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Remembering parents in parent-mediated early intervention: An approach to examining impact on parents and families

2016-12-04T21:48:32-08:00

The goal of this review is to advance the discussion regarding meaningful outcomes of early intervention for children with autism spectrum disorder. The rapid growth in the development and evaluation of early intervention approaches for autism spectrum disorder includes both therapist-driven and parent-mediated interventions. The majority of research on both approaches to early intervention focuses on promoting child outcomes (e.g. language acquisition) with less emphasis on family and parent outcomes (e.g. quality of life, self-efficacy). Given that parent buy-in is essential for parent-mediated interventions to be effective over time, increased attention to family outcomes that are of value to families and have the potential to be impacted positively by these interventions is needed to develop, disseminate, and sustain high-quality interventions in community settings. In this review, we draw from work on parent and family outcomes targeted in related fields (e.g. Part C early intervention, pediatric chronic illness, behavior management parent training) that we propose are particularly relevant for evaluating the impact of parent-mediated interventions in early intervention for autism spectrum disorder.




The neuroanatomy of autism spectrum disorder: An overview of structural neuroimaging findings and their translatability to the clinical setting

2016-12-04T21:48:32-08:00

Autism spectrum disorder is a complex neurodevelopmental disorder, which is accompanied by differences in brain anatomy, functioning and brain connectivity. Due to its neurodevelopmental character, and the large phenotypic heterogeneity among individuals on the autism spectrum, the neurobiology of autism spectrum disorder is inherently difficult to describe. Nevertheless, significant progress has been made in characterizing the neuroanatomical underpinnings of autism spectrum disorder across the human life span, and in identifying the molecular pathways that may be affected in autism spectrum disorder. Moreover, novel methodological frameworks for analyzing neuroimaging data are emerging that make it possible to characterize the neuroanatomy of autism spectrum disorder on the case level, and to stratify individuals based on their individual phenotypic make up. While these approaches are increasingly more often employed in the research setting, their applicability in the clinical setting remains a vision for the future. The aim of the current review is to (1) provide a general overview of recent structural neuroimaging findings examining the neuroanatomy of autism spectrum disorder across the human life span, and in males and females with the condition, (2) highlight potential neuroimaging (bio)markers that may in the future be used for the stratification of autism spectrum disorder individuals into biologically homogeneous subgroups and (3) inform treatment and intervention strategies.




Screening accuracy of the parent-completed Ages and Stages Questionnaires - second edition as a broadband screener for motor problems in preschoolers with autism spectrum disorders

2016-12-04T21:48:32-08:00

Children with autism spectrum disorders are at risk for motor problems. However, this area is often overlooked in the developmental evaluation in autism diagnostic clinics. An alternative can be to identify children who should receive intensive motor assessment by using a parent-based screener. The aim of this study was to examine whether the Ages and Stages Questionnaires – second edition may be used to identify gross and fine motor problems in children. High-functioning children with autism spectrum disorder (n = 43, 22–54 m) participated in this study. Sensitivity, specificity, predictive values and areas under the receiver operating characteristic curve were calculated by comparing the Ages and Stages Questionnaires – second edition scores to the developmental evaluation of the Peabody Developmental Motor Scale – second edition. The results revealed that both the Ages and Stages Questionnaires – second edition gross and fine motor domain may be used to identify children without motor problems. In contrast, sensitivity analyses revealed the likelihood of under screening motor problems in this population. The Ages and Stages Questionnaires – second edition met only the criteria of a fair to good accuracy to identify poor gross motor (sensitivity = 100%) and below-average fine motor development (sensitivity = 71%) in this sample. Hence, the capacity of the Ages and Stages Questionnaires – second edition to identify motor problems in preschoolers with autism spectrum disorder appears to be limited. It is recommended to include a formal standardized motor test in the diagnostic procedure for all children with autism spectrum disorder.




Play complexity and toy engagement in preschoolers with autism spectrum disorder: Do girls and boys differ?

2016-12-04T21:48:32-08:00

While sex differences in play have been extensively observed in typical development, only a handful of studies have explored this phenomenon in depth with children with autism spectrum disorders. This study explored sex differences in play complexity and toy engagement within caregiver–child interaction samples for preschool-aged children (2–5 years 11 months) with an autism spectrum disorder who were matched to typically developing children on sex and non-verbal development. Overall we found that girls and boys with autism spectrum disorder were largely equivalent in their play complexity. Despite similar play, girls and boys with autism spectrum disorder differed in a number of ways in their toy engagement, replicating traditional gender differences—girls played more with dolls and domestic items (though at lower rates than typically developing girls) and boys played more with the garage and cars (though at lower rates than typically developing boys). Our findings support the importance and utility of examining sex differences in autism spectrum disorder in light of those observed within typical development.




To include or not to include: Evaluations and reasoning about the failure to include peers with autism spectrum disorder in elementary students

2016-12-04T21:48:32-08:00

Given the significant role that typically developing children play in the social lives of children with autism spectrum disorder, it is important to understand how they evaluate and reason about the inclusion/exclusion of children with autism spectrum disorder in social situations. The objective of this study is to determine elementary students’ evaluations, reasoning patterns, and reasoning complexity regarding the failure to include children with autism spectrum disorder in social activities. Forty-four elementary-aged students participated in interviews, which included vignettes describing four contexts in which a child with autism spectrum disorder is not invited to a social event. Responses were analyzed according to social domain theory, an approach emphasizing that children identify and coordinate different domains of social knowledge, including the moral, personal, societal, and prudential. Results showed that regardless of grade and context, most children judge that failure to include on the basis of disability status is not acceptable. However, the complexity of children’s reasoning (i.e. the extent to which they drew upon and coordinated multiple domains) was higher in older children. Mean complexity scores were also higher in a birthday party context as compared to a playdate context. We offer implications for future research and practice regarding the social inclusion of children with autism spectrum disorder.




Attitudes of the autism community to early autism research

2016-12-04T21:48:33-08:00

Investigation into the earliest signs of autism in infants has become a significant sub-field of autism research. This work invokes specific ethical concerns such as use of ‘at-risk’ language, communicating study findings to parents and the future perspective of enrolled infants when they reach adulthood. This study aimed to ground this research field in an understanding of the perspectives of members of the autism community. Following focus groups to identify topics, an online survey was distributed to autistic adults, parents of children with autism and practitioners in health and education settings across 11 European countries. Survey respondents (n = 2317) were positively disposed towards early autism research, and there was significant overlap in their priorities for the field and preferred language to describe infant research participants. However, there were also differences including overall less favourable endorsement of early autism research by autistic adults relative to other groups and a dislike of the phrase ‘at-risk’ to describe infant participants, in all groups except healthcare practitioners. The findings overall indicate that the autism community in Europe is supportive of early autism research. Researchers should endeavour to maintain this by continuing to take community perspectives into account.




Adolescent boys with an autism spectrum disorder and their experience of sexuality: An interpretative phenomenological analysis

2016-12-04T21:48:33-08:00

This qualitative study explored how adolescent boys with autism spectrum disorder experience their sexuality. Previous research has demonstrated that sexuality is a developmental task for boys with autism spectrum disorder, as it is for their peers. Case studies have suggested a relation between autism spectrum disorder and atypical sexual development; empirical studies on this subject, however, are scant and inconsistent. This study is based on interviews with eight boys, aged 16–20 years, with Asperger’s disorder or autistic disorder. Interpretative phenomenological analysis of the data revealed three major themes relating to (a) how they experience sexual feelings, think about sexuality and think about themselves as sexual beings; (b) how they perceive messages relating to sexuality in their surroundings; and (c) how they experience finding and having a partner and partnered sex. We believe that attention to these themes is needed in assessment, education and further research.




Young children with autism spectrum disorders imitate in the context of others prior intention

2016-12-04T21:48:33-08:00

Many studies have shown that children with autism spectrum disorder have some understanding of intentions behind others’ goal-directed actions on objects. It is not clear whether they understand intentions at a high level of abstraction reliant on the context in which the actions occur. This study tested their understanding of others’ prior intentions with typically developing and developmentally delayed children. We replicated Carpenter et al.’s test of the ability to understand prior intentions embedded in the social situation with an additional context of no prior intention. Results showed that when the experimenter’s intention was made known before the demonstration, children without autism spectrum disorder performed not only better than the autism spectrum disorder children but also better than themselves when there was no information about prior intention. No between-condition difference was found in the autism spectrum disorder group. It thus appears that children with autism spectrum disorder have difficulty decoupling intentions from the context of the situation. The present findings, together with previous evidence for the intactness of the ability to understand and to imitate goal-directed actions, suggest that asymmetrical imitation performance occurs at different levels of understanding of intention by children with autism spectrum disorder.




Race, disability, and grade: Social relationships in children with autism spectrum disorders

2016-12-04T21:48:33-08:00

Race is associated with social relationships among typically developing children; however, studies rarely examine the impact of race on social outcomes for children with autism spectrum disorder. This study examined how race (African American, Latino, Asian, or White) in conjunction with disability status (autism spectrum disorders or typically developing) and grade (grades K–2 or 3–5) affects friendships and social networks. The sample comprises 85 children with autism spectrum disorders and 85 typically developing controls matched on race, gender, age/grade, and classroom (wherever possible). Race, disability, and grade each had an independent effect on friendship nominations, and there was an interaction among the three variables. Specifically, children with autism spectrum disorders who were African American or Latino in the upper elementary grades received fewer friendship nominations than typically developing White children in the lower elementary grades. Only the presence of autism spectrum disorders was associated with social network centrality. Our results also suggested that Latino children with autism spectrum disorders in the upper elementary grades were at the highest risk of social isolation. Implications for re-conceptualizing social skills interventions are discussed.




Gaze direction detection in autism spectrum disorder

2016-12-04T21:48:33-08:00

Detecting where our partners direct their gaze is an important aspect of social interaction. An atypical gaze processing has been reported in autism. However, it remains controversial whether children and adults with autism spectrum disorder interpret indirect gaze direction with typical accuracy. This study investigated whether the detection of gaze direction toward an object is less accurate in autism spectrum disorder. Individuals with autism spectrum disorder (n = 33) and intelligence quotients–matched and age-matched controls (n = 38) were asked to watch a series of synthetic faces looking at objects, and decide which of two objects was looked at. The angle formed by the two possible targets and the face varied following an adaptive procedure, in order to determine individual thresholds. We found that gaze direction detection was less accurate in autism spectrum disorder than in control participants. Our results suggest that the precision of gaze following may be one of the altered processes underlying social interaction difficulties in autism spectrum disorder.




Open-trial pilot study of a comprehensive outpatient psychosocial treatment for children with high-functioning autism spectrum disorder

2016-12-04T21:48:33-08:00

This study examined the feasibility and initial outcomes of a comprehensive outpatient psychosocial treatment (MAXout) for children aged 7–12 years with high-functioning autism spectrum disorder. The 18-week treatment, two 90-minute sessions per week, included instruction and therapeutic activities targeting social/social communication skills, facial emotion recognition, non-literal language skills, and interest expansion. A behavioral system was implemented to reduce autism spectrum disorder symptoms and problem behaviors and increase skills acquisition and maintenance. Feasibility was supported via high levels of treatment fidelity and parent, child, and staff satisfaction. Significant post-treatment improvements were found for the children’s non-literal language skills and facial emotion recognition skills, and parent and staff clinician ratings of targeted social/social communication skills, broad social skills, autism spectrum disorder symptoms, and problem behaviors. Results suggested that MAXout was feasible and may yield positive outcomes for children with high-functioning autism spectrum disorder.




The influence of media suggestions about links between criminality and autism spectrum disorder

2016-12-04T21:48:33-08:00

We examined whether media reports linking criminal behaviour and autism spectrum disorder foster negative attitudes towards individuals with autism spectrum disorder. In a between-subjects design, participants were exposed to (a) a media story in which a murderer was labelled with autism spectrum disorder (media exposure condition) or not labelled with any disorder (control) and (b) an autism spectrum disorder-education condition attacking the myth that people diagnosed with autism spectrum disorder are likely to be violent criminals or a no-autism spectrum disorder-education condition. Participants attitudes towards three different crime perpetrators (one with autism spectrum disorder) described in separate vignettes were probed. The media exposure linking crime and autism spectrum disorder promoted more negative attitudes towards individuals with autism spectrum disorder, whereas the positive autism spectrum disorder–related educational message had the opposite effect.




The missing voices of Indigenous Australians with autism in research

2016-12-04T21:48:33-08:00

The purpose of this Letter to the Editor is to raise awareness among those who read Autism about the limited amount of peer-reviewed literature on Aboriginal and Torres Strait Islander Australians living on the autism spectrum. This letter summarises the results of our search on Pubmed and Google Scholar for peer-reviewed literature on this subject. It then concludes by explaining why more research should be conducted on Aboriginal and Torres Strait Islander Australians living on the autism spectrum.




Lay abstracts

2016-12-04T21:48:33-08:00