Canada
| | - Pat Mirenda
- University of British Columbia, Vancouver, Canada
| | - Annie Richard
- Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Isabel M Smith
- Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, The Hospital for Sick Children, Toronto, Canada
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4
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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5
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Baribeau DA, Vigod SN, Pullenayegum E, Kerns CM, Vaillancourt T, Duku E, Smith IM, Volden J, Zwaigenbaum L, Bennett T, Elsabbagh M, Zaidman-Zait A, Richard AE, Szatmari P. Developmental cascades between insistence on sameness behaviour and anxiety symptoms in autism spectrum disorder. Eur Child Adolesc Psychiatry 2023; 32:2109-2118. [PMID: 35871413 DOI: 10.1007/s00787-022-02049-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/06/2022] [Indexed: 12/28/2022]
Abstract
Autistic children experience high rates of anxiety. Insistence on sameness behaviour (IS) is a core feature of autism that appears correlated with anxiety severity. The objective of this study was to examine the longitudinal relations between anxiety and IS in autistic children using a developmental cascade model. A longitudinal cohort of 421 autistic children was followed between 4 and 11 years of age. Anxiety was quantified using items from the Anxiety Problems subscale of the Child Behavior Checklist; sameness behaviours were measured using the Repetitive Behavior Scale-Revised, Ritualistic/sameness subscale (both parent-report measures). Structural equation modelling was used to examine the longitudinal and directional associations between anxiety and IS at four time-points, through cross-lagged panel models (CLPM) with and without a random-intercepts component (RI-CLPM). Both the CLPM and the RI-CLPM had good fit. Significant directional associations were detected whereby elevated or increasing IS preceded elevated or increasing anxiety symptoms 1-2 years later, respectively. Stable baseline tendencies towards anxiety and IS as between-person traits (intercepts) were strongly associated (standardized estimate = 0.69, p < 0.001). The magnitude of the cross-sectional associations between anxiety and IS appeared to lessen with age. IS and anxiety symptoms in autism are closely related. They appear to be shared traits that mirror each other particularly in younger children. Increasing IS may be a sign of emerging future anxiety. Interventions that target IS to reduce or prevent anxiety amongst school-aged autistic children merit further study.
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Affiliation(s)
- Danielle A Baribeau
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- The Hospital for Sick Children, Toronto, ON, Canada.
- The Hospital for Sick Children, University of Toronto, 123 Edward Street, 12th floor, Room 1210, Toronto, ON, M5G 1E2, Canada.
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Women's College Hospital and Women's College Research Institute, Toronto, ON, Canada
| | - Eleanor Pullenayegum
- The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Teresa Bennett
- Offord Centre for Child Studies, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education at the Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
- The School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Annie E Richard
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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6
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Chen YJ, Duku E, Zaidman-Zait A, Szatmari P, Smith IM, Ungar WJ, Zwaigenbaum L, Vaillancourt T, Kerns C, Bennett T, Elsabbagh M, Thompson A, Georgiades S. Variable patterns of daily activity participation across settings in autistic youth: A latent profile transition analysis. Autism 2023; 27:13623613231154729. [PMID: 36855223 PMCID: PMC10576904 DOI: 10.1177/13623613231154729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
LAY ABSTRACT What people do or engage in in their daily lives, or daily life participation, is often linked to their state of being happy and healthy, as well as potential for living independently. To date, little research has been conducted on daily activity participation by autistic youth at home, at school or in the community. Learning more about individual differences in participation levels and what might influence them can help to create custom supports for autistic youth and their families. In this study, 158 caregivers of autistic youth were asked how often their children took part in 25 common activities at two assessments, about one year apart. The analysis showed three profiles for each of the home and school settings and two profiles for the community setting. These profiles reflected distinct patterns in how often autistic youth took part in various daily activities, particularly in doing homework, school club activities and community gatherings. Most autistic youth were in profiles marked by often taking part at home but less often at school and in the community, and about three-fourths of them tended to stay in the same profile over time. Autistic youth with limited participation profiles were more likely to have lower scores on measures of cognitive ability and daily life skills and more challenging behaviour, and faced more barriers in their environment. These findings show how important it is to think about each autistic person's strengths and weaknesses, and changing needs, to better support their daily life participation.
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Affiliation(s)
| | | | | | - Peter Szatmari
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
- Centre for Addiction and Mental Health, Canada
| | | | - Wendy J Ungar
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
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7
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Zaidman-Zait A, Curle D, Jamieson JR. Health-related quality of life among mothers of children with cochlear implants with and without developmental disabilities. Res Dev Disabil 2023; 133:104397. [PMID: 36586392 DOI: 10.1016/j.ridd.2022.104397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cochlear implants (CIs) are widely used among children with severe to profound hearing loss. Raising a child with a CI presents unique challenges to the family, especially when the child has a developmental disability (CI-DD). AIMS This study aimed to elucidate the relations between the functioning of children with CIs, their mothers' coping resources (i.e., social support and family-centered care), and maternal health-related quality of life (HRQoL). Also, it examined whether the presence of a DD in addition to the child's deafness moderated these relations. METHODS AND PROCEDURES A sample of 100 mothers of children with CIs (54 in the CI-DD group) completed questionnaires regarding perceived social support, family-centered care, and HRQoL. OUTCOMES AND RESULTS Mothers of deaf children with CIs and DD experienced lower levels of family functioning and HRQoL across all dimensions compared to mothers of deaf children with CIs without DD. In addition, social support was positively related to HRQoL only among mothers of children in the CI-DD group, indicating the protective role of social support. CONCLUSIONS AND IMPLICATIONS Social support is an important coping resource, and psychosocial support is needed for mothers of children with CIs, especially for mothers whose children also have a DD.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel; University of British Columbia, Canada.
| | - Deirdre Curle
- Washington Center for Deaf and Hard of Hearing Youth, USA.
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8
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McVey AJ, Liu Q, Bedford SA, Zaidman-Zait A, Szatmari P, Smith IM, Vaillancourt T, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Kerns CM. Examining clinical characteristics of autism and links with parent perceptions of sibling relationship quality. Autism 2023; 27:309-320. [PMID: 35510331 DOI: 10.1177/13623613221094672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Sibling relationship quality is important for the well-being of children on the autism spectrum and their siblings. Little is known, however, about how varied behavior and abilities of children on the autism spectrum may be associated with parent perceptions of domains of sibling relationship quality. We drew data from a subsample of 119 children on the autism spectrum (ages 10-11 years), participating in an ongoing longitudinal study. We looked at how three clinical characteristics (autism symptoms, behavioral difficulties, and communication ability) related to four areas of parent-reported sibling relationship quality (warmth/closeness, conflict, relative status/power, and rivalry). We also examined whether the strength of the association between behavioral difficulties and parent-reported sibling relationship quality was influenced by communication ability. We found that more severe autism symptoms were associated with less conflict and rivalry, and higher communication ability was associated with more relative status/power. We also found that children on the autism spectrum with more behavioral difficulties and weaker communication ability had less warmth/closeness in their sibling relationships. Our findings highlight that it is important to consider autism symptoms, behavioral difficulties, and communication ability, as well as multiple domains of relationship quality, to better understand how parents view the relationships between autistic children and their siblings. Clinically, methods for improving sibling relationships may include teaching conflict resolution strategies to children on the autism spectrum with stronger communication abilities and their siblings, and fostering sibling connection for those with lower communication abilities.
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Affiliation(s)
- Alana J McVey
- University of British Columbia, Canada.,University of Washington, USA
| | - Quinn Liu
- University of British Columbia, Canada
| | - Saashi A Bedford
- University of British Columbia, Canada.,University of Cambridge, UK
| | | | | | | | | | | | - Teresa Bennett
- McMaster University, Canada.,Offord Centre for Child Studies, Canada
| | - Eric Duku
- McMaster University, Canada.,Offord Centre for Child Studies, Canada
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9
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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10
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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. Res Dev Disabil 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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11
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Farmer C, Thurm A, Condy E, Duku E, Szatmari P, Bennett T, Elsabbagh M, Kerns CM, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Georgiades S. Disentangling global and domain-level adaptive behavior trajectories among children with autism spectrum disorder. J Child Psychol Psychiatry 2022; 64:868-875. [PMID: 36562498 PMCID: PMC10369325 DOI: 10.1111/jcpp.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Heterogeneity in adaptive behavior abilities among people with autism spectrum disorder (ASD) is expressed not only as uneven levels of impairment across domains, but also in the developmental trajectories of adaptive skills. We studied the question of whether, after accounting for global adaptive behavior development, we find evidence of heterogeneity in the trajectories of specific domains of adaptive behavior. METHODS A sample of 504 children with ASD was obtained by combining data from two independent natural history studies conducted in North America. We used a factor of curves model to explain growth between 36 and 138 months in Vineland Adaptive Behavior Scales, Second Edition (VABS) age equivalents as a function of domain-specific and global growth processes. RESULTS The domain-specific trajectories in all three domains (Communication, Daily Living Skills, and Socialization) reflected impairment relative to age expectations as well as slower-than-expected growth with age, and the parameters of these trajectories were moderately-to-strongly correlated across domains. The global adaptive behavior trajectory had an initial (36-41 months of age) developmental level of about 22 age-equivalent months, and eventually slowed after initially increasing by about 6 months each year. The global trajectory accounted for the majority of variance in the domain-level processes; however, additional variance remained (14%-38%) in the domain-level intercepts, slopes, and quadratic processes. CONCLUSIONS These results extend existing theoretical and empirical support for the hierarchical structure of adaptive behavior to include its development over time in clinical samples of children with ASD. A latent global trajectory may be sufficient to describe the growth of adaptive behavior in children with ASD; however, the remaining domain-specific variability after accounting for global adaptive behavior development allows for the possibility that differential effects of intervention on specific domains may be possible and detectable.
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Affiliation(s)
- Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Emma Condy
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
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12
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Carter Leno V, Wright N, Pickles A, Bedford R, Zaidman-Zait A, Kerns C, Mirenda P, Zwaigenbaum L, Duku E, Bennett T, Georgiades S, Smith I, Vaillancourt T, Szatmari P, Elsabbagh M. Exposure to family stressful life events in autistic children: Longitudinal associations with mental health and the moderating role of cognitive flexibility. Autism 2022; 26:1656-1667. [PMID: 36113122 PMCID: PMC9483693 DOI: 10.1177/13623613211061932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mental health problems are prevalent in autistic youth, but the underpinning
mechanisms are not well explored. In neurotypical youth, stressful life events
are an established risk factor for mental health problems. This study tested
longitudinal bidirectional associations between family-level stressful life
events and mental health problems and whether these were moderated by cognitive
flexibility, in a cohort of autistic children (N = 247).
Family-stressful life events, assessed using the parent-reported Family
Inventory of Life Events and Changes, and mental health problems, assessed using
the teacher-reported Child Behavior Checklist Internalizing and Externalizing
Symptoms subscales, were measured at multiple points between 7 and 11 years.
Analyses showed no significant pathways from internalizing or externalizing
symptoms to family-stressful life events or from family-stressful life events to
internalizing or externalizing symptoms. There was some evidence of moderation
by cognitive flexibility; the family-stressful life events to internalizing
symptoms pathway was non-significant in the group with typical shifting ability
but significant in the group with clinically significant shifting problems.
Information about family-level stressful life event exposure and cognitive
flexibility may be helpful in identifying autistic youth who may be at higher
risk of developing mental health problems. Established risk factors for mental
health problems in neurotypical populations are relevant for understanding
mental health in autistic youth.
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Affiliation(s)
| | | | | | | | - Anat Zaidman-Zait
- Tel Aviv University, Israel
- The University of British Columbia, Canada
| | | | | | | | - Eric Duku
- Offord Centre for Child Studies, Canada
- McMaster University, Canada
| | - Teresa Bennett
- Offord Centre for Child Studies, Canada
- McMaster University, Canada
| | | | - Isabel Smith
- Dalhousie University, Canada
- IWK Health Centre, Canada
| | | | - Peter Szatmari
- University of Toronto, Canada
- The Hospital for Sick Children, Canada
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13
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Joyal-Desmarais K, Stojanovic J, Kennedy EB, Enticott JC, Boucher VG, Vo H, Košir U, Lavoie KL, Bacon SL, Granana N, Losada AV, Boyle J, Shawon SR, Dawadi S, Teede H, Kautzky-Willer A, Dash A, Cornelio ME, Karsten M, Matte DL, Reichert F, Abou-Setta A, Aaron S, Alberga A, Barnett T, Barone S, Bélanger-Gravel A, Bernard S, Birch LM, Bondy S, Booij L, Da Silva RB, Bourbeau J, Burns R, Campbell T, Carlson L, Charbonneau É, Corace K, Drouin O, Ducharme F, Farhadloo M, Falk C, Fleet R, Fournier M, Garber G, Gauvin L, Gordon J, Grad R, Gupta S, Hellemans K, Herba C, Hwang H, Jedwab J, Kakinami L, Kim S, Liu J, Norris C, Pelaez S, Pilote L, Poirier P, Presseau J, Puterman E, Rash J, Ribeiro PAB, Sadatsafavi M, Chaudhuri PS, Suarthana E, Tse S, Vallis M, Caceres NB, Ortiz M, Repetto PB, Lemos-Hoyos M, Kassianos A, Rod NH, Beraneck M, Ninot G, Ditzen B, Kubiak T, Codjoe S, Kpobi L, Laar A, Skoura T, Francis DL, Devi NK, Meitei S, Nethan ST, Pinto L, Saraswathy KN, Tumu D, Lestari S, Wangge G, Byrne M, Durand H, McSharry J, Meade O, Molloy G, Noone C, Levine H, Zaidman-Zait A, Boccia S, Hoxhaj I, Paduano S, Raparelli V, Zaçe D, Aburub A, Akunga D, Ayah R, Barasa C, Godia PM, Kimani-Murage EW, Mutuku N, Mwoma T, Naanyu V, Nyamari J, Oburu H, Olenja J, Ongore D, Ziraba A, Bandawe C, Yim L, Ajuwon A, Shar NA, Usmani BA, Martínez RMB, Creed-Kanashiro H, Simão P, Rutayisire PC, Bari AZ, Vojvodic K, Nagyova I, Bantjes J, Barnes B, Coetzee B, Khagee A, Mothiba T, Roomaney R, Swartz L, Cho J, Lee MG, Berman A, Stattin NS, Fischer S, Hu D, Kara Y, Şimşek C, Üzmezoğlu B, Isunju JB, Mugisha J, Byrne-Davis L, Griffiths P, Hart J, Johnson W, Michie S, Paine N, Petherick E, Sherar L, Bilder RM, Burg M, Czajkowski S, Freedland K, Gorin SS, Holman A, Lee J, Lopez G, Naar S, Okun M, Powell L, Pressman S, Revenson T, Ruiz J, Sivaram S, Thrul J, Trudel-Fitzgerald C, Yohannes A, Navani R, Ranakombu K, Neto DH, Ben-Porat T, Dragomir A, Gagnon-Hébert A, Gemme C, Jamil M, Käfer LM, Vieira AM, Tasbih T, Woods R, Yousefi R, Roslyakova T, Priesterroth L, Edelstein S, Snir R, Uri Y, Alyami M, Sanuade C, Crescenzi O, Warkentin K, Grinko K, Angne L, Jain J, Mathur N, Mithe A, Nethan S. How well do covariates perform when adjusting for sampling bias in online COVID-19 research? Insights from multiverse analyses. Eur J Epidemiol 2022; 37:1233-1250. [PMID: 36335560 PMCID: PMC9638233 DOI: 10.1007/s10654-022-00932-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/06/2022] [Indexed: 11/07/2022]
Abstract
COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.
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Affiliation(s)
- Keven Joyal-Desmarais
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ,Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
| | - Jovana Stojanovic
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada ,Canadian Agency for Drugs and Technologies in Health, Ottawa, Canada
| | - Eric B. Kennedy
- Disaster and Emergency Management, York University, Toronto, Canada
| | - Joanne C. Enticott
- Department of General Practice, Monash University, Melbourne, Australia ,Monash Partners, Advanced Health Research and Translation Centre, Melbourne, Australia
| | | | - Hung Vo
- Austin Health, Victoria, Australia
| | - Urška Košir
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ,Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
| | - Kim L. Lavoie
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada ,Département de Psychologie, Université du Québec à Montréal, Montreal, Canada
| | - Simon L. Bacon
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6 Canada ,Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
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14
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Courchesne V, Bedford R, Pickles A, Duku E, Kerns C, Mirenda P, Bennett T, Georgiades S, Smith IM, Ungar WJ, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. Non-verbal IQ and change in restricted and repetitive behavior throughout childhood in autism: a longitudinal study using the Autism Diagnostic Interview-Revised. Mol Autism 2021; 12:57. [PMID: 34391468 PMCID: PMC8364071 DOI: 10.1186/s13229-021-00461-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. METHODS The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years. RESULTS The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age. LIMITATIONS The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children. CONCLUSIONS These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.
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Affiliation(s)
- V Courchesne
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
| | - R Bedford
- King's College London, London, UK
- University of Bath, Bath, UK
| | | | - E Duku
- McMaster University, Hamilton, Canada
| | - C Kerns
- University of British Columbia, Vancouver, Canada
| | - P Mirenda
- University of British Columbia, Vancouver, Canada
| | - T Bennett
- McMaster University, Hamilton, Canada
| | | | - I M Smith
- Dalhousie University, IWK Health Centre, Halifax, Canada
| | - W J Ungar
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | | | | | - P Szatmari
- Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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15
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Cost KT, Zaidman-Zait A, Mirenda P, Duku E, Zwaigenbaum L, Smith IM, Ungar WJ, Kerns C, Bennett T, Szatmari P, Georgiades S, Waddell C, Elsabbagh M, Vaillancourt T. Correction to: "Best Things": Parents Describe Their Children with Autism Spectrum Disorder Over Time. J Autism Dev Disord 2021; 51:4575-4576. [PMID: 34286396 DOI: 10.1007/s10803-021-05144-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Katherine T Cost
- Hospital for Sick Children, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | | | - Pat Mirenda
- University of British Columbia, Vancouver, BC, Canada.
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | | | - Isabel M Smith
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Wendy J Ungar
- Hospital for Sick Children, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Connor Kerns
- University of British Columbia, Vancouver, BC, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | | | - Mayada Elsabbagh
- McGill University/Montreal Children's Hospital, Montreal, PQ, Canada
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16
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Tesfaye R, Wright N, Zaidman-Zait A, Bedford R, Zwaigenbaum L, Kerns CM, Duku E, Mirenda P, Bennett T, Georgiades S, Smith IM, Vaillancourt T, Pickles A, Szatmari P, Elsabbagh M. 'Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism'. Sleep 2021; 44:6275587. [PMID: 33987680 DOI: 10.1093/sleep/zsab122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF difficulties in ASD are exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. A subsample (n=217) from the Pathways in ASD longitudinal study was analyzed. The Children's Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (Mean=3.5years). Metacognition (MI) and Behavioral Regulation (BRI) indices, on the Teacher Behavior Rating Inventory of Executive Functioning, were used to measure cognitive and affective components of EF respectively at four time-points (7.8-11.8years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (Mean=6.7years). Sleep traits had different age-related impacts on behavioral regulation, but not metacognition. Longer sleep onset at 3.5 years was associated with a worsening BRI difficulties slope (b=2.07, p<0.04), but conversely associated with lower BRI difficulties at 7.7 years (b=-4.14, p=0.04). A longer sleep onset at 6.7 years was related to higher BRI difficulties at 7.7 years (b=7.78, p<0.01). Longer sleep duration at 6.7 years was associated with higher BRI difficulties at age 7.7 (b=3.15, p=0.01), but subscale analyses revealed shorter sleep duration at age 6.7 was linked to a worsening inhibition slope (b=-0.60, p=0.01). Sleep onset is a robust early correlate of behavior regulation in children with ASD, whereas sleep duration is a later childhood correlate.
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Affiliation(s)
- Rackeb Tesfaye
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Canada
| | - Nicola Wright
- King's College London, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Anat Zaidman-Zait
- Tel Aviv University, Department of Educational Sciences, Tel Aviv, Israel
| | - Rachael Bedford
- King's College London, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,University of Bath, Department of Psychology, Bath, UK
| | | | - Connor M Kerns
- University of British Columbia, Department of Psychology, Vancouver, Canada
| | - Eric Duku
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Pat Mirenda
- University of British Columbia, Education and Counseling Psychology, Vancouver, Canada
| | - Teresa Bennett
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Stelios Georgiades
- McMaster University, Psychiatry and Behavioural Neurosciences, Hamilton, Canada
| | - Isabel M Smith
- Dalhousie University, IWK Health Centre, Pediatrics, Halifax, Canada
| | | | - Andrew Pickles
- King's College London, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- University of Toronto, Department of Psychiatry, Toronto, Canada.,Centre for Addiction and Mental Health, Child and Youth Mental Health, Toronto, Canada.,SickKids Department of Psychiatry, child and adolescent psychiatry, Toronto, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Canada
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17
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Eichengreen A, Zaidman-Zait A, Most T, Golik G. Resilience from childhood to young adulthood: retrospective perspectives of deaf and hard of hearing people who studied in regular schools. Psychol Health 2021; 37:331-349. [PMID: 33780302 DOI: 10.1080/08870446.2021.1905161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Most deaf and hard of hearing (DHH) youth grow up in hearing familial and educational environments, posing unique risks for their socio-emotional well-being. The study's objective was to explore protective processes contributing to resilience among DHH individuals in different life periods. DESIGN We conducted semi-structured interviews with 23 DHH young adults on their life-long coping with having a hearing loss (HL). MAIN OUTCOME MEASURES Thematic analysis identified, according to participants' retrospective perceptions, processes that supported their positive adjustment from childhood up to early adulthood. RESULTS Themes were organised at three ecological levels: individual, including five subthemes (e.g. certain attitudes to HL); family, including various types of parental support; and community, including four subthemes (e.g. extra-curricular activities). Family and community level resources enabled and nurtured personal attitudes and coping abilities. The perceptions of which personal attitudes and contextual resources were helpful changed from childhood to young adulthood. CONCLUSIONS Findings show how resilience is heterogeneously promoted in the unique context of DHH individuals living in hearing environments. They also show interactions between the individual, family and wider society and the dynamics of coping resources across time. Findings indicate the important of considering DHH individuals' coping choices in their specific life context.
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Affiliation(s)
- Adva Eichengreen
- The Department of Counselling and Special Education at the Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel.,The Department of Developmental Psychology at the Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Anat Zaidman-Zait
- The Department of Counselling and Special Education at the Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
| | - Tova Most
- The Department of Counselling and Special Education at the Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel.,The Department of Communication Disorders at the Stanley Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Gelena Golik
- The Department of Counselling and Special Education at the Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
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18
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Georgiades S, Tait PA, McNicholas PD, Duku E, Zwaigenbaum L, Smith IM, Bennett T, Elsabbagh M, Kerns CM, Mirenda P, Ungar WJ, Vaillancourt T, Volden J, Waddell C, Zaidman-Zait A, Gentles S, Szatmari P. Trajectories of Symptom Severity in Children with Autism: Variability and Turning Points through the Transition to School. J Autism Dev Disord 2021; 52:392-401. [PMID: 33704613 PMCID: PMC8732828 DOI: 10.1007/s10803-021-04949-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 11/27/2022]
Abstract
This study examined the trajectories of autistic symptom severity in an inception cohort of 187 children with ASD assessed across four time points from diagnosis to age 10. Trajectory groups were derived using multivariate cluster analysis. A two trajectory/cluster solution was selected. Change in trajectory slopes revealed a turning point marked by plateauing in symptom reduction during the period of transition to school (age 6) for one of the two trajectories. Trajectories were labelled: Continuously Improving (27%) and Improving then Plateauing (73% of sample). Children in the two trajectories differed in levels of symptom severity, language, cognitive, and adaptive functioning skills. Study findings can inform the development of more personalized services for children with ASD transitioning into the school system.
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Affiliation(s)
- Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W. - MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada.
| | - Peter A Tait
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W. - MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Paul D McNicholas
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W. - MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W. - MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | | | - Isabel M Smith
- IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Teresa Bennett
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W. - MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | | | | | - Pat Mirenda
- University of British Columbia, Vancouver, Canada
| | - Wendy J Ungar
- University of Toronto, The Hospital for Sick Children, Toronto, Canada
| | | | | | | | | | - Stephen Gentles
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W. - MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Peter Szatmari
- Centre for Addition and Mental Health, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Canada
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19
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Szatmari P, Cost KT, Duku E, Bennett T, Elsabbagh M, Georgiades S, Kerns C, Mirenda P, Smith IM, Ungar WJ, Vaillancourt T, Waddell C, Zaidman-Zait A, Zwaigenbaum L. Association of Child and Family Attributes With Outcomes in Children With Autism. JAMA Netw Open 2021; 4:e212530. [PMID: 33779740 PMCID: PMC8008283 DOI: 10.1001/jamanetworkopen.2021.2530] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE The prevalence and attributes of positive outcomes (or doing well) among children with autism spectrum disorder (ASD) in midchildhood are not well known. OBJECTIVE To estimate the prevalence of doing well according to metrics of proficiency and growth and to investigate the extent to which significant associations exist between child- and family-level variables and doing well. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study included children with ASD from regional clinics across Canada. Participants were sampled 3 times between ages 2 and 4.9 years (T1) and twice in follow-up into middle childhood (T2). Data were analyzed March 2018 through January 2020. EXPOSURES Language and IQ assessments at first sample; household income, parent coping, and family functioning. MAIN OUTCOMES AND MEASURES Key outcome domains of developmental health included measures of socialization, communication, independent living skills, and measures of internalizing and externalizing behaviors. Thresholds for doing well in these domains by either proficiency or growth were established. The extent to which language, IQ, household income, parent coping, and family functioning were associated with assessed outcomes was determined by logistic regression. The association between outcomes and concurrent Autism Diagnostic Observation Schedule (ADOS) classification scores was also estimated. RESULTS In a total cohort of 272 children (234 [86.0%] boys; mean [SD] age, 10.76 [0.26] years), approximately 78.8% (95% CI, 73.2%-84.4%) of the sample were estimated to be doing well by either metric on at least 1 domain, and 23.6% (95% CI, 17.7%-29.4%) were doing well in 4 or 5 domains. It was possible to be doing well by either proficiency or growth and still meet ADOS criteria for ASD. For the growth metric, between 61.5% (95% CI, 40.7%-79.1%) and 79.6% (95% CI, 66.0%-88.9%) of participants had ADOS scores of 4 or greater; for the proficiency metric, between 63.8% (95% CI, 48.4%-76.9%) and 75.8% (95% CI, 63.0%-85.4%) had scores of 4 or greater. Doing well by either metric for all domains was associated with T1 scores on that outcome domain (eg, T1 daily living skills associated with doing well at T2 daily living by the proficiency metric as measured by the Vineland Adaptive Behavior Scales-Second Edition daily living skills scale [202 participants]: β = 0.07; OR, 1.07; 95% CI, 1.03-1.11; P < .001). Doing well in socialization by the growth metric was also associated with better T1 language skills scores (202 participants) (β = 0.04; OR, 1.04; 95% CI, 1.00-1.07, P = .04). Doing well in externalizing by the growth metric was also associated with higher household income at T1 (178 participants) (β = 0.10; OR, 1.10; 95% CI, 1.06-1.15; P < .001). Better family functioning at T1 was associated with doing well on both socialization and externalizing by proficiency metric and on internalizing by growth metric (socialization by proficiency [202 participants]: β = -1.01; OR, 0.36; 95% CI, 0.14-0.93; P = .04; externalizing by proficiency [178 participants]: β = 1.00; OR, 0.37; 95% CI, 0.16-0.82; P = .02; internalizing by growth [178 participants]: β = -1.03; OR, 0.36; 95% CI, 0.16-0.79; P = .01). CONCLUSIONS AND RELEVANCE This cohort study found that a substantial proportion of children with ASD were doing well by middle childhood in at least 1 key domain of developmental health, and that doing well was possible even in the context of continuing to meet criteria for ASD. These results support a strengths-based approach to treatment planning that should include robust support for families to increase the potential likelihood of doing well later in life.
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Affiliation(s)
- Peter Szatmari
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Eric Duku
- McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | - Pat Mirenda
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Wendy J. Ungar
- The Hospital for Sick Children, Toronto, Ontario, Canada
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20
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Cost KT, Zaidman-Zait A, Mirenda P, Duku E, Zwaigenbaum L, Smith IM, Ungar WJ, Kerns C, Bennett T, Szatmari P, Georgiades S, Waddell C, Elsabbagh M, Vaillancourt T. "Best Things": Parents Describe Their Children with Autism Spectrum Disorder Over Time. J Autism Dev Disord 2021; 51:4560-4574. [PMID: 33532881 DOI: 10.1007/s10803-021-04890-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2021] [Indexed: 01/02/2023]
Abstract
This study examined parental perceptions of the character traits of children with autism from early childhood to age 11. Parents (n = 153) provided descriptions of the "best things" about their children on the Child Behavior Checklist (CBCL) at ages 3-4, 7-8, and 10-11 years. Descriptions were coded using the framework of the Values in Action Classification of Strengths, with additional traits added as needed. Parent-endorsed traits included love, kindness, happiness, and humor in children across all ages and traits such as perseverance as children entered school. Higher CBCL scores were associated with a lower likelihood of endorsement for Humanity traits. Results are congruent with a contemporary neurodiversity perspective that emphasizes strengths and resilience.
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Affiliation(s)
- Katherine T Cost
- Hospital for Sick Children, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | | | - Pat Mirenda
- University of British Columbia, Vancouver, BC, Canada.
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | | | - Isabel M Smith
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Wendy J Ungar
- Hospital for Sick Children, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Connor Kerns
- University of British Columbia, Vancouver, BC, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | | | - Mayada Elsabbagh
- McGill University/Montreal Children's Hospital, Montreal, PQ, Canada
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21
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Abstract
Objective: The study examined how the interplay between maternal ADHD symptoms and maternal inhibitory control and child ADHD is related to parenting behaviors. Method: The sample included 141 mothers and their 8- to 12-year-old children, 61 children with ADHD and 80 without. Parenting was measured using self-reports (i.e., overreactive and lax parenting) and observation (i.e., negative and supportive parenting). Maternal inhibitory control was measured using a neurocognitive task. Hierarchical multiple regressions were conducted to predict parenting, controlling for child sex, conduct behaviors, and parenting distress. Results: Interactions between maternal ADHD symptoms and maternal inhibitory control suggested that hyperactive-impulsive symptoms were linked to parenting negativity only when inhibitory control was low, and maternal inattention symptoms were related to lax parenting only when maternal inhibitory control was high or when children did not have ADHD. Conclusion: Results indicate the importance of maternal regulation processes in the mechanisms linking maternal ADHD with parenting.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel.,The University of British Columbia, Vancouver, Canada
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22
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Hunsche MC, Saqui S, Mirenda P, Zaidman-Zait A, Bennett T, Duku E, Elsabbagh M, Georgiades S, Smith IM, Szatmari P, Ungar WJ, Vaillancourt T, Waddell C, Zwaigenbaum L, Kerns CM. Parent-Reported Rates and Clinical Correlates of Suicidality in Children with Autism Spectrum Disorder: A Longitudinal Study. J Autism Dev Disord 2020; 50:3496-3509. [PMID: 32034647 DOI: 10.1007/s10803-020-04373-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study investigated rates of suicidal ideation (SI) and suicidal and/or self-injurious behaviour (SSIB) reported by parents on the Child Behavior Checklist for 178 children with ASD over four annual assessments (ages 7-11 years). Analyses examined the frequency and persistence of SI and SSIB, and the association of SI and SSIB at any time point with child characteristics and internalizing and externalizing problems at age 7. SI occurred in 9.6% of children and was associated with fewer ASD symptoms and better adaptive functioning at age 7. SSIB occurred in 14.6% and was associated with poorer adaptive functioning and more externalizing behaviour at age 7. Internalizing problems were not associated with SI or SSIB at any time point. SI and SSIB rarely co-occurred (4%).
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Affiliation(s)
- Michelle C Hunsche
- University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Sonja Saqui
- University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Pat Mirenda
- University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Anat Zaidman-Zait
- University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.,Tel Aviv University, Tel Aviv, Israel
| | | | - Eric Duku
- McMaster University, Vancouver, BC, Canada
| | | | | | | | | | | | | | | | | | - Connor M Kerns
- University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
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23
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Abstract
OBJECTIVES The goals of the current study were to (1) examine differences in pragmatic abilities and peer relationship behaviors among deaf and hard of hearing (DHH) adolescents who use spoken language, in comparison with their hearing peers; and (2) explore the contribution of pragmatic skills and speech (ie, articulation and intelligibility [AI]) to social aspects of school functioning among DHH and typically hearing adolescents. METHODS Thirty-three DHH adolescents and 34 adolescents with typical hearing participated. All DHH adolescents attended mainstream school settings and used spoken language. Teacher reports were obtained on prosocial behaviors, peer problems, pragmatic abilities, and speech AI of the adolescents. Adolescents self-reported on the supportiveness of their peer relationships and their school emotional engagement. RESULTS Multiple hierarchical regression analyses revealed that DHH adolescents had greater difficulties with peers than their hearing counterparts. Increased pragmatic difficulties were related to more peer problems and decreased prosocial behaviors, regardless of adolescents' hearing status. A significant positive correlation was found between pragmatic competence and adolescents' perceptions of peers' support. Finally, better speech AI were associated with higher levels of school emotional engagement. CONCLUSIONS The results emphasize the significant role of pragmatics for both DHH and typically hearing adolescents. Medical care providers and allied health professionals should be aware of possible difficulties that DHH adolescents may have in complex and nuanced pragmatic skills. Some adolescents may require a referral to specialized services to support the development of their pragmatic understanding and their skills.
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Affiliation(s)
| | - Tova Most
- Department of Counseling and Special Education, The Jaime and Joan Constantiner School of Education.,Department of Communication Disorders, Stanley Steyer School of Health Professions
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24
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Zwaigenbaum L, Zaidman-Zait A, Duku E, Bennett T, Mirenda P, Smith I, Szatmari P, Vaillancourt T, Waddell C, Elsabbagh M, Georgiades S, Kerns C, Ungar W. 55 Profiles of Sleep Problems among Young Children with Autism Spectrum Disorders. Paediatr Child Health 2020. [DOI: 10.1093/pch/pxaa068.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sleep problems are more common and severe among children with autism spectrum disorder (ASD) compared to their typically developing peers. The goal of this study was to characterize sleep problems profiles and their clinical correlates, based on a five-factor model of the Children’s Sleep Habits Questionnaire (CSHQ) among preschool children with ASD.
Objectives
(1) To describe empirically-derived patterns (i.e., latent profiles) of sleep problems among young children with ASD; and (2) To examine relations between family cumulative risk and emotional-behavioral dysregulation symptoms and sleep profile membership.
Design/Methods
The study included 318 three-to-five year old children (M= 49.45 months; SD = 5.77). Latent profile analysis was used to identify and describe profiles of sleep problems. Sleep problems were assessed using a previously established CSHQ five-factor model: (1) Bedtime Routine; (2) Sleep Onset & Duration; (3) Night Waking; (4) Morning Waking; and (5) Sleep Disordered Breathing, with higher scores indicating greater problems. We assess whether profile membership was associated with dysregulation difficulties (CBCL 1.5-5) and family cumulative risk index (CRI; constructed based on socioeconomic status, maternal distress, family functioning, and other related factors) using a three-step method (Vermunt & Magidson, 2013).
Results
A five-profile model of children’s sleep problems showed the best fit (Figure 1). Profile 1, Nighttime Sleep Problems (28%), consisted of children with scores around the sample mean, except relatively lower scores on Morning Waking. Profile 2, Severe Sleep Problems (25%), consisted of children with relatively high scores across all sleep problems. Profile 3, Low Sleep Problems (18%), included children with the lowest levels of all sleep problems. Profile 4, Moderate Sleep Problems (17%), included children with all sleep problem levels near the sample mean. Profile 5, Morning Waking Problems (12%), consisted of children with low scores on Bedtime Routine problems but pronounced Morning Waking problems. Dysregulation difficulties (Wald = 13.90; p = .001) and family CRI (Wald = 13.27; p =.001) emerged as significant predictors of profile membership. Higher CRI was associated with higher odds of membership in Profile 2 (Severe Sleep Problems), and lower scores for dysregulation difficulties were associated with higher odds of membership in Profile 3 (Low Sleep Problems).
Conclusion
Children with ASD present distinct profiles of sleep problems that differ, not only by overall severity, but also by relative severity across types of sleep problems. Children’s dysregulation and family risk should be considered in examining children’s sleep.
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25
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Lee V, Duku E, Zwaigenbaum L, Bennett T, Szatmari P, Elsabbagh M, Kerns C, Mirenda P, Smith IM, Ungar WJ, Vaillancourt T, Volden J, Waddell C, Zaidman-Zait A, Thompson A, Georgiades S. Temperament influences the relationship between symptom severity and adaptive functioning in children with autism spectrum disorder. Autism 2020; 24:2057-2070. [PMID: 32615784 DOI: 10.1177/1362361320933048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Temperament is often thought of as behavioural traits that are relatively stable over time but can vary between individuals. Children diagnosed with autism spectrum disorder are often characterized as having 'reactive' and 'negative' temperaments when compared to same-aged peers with or without disabilities, which can negatively impact the development of adaptive functioning skills but little is known about variations of temperament between individual children diagnosed with autism spectrum disorder. This study aimed to (a) explore the variation of individual temperament traits within a sample of school-aged children with autism spectrum disorder to determine whether subgroups with similar trait profiles emerge and (b) examine whether temperament influences the relationship between autism symptoms and adaptive functioning outcomes. Results from our dataset suggest that children diagnosed with autism spectrum disorder fit under two profiles: 'even' and 'reactive'. Furthermore, our analysis shows that temperament can influence the impact of increasing symptom severity on adaptive functioning skills in children with autism spectrum disorder. Study findings highlight the importance of considering temperament when trying to understand the individual differences that influence the development of functioning and developmental outcomes in children with autism spectrum disorder.
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Affiliation(s)
| | | | | | | | - Peter Szatmari
- CAMH/SickKids, Canada.,University of Toronto, Toronto, Ontario
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26
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Baribeau DA, Vigod S, Pullenayegum E, Kerns CM, Mirenda P, Smith IM, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Ungar WJ, Zaidman-Zait A, Szatmari P. Repetitive Behavior Severity as an Early Indicator of Risk for Elevated Anxiety Symptoms in Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:890-899.e3. [PMID: 31541676 DOI: 10.1016/j.jaac.2019.08.478] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/15/2019] [Accepted: 09/13/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE A significant proportion of children with autism spectrum disorder (ASD) will develop an anxiety disorder during childhood. Restricted and repetitive behavior severity in ASD positively correlates with anxiety severity in cross-sectional surveys. The longitudinal relationship between restricted/repetitive behavior and future anxiety symptoms is unclear. METHOD In a longitudinal cohort of children with ASD (n = 421), restricted/repetitive behavior severity at enrollment (age 2-5 years) was categorized as "mild," "moderate," or "severe" using the Autism Diagnostic Interview-Revised. Elevated anxiety symptoms were defined by a Child Behavior Checklist (parent report) Anxiety subscale T-score of >65 at ages 8 to 11 years. Multivariable logistic regression with multiple imputation for missing data was used to examine the association between restricted/repetitive behavior severity and elevated anxiety symptoms while adjusting for age, sex, adaptive functioning, baseline anxiety, income, and parenting stress, generating adjusted odds ratios (aORs) and 95% CIs. RESULTS Approximately 58% of children with severe restricted/repetitive behavior at enrollment had elevated anxiety symptoms by age 11, compared to 41% of those with moderate, and 20% of those with mild restricted/repetitive behavior, respectively. Moderate and severe restricted/repetitive behavior were both associated with increased odds of elevated anxiety (moderate aOR: 2.5 [1.2-5.3]; severe aOR: 3.2 (1.4-7.5]). CONCLUSION Restricted/repetitive behavior severity at time of ASD diagnosis indicates risk for future anxiety symptoms. This finding increases our understanding of which children with ASD will develop anxiety disorders and may guide research concerning early interventions and etiological mechanisms.
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Affiliation(s)
| | - Simone Vigod
- University of Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada; Women's College Hospital and Women's College Research Institute, Toronto, Ontario, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | | | - Pat Mirenda
- University of British Columbia, Vancouver, Canada
| | - Isabel M Smith
- Dalhousie University, Halifax, Nova Scotia, Canada; Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of, Ottawa, Ontario, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - Teresa Bennett
- Offord Centre for Child Studies, Hamilton, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Hamilton, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, Hamilton, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | - Wendy J Ungar
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Anat Zaidman-Zait
- Constantine School of Education, Tel Aviv University, Israel; The School of Population and Public Health, Faculty of Medicine, University of British Columbia, Canada
| | - Peter Szatmari
- University of Toronto, Ontario, Canada; Centre for Addiction and Mental Health and The Hospital for Sick Children, Toronto, Ontario, Canada.
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27
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Bal VH, Fok M, Lord C, Smith IM, Mirenda P, Szatmari P, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Ungar WJ, Zaidman-Zait A. Predictors of longer-term development of expressive language in two independent longitudinal cohorts of language-delayed preschoolers with Autism Spectrum Disorder. J Child Psychol Psychiatry 2020; 61:826-835. [PMID: 31429087 PMCID: PMC7028445 DOI: 10.1111/jcpp.13117] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Studies estimate that 30% of individuals with autism are minimally verbal. Understanding what factors predict longer-term expressive development in children with language delays is critical to inform identification and treatment of those at-risk for persistent language impairments. The present study examined predictors of expressive language development in language-delayed preschoolers followed through later school-age and young adulthood. METHODS Children using single words or less on the Autism Diagnostic Observation Schedule (ADOS) at approximately 3 years old were drawn from the Early Diagnosis (EDX) and Pathways in ASD longitudinal cohorts. Age-3 predictors of Age-19 ADOS language level were identified using Classification and Regression Trees (CART) in the EDX sample. Linear mixed models examined the effects of CART-identified predictors on Vineland expressive communication (VExp) trajectories from Age-3 to Age-19. The same linear mixed models were examined in the Pathways sample, identifying predictors of VExp from ages 3 to 10.5 years. RESULTS Significantly delayed fine motor skills (T-score < 20) was the strongest CART predictor of Age-19 language. In the linear mixed models, time, Age-3 fine motor skills and initiation of joint attention (IJA) predicted VExp trajectories in the EDX sample, even when controlling for Age-3 visual receptive abilities. In the Pathways sample, time and Age-3 fine motor skills were significant predictors of VExp trajectories; IJA and cognitive skills were not significant predictors. CONCLUSIONS Marked deficits in fine motor skills may be a salient proxy marker for identifying language-delayed children with ASD who are at risk for persistent language impairments. This finding adds to the literature demonstrating a relation between motor and language development in ASD. Investigating individual skill areas (e.g., fine motor and nonverbal problem-solving skills), rather than broader indices of developmental level (e.g., nonverbal IQ) may provide important cues to understanding longer-term language outcomes that can be targeted in early intervention.
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Affiliation(s)
| | - Megan Fok
- Rutgers University-New Brunswick; Piscataway, NJ, USA
| | - Catherine Lord
- University of California Los Angeles Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine; Los Angeles, CA, USA
| | - Isabel M. Smith
- Dalhousie University and IWK Health Centre; Halifax, NS, Canada
| | - Pat Mirenda
- University of British Columbia; Vancouver, BC, Canada
| | - Peter Szatmari
- University of Toronto, The Hospital for Sick Children, Centre for Addiction and Mental Health; Toronto, ON, Canada
| | | | - Joanne Volden
- University of Alberta, Glenrose Rehabilitation Hospital; Edmonton, AB, Canada
| | | | - Lonnie Zwaigenbaum
- University of Alberta, Glenrose Rehabilitation Hospital; Edmonton, AB, Canada
| | | | - Eric Duku
- McMaster University; Hamilton, ON, Canada
| | | | | | - Wendy J. Ungar
- University of Toronto, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
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28
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Zaidman-Zait A, Mirenda P, Szatmari P, Duku E, Smith IM, Zwaigenbaum L, Vaillancourt T, Kerns C, Volden J, Waddell C, Bennett T, Georgiades S, Ungar WJ, Elsabbagh M. Profiles and Predictors of Academic and Social School Functioning among Children with Autism Spectrum Disorder. Journal of Clinical Child & Adolescent Psychology 2020; 50:656-668. [DOI: 10.1080/15374416.2020.1750021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Anat Zaidman-Zait
- Department of School Counseling and Special Education, Tel Aviv University
| | - Pat Mirenda
- Department of Educational and Counselling Psychology and Special Education, University of British Columbia
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University
| | | | | | | | - Connor Kerns
- Department of Educational and Counselling Psychology and Special Education, University of British Columbia
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University
| | - Teresa Bennett
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University
| | - Stelios Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University
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Zaidman-Zait A, Zwaigenbaum L, Duku E, Bennett T, Szatmari P, Mirenda P, Smith I, Vaillancourt T, Volden J, Waddell C, Kerns C, Elsabbagh M, Georgiades S, Ungar WJ, Fombonne E, Roberts W. Factor analysis of the children's sleep habits questionnaire among preschool children with autism spectrum disorder. Res Dev Disabil 2020; 97:103548. [PMID: 31901672 DOI: 10.1016/j.ridd.2019.103548] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 11/17/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Sleep problems are prevalent among young children with autism spectrum disorders (ASD). The Children's Sleep Habits Questionnaire (CSHQ) is commonly used for assessment, but there are outstanding questions regarding its optimal measurement model. AIMS To examine the factor structure of the CSHQ in preschool children with ASD, and relationships between CSHQ factors and children's emotional, cognitive, and behavioral dysregulation. METHODS AND PROCEDURES Participants included 4- to 5-year-olds with ASD (n = 281). Confirmatory factor analysis was used to examine whether two previously reported CSHQ factor structures provided adequate fit to the sample data. Exploratory Factor Analysis (EFA) was used examine alternative models. Regression analyses were used to examine how CSHQ factor scores explained variance in dysregulation symptoms, measured by the Child Behavior Checklist. RESULTS Previously reported factor models in children with ASD were not confirmed, but a novel five-factor model identified using EFA provided excellent fit to the sample data. Sleep factors were generally not correlated with autism symptoms but were associated with aggression, anxiety/depression and attention problems, with evidence of specificity in these relationships. CONCLUSIONS The proposed CSHQ five-factor model may be useful in future studies of sleep problems in young children with ASD.
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Affiliation(s)
| | | | - Eric Duku
- McMaster University & Offord Centre for Child Studies
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto
| | | | | | | | | | | | | | | | | | | | | | - Wendy Roberts
- Integrated Services for Autism and Neurodevelopmental Disorders, Toronto
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Eichengreen A, Zaidman-Zait A. Relationships Among Deaf/Hard-of-Hearing Siblings: Developing a Sense of Self. J Deaf Stud Deaf Educ 2020; 25:43-54. [PMID: 31875906 PMCID: PMC7225570 DOI: 10.1093/deafed/enz038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 08/20/2019] [Accepted: 09/01/2019] [Indexed: 06/10/2023]
Abstract
While sibling relationships are known to be important for children's social and emotional well-being, little is known about sibling relationships when both siblings are deaf or hard-of-hearing (DHH). In-depth interviews were conducted with 10 young DHH adults (20-30 years old) who had studied in mainstream schools to explore their retrospective experiences of growing up with a DHH sibling. Interviews were analyzed using interpretive phenomenological analysis. Findings revealed two superordinate themes: (1) sibling relationship and sense of self and (2) family coping and relationships, with each superordinate theme containing several subthemes. Findings highlighted the various ways sibling relationships contribute to siblings' psychological development, identity formation, and coping with deafness. Potential challenges were identifed, as well as the role of parents' attitudes and coping with hearing loss in promoting supportive sibling relationships. Parents and professionals should be aware of the valuable and unique aspects of DHH siblingship and attend to imporatnt relationship asepcts such as sibling communication, sibling comparisons, and parental differential treatment.
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31
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Zaidman-Zait A, Yechezkiely M, Regev D. The quality of the relationship between typically developing children and their siblings with and without intellectual disability: Insights from children's drawings. Res Dev Disabil 2020; 96:103537. [PMID: 31783274 DOI: 10.1016/j.ridd.2019.103537] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 10/30/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
Abstract
The current study examined the relationships of typically developing (TD) children with siblings with and without intellectual disabilities (ID), as expressed in TD children's drawings and questionnaires answered by TD children and their mothers. It also examined group differences in the sibling relationships, as well as the associations between having a sibling with or without ID and sibling relationships, and TD children's social-emotional adjustment. Participants were mothers and their TD children (8-13 years). Some had ID siblings ID (N=28); others had TD siblings (N=31). Sibling relationships were examined via mothers' and target children's completion of questionnaires, and objective visual indicators (location, size, distance) and observed content-based indicators (support, investment, presence of parents) of children's drawings were assessed following the art-based phenomenological analytic approach. Mothers reported on children's social-emotional adjustment. Findings indicated differences in sibling relationships, including higher levels of positive relationships for children with ID siblings. Children's drawings also showed positive relationship aspects for these children. Sibling relationship qualities were significantly associated with children's adjustment. Children's drawings may be a useful data gathering tool to deepen our understanding of unique aspects of sibling relationships.
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Affiliation(s)
- Anat Zaidman-Zait
- Constantiner School of Education, Department of School Counseling and Special Education, School of Education, Tel Aviv University, Tel Aviv, 69978 Israel.
| | - Miri Yechezkiely
- The Graduate School of Creative Art Therapies and the Emili Sagol Creative Arts, Therapies Research Center, University of Haifa, Israel
| | - Dafna Regev
- The Graduate School of Creative Art Therapies and the Emili Sagol Creative Arts, Therapies Research Center, University of Haifa, Israel
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32
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Zaidman-Zait A, Hall W. Contributions of parents' reports of children's sleep and challenging family contexts at age five to teachers' reports of children's classroom engagement and academic achievement two years later. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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33
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Zaidman-Zait A. The contribution of maternal executive functions and active coping to dyadic affective dynamics: Children with autism spectrum disorder and their mothers. Autism 2019; 24:645-657. [PMID: 31647318 DOI: 10.1177/1362361319854653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parenting is a cognitive, emotional, and behavioral endeavor, where parents' control capacities, including executive functions and active control coping, help parents to guide and regulate interactions with their children; yet limited research investigates how these capacities are associated with parent-child affective regulation processes during parent-child interactions. This study examined whether maternal executive functions (sustained attention, interference inhibitory control, working memory) and active engaged coping were related to dyadic affective flexibility and positive mutual affective interactions between mothers and their young children with autism spectrum disorders (N = 40). Dyadic flexibility and mutual positive affect were measured using dynamic systems-based modeling of second-by-second affective patterns during a mother-child interaction. The results showed that higher levels of maternal sustained attention and inhibitory control were related to increased dyadic affective flexibility. In addition, higher levels of maternal sustained attention and higher use of engaged coping were related to dyadic mutual positive affect. The findings highlight the importance of maternal cognitive control capacity in promoting adaptive parent-child dyadic regulatory processes.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel.,The University of British Columbia, Canada
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34
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Zaidman-Zait A, Poon BT, Curle D, Jamieson JR, Norman N. The Transition to School Among Deaf/Hard-of-Hearing Children: Teacher and Parent Perspectives. J Deaf Stud Deaf Educ 2019; 24:396-407. [PMID: 31381069 DOI: 10.1093/deafed/enz027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/16/2019] [Accepted: 05/24/2019] [Indexed: 06/10/2023]
Abstract
Although entry into the school system is a major milestone in the lives of young d/Deaf or hard-of-hearing (DHH) children and their families, relatively little is known about parents' and teachers' experiences and perspectives of this important transition. The aims of this study were to describe parents' concerns during their children's transition from early intervention to school, to describe practices available for families of DHH children, and to explore parents' and teachers' perspectives regarding practices that support a smooth transition to school. Parents (N = 40) and teachers (N = 37) of the deaf and hard of hearing completed surveys examining their experiences and perspectives on DHH children's transition to school. Among concerns expressed among parents was their child's ability to participate successfully in an inclusive school setting, as well as the level of supports their child would receive. Teachers reported numerous policies and practices that supported the transition to school, emphasizing high-intensity practices often used to gather information about the child and set accommodations in place. Parent and teacher reports on facilitators for the transition are compared and contrasted. Recommendations for research and practice are provided.
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Tesfaye R, Courchesne V, Yusuf A, Savion-Lemieux T, Singh I, Shikako-Thomas K, Mirenda P, Waddell C, Smith IM, Nicholas D, Szatmari P, Bennett T, Duku E, Georgiades S, Kerns C, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Elsabbagh M. Assuming ability of youth with autism: Synthesis of methods capturing the first-person perspectives of children and youth with disabilities. Autism 2019; 23:1882-1896. [PMID: 30915852 PMCID: PMC6779014 DOI: 10.1177/1362361319831487] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most research regarding youth with autism spectrum disorder has not focused on their first-person perspectives providing limited insight into methodologies best suited to eliciting their voices. We conducted a synthesis of methods previously used to obtain the first-person perspectives of youth with various disabilities, which may be applicable to youth with autism spectrum disorder. Two-hundred and eighty-four articles met the inclusion criteria of our scoping review. We identified six distinct primary methods (questionnaires, interviews, group discussion, narratives, diaries, and art) expressed through four communication output modalities (language, sign language and gestures, writing, and images). A group of parents who have children with autism spectrum disorder were then presented with a synthesis of results. This parent consultation was used to build on approaches identified in the literature. Parents identified barriers that may be encountered during participant engagement and provided insights on how best to conduct first-person research with youth with autism spectrum disorder. Based on our findings, we present a novel methodological framework to capture the perspectives of youth with various communication and cognitive abilities, while highlighting family, youth, and expert contributions.
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36
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Marshall SK, Stainton T, Wall JM, Zhu M, Murray J, Wu S, El Bouhali A, Parada F, Zaidman-Zait A, Young RA. Transition to Adulthood as a Joint Parent-Youth Project for Young Persons With Intellectual and Developmental Disabilities. Intellect Dev Disabil 2018; 56:263-277. [PMID: 30024849 DOI: 10.1352/1934-9556-56.5.263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Eight dyads ( N = 16) residing in Western Canada participated in this investigation of how young adults with intellectual and developmental disabilities (IDD) and their parents jointly construct, articulate, and act on goals pertinent to the young adults' transition to adulthood. Using the action-project method to collect and analyze conversations and video recall data, cases were grouped representing the ways goal-directed projects brought relationship ( n = 4), planning ( n = 3) or both ( n = 1) to the foreground as joint projects. Resources internal to the dyad such as emotional resources, and external to the dyad, facilitated formulation and pursuit of projects. Lack of external supports and limited parental knowledge about IDD hindered joint project formulation.
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Affiliation(s)
- Sheila K Marshall
- Sheila K. Marshall, Tim Stainton, Jessie M. Wall, Ma Zhu, and John Murray, University of British Columbia
| | - Tim Stainton
- Sheila K. Marshall, Tim Stainton, Jessie M. Wall, Ma Zhu, and John Murray, University of British Columbia
| | - Jessie M Wall
- Sheila K. Marshall, Tim Stainton, Jessie M. Wall, Ma Zhu, and John Murray, University of British Columbia
| | - Ma Zhu
- Sheila K. Marshall, Tim Stainton, Jessie M. Wall, Ma Zhu, and John Murray, University of British Columbia
| | - John Murray
- Sheila K. Marshall, Tim Stainton, Jessie M. Wall, Ma Zhu, and John Murray, University of British Columbia
| | - Siwei Wu
- Siwei Wu, Hengyang Normal University
| | | | | | - Anat Zaidman-Zait
- Anat Zaidman-Zait, University of Tel Aviv; and Richard A. Young, University of British Columbia
| | - Richard A Young
- Anat Zaidman-Zait, University of Tel Aviv; and Richard A. Young, University of British Columbia
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37
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Brand D, Zaidman-Zait A, Most T. Parent Couples' Coping Resources and Involvement in their Children's Intervention Program. J Deaf Stud Deaf Educ 2018; 23:189-199. [PMID: 29672722 DOI: 10.1093/deafed/eny011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Parental involvement is vital to the implementation of intervention programs for deaf and hard-of-hearing (DHH) children. The current study examined the dyadic relationships between mothers' and fathers' coping resources and their involvement in their child's intervention program. In addition, the moderating roles of parent's gender and family religiosity on the associations between coping resources and involvement were examined. Seventy Jewish couples of parents of DHH children, representing various levels of religiosity, completed questionnaires regarding involvement in their child's intervention program, child acceptance, parental self-efficacy, and perceived social support. Multilevel modeling analyses were used to test actor-partner interdependence. The findings indicated significant actor effects for child acceptance, parental self-efficacy, and social support. All were positively associated with parental involvement. Gender was found to moderate the actor effect of child acceptance. Partner effects were found only for mothers, for child acceptance, and social support. Fathers' child acceptance and social support were negatively associated with mothers' involvement. Religiosity did not moderate neither actor nor partner effects. These results have important implications for planning intervention programs that are sensitive to each of the parent's needs.
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38
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Zaidman-Zait A, Mirenda P, Szatmari P, Duku E, Smith IM, Vaillancourt T, Volden J, Waddell C, Bennett T, Zwaigenbaum L, Elsabaggh M, Georgiades S, Ungar WJ. Correction to: Profiles of Social and Coping Resources in Families of Children with Autism Spectrum Disorder: Relations to Parent and Child Outcomes. J Autism Dev Disord 2018; 48:2077. [PMID: 29450834 DOI: 10.1007/s10803-018-3498-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The original version of this article unfortunately contained a mistake.
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Affiliation(s)
- Anat Zaidman-Zait
- School of Education, Tel Aviv University, P.O. Box 39040, 6997801, Tel Aviv, Israel.
| | - Pat Mirenda
- University of British Columbia, 215 Main Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | - Isabel M Smith
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | | | | | | | | | | | - Mayada Elsabaggh
- McGill University/Montreal Children's Hospital, Montreal, PQ, Canada
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39
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Young RA, Marshall SK, Stainton T, Wall JM, Curle D, Zhu M, Munro D, Murray J, El Bouhali A, Parada F, Zaidman-Zait A. The transition to adulthood of young adults with IDD: Parents' joint projects. J Appl Res Intellect Disabil 2017; 31 Suppl 2:224-233. [PMID: 28834118 DOI: 10.1111/jar.12395] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Parents have found the transition to adulthood for their sons or daughters with intellectual and/or developmental disabilities (IDD) particularly challenging. The literature has not examined how parents work together and with others in face of this transition nor has it highlighted parental goals in this process. This study used a perspective based on joint, goal-direct action to describe the projects that Canadian parents engaged in together and with others relative to this transition. METHODS Using the qualitative action-project method, joint projects between parents and with others were identified from their conversations and followed for 6 months. FINDINGS Three groups of projects were described: equipping the young adult for adult life, connecting for personal support and managing day-to-day while planning for the future. CONCLUSIONS Parents act together and with others relative to the transition to adulthood of their young adult children with IDD. These projects are complex and differ in goals, steps, resources and emotional regulation and motivation.
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Affiliation(s)
| | | | - Tim Stainton
- University of British Columbia, Vancouver, BC, Canada
| | - Jessie M Wall
- University of British Columbia, Vancouver, BC, Canada
| | - Deirdre Curle
- University of British Columbia, Vancouver, BC, Canada
| | - Ma Zhu
- University of British Columbia, Vancouver, BC, Canada
| | - David Munro
- University of British Columbia, Vancouver, BC, Canada
| | - John Murray
- University of British Columbia, Vancouver, BC, Canada
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Zaidman-Zait A, Dotan A. Everyday Stressors in Deaf and Hard of Hearing Adolescents: The Role of Coping and Pragmatics. J Deaf Stud Deaf Educ 2017; 22:257-268. [PMID: 28334795 DOI: 10.1093/deafed/enw103] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/09/2017] [Indexed: 06/06/2023]
Abstract
The current mixed-methods study examined everyday problems among deaf and hard of hearing (DHH) adolescents across various life domains. To better understand the factors influencing levels of perceived stress, the impact of DHH adolescents' coping and pragmatic abilities was also examined. Thirty DHH adolescents completed questionnaires about everyday stressors and coping, and 13 of these respondents were interviewed regarding their everyday problems. All participants used spoken language and attended mainstream high schools. Teachers evaluated the pragmatic skills of each participant through a communication assessment tool. The quantitative-based results showed that DHH adolescents perceived greatest stress related to the future, peers, and school, in that order. Considerably less stress was experienced with regard to parents, leisure, and romantic relationships. The qualitative data reflected the context-specific everyday stressors experienced by DHH adolescents and suggested they have been generated by problems related to having a hearing loss, experiences in social interactions, classroom environment, and academic challenges. Importantly, lower pragmatic abilities and increased level of withdrawal coping style were found to be associated with higher perceived stress. The conclusions focused on ways in which schools, teachers, and professionals can implement prevention and intervention efforts to adequately support DHH adolescents in facing everyday challenges.
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Zaidman-Zait A, Most T, Tarrasch R, Haddad E. Mothers’ and fathers’ involvement in intervention programs for deaf and hard of hearing children. Disabil Rehabil 2017; 40:1301-1309. [DOI: 10.1080/09638288.2017.1297491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Anat Zaidman-Zait
- Department of School Counseling and Special Education, Tel Aviv University, Tel Aviv, Israel
| | - Tova Most
- Department of School Counseling and Special Education, Tel Aviv University, Tel Aviv, Israel
| | - Ricardo Tarrasch
- Department of School Counseling and Special Education, Tel Aviv University, Tel Aviv, Israel
| | - Eliana Haddad
- Department of School Counseling and Special Education, Tel Aviv University, Tel Aviv, Israel
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Curle D, Jamieson J, Buchanan M, Poon BT, Zaidman-Zait A, Norman N. The Transition From Early Intervention to School for Children Who Are Deaf or Hard of Hearing: Administrator Perspectives. J Deaf Stud Deaf Educ 2017; 22:131-140. [PMID: 27789553 DOI: 10.1093/deafed/enw067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/28/2016] [Accepted: 09/30/2016] [Indexed: 06/06/2023]
Abstract
Although the transition from early intervention (EI) to school is a significant milestone in the lives of young children, little research to date has investigated this transition among children who are deaf or hard of hearing (D/HH). The aims of this study were to investigate the organizational policies, procedures, and guidelines that facilitate or hinder the transition from the EI system to the school system for children who are D/HH from the perspective of program administrators. Using the Enhanced Critical Incident Technique methodology, 146 incidents were extracted from 10 interviews and sorted into 10 helping, 9 hindering, and 5 wish list categories. Findings are consistent with the Ecological and Dynamic Model of Transition (Rimm-Kaufman & Pianta, 2000), which conceptualizes the transition to school as being influenced by the pattern of interactions between the individuals, groups, and institutions connected to the child.
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Zaidman-Zait A, Mirenda P, Duku E, Vaillancourt T, Smith IM, Szatmari P, Bryson S, Fombonne E, Volden J, Waddell C, Zwaigenbaum L, Georgiades S, Bennett T, Elsabaggh M, Thompson A. Impact of personal and social resources on parenting stress in mothers of children with autism spectrum disorder. Autism 2016; 21:155-166. [PMID: 27091948 DOI: 10.1177/1362361316633033] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
This study examined the longitudinal associations between child behavior problems, coping strategies, social resources, and parenting stress in mothers of young children with autism spectrum disorder. Participants were 283 mothers who completed self- and child-report measures at the time of diagnosis and 2 years later. Hierarchical multiple regression was conducted to predict overall parenting stress. At diagnosis, the final model indicated that high levels of social support and mothers' use of active engaged coping strategies were associated with lower levels of parenting stress. Conversely, high levels of child externalizing behavior problems, family dysfunction, and mothers' use of disengaged coping strategies were associated with higher parenting stress. Two years later, high levels of parenting stress at diagnosis predicted increased parenting stress. In addition, high or increasing levels of social support predicted a decrease in parenting stress, while high or increasing levels of family dysfunction predicted increased stress. Finally, increased use of disengaged coping strategies and decreased use of active coping strategies over time predicted higher levels of parenting stress. Results are discussed in terms of their implications for the provision of targeted supports that are designed to enhance the personal and social resources available to mothers of children with autism spectrum disorder.
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Zaidman-Zait A, Curle D. Complexity: An interpretative phenomenological analysis of the experiences of mothers of deaf children with cochlear implants and autism. J Health Psychol 2016; 23:1173-1184. [DOI: 10.1177/1359105316646171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to explore the experiences of parenting a child with a dual diagnosis of childhood deafness and autism spectrum disorder who underwent cochlear implantation. Experiences of these parents are rarely discussed within the literature. Interpretive Phenomenological Analysis was used to examine nine mothers of boys (4–9 years old) for understanding their parenting experiences. Three superordinate themes were identified: complexity, personal and family sacrifices and parent–professional partnerships. These themes provide a rich account of mothers’ interpretations of their experiences, and reflect the numerous challenges they face. This study helps expand the literature on cochlear implantation for children with autism spectrum disorder, and discusses implications for clinical and educational practice.
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Zaidman-Zait A, Most T, Tarrasch R, Haddad-eid E, Brand D. The Impact of Childhood Hearing Loss on the Family: Mothers' and Fathers' Stress and Coping Resources. J Deaf Stud Deaf Educ 2016; 21:23-33. [PMID: 26363022 DOI: 10.1093/deafed/env038] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/12/2015] [Indexed: 06/05/2023]
Abstract
Parenting children who are deaf or hard of hearing (D/HH) presents unique long-term challenges that can place the parents at a greater risk for elevated levels of parenting stress. Adaptation of families to the various challenges presented by childhood hearing loss is influenced by their personal and social coping resources available for managing these stressors and challenges. The current study examined differences in parenting stress and personal (i.e., acceptance of the child who is D/HH and parents' sense of parenting self-efficacy) and social (i.e., formal and informal social support) coping resources between mothers and fathers of children who are D/HH in the Arab sector in Israel. Further, the study examined the relations between coping resources and parenting stress among these parents. Participants included 30 Israeli Arab mother-father couples (n = 60) having a child who is D/HH aged 3-8 years. Findings revealed no significant differences between mothers and fathers regarding parenting stress, child acceptance, or parental support systems. However, mothers reported significantly higher self-efficacy. In addition, correlation analysis indicated that higher coping resources decreased parenting stress levels. Theoretical and practical implications of parental gender in the context of cultural background are discussed regarding parent intervention programs.
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Zaidman-Zait A, Hall WA. Children's night waking among toddlers: relationships with mothers' and fathers' parenting approaches and children's behavioural difficulties. J Adv Nurs 2015; 71:1639-49. [DOI: 10.1111/jan.12636] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Anat Zaidman-Zait
- Department of School Counseling and Special Education; Constantiner School of Education; Tel-Aviv University; Israel
- Department of Human Early Learning Partnership (HELP); University of British Columbia; Vancouver British Columbia Canada
| | - Wendy A. Hall
- University of British Columbia School of Nursing; Vancouver British Columbia Canada
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Zaidman-Zait A, Curle D, Jamieson JR, Chia R, Kozak FK. Cochlear implantation among deaf children with additional disabilities: parental perceptions of benefits, challenges, and service provision. J Deaf Stud Deaf Educ 2015; 20:41-50. [PMID: 25225328 DOI: 10.1093/deafed/enu030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Although increasing numbers of children with additional disabilities are receiving cochlear implants (CIs), little is known about family perspectives of the benefits and the challenges of cochlear implantation in this pediatric population. This study examines perceptions among parents of deaf children with additional disabilities regarding satisfaction with service provision, benefits, and challenges of the CI process. This was a mixed-methods study, which included a survey and interviews. Twenty-three families of deaf children with additional disabilities participated in this study, and 17 of these parents participated in in-depth interviews regarding their child's experience with the CI, including benefits and challenges. Interviews were analyzed through inductive thematic analysis. Parent-perceived benefits of cochlear implantation included children's improved sound awareness, communication skills, and greater well-being compared to preimplantation status. However, the majority of families felt that they and their children were not receiving enough services. Major challenges included managing funding; coping with limited availability of specialized services, particularly in rural areas; and continuing concerns about the child's communication, social skills, and academic performance. Results suggest that children with additional disabilities benefit from CIs, but they and their families also face unique challenges that professionals should consider when working with these families.
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Abstract
In light of claims that social support needs to be defined within specific context, we conducted a metasynthesis to identify ways that social support has been studied and contextualized in research focused on hearing parents of children with hearing loss. A literature search of published articles was conducted to identify research studies related to support and hearing parents of children with hearing loss. Our search yielded 108 items from Psycinfo and 154 items from Web of Science; 26 studies met our inclusion criteria. Our analyses involved summary and integration of information regarding research methods, guiding theoretical frameworks, and findings in relation to diverse support contexts. We found that it is the multidimensionality of social support and its specific functions, individually and in combination, that are particularly relevant in informing family-centered service provision. Further understanding of the multidimensional and dynamic nature of support could occur through investigation of diverse functions of support within and across ecological contexts. Findings from this study contributed to a descriptive framework that can be used to explore the multidimensionality of support; facilitate use of methods that assess specific support functions; and also inform the development of interventions that are responsive and match the needs of parents.
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Affiliation(s)
- Brenda T Poon
- Human Early Learning Partnership, School of Population and Public Health, 440-2206 East Mall, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada.
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Zaidman-Zait A, Mirenda P, Duku E, Szatmari P, Georgiades S, Volden J, Zwaigenbaum L, Vaillancourt T, Bryson S, Smith I, Fombonne E, Roberts W, Waddell C, Thompson A. Examination of Bidirectional Relationships Between Parent Stress and Two Types of Problem Behavior in Children with Autism Spectrum Disorder. J Autism Dev Disord 2014; 44:1908-17. [DOI: 10.1007/s10803-014-2064-3] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND While evidence suggests sleep problems are common in young children and linked to behavioural problems, studies of toddlers are rare. This community-based cross-sectional study examined associations between sleep problems and daytime behaviour among 58 children aged 1 to 3 years who attended daycare centres. METHODS Mothers and daycare providers completed four and three questionnaires, respectively, about children's sleep patterns and behaviour. Two hypotheses were tested: (1) children with higher sleep problem scores would have more behavioural problems by parental and daycare provider report; (2) problematic napping behaviours would be associated with night sleep problems. RESULTS Mothers' reports of sleep problems were positively associated with children's behavioural problems at home and daycare providers' reports of nap problems were positively correlated with children's behavioural problems at daycare. Daycare providers' reports of children's behavioural problems at daycare were associated with maternal reports of behavioural problems. Older children in the sleep problem group had maternal reports of more behavioural problems. Daycare providers reported that children with sleep problems were less happy at daycare. Children who were happier following naps had less reported night settling difficulties. Children with difficulty settling for naps at daycare had maternal reports of more behavioural problems. CONCLUSIONS Napping in daycare settings is an important component of toddlers' sleep. Crossover effects between children's sleep and behaviour at daycare and home indicate similarities in mothers' and daycare providers' perceptions. Findings suggest parent and daycare provider interactions include discussions about sleep problems and settling at home and in daycares. Parents and daycare providers would benefit from education about relationships between sleep and behavioural problems.
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Affiliation(s)
- W A Hall
- School of Nursing, University of British Columbia Human Early Learning Partnership, University of British Columbia, Vancouver, BC, Canada.
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