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The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha =.93) and test–retest (ICC =.95) reliability. Scores were normally distributed and sensitive to age (r = −.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = −.35), and challenging behaviors (r =.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children. [ABSTRACT FROM AUTHOR]

This paper used Social Security Administration program data from 2005 to 2019 to examine national- and state-level changes in the number of new adult supplemental security income (SSI) awardees on the autism spectrum relative to awardees with intellectual disability and other mental health disorders. We identified three main findings: the number of autistic awards increased between 2005 and 2019 when awards for all other mental health disorders declined; roughly nine out of every 10 autistic adult awardees were between ages 18–25 years; there was variation in the growth of autistic awards across states. These findings support the need to consider geographic and age differences in SSI program participation among autistic adults and determine the underlying causes. [ABSTRACT FROM AUTHOR]

This paper examines age of autism spectrum disorder (ASD) identification and related factors in a diverse urban sample, focusing on ASD identification in the East African Somali community. The overall average age of initial ASD identification was 4.8 years. Somali children received an initial clinical diagnosis of Autistic Disorder later than White children, and Somali children diagnosed with ASD born outside of Minnesota (MN) received their first comprehensive evaluation later than Somali children diagnosed with ASD born in MN. Most children had noted developmental concerns before age 3, with no significant racial or ethnic differences in those concerns. The current study contributes to a limited number of studies on early ASD identification in culturally and linguistically diverse populations. [ABSTRACT FROM AUTHOR]

Studies on the impact of the COVID-19 pandemic on autistic children's psychosocial outcomes have shown mixed results. In the current study we aimed to gain a better insight into the effect of the COVID-19 pandemic by comparing psychosocial outcomes collected pre-pandemic with data collected during the pandemic. We used the Strengths and Difficulties Questionnaire (SDQ) to examine change over time in psychosocial outcomes of autistic children from pre-pandemic (T0) to lockdown I (T1) and lockdown II (T2) in the Netherlands. We expected a deterioration in psychosocial outcomes. There were 224 participants in T0 and T1, of which 141 also participated in T2. The results showed a surprising improvement in psychosocial outcomes from T0 to T1. Special education and female gender were associated with increased difficulties over time, while higher age was associated with decreased difficulties. At the subdomain level we found that emotional problems remained stable, while hyperactivity, conduct problems, and peer problems decreased, and prosocial behavior increased. Attending special education predicted increased peer problems over time, while higher age predicted both decreased conduct problems and increased prosocial behavior over time. The COVID-19 pandemic may have temporarily improved the fit between the psychosocial needs and the environment for children with autism in the Netherlands. [ABSTRACT FROM AUTHOR]

Several studies suggest that a valuable tool to examine linguistic skills in communication disorders is offered by procedures of narrative discourse assessment. Following this line of research, we present an exploratory study aimed to investigate storytelling abilities of autistic children to better define the characteristics of their story production. Participants included 41 autistic children and 41 children with typical development aged between 7.02 and 11.03 years matched on age, gender, level of formal education, intelligence quotient, working memory, attention skills, theory of mind, and phonological short-term memory. Narrative production was assessed by analysing the language samples obtained through the "Nest Story" description task. A multilevel analysis including micro- and macro-linguistic variables was adopted for narrative assessment. Group differences emerged on both micro- and macro-linguistic dimensions: autistic children produced narratives with more phonological errors and semantic paraphasias (microlinguistic variables) as well as more errors of global coherence and a fewer number of visible events and inferred events (macrolinguistic variables) than the control group.This study shows that even autistic children with adequate cognitive skills display several limitations in their narrative competence and that such weaknesses affect both micro- and macrolinguistic aspects of story production. [ABSTRACT FROM AUTHOR]

Purpose: Although there is growing interest in telehealth to deliver parent-mediated intervention for autistic children, empirical evaluations are limited, and little is known regarding the relative benefits of self-directed and therapist-assisted telehealth interventions. This study examined the effect of self-directed and therapist-assisted ImPACT Online on parent learning and well-being, moderators of treatment, and predictors of program engagement. Method: Sixty-four young autistic children and their primary caregiver participated. Children were matched on age and developmental quotient and randomly assigned to a therapist-assisted, self-directed, or resource support control group. Participants were assessed at intake, after 6 months (post), and at a 3-month follow-up. Results: There was a significant treatment effect for parent learning for the therapist-assisted but not self-directed program; when analysis was limited to parents who completed the program, treatment effects were observed for both groups. There were no treatment effects for parent self-efficacy or parenting stress; however, there was an effect on parents' perception of their child's positive impact. Parenting stress did not moderate the effect of group on parent outcomes. Parent age, program satisfaction, and therapist assistance were all significant predictors of parent program engagement. Conclusion: This study supports the efficacy of therapist-assisted telehealth parent-mediated intervention for teaching parents intervention strategies to support their child's social communication and improving their perceptions of their child's positive impact, and suggests that self-directed programs may be beneficial for parents who fully engage with the program. [ABSTRACT FROM AUTHOR]

Sensory difficulties are a commonly occurring feature of autism spectrum disorders and are now included as one manifestation of the 'restricted, repetitive patterns of behavior, interests, or activities' diagnostic criteria of the DSM5 necessitating guidelines for comprehensive assessment of these features. To facilitate the development of such guidelines, this paper provides an overview of the literature on sensory features in autism spectrum disorder. We summarize the literature pertaining to: terminology, current assessment practices, sensory development, and the relationship of sensory features to core symptoms of autism. The paper concludes with recommendations for clinical assessment of sensory features in Autism. [ABSTRACT FROM AUTHOR]

This paper charted the cognitive and behavioural profiles from toddlerhood to middle childhood in 48 children diagnosed with ASD at 24-months. The Mullen Scales of Early Learning (MSEL) was administered at 24- and 48-months and the Wechsler Abbreviated Scale of Intelligence (WASI) at school age. Autism severity was derived using The Autism Diagnostic Observation Schedule (ADOS) Results: Developmental Disability/Intellectual Disability (DD/ID; Developmental Quotient <70) reduced from 64% at 24-months to 8% at outcome. Seventy-three percent of children continued to meet ADOS cut-off at school age. Conclusion: Diagnoses at 24-months, appear to be reliable and stable. Further research is needed to investigate whether early identification, which provides more opportunity to access early intervention, may in turn facilitate cognitive development over time. [ABSTRACT FROM AUTHOR]

Substantial variability exists with regard to autism service provision around the world. Service disparities observed in many low- and middle-income countries may be driven, in part, by limited autism knowledge; however, measurement limitations have made it difficult to quantify autism knowledge across countries. The current study uses the autism stigma and knowledge questionnaire (ASK-Q) to quantify autism knowledge and stigma between different countries and demographics. The current study compiled data from 6830 participants collected using adapted versions of the ASK-Q administered in 13 different countries, representing four different continents. Structural equation modeling was used to examine how autism knowledge varied across country and individual factors. Results reveal cross country variability with a large, 17-point difference between the countries with the highest knowledge (Canada) and the lowest knowledge (Lebanon). As expected, countries with higher economies had higher levels of knowledge. We also documented differences based on country worldview, participant occupation, gender, age, and education level. These results help to identify specific regions and populations that might most need greater information about autism. [ABSTRACT FROM AUTHOR]

This was an exploratory cross-sectional study comparing 45 children with ASD to 24 typically developing drug-naïve controls, group-matched on age, sex, and body mass index. Objective data was obtained using the following: an ambulatory circadian monitoring device; saliva samples to determine dim light melatonin onset (DLMO): and three parent-completed measures: the Child Behavior Checklist (CBCL); the Repetitive Behavior Scale-Revised (RBS-R); and the General Health Questionnaire (GHQ28). The CBCL and RBS-R scales showed the highest scores amongst poor sleepers with ASD. Sleep fragmentation was associated with somatic complaints and self-injury, leading to a higher impact on family life. Sleep onset difficulties were associated with withdrawal, anxiety, and depression. Those with phase advanced DLMO had lower scores for "somatic complaints"; "anxious/depressed" state; and "social problems", suggesting that this phenomenon has a protective role. [ABSTRACT FROM AUTHOR]

Intellectual disability in India is substantially under-reported, especially amongst females. This study quantifies the prevalence and gender bias in household reporting of intellectual disability by estimating the age-and-gender specific prevalence of the intellectually disabled by education, Socio-Demographic Index (SDI) score, place of residence, (rural/urban) and income of household head. We estimated prevalence (per 100,000) at 179 (95% CI: 173 to 185) for males and 120 (95% CI: 115 to 125) for females. Gender differences declined sharply with increased education, was higher for lower ages and low income and varied little by state development. Under-identification and under-reporting due to stigma are two plausible reasons for the gender differences in prevalence that increase with age. [ABSTRACT FROM AUTHOR]

This paper evaluated age differences in emergency department care and inpatient hospitalizations in 252 preadolescent and adolescent youth with autism spectrum disorders (ASDs; ages 9-18). Records from youth with ASDs were linked to acute care utilization records and were compared to a demographically similar comparison group of youth without ASDs ( N = 1260). A particular focus was placed on utilization for psychiatric concerns and injuries or accidents. Results suggested that psychiatric care was more likely for youth with ASDs in both the preadolescent and adolescent cohorts versus comparison youth, with no significant differences between age cohorts. In contrast, results for the accident and injury categories suggested age-specific findings. Results suggest opportunities for prevention efforts for youth with ASDs. [ABSTRACT FROM AUTHOR]

The EEG reflects the activation of large populations of neurons that act in synchrony and propagate to the scalp surface. This activity reflects both the brain's background electrical activity and when the brain is being challenged by a task. Despite strong theoretical and methodological arguments for the use of EEG in understanding the neural correlates of autism, the practice of collecting, processing and evaluating EEG data is complex. Scientists should take into consideration both the nature of development in autism given the life-long, pervasive course of the disorder and the disability of altered or atypical social, communicative, and motor behaviors, all of which require accommodations to traditional EEG environments and paradigms. This paper presents guidelines for the recording, analyzing, and interpreting of EEG data with participants with autism. The goal is to articulate a set of scientific standards as well as methodological considerations that will increase the general field's understanding of EEG methods, provide support for collaborative projects, and contribute to the evaluation of results and conclusions. [ABSTRACT FROM AUTHOR]

Sensory features are common and impairing in autism spectrum disorder (ASD), but there are few observational sensory assessments that are valid across ages. We used the Sensory Processing 3-Dimensional (SP3-D) observed Assessment and parent-reported Inventory to examine sensory responsivity in 41 ASD and 33 typically-developing (TD) youth across 7–17 years. ASD youth had higher and more variable observed and reported sensory responsivity symptoms compared to TD, but the two measures were not correlated. Observed sensory over-responsivity (SOR) and sensory craving (SC) decreased with age in ASD, though SOR remained higher in ASD versus TD through adolescence. Results suggest that in ASD, the SP3-D Assessment can identify SOR through adolescence, and that there is value in integrating multiple sensory measures. [ABSTRACT FROM AUTHOR]

There is growing evidence of a camouflaging effect among females with autism spectrum disorder (ASD), particularly among those without intellectual disability, which may affect performance on gold-standard diagnostic measures. This study utilized an age- and IQ-matched sample of school-aged youth (n = 228) diagnosed with ASD to assess sex differences on the ADOS and ADI-R, parent-reported autistic traits, and adaptive skills. Although females and males were rated similarly on gold-standard diagnostic measures overall, females with higher IQs were less likely to meet criteria on the ADI-R. Females were also found to be significantly more impaired on parent reported autistic traits and adaptive skills. Overall, the findings suggest that some autistic females may be missed by current diagnostic procedures. [ABSTRACT FROM AUTHOR]

In this article the author reflects on the article "Autism Treatment in the First Year of Life: A Pilot Study of Infant Start, a Parent-Implemented Intervention for Symptomatic Infants" by S. J. Rogers, A. Vismara, A. L. Wagner et al., which appears in the issue. He suggests that the article raises important points which may impact social policy and research. He argues that the paper should raise awareness of autism in adolescents and adults.

The study examined timing of autism spectrum disorder (ASD) identification in education versus health settings for 8-year-old children with ASD identified through records-based surveillance. The study also examined type of ASD symptoms noted within special education evaluations. Results indicated that children with records from only education sources had a median time to identification of ASD over a year later than children with records from health sources. Black children were more likely than White children to have records from only education sources. Restricted and repetitive behaviors were less frequently documented in educational evaluations resulting in developmental delay eligibility compared to specific ASD eligibility among children with ASD. Future research could explore strategies reduce age of identification in educational settings and increase equitable access to health evaluations. [ABSTRACT FROM AUTHOR]

Visual, as compared to verbal, tasks are often assumed to be easier for individuals with autism spectrum disorder (ASD), but is this true for story comprehension? This study evaluated story comprehension monitoring across visual, listening, and written modalities and assessed predictors in two closely matched groups (age, socioeconomic status, language, nonverbal cognition, and word reading) of children and adolescents (8–14 years) with ASD (n = 20) and typical development (typically developing [TD]; n = 20). The results of mixed-effects models indicated that story comprehension monitoring was low overall, and performance was comparable across visual, listening, and written modalities for participants with ASD. Age, vocabulary, nonverbal working memory, response and distractor inhibition, and social communication significantly predicted comprehension monitoring. [ABSTRACT FROM AUTHOR]

Given long waitlists for autism spectrum disorder (ASD) evaluation coupled with the COVID-19 pandemic, it is crucial to triage patients to services they are likely to receive diagnostic clarity (i.e., virtual, in-person evaluation). Participants attended a virtual ASD assessment. A subset also attended in-person evaluation. Results suggest younger children with educational services for ASD may benefit from virtual assessment while older patients with a history of psychiatric conditions may benefit from in-person evaluation. An ASD symptom severity tool related to virtual and in-person diagnostic clarity. Family history of ASD related to in-person diagnosis while other variables (e.g., age, educational services) did not. The study suggests patient characteristics may be used to determine for whom virtual ASD assessment may be appropriate. [ABSTRACT FROM AUTHOR]

Children on the autism spectrum miss more school than their peers, but limited work has explored why this may be. This study aimed to document the frequency at which children on the autism spectrum miss half and full days of school and the reasons for these absences. Parents of 106 school-aged children on the autism spectrum completed online questionnaires on rates of school non-attendance, family factors, child anxiety, and parental mental health. On average across a four week period, children missed 6 full days of school. The most common reason for full-day absences was school refusal and for half-day absences was medical/therapy appointments. Parental employment status, increased child age, child anxiety, and differing aspects of parental mental health were identified as correlates of specific subtypes of school non-attendance. [ABSTRACT FROM AUTHOR]

This study mainly explored psychological stress caused by the COVID-19 among parents in developmental disabilities and how it was related to parents' views of school success in mainland China. The Psychological Stress Questionnaire and Views of Social and Academic Success were administered to 1919 parents of children with developmental disabilities. Results showed that parent characteristics including gender, age, educational level, family income and job nature and children characteristics (i.e., disability types) were related to psychological stress caused by the COVID-19, and that psychological stress caused by the COVID-19 significantly negatively predicted parents' views of school success. The contributions, limitations, and implications of the present research are discussed. [ABSTRACT FROM AUTHOR]

The cost of ASD in the U.S. is estimated using a forecast model that for the first time accounts for the true historical increase in ASD. Model inputs include ASD prevalence, census population projections, six cost categories, ten age brackets, inflation projections, and three future prevalence scenarios. Future ASD costs increase dramatically: total base-case costs of $223 (175–271) billion/year are estimated in 2020; $589 billion/year in 2030, $1.36 trillion/year in 2040, and $5.54 (4.29–6.78) trillion/year by 2060, with substantial potential savings through ASD prevention. Rising prevalence, the shift from child to adult-dominated costs, the transfer of costs from parents onto government, and the soaring total costs raise pressing policy questions and demand an urgent focus on prevention strategies. [ABSTRACT FROM AUTHOR]

Few instruments have been developed that measure impairments in reciprocity, a defining feature of autism. We introduce a new test assessing the quality of reciprocal behaviour: the interactive drawing test (IDT). Children and adolescents (n = 49) with and without high functioning autism spectrum disorders (HFASD) were invited to collaborate with an experimenter in making a joint drawing. Within both groups the performance on collaborative reciprocity improved with age. However, compared to the control group, HFASD participants showed less collaborative and more basic reciprocal behaviour and preferred to draw their own objects. They were less tolerant of the experimenter's input as well. Performance on the IDT was independent of estimated verbal IQ. Reciprocal behaviour in self-initiated objects corresponded with more parental reported autistic traits, while reciprocal behaviour in other-initiated objects corresponded with less autistic traits. The findings of this study suggest that IDT is a promising instrument to assess reciprocity. [ABSTRACT FROM AUTHOR]

Youth with Autism Spectrum Disorder (ASD) are at an increased risk for developing obesity when compared to their typically developing peers. Given higher prevalence of obesity in youth with ASD, understanding factors relating to success in obesity treatment provides insight into implementing efficacious treatments for youth. The current study examines age, sleep, and metabolic factors potentially affecting success in 74 youth (Mage = 11.66) attending a multidisciplinary weight management treatment program over a year. Multilevel modeling indicated that higher baseline BMI class category, medications at baseline, and absence of sleep difficulties predicted greater reduction in BMI after a year of treatment. [ABSTRACT FROM AUTHOR]

The present study examined language trajectories and placement outcomes for children with autism spectrum disorder (ASD) receiving early intensive behavioral intervention (EIBI). Language measures were collected at baseline and 6, 12, 18, 24, and 36 months or until exit from EIBI in 131 children with ASD. Growth models estimated overall and subgroup language trajectories. Overall, children receiving EIBI showed substantial increases in language relative to normative expectations. Earlier age at EIBI start, higher baseline cognitive function, and lower baseline ASD severity predicted better language trajectories. Although there was significant variability in language trajectories and educational outcomes, most children showed significant increases in language scores, relative to normative expectations. Additional research, in more representative samples, is needed to understand this variability. [ABSTRACT FROM AUTHOR]

Feeding problems are prevalent in children with ASD. We investigated whether the Montreal Children's Hospital Feeding Scale (MCH-FS, Ramsay et al. in Pediatrics and Child Health 16:147–151, 2011) can be used for young children with ASD. Participants (1–6 years) were selected from a clinical ASD sample (n = 80) and a general population sample (n = 1389). Internal consistency was good in both samples. In general, parents of children with ASD reported more feeding problems than those from the population sample. The response patterns on the individual items was highly similar. There was a slight increase in symptoms with age in the population sample, but not in the ASD sample. These results suggest that the MCH-FS can be used in populations that include children with ASD. [ABSTRACT FROM AUTHOR]

The effects of environmental factors [including Socio-Economic Status, Cultural Capital, and Social Capital (Socio-Cultural Level) of both parents] on the Vineland-II adaptive behavior dimensions of toddlers with autism spectrum disorder (ASD), in addition to individual factors, was investigated in 148 Italian toddlers (82% males), aged 18 to 37 months with ASD. Toddlers' age and Griffiths Mental Development Scales general development affected all of the adaptive behavior dimensions, with negative and positive associations, respectively. The Child Behavior Checklist comorbid conditions were negatively associated with some adaptive behavior dimensions while the ADOS-2 Social affect only with the communication dimension. Mothers' and fathers' specific Socio-Cultural Level dimensions were positively associated with toddlers' specific adaptive behavior dimensions with the same magnitude as comorbid conditions. [ABSTRACT FROM AUTHOR]

This study compares the lexical composition of 118 children with autism spectrum disorder (ASD) aged 12 to 84 months with 4626 vocabulary-matched typically developing toddlers with and without language delay, aged 8 to 30 months. Children with ASD and late talkers showed a weaker noun bias. Additionally, differences were identified in the proportion of nouns and verbs, and in the semantic categories of animals, toys, household items and vehicles. Most differences appear to reflect the extent of the age differences between the groups. However, children with ASD produced fewer high-social verbs than typical talkers and late talkers, a difference that might be associated with ASD features. In sum, our findings identified areas of overlap and distinction across the developing lexical profiles. [ABSTRACT FROM AUTHOR]

The study aimed to identify the mediating role of emotional intelligence and social competences in the relationship between gender and broad autism phenotype (BAP) as well as between age and BAP. It comprised 85 parents of children with ASD. They completed the questionnaires of Autism-Spectrum Quotient, social competences, and emotional intelligence. The results revealed that emotional intelligence in general and its two dimensions: the ability to accept and express emotions and to empathize are important mediators of the relationship between gender and BAP. Also, social competences in general and two of their dimensions: the effectiveness of behavior in intimate situations and in social situations were significant mediators. The relationship between age and BAP could not be confirmed. [ABSTRACT FROM AUTHOR]

Cornelia de Lange syndrome (CdLS) is associated with repetitive and self-injurious behaviors (RBs, SIB). Evaluating children with CdLS, this study: (1) characterizes the spectrum of RBs; (2) characterizes the impact and severity of RBs including SIB; (3) describes how age and adaptive functioning relate to RBs including SIB. Fifty children (5–17 years) with CdLS were assessed with Children's Yale-Brown Obsessive Compulsive Scale Modified for PDD; Aberrant Behavior Checklist (ABC); Vineland Adaptive Behaviors Scales (VABS). All children had ≥ 1 type of RB; 44% had some form of SIB. 64% spent > 1 h/day displaying RBs. Lower VABS adaptive functioning was associated with higher stereotypy and SIB scores (ABC). In children with CdLS, RBs including SIB are common, impactful, and associated with lower adaptive functioning. [ABSTRACT FROM AUTHOR]

The experience of being bullied is widespread among autistic youth. Relatively little empirical work has been done on the relationship between the bullying of these youth and school refusal (SR). This study of 67 school-age autistic boys (M = 11.7 years, SD = 2.3 years) examined several factors that may contribute to SR. Data regarding boys' age, generalised anxiety disorder (GAD), major depressive disorder (MDD), key ASD diagnostic criteria, and frequency of being bullied were collected. Results indicated that, while boys displaying emerging SR also had significantly higher GAD and MDD than boys without emerging SR, only the frequency of being bullied made a significant contribution to emerging SR. Implications for prevention and treatment of SR among autistic youth are discussed. [ABSTRACT FROM AUTHOR]

Increased prevalence of autism spectrum disorder (ASD) has underscored the need for early intervention services. Early Intensive Behavioral Intervention (EIBI) is among the most common evidence-based approaches, however, stakeholders report significant waitlists. The effects of these delays to intervention are unknown. The purpose of this study was to evaluate the effects of delay to EIBI for preschool aged children with ASD on later educational outcomes. Medicaid records from Minnesota (2008–2010) were used to evaluate a cohort diagnosed with ASD and their later educational outcomes from 2010 to 2014 (n = 667) using generalized estimating equations. Approximately 70% of children experienced a delay to EIBI and children that experienced less delay and started EIBI at a younger age had better educational outcomes. [ABSTRACT FROM AUTHOR]

Aggressive behaviors in those with intellectual disability (ID) and autism (ASD) have been linked to a variety of factors including ID level, age, sex, psychiatric disorders, and medical conditions but these factors have not been studied, in large samples, in terms of how they affect the stimuli that trigger aggression. In this survey of 2243 adults, four triggers of aggression associated with frustration, discomfort, change in the physical/social environment, and defensive reactions were analyzed for their relation to ID level, ASD, age, sex, number of psychiatric diagnoses, sleeping problems, seizures, visual impairment, ear infections and gastrointestinal problems. All four triggers were associated with increasing number of psychiatric disorders, with frustration, discomfort, and change intolerance commonly linked to sleeping problems and ASD. Implications for assessment and intervention are discussed. [ABSTRACT FROM AUTHOR]

Determining diagnostic stability of ASD, as well stability of functioning in early childhood, is relevant to prevalence, best practices for communicating early ASD diagnoses to caregivers, families' experiences, and developmental trajectories. Generalizability of findings from prior research has been limited by small and homogenous samples, short follow-up time intervals, and inconsistent diagnostic procedures. This report presents follow-up evaluations of 60 children (86.7% male, mean age: 51.3 months) with diverse backgrounds (79.7% racial/ethnic minorities) who received initial ASD diagnoses before 36 months of age (mean age: 27 months). Fifty-three children (88.3%) met diagnostic criteria for ASD at follow-up, a proportion consistent with previous studies. On average, children demonstrated significant cognitive gains and ASD symptom improvement. Clinical implications of findings are discussed. [ABSTRACT FROM AUTHOR]

Social cognition impairment is a core shared phenotype in both schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD). This study compares social cognition performance through four different instruments in a sample of 147 individuals with ASD or SSD and in healthy controls. We found that both clinical groups perform similarly to each other and worse than healthy controls in all social cognition tasks. Only performance on the Movie for the Assessment of Social Cognition (MASC) test was independent of age and intelligence. Proportionately, individuals in the control group made significantly more overmentalization errors than both patients group did and made fewer undermentalization errors than patients with SSD did. AUC analyses showed that the MASC was the instrument that best discriminated between the clinical and control groups. Multivariate analysis showed negative symptom severity as a potential mediator of the association between social cognition deficit and poor global functioning. [ABSTRACT FROM AUTHOR]

The prevalence of ASD remains relatively stable across the lifespan, necessitating a quantitative understanding of how intervention clinical research is applied across age groups. Here we report a systematic review of treatment studies between 2013 and 2017, enrolling 11,213 subjects with ASD in 218 studies. Individuals under 18 years old constituted the majority of studies (84%) and subjects (92%). Subjects under 18 years old were more likely to be enrolled in behavioral studies (OR (CI) = 1.34 (1.17–1.54)), and less likely to be enrolled in pharmacological (OR = 0.60 (0.52–0.69)) studies than subjects ≥ 18 years old. Identified disparities in both intervention modalities and outcome measures should serve to guide future research priorities. [ABSTRACT FROM AUTHOR]

This meta-analysis examined the effects of early interventions on social communication outcomes for young children with autism spectrum disorder. A systematic review of the literature included 1442 children (mean age 3.55 years) across 29 studies. The overall effect size of intervention on social communication outcomes was significant (g = 0.36). The age of the participants was related to the treatment effect size on social communication outcomes, with maximum benefits occurring at age 3.81 years. Results did not differ significantly depending on the person implementing the intervention. However, significantly larger effect sizes were observed in studies with context-bound outcome measures. The findings of this meta-analysis highlight the need for further research examining specific components of interventions associated with greater and more generalized gains. [ABSTRACT FROM AUTHOR]

Here we report the results of the subgroup analyses of an observational cohort of children whose parents completed the Autism Treatment Evaluation Checklist (ATEC) over the period of several years. A linear mixed effects model was used to evaluate longitudinal changes in ATEC scores within different patient subgroups. All groups decreased their mean ATEC score over time indicating improvement of symptoms, however there were significant differences between the groups. Younger children improved more than the older children. Children with milder ASD improved more than children with more severe ASD in the Communication subscale. There was no difference in improvement between females vs. males. One surprising finding was that children from developed English-speaking countries improved less than children from non-English-speaking countries. [ABSTRACT FROM AUTHOR]

Previous data have suggested that parents of boys with autism spectrum disorder (ASD) may rate their sons' generalised anxiety disorder (GAD) more severely than the boys do themselves. However, no reports have been published to date which examine this issue in a girls-only sample. This study investigated the extent and nature of mother–daughter agreement on ratings of GAD in a sample of 53 girls with an ASD with mild impairment, aged 6 to 17 years. Mothers rated their daughters' GAD more severely than the girls did themselves, despite confounding effects from the girls' medication and menarche status. Suggestions are made for the valid assessment of GAD in girls with an ASD. [ABSTRACT FROM AUTHOR]

Visual perception in individuals with autism spectrum disorder (ASD) is often debated in terms of enhanced local and impaired global perception. Deficits in global motion perception seem to support this characterization, although the evidence is inconsistent. We conducted a large meta-analysis on global motion, combining 48 articles on biological and coherent motion. Results provide evidence for a small global motion processing deficit in individuals with ASD compared to controls in both biological and coherent motion. This deficit appears to be present independent of the paradigm, task, dependent variable, age or IQ of the groups. Results indicate that individuals with ASD are less sensitive to these types of global motion, although the difference in neural mechanisms underlying this behavioral difference remains unclear. [ABSTRACT FROM AUTHOR]

Empathy is an essential component of human social life. It requires the ability to understand another's mental state and respond with an appropriate emotion or action. Individuals with autism spectrum disorder (ASD) have been described to exhibit atypical empathic responses which limit communication and social interactions. This review highlights the clinical characteristics and mechanisms underlying empathy in ASD by summarizing 61 peer-reviewed articles. Studies characterized empathic differences due to sex, age, intelligence, and disorder severity and provided valuable insights into the roles that genetics, neural networks, and sensory processing have in eliciting empathy. This knowledge will lead to improved diagnostics and therapies to improve social cognition, emotional recognition, and the empathic response in patients with ASD. [ABSTRACT FROM AUTHOR]

The aim of this study was to delve into the role of gender differences in social inclusion of children and youth with autism spectrum disorder (ASD) and intellectual disability (ID). A sample of 420 participants with ASD and ID aged between 4 and 21 years was evaluated using the ASD-KidsLife Scale. Females obtained lower scores in most of the items of social inclusion. These differences remained when the covariables of level of ID, support needs, and age were controlled. None of the items presented differential item functioning as a function of gender. Gender differences, as were found in social inclusion, are discussed and recommendations are given in order to provide equal opportunities to girls and boys with ASD. [ABSTRACT FROM AUTHOR]

Previous research has demonstrated irrational asymmetry in belief updating: people tend to take into account good news and neglect bad news. Contradicting formal learning principles, belief updates were on average larger after better-than-expected information than after worse-than-expected information. In the present study, typically developing subjects demonstrated this optimism bias in self-referential judgments. In contrast, adults with high-functioning autism spectrum disorder (ASD) were significantly less biased when updating self-referential beliefs (each group n = 21, matched for age, gender and IQ). These findings indicate a weaker influence of self-enhancing motives on prospective judgments in ASD. Reduced susceptibility to emotional and motivational biases in reasoning in ASD could elucidate impairments of social cognition, but may also confer important cognitive benefits. [ABSTRACT FROM AUTHOR]

Some evidence suggests that bilingualism improves communication and cognitive skills which are often impaired in autism. However, diagnosing autism in bilinguals may suffer a cultural bias, which can affect the investigation of bilingualism and autism. Therefore, the current study investigates relations between autistic-like traits (ALTs) and bilingualism in a general population sample of 394 children (M age = 8;3). Within the high-scoring group on the ALT measure, monolinguals had significantly higher ALT scores than bilinguals. There were no differences between monolinguals and bilinguals in the low-scoring group. Across the whole sample, age and structural language skills accounted for 35% variance in ALTs, while bilingualism had no effect on ALTs. Furthermore, structural language skills explained more variance in ALTs among bilinguals than among monolinguals. [ABSTRACT FROM AUTHOR]

Few studies have investigated the effect of age on treatment effectiveness of evidence-based social skills training in autism spectrum disorder (ASD) adolescents. This study evaluated the effectiveness of Program for the Education and Enrichment of Relational Skills (PEERS®) in different ages of ASD adolescents. A total of 110 ASD adolescents aged 11–19 years were divided into early, middle, and late adolescence groups, and the changes in outcome measures following intervention were compared among the three groups. We found that the improvements in social competence after PEERS® were significant, but the treatment effects were not significantly different among the three age groups. The findings suggest that PEERS® is beneficial for ASD adolescents regardless of patient age and adolescence stage. [ABSTRACT FROM AUTHOR]

Capturing variability in use of commercial technologies by autistic children can inform future learning and support technology design. Survey data were collected from parents (n = 388) in the UK, Spain, and Belgium, and includes information about individuals with a range of ages and ability levels. We found a comparable pattern of access and usage across age groups, though higher reading and language ability was linked to use of more devices and interfaces. Reported worries about technology correlated with longer time spent using technology. Autistic children use mainstream technologies for a broad range of recreational uses. The data suggest that technologies developed with therapeutic goals in mind may need to achieve a high standard of design to engage users. [ABSTRACT FROM AUTHOR]

Subclinical traits of autism were measured in children with somatic symptom disorder (SSD, n = 28) and compared with age-matched controls (n = 26) using the Autism Spectrum Quotient (AQ) children's version. The KINDLR quality of life questionnaire was used to assess functional disability. Although there was no significant group difference in total traits of autism, SSD group had significantly greater difficulty in attention switching domain. Logistic regression analysis confirmed attention switching and age were associated with increased likelihood of SSD. In SSD group, difficulty in attention switching significantly negatively correlated with total, family, and friends quality of life scores. In conclusion, assessment and treatment targeting difficulties in attention switching could be useful when dealing with children with SSD. [ABSTRACT FROM AUTHOR]

Recent evidence suggests the male predominance in Autism Spectrum Disorder (ASD) may be decreasing. Secondary analyses of Australian Medicare data (paediatrician/child psychiatrist items for diagnosing ASD before age 13) were used (N = 73,463 unique children from 1-July-2008 to 30-June-2016). Cumulative incidence of ASD in 4-year-olds in 2015/2016 was 1.10% [95% CI 1.06-1.14], males 1.66% [95% CI 1.60-1.72] and females 0.51% [95% CI 0.47-0.55]. New diagnoses significantly increased in older (5-12 years) males and females but not younger (0-4 years) children, from 2010/2011 to 2015/2016. The M:F ratio decreased in older children (4.1-3.0), but not significantly in younger children (4.2-3.5). Identification of older males and females is contributing to the increased in ASD in Australia and proportionally more older females are being diagnosed. [ABSTRACT FROM AUTHOR]

Youth with autism spectrum disorder (ASD) experience high rates of psychiatric symptoms, but the relation between verbal ability and psychiatric symptoms is unknown. This study utilized a large sample of clinically referred inpatient and outpatient youth with ASD to compare psychiatric comorbidity between verbal and minimally-verbal youth, adjusting for nonverbal IQ, age, and ASD symptom severity. Results indicated that verbal youth were more likely to present with and meet clinical cutoffs for depression and oppositional defiant disorder symptoms, with greater impairment associated with depression. Youth in inpatient settings had greater symptom severity and impairment across almost all psychiatric comorbidities. These results present the most direct estimate to date of the association between verbal ability and psychiatric comorbidity in ASD. [ABSTRACT FROM AUTHOR]

Word reading and oral language predict reading comprehension, which is generally poor, in individuals with autism spectrum disorder (ASD). However, working memory (WM), despite documented weaknesses, has not been thoroughly investigated as a predictor of reading comprehension in ASD. This study examined the role of three parallel WM N-back tasks using abstract shapes, familiar objects, and written words in children (8-14 years) with ASD (n = 19) and their typically developing peers (n = 24). All three types of WM were significant predictors of reading comprehension when considered alone. However, these relationships were rendered non-significant with the addition of age, word reading, vocabulary, and group entered into the models. Oral vocabulary emerged as the strongest predictor of reading comprehension. [ABSTRACT FROM AUTHOR]