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This randomized controlled trial (NCT03889821) examined Mindfulness Based Stress Reduction (MBSR) in conjunction with the Parent-implemented Early Start Denver Model (P-ESDM). A previous report described improved metrics of parental distress (Weitlauf et al. in Pediatrics 145(Supplement 1):S81-S92, 2020). This manuscript examines child outcomes. 63 children with ASD (< 36 months) and their parents received 12 P-ESDM sessions. Half of parents also received MBSR. Longitudinal examination of whole sample means revealed modest improvements in autism severity, cognitive, and adaptive skills. There was not a significant time × group interaction for children whose parents received MBSR. Future work should examine more proximal markers of child or dyadic change to enhance understanding of the impact of providing direct treatment for parents as part of early intervention initiatives.

The COVID-19 pandemic has increased the use of telemedicine as an avenue to address the need for diagnostic clarification in young children at risk for autism spectrum disorder (ASD). Although preliminary research has supported the use of telemedicine for identifying ASD in toddlers, little is known about the experiences of practitioners attempting direct-to-home tele-assessment. We surveyed diagnostic providers regarding changes in practice behavior in the initial months of the COVID-19 pandemic and their perceptions of ASD tele-assessment. We also examined the use of the TELE-ASD-PEDS, a novel tool for ASD tele-assessment, in response to COVID-19 at seven sites across the country. Results support the clinical acceptability and diagnostic utility of ASD tele-assessment while also highlighting critical avenues of future investigation.

Barriers to identifying autism spectrum disorder (ASD) in young children in a timely manner have led to calls for novel screening and assessment strategies. Combining computational methods with clinical expertise presents an opportunity for identifying patterns within large clinical datasets that can inform new assessment paradigms. The present study describes an analytic approach used to identify key features predictive of ASD in young children, drawn from large amounts of data from comprehensive diagnostic evaluations. A team of expert clinicians used these predictive features to design a set of assessment activities allowing for observation of these core behaviors. The resulting brief assessment underlies several novel approaches to the identification of ASD that are the focus of ongoing research.

The COVID-19 pandemic has caused unprecedented disruptions to healthcare, including direct impacts on service delivery related to autism spectrum disorder (ASD). Caregiver-mediated tele-assessment offers an opportunity to continue services while adhering to social distancing guidelines. The present study describes a model of tele-assessment for ASD in young children, implemented in direct response to disruptions in care caused by the COVID-19 pandemic. We present preliminary data on the outcomes and provider perceptions of tele-assessments, together with several lessons learned during the period of initial implementation.

Telemedicine tools have potential for increasing access to diagnostic services for children with autism spectrum disorder (ASD). Past work has utilized tele-assessment procedures in which remote psychologists observe administration of interactive screening instruments by trained, on-site providers. Although promising, this approach relies on two clinicians, limiting its efficiency and scalability. The present study examined the use, acceptability, and parents' perceptions of two caregiver-mediated tools for assessing ASD risk in toddlers, in which remote clinicians guided parents to complete interactive screening activities with their children. Most parents found tele-assessment to be comfortable, and many reported liking the parent-led nature of these tools. Parents also offered constructive feedback, which was used to modify the tele-assessment process for future study.

Existing literature regarding social communication outcomes of interventions in autism spectrum disorder (ASD) depends upon human raters, with limited generalizability to real world settings. Technological innovation, particularly virtual reality (VR) and collaborative virtual environments (CVE), could offer a replicable, low cost measurement platform when endowed with intelligent agent technology and peer-based interactions. We developed and piloted a novel collaborative virtual environment and intelligent agent (CRETA) for the assessment of social communication and collaboration within system and peer interactions. The system classified user statements with moderate to high accuracies. We found moderate to high agreement in displayed communication and collaboration skills between human--human and human--agent interactions. CRETA offers a promising avenue for future development of autonomous measurement systems for ASD research.

As prevalence of autism spectrum disorder continues to increase, so too does the need for timely, accessible diagnostic consultation. The present work extends from a previous study which provided preliminary evidence for the feasibility of expert clinicians to utilize telemedicine to triage autism spectrum disorder risk in young children. However, it did not examine whether a telediagnostic model had a demonstrable impact on tertiary care center referrals and usage. We therefore examined whether the introduction of telemedicine-based diagnostic consultation for families served by a rural medical facility affected referrals overall as well as to a metropolitan tertiary care diagnostic center. Results suggest that telemedicine diagnostic consultation in partnership with a referring early intervention system may positively impact referrals for diagnostic evaluation as well as the ability of families to schedule and attend appointments.

Increasing access to diagnostic services is crucial for identifying ASD in young children. We therefore evaluated a telemedicine assessment procedure. First, we compared telediagnostic accuracy to blinded gold-standard evaluations (n = 20). ASD cases identified via telemedicine were confirmed by in-person evaluation. However, 20% of children diagnosed with ASD in-person were not diagnosed via telemedicine. Second, we evaluated telediagnostic feasibility and acceptability in a rural catchment. Children (n = 45) and caregivers completed the telemedicine procedure and provided feedback. Families indicated high levels of satisfaction. Remote diagnostic clinicians diagnosed 62% of children with ASD, but did not feel capable of ruling-in or out ASD in 13% of cases. Findings support preliminary feasibility, accuracy, and clinical utility of telemedicine-based assessment of ASD for young children.

Mothers of children with autism report higher levels of depression than mothers of children with other developmental disabilities. We explored the relations between child characteristics of diagnostic severity and problem behaviors, parenting stress, relationship quality, and depressive symptoms in 70 mothers of young children with autism. We hypothesized that relationship quality and parenting stress would relate to maternal depression beyond contributions of child characteristics. Multiple regression analysis revealed a main effect of parenting stress above and beyond child problem behaviors and autism severity. A significant interaction emerged, with relationship quality buffering the effect of parenting stress on depression. Results suggest that the relation between child problem behaviors and maternal depression should be considered in conjunction with other measures of marriage and family stress. Relationship quality and parenting stress may also represent important factors to be explicitly considered within intervention paradigms for young children with autism spectrum disorders.

Proposed DSM-5 revisions to the diagnosis of autism spectrum disorder (ASD) include a "severity" marker based on degree of impairment. Although qualitative differences between support levels are described, quantitative methods or practice recommendations for differentiating between levels remain undetermined. This leaves the field vulnerable to potential discrepancies between severity categorizations that may have inadvertent service implications. We examined overlap between mild, moderate, and severe impairment classifications based on autism symptoms, cognitive skills, and adaptive functioning in 726 participants (15 months-17 years) with ASD. Participants with mild, moderate, and severe autism symptoms demonstrated varying levels of adaptive and cognitive impairment. These discrepancies highlight the need for a clearly elucidated method of classifying level of support in ASD diagnosis.

The purpose of this study was to assess the validity of an autism e‐screener, Paisley, when utilized in a clinical research setting via a tablet application. The Paisley application used a series of play‐based activities, all of which incorporated varying aspects of the ASD‐PEDS. Participants included children (18–36 months; n = 198) referred for evaluation of autism spectrum disorder (ASD) and community providers (n = 66) with differing levels of familiarity with ASD. Community providers administered the Paisley application to children who then completed a comprehensive psychological evaluation. Based on comprehensive evaluation, 75% of children met diagnostic criteria for ASD. Paisley scores were significantly higher for children diagnosed with ASD (15.06) versus those not diagnosed (9.34). The newly determined cutoff ASD‐PEDS cutoff score of 13 had significantly higher specificity and positive predictive value than the originally proposed cutoff of 11. Results support the use of Paisley by community providers to identify autism risk in toddlers. Limitations and strengths of the work, as well as opportunities for future clinical validation, are described. Lay Summary: Prior research has shown the importance and significance of early screening of autism spectrum disorder (ASD) for children under the age of three to improve long‐term outcomes. In this paper, we discuss the validity of a tablet‐based autism screener ("Paisley") deployed in a clinical research setting to detect early signs of ASD in children. Each child that was seen through this research study all received a diagnostic evaluation to assess the presence or non‐presence of ASD following their interaction with the provider using the Paisley application. Results showed that the application has been successful at the detection of ASD and that its' users were also satisfied with their experience in and around using it. [ABSTRACT FROM AUTHOR]

Attributional style models of depression in adults (Abramson et al. 1989, 1978) have been adapted for use with children; however, most applications do not consider that children's understanding of causal relations may be qualitatively different from that of adults. If children's causal attributions depend on children's level of cognitive development, then support for attributional models of depression in young people will vary with cognitive development. In this paper, a new measure of cognitive development, the Peabody Causal Reasoning Test (PCRT), is introduced to assess children's understanding of ability versus effort, task difficulty, and luck as causal factors. Analyses revealed that in 8- to 16-year-old children, failure to control for level of cognitive development suppressed empirical support for cognitive diathesis-stress models of depression. Statistically controlling for measures of cognitive development strengthened support for this model.

Autistic adults possess many skills sought by employers, but may be at a disadvantage in the workplace if social-communication differences negatively impact teamwork. We present a novel collaborative virtual reality (VR)-based activities simulator, called ViRCAS, that allows autistic and neurotypical adults to work together in a shared virtual space, offering the chance to practice teamwork and assess progress. ViRCAS has three main contributions: 1) a new collaborative teamwork skills practice platform; 2) a stakeholder-driven collaborative task set with embedded collaboration strategies; and 3) a framework for multimodal data analysis to assess skills. Our feasibility study with 12 participant pairs showed preliminary acceptance of ViRCAS, a positive impact of the collaborative tasks on supported teamwork skills practice for autistic and neurotypical individuals, and promising potential to quantitatively assess collaboration through multimodal data analysis. The current work paves the way for longitudinal studies that will assess whether the collaborative teamwork skill practice that ViRCAS provides also contributes towards improved task performance. [ABSTRACT FROM AUTHOR]

The goal of the current study was to develop and pilot the utility of two simple internal response bias metrics, over-reporting and under-reporting, in terms of additive clinical value within common screening practices for early detection of autism spectrum disorder risk. Participants were caregivers and children under 36 months of age (n = 145) participating in first-time diagnostic appointments across our clinical research center due to developmental concerns. Caregivers were asked to complete the Modified Checklist for Autism in Toddlers (MCHAT) as well as a questionnaire embedding six response bias indicator questions. These questions were items that in previous clinical studies had been endorsed by an overwhelming majority of parents within clinically identified populations. Results indicated that removal of self-reports indicative of potential response bias dramatically reduced both false positives and false negatives on the MCHAT within this sample. This suggests that future work developing internal metrics of response bias may be promising in addressing limits of current screening measures and practices. Keywords Autism * Screening * Early identification * Internal metrics, Introduction With an estimated prevalence of one in 88 (CDC 2012) the accurate and effective identification of young children with autism spectrum disorder (ASD) represents a pressing public health and [...]

In a school-based, four-wave, longitudinal study, children (grades 4-7) and young adolescents (grades 6-9) completed questionnaires measuring depressive symptoms and depressive cognitions, including positive and negative cognitions on the Cognitive Triad Inventory for Children (CTI-C; Kaslow, Stark, Printz, Livingston, & Tsai, 1992) and self-perceived competence on the Self-Perception Profile for Children (SPPC; Harter, 1985). Application of the Trait-State-Occasion model (Cole, Martin, & Steiger, 2005) revealed the existence of a time-invariant trait factor anda set of time-varying occasion factors. Gender differences emerged, indicating that some cognitive diatheses were more trait-like for girls than for boys (i.e., positive and negative cognitions on the CTI-C; self-perceived physical appearance and global self-worth on the SPPC). Implications focus on the emergent gender difference in depression, the design of longitudinal studies, and clinical decisions about the implementation of prevention versus intervention programs. Keywords: children; adolescents; depression; gender; developmental psychopathology DOI: 10.1002/jclp.20631

Many children with Autism Spectrum Disorder (ASD) exhibit atypical gaze behaviors related to joint attention, a fundamental social-communication skill. Specifically, children with ASD show differences in the skills of gaze sharing and gaze following. In this work we present a novel virtual reality (VR)-based system, called InViRS, in which children with ASD play games allowing them to practice gaze sharing and gaze following. InViRS has three main design contributions: (i) a closed-loop joint attention paradigm with real-time tracking of the participant’s eye gaze and game performance measures, (ii) an assistive feedback mechanism that provides guidance and hints in real time, and (iii) a controller that adaptively changes the avatar’s gaze prompts according to the performance measures. Results from a pilot study to evaluate the feasibility of InViRS with 9 autistic1 children and 9 typically developing (TD) children offered preliminary support for the feasibility of successful gameplay as well as positive impacts on the targeted skills of gaze sharing and gaze following. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD) affects 1 in 54 children in the United States. A core social communication skill negatively impacted by ASD is joint attention (JA), which influences the development of language, cognitive, and social skills from infancy onward. Although several technology-based JA studies have shown potential, they primarily focus on response to joint attention (RJA). The other important component of JA, the initiation of joint attention (IJA), has received less attention from a technology-based intervention perspective. In this work, we present an immersive Computer-mediated Caregiver-Child Interaction (C3I) system to help children with ASD practice IJA skills. C3I is a novel computerized intervention system that integrates a caregiver in the teaching loop, thereby preserving the advantages of both human and computer-administered intervention. A feasibility study with 6 dyads (caregiver-child with ASD) was conducted. A near significant increase with medium effect size on IJA performance was observed. Meanwhile, physiology-based stress analysis showed that C3I did not increase stress of the caregivers over the course of the study. To the best of our knowledge, this is the first autonomous system designed for teaching IJA skills to children with ASD incorporating caregivers within the loop to enhance the potential for generalization in real-world. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Systems of care emphasize parent-delivered intervention for children with autism spectrum disorder (ASD). Meanwhile, multiple studies document psychological distress within these parents. This pilot longitudinal randomized controlled trial compared the parent-implemented Early Start Denver Model (P-ESDM) to P-ESDM plus mindfulness-based stress reduction (MBSR) for parents. We evaluated changes in parent functioning during active treatment and at follow-up. METHODS: Participants included children (<36 months old) with autism spectrum disorder and caregivers. Participants were randomly assigned to P-ESDM only (n = 31) or P-ESDM plus MBSR (n = 30). Data were collected at baseline, midtreatment, the end of treatment, and 1, 3, and 6 months posttreatment. Multilevel models with discontinuous slopes were used to test for group differences in outcome changes over time. RESULTS: Both groups improved during active treatment in all subdomains of parent stress (β = -1.42, -1.25, -0.92; P < 0.001), depressive symptoms, and anxiety symptoms (β = -0.62 and -0.78, respectively; P < 0.05). Parents who received MBSR had greater improvements than those receiving P-ESDM only in parental distress and parent-child dysfunctional interactions (β = -1.91 and -1.38, respectively; P < 0.01). Groups differed in change in mindfulness during treatment (β = 3.15; P < .05), with P-ESDM plus MBSR increasing and P-ESDM declining. Treatment group did not significantly predict change in depressive symptoms, anxiety symptoms, or life satisfaction. Differences emerged on the basis of parent sex, child age, and child behavior problems. CONCLUSIONS: Results suggest that manualized, low-intensity stress-reduction strategies may have long-term impacts on parent stress. Limitations and future directions are described. [ABSTRACT FROM AUTHOR]

Increasing access to diagnostic services is crucial for identifying ASD in young children. We therefore evaluated a telemedicine assessment procedure. First, we compared telediagnostic accuracy to blinded gold-standard evaluations (n = 20). ASD cases identified via telemedicine were confirmed by in-person evaluation. However, 20% of children diagnosed with ASD in-person were not diagnosed via telemedicine. Second, we evaluated telediagnostic feasibility and acceptability in a rural catchment. Children (n = 45) and caregivers completed the telemedicine procedure and provided feedback. Families indicated high levels of satisfaction. Remote diagnostic clinicians diagnosed 62% of children with ASD, but did not feel capable of ruling-in or out ASD in 13% of cases. Findings support preliminary feasibility, accuracy, and clinical utility of telemedicine-based assessment of ASD for young children. [ABSTRACT FROM AUTHOR]

As the prevalence of autism spectrum disorder (ASD) continues to rise, so do the number of families in need of services. ASD is characterized by varying levels of social communicative deficits and repetitive or restrictive patterns of behaviors or interests, which often require a unique combination of services. Young children with ASD may have more complex service needs than children with other developmental disabilities, and families of children with ASD frequently have more difficulty finding appropriate services than children with other disabilities (Kogan et al., 2008). From diagnosis to treatment, the challenge of connecting providers and families with resources to improve outcomes for their children with ASD is often daunting. Telepractice refers to the provision of services or related activities via communications technology (American Speech and Hearing Association, 2005). Telepractice is an approach that may lessen the distance, both physically and metaphorically, between providers and families. In this chapter, we: (a) present the barriers facing families of children with ASD; (b) provide a basic overview of telepractice; (c) describe how telepractice models are being used for children with ASD; (d) highlight possible benefits, capacities, and considerations for use; (e) present some site-specific models currently using telepractice; and (f) discuss implications for future research. [ABSTRACT FROM AUTHOR]

CONTEXT: Sensory challenges are common among children with autism spectrum disorder (ASD). OBJECTIVE: To evaluate the effectiveness and safety of interventions targeting sensory challenges in ASD. DATA SOURCES: Databases, including Medline and PsycINFO. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria. DATA EXTRACTION: One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE), or confidence in the estimate of effects. RESULTS: Twenty-four studies, including 20 randomized controlled trials (RCTs), were included. Only 3 studies had low risk of bias. Populations, interventions, and outcomes varied. Limited, short-term studies reported potential positive effects of several approaches in discrete skill domains. Specifically, sensory integration-based approaches improved sensory and motor skills-related measures (low SOE). Environmental enrichment improved nonverbal cognitive skills (low SOE). Studies of auditory integration-based approaches did not improve language (low SOE). Massage improved symptom severity and sensory challenges in studies with likely overlapping participants (low SOE). Music therapy studies evaluated different protocols and outcomes, precluding synthesis (insufficient SOE). Some positive effects were reported for other approaches, but findings were inconsistent (insufficient SOE). LIMITATIONS: Studies were small and short-term, and few fully categorized populations. CONCLUSIONS: Some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor. [ABSTRACT FROM AUTHOR]

Social communication is among the core areas of impairment for children with Autism Spectrum Disorders (ASD). The training of social orientation is important for improving social communication of children with ASD. In recent years, technology-assisted ASD intervention had gained momentum due to its potential advantages in terms of precision, sustainability, flexibility and cost. In this paper, we propose a closed-loop autonomous computer system, named ASOTS, for training social orientation skills to young children with ASD. This system is designed to detect and track a child’s attention in response to social orientation bids and help the child towards appropriate social orientation when needed. Response to name, an important social orientation skill, was used to demonstrate the functionality of the proposed system. Ten toddlers with ASD participated in a pilot user study to show whether the system could be used on young children who have been diagnosed with ASD. Another pilot user study with 10 TD infants tested whether this system has a potential to be applied for early detection for infants who were younger than the age when ASD diagnoses can be done. This was done intentionally to separately demonstrate utility and functionality for the clinical population of interest and to demonstrate functionality beyond current clinical identification capacity (i.e., infants). The results showed that the proposed system and the protocol were well tolerated by both groups, successfully captured young children’s attention, and elicited the desired behavior. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) impacts 1 in 68 children in the U.S., with tremendous individual and societal costs. Technology-aided intervention, more specifically robotic intervention, has gained momentum in recent years due to the inherent affinity of many children with ASD towards technology. In this paper we present a novel robot-mediated intervention system for imitation skill learning, which is considered a core deficit area for children with ASD. The Robot-mediated Imitation Skill Training Architecture (RISTA) is designed in such a manner that it can operate either completely autonomously or in coordination with a human therapist depending on the intervention need. Experimental results are presented from small user studies validating system functionality, assessing user tolerance, and documenting subject performance. Preliminary results show that this novel robotic system draws more attention from the children with ASD and teaches gestures more effectively as compared to a human therapist. While no broad generalized conclusions can be made about the effectiveness of RISTA based on our small user studies, initial results are encouraging and justify further exploration in the future. [ABSTRACT FROM PUBLISHER]

The article discusses the potential benefits of early diagnosis of autism spectrum disorder (ASD) in early childhood. It mentions about the experience of families and clinicians regarding obtaining the diagnosis of disorder in children. It further highlights about the challenging aspects and benefits of early diagnosis of ASD in children.

Youths with high (N = 52) or low cognitive vulnerability (N = 48) for depression were selected from a larger sample (N = 515) of students (7-10 years old), based on their attributional style (AS), negative cognitions (NC), and/or self-competence (SC). Long-term effects of cognitive vulnerabilities on depressive symptoms were examined in a 3-year, three-wave, multi-informant, longitudinal design. Three findings emerged. First, some empirical overlap exists among these three types of cognitive diatheses, especially between NC and SC. Second, the combination of AS, NC, and SC had a significant (but diminishing) relationship to depressive symptoms at 6, 18, and 30 months, primarily due to NC and SC, not AS. Third, interactions between cognitive risk and life events were not significant, suggesting an additive type of diathesis-stress model for depression in young adolescents. [ABSTRACT FROM AUTHOR]

The article authors comment on a study by Fraguas et al that analyzed nutritional and dietary interventions for autism spectrum disorder (ASD) in an attempt to synthesize evidence of their potential effects. Given its method limits the study cautiously suggests that dietary supplementation may play a role in managing symptoms and functions of individuals with ASD. Ultimately, Fraguas supports the assertion that there is little evidence to support therapeutic nutritional supplementation in ASD.

Autism Spectrum Disorder (ASD) impacts 1 in 54 children in the US. Two-thirds of children with ASD display problem behavior. If a caregiver can predict that a child is likely to engage in problem behavior, they may be able to take action to minimize that risk. Although experts in Applied Behavior Analysis can offer caregivers recognition and remediation strategies, there are limitations to the extent to which human prediction of problem behavior is possible without the assistance of technology. In this paper, we propose a machine learning-based predictive framework, PreMAC, that uses multimodal signals from precursors of problem behaviors to alert caregivers of impending problem behavior for children with ASD. A multimodal data capture platform, M2P3, was designed to collect multimodal training data for PreMAC. The development of PreMAC integrated a rapid functional analysis, the interview-informed synthesized contingency analysis (IISCA), for collection of training data. A feasibility study with seven 4 to 15-year-old children with ASD was conducted to investigate the tolerability and feasibility of the M2P3 platform and the accuracy of PreMAC. Results indicate that the M2P3 platform was well tolerated by the children and PreMAC could predict precursors of problem behaviors with high prediction accuracies. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the validity of an autism e-screener, Paisley, when utilized in a clinical research setting via a tablet application. The Paisley application used a series of play-based activities, all of which incorporated varying aspects of the ASD-PEDS. Participants included children (18-36 months; n = 198) referred for evaluation of autism spectrum disorder (ASD) and community providers (n = 66) with differing levels of familiarity with ASD. Community providers administered the Paisley application to children who then completed a comprehensive psychological evaluation. Based on comprehensive evaluation, 75% of children met diagnostic criteria for ASD. Paisley scores were significantly higher for children diagnosed with ASD (15.06) versus those not diagnosed (9.34). The newly determined cutoff ASD-PEDS cutoff score of 13 had significantly higher specificity and positive predictive value than the originally proposed cutoff of 11. Results support the use of Paisley by community providers to identify autism risk in toddlers. Limitations and strengths of the work, as well as opportunities for future clinical validation, are described., (© 2023 International Society for Autism Research, Wiley Periodicals LLC.)

Children with autism spectrum disorders (ASD) often exhibit impairments in communication and social interaction, and thus face various social challenges in collaborative activities. Given the cost of ASD intervention and lack of access to trained clinicians, technology-assisted ASD intervention has gained momentum in recent years. In this paper, we present a novel collaborative virtual environment (CVE) based social interaction platform for ASD intervention. The development of CVE technology for ASD intervention may lead to the creation of a novel low-cost intervention environment that will foster collaboration with peers and provide flexibility in communication. The presented Communication-Enhancement CVE system, Hand-in-Hand, allows two children to play a series of interactive games in a virtual reality environment by using simple hand gestures to collaboratively move virtual objects that are tracked in real-time via cameras. Further, these games are designed to promote natural communication and cooperation between the users via the presented Communication-Enhancement mode that allows users to share information and discuss game strategies using gaze and voice based communication. The results of a feasibility study with 12 children with ASD and 12 typically developing peers show that this system was well accepted by both the children with and without ASD, improved their cooperation in game play, and demonstrated the potential for fostering their communication and collaboration skills.

Research indicates that human-robot interaction can help children with Autism Spectrum Disorder (ASD). While most early robot-mediated interaction studies were based on free interactions, recent studies have shown that robot-mediated interventions that focus on the core impairments of ASD such as joint attention deficit tend to produce better outcomes. Joint attention impairment is one of the core deficits in ASD that has an important impact in the neuropsychological development of these children. In this work, we propose a novel joint attention intervention system for children with ASD that overcomes several existing limitations in this domain such as the need to use body-worn sensors, non-autonomous robot operation requiring human involvement and lack of a formal model for robot-mediated joint attention interaction. We present a fully autonomous robotic system, called NORRIS, that can infer attention through a distributed non-contact gaze inference mechanism with an embedded Least-to-Most (LTM) robot-mediated interaction model to address the current limitations. The system was tested in a multi-session user study with 14 young children with ASD. The results showed that participants' joint attention skills improved significantly, their interest in the robot remained consistent throughout the sessions, and the LTM interaction model was effective in promoting the children's performance.

The purpose of this study is to find longitudinal evidence of the effect of targeted peer victimization (TPV) on depressive cognitions as a function of victimization type and gender. Prospective relations of physical and relational peer victimization to positive and negative self-cognitions were examined in a 1-year, 2-wave longitudinal study. Self-reports of cognitions and both peer nomination and self-report measures of peer victimization experiences were obtained from 478 predominantly Caucasian children and young adolescents (Grades 3-6 at the beginning of the study) evenly split between genders. As a result, (a) peer victimization predicted increases in negative cognitions and decreases in positive cognitions over time; (b) relational victimization was more consistently related to changes in depressive cognitions than was physical victimization; (c) the prospective relation between victimization and depressive cognitions was stronger for boys than for girls; and (d) when the overlap between relational and physical TPV was statistically controlled, girls experienced more relational TPV than did boys, and boys experienced more physical TPV than did girls. Peer victimization, particularly relational TPV, has a significant impact on children's depressive cognitions. This relation seems particularly true for boys. Implications for future research, clinical work with victimized youth at risk for depression, and school policy to help both victims and bullies are discussed.

Multiple theories of cognitive vulnerability to depression have been proposed, each focusing on different aspects of negative cognition and utilising different measures of risk. Various methods of integrating such multiple indices of risk have been examined in the literature, and each demonstrates some promise. Yet little is known about the interrelations among these methods, or their incremental validity in predicting changes in depression. The present study compared three integrative models of cognitive vulnerability: the additive, weakest link, and keystone models. Support was found for each model as predictive of depression over time, but only the weakest link model demonstrated incremental utility in predicting changes in depression over the other models. We also explore the correlation between these models and each model's unique contribution to predicting onset of depressive symptoms.