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Background: As autistic children are being diagnosed at a younger age, the need to identify appropriate early supports has increased. Therapist-delivered and parent-mediated autism intervention may benefit children and parents. Objective: This pilot study examined developmental outcomes for autistic pre-schoolers and mental health and wellbeing outcomes for their parents (n = 53) following a 10-month intervention period. Methods: All families were accessing therapist-delivered interventions—the Early Start Denver Model (ESDM) or usual community services—and some families also received additional parent-coaching ESDM (P-ESDM). Families were assessed at 3 timepoints. Results: Overall children made significant gains in cognitive skills and adaptive behaviour, with no differences between groups. Parents overall reported increased parenting stress over time. P-ESDM conferred no added benefit for child outcomes, and similarly, no clear benefit for parent outcomes. Conclusions: Our findings suggest that children receiving early intervention make developmental gains, regardless of type of intervention, and challenges assumptions that, as an adjunct to other intervention programs, P-ESDM improves child or parent outcomes. Further research is needed to explore the effects of parent-mediated programs. [ABSTRACT FROM AUTHOR]

Both the amount and responsiveness of adult language input contribute to the language development of autistic and non-autistic children. From parent–child interaction footage, we measured the amount of adult language input, overall parent responsiveness, and six discrete parent responsive behaviours (imitations, expansions, open-ended questions, yes/no questions, comments and acknowledgements) to explore which types of responsiveness predicted autistic preschoolers' language five months later, after controlling for adult language input. We found expansions and particularly imitations to be more important for later language than overall responsiveness. This study emphasises the need to capture what exactly about parent language input influences child language acquisition, and adds to the evidence that imitating and expanding early language might be particularly beneficial for autistic preschoolers. [ABSTRACT FROM AUTHOR]

Many autistic children have co-occurring behavioural problems influencing core autism symptomology potentially relevant for intervention planning. Parental Expressed Emotion – reflecting critical, hostile and overprotective comments – contributes to understanding and predicting behaviour in autistic school-aged children, adolescents and adults and is typically measured using the Five-Minute Speech Sample. However, limitations exist for its use with parents of younger autistic children and so the Autism-Specific Five-Minute Speech Sample was adapted with the goal of better measuring parent Expressed Emotion in the context of childhood autism. The Autism-Specific Five-Minute Speech Sample has not yet been used to explore Expressed Emotion in parents of autistic preschoolers, nor has the relative predictive utility of the Autism-Specific Five-Minute Speech Sample and Five-Minute Speech Sample been evaluated in the same sample. We compared the two measures from speech samples provided by 51 Australian parents with newly diagnosed autistic preschoolers, including investigating their predictive value for concurrent and subsequent child internalising and externalising behaviour problems. While Autism-Specific Five-Minute Speech Sample Expressed Emotion and Five Minute Speech Sample Expressed Emotion were associated in this sample, only Autism-Specific Five-Minute Speech Sample codes contributed significant predictive value for concurrent and subsequent child problem behaviour. These preliminary data strengthen the position that the Autism-Specific Five-Minute Speech Sample may better capture Expressed Emotion, than the Five-Minute Speech Sample, among parents of autistic preschool-aged children related to child behavioural challenges. This adds support to the suggestion that the Autism-Specific Five-Minute Speech Sample may be a more useful measure of parental Expressed Emotion in this group, and provides a first step towards understanding how autistic children might be better supported by targeting parental Expressed Emotion. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASD) are neurodevelopmental disorders with an estimated heritability of >60%. Family‐based genetic studies of ASD have generally focused on multiple small kindreds, searching for de novo variants of major effect. We hypothesized that molecular genetic analysis of large multiplex families would enable the identification of variants of milder effects. We studied a large multigenerational family of European ancestry with multiple family members affected with ASD or the broader autism phenotype (BAP). We identified a rare heterozygous variant in the gene encoding 1,4‐ɑ‐glucan branching enzyme 1 (GBE1) that was present in seven of seven individuals with ASD, nine of ten individuals with the BAP, and none of four tested unaffected individuals. We genotyped a community‐acquired cohort of 389 individuals with ASD and identified three additional probands. Cascade analysis demonstrated that the variant was present in 11 of 13 individuals with familial ASD/BAP and neither of the two tested unaffected individuals in these three families, also of European ancestry. The variant was not enriched in the combined UK10K ASD cohorts of European ancestry but heterozygous GBE1 deletion was overrepresented in large ASD cohorts, collectively suggesting an association between GBE1 and ASD. [ABSTRACT FROM AUTHOR]

Parents from individualist cultures (those focused on autonomy of individuals; that is, Australian) may view their autistic children differently compared to parents from collectivist cultures (where community needs are valued over an individual's, that is, South-East Asian cultures). As most research on autism and parenting has been undertaken in Western individualist cultures, knowledge of parenting beliefs and mental health within collectivist cultures is lacking. We compared the mental health, quality of life, well-being and parenting sense of competency between families raising an autistic child from two groups: 97 Australian parents and 58 parents from South-East Asian backgrounds. Children from both groups were receiving the same community-based early intervention. No group differences were found on the measures of mental health but, when compared to Australian parents, parents from South-East Asian backgrounds reported higher well-being and less impact on their quality of life resulting from their child's autism-specific difficulties. Furthermore, a positive association between well-being and quality of life was only observed for South-East Asian parents. Hence, the views of, and responses to, disability for South-East Asian parents may act as a protective factor promoting well-being. This novel research indicates that culture plays a role in parenting autistic children and highlights the need to accurately capture cultural background information in research. We know that parents of autistic children experience poorer mental health and lower well-being than parents of non-autistic children. We also know that poorer mental health among parents of autistic children has been observed across different cultures. Most research focuses on Western cultures, so we know little about parental mental health and well-being of parents from different cultural backgrounds; yet, it is likely that cultural background contributes to how parents view their child's condition and respond to the diagnosis. Here, we compared mental health, quality of life and well-being between families raising an autistic child from Australian backgrounds to families from South-East Asian backgrounds. All children in the current study were receiving the same community-based early intervention. When compared to the general population, parents had poorer mental health overall, but there were no differences between the two groups of parents. However, parents from South-East Asian backgrounds reported higher well-being and fewer difficulties associated with their child's autism. These findings suggest that cultural background likely influences not only parent's view of, and response to, their child's autism, but also their own sense of well-being. As researchers and clinicians working with families of autistic children, we should more explicitly consider family's cultural background within our work. [ABSTRACT FROM AUTHOR]

Extensive research has shown elevated mental health difficulties among parents of children with autism compared to other parents. Although several studies have explored factors related to mental health among parents of children with autism, the factors that influence and promote well-being remain poorly characterised. Parents of young, newly diagnosed autistic children may also be particularly vulnerable to stressors that impact mental health and well-being. We examined child-, parent-, and family/socioeconomic factors associated with concurrent mental health and well-being among 136 parents of young children with autism, aged 13–48 months. Parental mental health was predicted by both trait negative emotionality and reported child autism symptoms, while well-being was predicted by parent factors alone, including trait extraversion and mindfulness. Broader child characteristics and family/socioeconomic contextual factors made no significant contribution in regression models. While the mental health and well-being of parents with young autistic children are associated with one another, unique predictors seem to exist. That well-being was uniquely predicted by a modifiable parent characteristic – mindfulness – suggests the potential for early supports to bring direct benefits for parents, in the context of raising a young child with autism. Raising a child with autism has been linked to mental health difficulties. Poor parental mental health is likely influenced by various factors – including child-, parent-, and family/socioeconomic characteristics. However, little is known about what influences and promotes well-being (as opposed to mental health) among parents of young, newly diagnosed autistic children who may be particularly vulnerable. We examined child-, parent-, and family/socioeconomic factors associated with each of mental health and well-being in a sample of 136 parents of pre-school-aged children. Parental mental health was linked to both child- (i.e. autism symptom severity) and parent-related factors (i.e. personality traits reflecting a tendency to experience negative emotions). By contrast, in additional to mental health difficulties, which were linked to well-being, only other parent-related characteristics (and not child characteristics) were related to well-being. These included personality traits reflecting a tendency to be more extraverted/sociable, and also mindfulness. Other child-related and family/socioeconomic context factors (including household income, parental education level) were not linked to parental mental health or well-being in this sample. These results support the idea that poorer mental health and well-being are not simply the opposite of one another. That is, while these two factors were related, they were linked to different personal characteristics. Perhaps most importantly, the link between well-being and mindfulness – a personal characteristic that parents can improve – suggests mindfulness-based interventions may be helpful in directly supporting parental well-being in the context of raising a young child with autism. [ABSTRACT FROM AUTHOR]

Little is known about executive functions (EFs) associated with advanced theory of mind (ToM) abilities. We aimed to determine if advanced ToM abilities were reduced in individuals with subclinical traits of autism spectrum disorder (ASD), known as the "Broader Autism Phenotype" (BAP), and identify the EFs that predicted unimpaired performance on an advanced ToM task, the faux pas test. We assessed 29 participants (13 males) with the BAP who were relatives of children with ASD. Thirteen participants showed reduced ability to understand a faux pas. A discriminant function analysis correctly classified 79% of cases as impaired or unimpaired, with high sensitivity (80%) and specificity (77%), which was best predicted by language‐mediated EFs, including verbal generativity, working memory, cognitive inhibition, and flexibility. Autism Res 2020, 13: 921‐934. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Little is known about the complex cognitive processes that enable accurate interpretation of another person's thoughts and emotions, known as "theory of mind." In relatives of individuals with autism, who had mild traits of autism themselves, approximately half had difficulty interpreting situations involving a social faux pas. Cognitive inhibition and flexibility, working memory, and verbal generativity were related to, and appeared to be protective for, unimpaired understanding of a faux pas. [ABSTRACT FROM AUTHOR]

Background and aims: Although bilingualism is a common worldwide phenomenon, limited research has considered the experiences of children with autism growing up in bilingual environments. Here, we investigated the potential influence of parental bilingualism, and native vs. non-native language use, on responsiveness to children's communication attempts during parent–child interactions where the child had autism. Specifically, we investigated the amount of parent responses to child verbal communication (frequency) and the promptness of these responses (temporal synchrony). Methods: Participants were 22 monolingual and 20 bilingual parents and their children with autism aged 2–6 years, recruited from a multicultural, metropolitan city where English is the dominant language. Extending from our previous report on this sample, we identified the frequency and temporal synchrony of parent responses from filmed 10-minute free-play sessions. Monolingual parents were videoed during one free-play session in English. Bilingual parents were videoed during two free-play sessions; one in their native language and one in English. We compared the frequency and temporal synchrony of parental responses across monolingual and bilingual parent groups and, for bilingual parents, across native vs. non-native (English) language interaction samples. Finally, we examined how other measures of bilingual parents' non-native language proficiency were associated with interaction responsiveness measures. Results: When using their native language, bilingual parents demonstrated reduced frequency of responsiveness (even when controlling for opportunities provided by the child) and less temporal synchrony to child communication compared to English-speaking monolingual parents. Bilingual parents were also less frequently responsive (but not less temporally synchronous) during their native- compared to during their non-native (English) language interactions. Moreover, for bilingual parents, more frequent responsiveness to child communication bids when interacting in non-native English was associated with greater assessed English vocabulary knowledge. Conclusions: In this sample, use of non-native English did not appear to adversely affect how often, or how quickly, bilingual parents responded to their children's verbal communication bids. However, nor did we find evidence of a native-language advantage. Rather, during English-language interactions, when these bilingual parents were responsive towards their children, this was on par with rates and timing of responsiveness shown by English-speaking monolinguals. This may partly be explained by bilinguals' non-native language proficiency, and habitual use/personal dominance patterns. Implications: These data suggest no definitive drawback of non-native language use for synchronous responsiveness by bilingual parents interacting with young children with autism. However, our data also serve to highlight the complex, multifaceted nature of adult bilingualism, and indicate the need for more research – with large, well-characterised samples – to permit strong conclusions concerning how parental language-use choices may influence children's natural learning environments, including in the context of autism and developmental language impairments. [ABSTRACT FROM AUTHOR]

Recent findings suggest that children with Autism Spectrum Disorder (ASD) are larger in size for head circumference (HC), height, and weight compared to typically developing (TD) children; however, little is known about their rate of growth, especially in height and weight. The current study aimed to: (a) confirm and extend upon previous findings of early generalized overgrowth in ASD; and (b) determine if there were any differences in the rate of growth between infants and toddlers with ASD compared to their TD peers. Measurements of HC, height, and weight were available for 135 boys with ASD and 74 TD boys, from birth through 3 years of age. Size and growth rate in HC, height, and weight were analyzed using a linear mixed‐effects model. Infants with ASD were significantly smaller in size at birth for HC, body length, and weight compared to TD infants (all P < 0.05); however, they grew at a significantly faster rate in HC and height in comparison to the TD children (P < 0.001); there was no significant difference between the groups in growth rate for weight (P > 0.05). The results confirmed that male infants and toddlers with ASD exhibit skeletal growth dysregulation early in life. Autism Res 2018, 11: 846–856. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Recent findings suggest that infants with Autism Spectrum Disorder (ASD) are smaller in size at birth compared to typically developing infants but grow larger than their peers during the first year. Little is known about their rate of growth, especially for height and weight. Our findings confirmed that infants with ASD are smaller in size at birth for head circumference (HC), height, and weight, but grow at a faster rate in HC and height than their peers from birth to 3 years. [ABSTRACT FROM AUTHOR]

Families comprising many individuals with Autism Spectrum Disorders (ASD) may carry a dominant predisposing mutation. We implemented rigorous phenotyping of the "Broader Autism Phenotype" (BAP) in large multiplex ASD families using a novel endophenotype approach for the identification and characterisation of distinct BAP endophenotypes. We evaluated ASD/BAP features using standardised tests and a semi-structured interview to assess social, intellectual, executive and adaptive functioning in 110 individuals, including two large multiplex families (Family A: 30; Family B: 35) and an independent sample of small families (n = 45). Our protocol identified four distinct psychological endophenotypes of the BAP that were evident across these independent samples, and showed high sensitivity (97%) and specificity (82%) for individuals classified with the BAP. Patterns of inheritance of identified endophenotypes varied between the two large multiplex families, supporting their utility for identifying genes in ASD. [ABSTRACT FROM AUTHOR]

Background and aims: Although bilingualism is a common worldwide phenomenon, limited research has considered the experiences of children with autism growing up in bilingual environments. Here, we investigated the potential influence of parental bilingualism, and native vs. non-native language use, on responsiveness to children's communication attempts during parent–child interactions where the child had autism. Specifically, we investigated the amount of parent responses to child verbal communication (frequency) and the promptness of these responses (temporal synchrony). Methods: Participants were 22 monolingual and 20 bilingual parents and their children with autism aged 2–6 years, recruited from a multicultural, metropolitan city where English is the dominant language. Extending from our previous report on this sample, we identified the frequency and temporal synchrony of parent responses from filmed 10-minute free-play sessions. Monolingual parents were videoed during one free-play session in English. Bilingual parents were videoed during two free-play sessions; one in their native language and one in English. We compared the frequency and temporal synchrony of parental responses across monolingual and bilingual parent groups and, for bilingual parents, across native vs. non-native (English) language interaction samples. Finally, we examined how other measures of bilingual parents' non-native language proficiency were associated with interaction responsiveness measures. Results: When using their native language, bilingual parents demonstrated reduced frequency of responsiveness (even when controlling for opportunities provided by the child) and less temporal synchrony to child communication compared to English-speaking monolingual parents. Bilingual parents were also less frequently responsive (but not less temporally synchronous) during their native- compared to during their non-native (English) language interactions. Moreover, for bilingual parents, more frequent responsiveness to child communication bids when interacting in non-native English was associated with greater assessed English vocabulary knowledge. Conclusions: In this sample, use of non-native English did not appear to adversely affect how often, or how quickly, bilingual parents responded to their children's verbal communication bids. However, nor did we find evidence of a native-language advantage. Rather, during English-language interactions, when these bilingual parents were responsive towards their children, this was on par with rates and timing of responsiveness shown by English-speaking monolinguals. This may partly be explained by bilinguals' non-native language proficiency, and habitual use/personal dominance patterns. Implications: These data suggest no definitive drawback of non-native language use for synchronous responsiveness by bilingual parents interacting with young children with autism. However, our data also serve to highlight the complex, multifaceted nature of adult bilingualism, and indicate the need for more research – with large, well-characterised samples – to permit strong conclusions concerning how parental language-use choices may influence children's natural learning environments, including in the context of autism and developmental language impairments. [ABSTRACT FROM AUTHOR]