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In the typically developing population, social touch experiences are influenced by several factors, including the biological sex of toucher and receiver, the body area wherein the touch is delivered and the social context in which the tactile exchange occurs. However, it is currently unexplored how social touch experiences of autistic adults are modulated by these factors. We sought to address this by utilizing a self-report body-painting task. Our main results show that autistic, compared with non-autistic, adults reported lower levels of pleasantness, erogeneity and appropriateness, specifically in intimate and friendly social contexts and in body areas typically touched in these situations. Importantly, sex played a major role in group differences. For instance, although autistic females reported, across social contexts, less pleasantness than both non-autistic females and autistic males, they experienced similar levels of appropriateness in the professional social context, usually deemed as touch-appropriate. Our findings provide new support to the hypothesis that social touch is experienced and possibly conceptualized differently by autistic compared with non-autistic adults. Moreover, by identifying the factors that influence social touch processing in autistic adults, our results might aid the development of support for autistic individuals seeking help in the spheres of social and intimate touch. What is already known about the topic? At least in neurotypical individuals, social touch represents an important channel for emotional communication associated with social bonding and pain/anxiety modulation. Autistic adults report to avoid social touch more and to have different tactile sensitivity than their non-autistic comparisons. What this paper adds? Few studies specifically investigated social touch in autistic individuals, and none of them examined the role of participants' sex, social context in which social touch occurs, and specific body areas being touched. In our study, adult participants reported how pleasant, erogenous and appropriate they would consider touches delivered by another person over their entire body in intimate (date), friendly (dance class) and professional (physiotherapy-massage session) social contexts. Autistic adults reported social touch to be less pleasant, erogenous and appropriate specifically in intimate and friendly social contexts and in body areas typically touched in these situations. Importantly, autistic females seem more at risk to experience unpleasant social touch as, although they considered it more unpleasant than non-autistic females and autistic males, they did consider it similarly appropriate in professional social contexts where touch is normed to be socially appropriate. Implications for practice, research or policy Our results might improve awareness and understanding about autistic adults' different, and often more discomforting, experience of social touch and thus help consider and respect it during everyday social interactions. Our results might also benefit future research investigating, for instance, the neural underpinnings of social touch differences in autism or aiming at developing support for autistic individuals seeking help in the diverse spheres of social touch. [ABSTRACT FROM AUTHOR]

Caregivers of children with autism spectrum disorder (ASD) experience increased levels of stress, anxiety, and depression compared to caregivers of neurotypical children. The high levels of stress and the prevalence of emotional disorders experienced by caregivers may negatively impact their capacity and confidence to effectively manage their child's complex emotional and behavioral needs. Given these demands, caregivers of children with ASD require additional support to improve their psychological well-being and parenting self-efficacy. While support programs and treatments for children and adolescents with ASD are abundant, prevention programs that specifically targeted the emotional well-being of caregivers during the COVID-19 pandemic were limited. In this case paper, we describe Coping Options for Parent Empowerment (COPE), a prevention program for parents adapted from the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Adults, Children, and Adolescents developed during the pandemic. To alleviate the stressors faced by caregivers during the pandemic and beyond, including increased caregiving responsibilities and financial difficulties, Project COPE targeted parent anxiety and depression through four brief, telehealth group sessions provided free of cost for caregivers of school-age children with ASD. In the case example presented, decreases in anxiety and depression, and increases in parent self-efficacy were reported after completing this program. Key insights about the intervention's feasibility and content reported by parents are described. Findings suggest that the intervention removes some treatment access barriers typically seen in caregivers of children with ASD during and following the pandemic and that the program can be modified to increase engagement and acceptability. [ABSTRACT FROM AUTHOR]

Diagnosis is a profoundly social phenomenon which, while putatively identifying disease entities, also provides insights into how societies understand and explain health, illness and deviance. In this paper, we explore how diagnosis becomes part of popular culture through its use in many non-clinical settings. From historical diagnosis of long-deceased public personalities to media diagnoses of prominent politicians and even diagnostic analysis of fictitious characters, the diagnosis does meaningful social work, explaining diversity and legitimising deviance in the popular imagination. We discuss a range of diagnostic approaches from paleopathography to fictopathography, which all take place outside of the clinic. Through pathography, diagnosis creeps into widespread and everyday domains it has not occupied previously, performing medicalisation through popularisation. We describe how these pathographies capture, not the disorders of historical or fictitious figures, rather, the anxieties of a contemporary society, eager to explain deviance in ways that helps to make sense of the world, past, present and imaginary. [ABSTRACT FROM AUTHOR]

Background and aims: Play-based interventions are used ubiquitously with children with social, communication, and language needs but the impact of these interventions on the mental health of this group of children is unknown. Despite their pre-existing challenges, the mental health of children with developmental language disorder (DLD) and autism spectrum disorder (ASD) should be given equal consideration to the other more salient features of their condition. To this aim, a systematic literature review with meta-analysis was undertaken to assess the impact of play-based interventions on mental health outcomes from studies of children with DLD and ASD, as well as to identify the characteristics of research in this field. Methods: The study used full systematic review design reported to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (PRISMA prisma-statement.org) with pre-specified inclusion criteria and explicit, transparent and replicable methods at each stage of the review. The study selection process involved a rigorous systematic search of seven academic databases, double screening of abstracts, and full-text screening to identify studies using randomised controlled trial (RCT) and quasi-experimental (QE) designs to assess mental health outcomes from interventions supporting children with DLD and ASD. For reliability, data extraction of included studies, as well as risk of bias assessments were conducted by two study authors. Qualitative data were synthesised narratively and quantified data were used in the metaanalytic calculation. Main contribution: A total of 2,882 papers were identified from the literature search which were double screened at the abstract (n = 1,785) and full-text (n = 366) levels resulting in 10 papers meeting the criteria for inclusion in the review. There were 8 RCTs and 2 QEs using 7 named play-based interventions with ASD participants only. Meta-analysis of 5 studies addressing positive mental health outcomes (e.g. positive affect and emotional functioning) found a significant overall intervention effect (Cohen's d = 1.60 (95% CI [0.37, 2.82], p = 0.01); meta-analysis of 6 studies addressing negative mental health outcomes (e.g., negative affect, internalising and externalising problems) found a non-significant overall intervention effect (Cohen's d = 0.04 -0.17 (95% CI [-0.04, 0.51], p = 0.88). Conclusions: A key observation is the diversity of study characteristics relating to study sample size, duration of interventions, study settings, background of interventionists, and variability of specific mental health outcomes. Play-based interventions appear to have a beneficial effect on positive, but not negative, mental health in children with ASD. There are no high quality studies investigating the efficacy of such interventions in children with DLD. Implications: This review provides good evidence of the need for further research into how commonly used play-based interventions designed to support the social, communication, and language needs of young people may impact the mental health of children with ASD or DLD. [ABSTRACT FROM AUTHOR]

This position paper explores the needs of rural families of children, adolescents, and adults with autism spectrum disorder (ASD) during the COVID-19 pandemic. Prior to COVID-19, literature portrays elevated stress in families of individuals with ASD and health and socioeconomic disparities for rural and underserved populations. These disparities were exacerbated due to COVID-19 and subsequent lockdowns and economic turmoil. Academic and adaptive skills training were particularly impacted due to school closures, with parents tasked with taking some responsibility for training these skills. Our goals for this article focus on special considerations for rural families regarding (a) neurobiological and developmental impacts of stressful experiences like COVID-19, (b) delineation of the impacts on individuals with ASD and other comorbid and related conditions, and (c) education and intervention needs during these times. Finally, we offer suggestions for future care during pandemic events, including recommendations for improving service delivery under such conditions. [ABSTRACT FROM AUTHOR]

Understanding the instructional role of tablet devices while teaching a group of learners diagnosed with autism was the purpose of this research study. Five children diagnosed with autism participated in activities involving traditional paper and pencil and tablet devices. Observations and interviews with learners and one teacher were conducted. The case study provided an understanding of the motivational impact tablet devices potentially have on learners on the autism spectrum concerning engagement and participation in learning activities. The study also revealed that technology in general and tablet devices, in particular, are used in the classroom as reward mechanisms and entertaining strategies to seize and retain the learners' attention to achieve instructional goals. [ABSTRACT FROM AUTHOR]

Understanding the needs and stressors of caregivers of individuals with autism spectrum disorder (ASD) informs targeted support strategies. However, most caregiver needs measures lack the breadth of experiences relevant to these families. This study examined the underlying factor structure of the Challenges and Needs Survey (CANS), a caregiving needs measure designed for family caregivers of individuals with ASD. The sample consisted of 286 family caregivers. Participants completed the CANS either online or in the paper form. Exploratory factor analysis was used to examine the underlying structure of the measure. T-tests and correlations were used to compare results by age and gender of the participants. Exploratory factor analysis resulted in 39 items of four factors: autism-related challenges (child), functional challenges, psychological challenges (parent), and aggressive behaviors (child). Parents with both high stress and high needs reported the lowest levels of mental health functioning. [ABSTRACT FROM AUTHOR]

Research suggests that *whilst not more likely to offend, autistic people are overrepresented within the Criminal Justice System. To date, prevalence estimates are available only for male autistic offenders. Thus, this research aimed to provide the prison-reported rate of autistic female prisoners currently residing in the female prison estate in England. All 12 of the female prisons in England were contacted to request the following information: (1) the total number of autistic females; and (2) the total female prison population. Findings show an English female prison-reported rate of autism of 4.78% indicating that autism is approximately 13.7 times higher in female prisons compared to the general population. To the authors’ knowledge, this is the first research article to focus exclusively on female autistic offenders. Further research is needed to understand the risk factors for offending, offender characteristics, offence types/patterns and autistic experience of the Criminal Justice System for female autistic offenders.What is already known about the topic? Autistic people are reported to offend at lower or comparable rates to non-autistic people. However, autism is overrepresented within male prisons due to a number of suggested reasons including an increased chance of being caught and a lack of autistic sensitive interventions which lead to longer stays in prison. To the authors’ knowledge, no papers currently exist focussing on autistic females in prison. What does this paper add? To the authors’ knowledge, this is the first piece of research to solely include autistic females in prison settings. This research provides an estimate of how many autistic people are in female prisons. All 12 female prisons in England were contacted. Data provided indicate a prison-reported female autism rate of 4.78%. This prison-reported female autism rate is 13.7 times higher than the prevalence of autistic females in the general population. Implications for practice research or policy? Autism is overrepresented in female prisons; however, to the authors’ knowledge no current research exists on this group to understand their needs or experience. Autistic females often have differing requirements to males and the lack of research highlights the need for future research to investigate areas such as factors which increase the risk of offending, offences typically committed and the female autistic experience of the Criminal Justice System. [ABSTRACT FROM AUTHOR]

The quantity and quality of research focused on autism spectrum disorder (ASD) have grown over the past several decades. Ensuring that research findings are accessible and understood by education professionals is essential for improving outcomes for individuals with ASD. In this study, we evaluated education professionals' knowledge about ASD, specifically (a) beliefs about causes of ASD, (b) their familiarity with evidence-based practices (EBPs) and non-EBPs, (c) the likelihood of using or recommending EBPs compared with non-EBPs, and (d) the extent to which source credibility influenced the likelihood of using or recommending different types of practices. Education professionals (N = 62) completed a paper survey. Responses on a modified version of the Illness Perception Questionnaire–Revised (Moss-Morris et al., 2002) were used to evaluate participants' beliefs regarding causal attributes of ASD. Educators were also asked to read texts describing four EBPs and four non-EBPs. The text presentation was based on a 2 × 2 within-subjects factorial design with practice status (EBP or non-EBP) and source credibility (credible or not credible) as the independent variables. After reading each text, participants reported on whether they were (a) familiar with the practice and (b) the extent to which they would use or recommend the practice. Results indicate that school personnel were highly confident that neurobiological factors were a causal attribute of ASD. In addition, respondents were more familiar with, and more likely to recommend or use, EBPs as compared with non-EBPs. Source credibility did not significantly affect participants' likelihood of using or recommending practices. [ABSTRACT FROM AUTHOR]

Informant-report measures for screening symptoms of autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs) are needed for low-resource settings if early identification is to be prioritized because early developmental concerns are likely to be expressed by parents and other caregivers. This paper describes the initial psychometric evaluation of the Nigeria Autism Screening Questionnaire (NASQ). Parents and other caregivers completed the NASQ on 12,311 children ages 1 to 18 in a Nigerian population sample as part of the World Bank National General Household Survey conducted in the country in 2016. Factor analyses indicated a parsimonious three-factor structure with social communication/interaction, repetitive sensory motor, and insistence on sameness dimensions. Measurement invariance was excellent across age and sex. Reliability of the subscales and total scale was good, and item response theory analyses indicated good measurement precision in the range from below average to high scores, crucial for screening, and tracking ASD symptoms. Studies with gold standard ASD diagnostic instruments and clinical confirmation are needed to evaluate screening and diagnostic accuracy. The NASQ appears to be a reliable instrument with a clear factor structure and potential for use in screening and tracking ASD symptoms in future Nigerian samples. [ABSTRACT FROM AUTHOR]

Background and Aims: Echolalia, the repetition of speech, is highly prevalent in school aged children with Autism. Prior research has found that individuals with echolalia use their repetitions to engage in communicatively functional speech, in the absence of self-generated speech. Educators are the natural audience for a wide vary of echoed utterances across environments and in differing contexts. The objectives of this paper were three-fold: (1) to systematically investigate how researchers identify and ascribe communicative function to echoed utterances; (2) to gather and evaluate the evidence that might assist teachers to identify and better understand echoed utterances as being communicatively purposeful; and (3) to provide teachers with evidence-informed response strategies they can use to assist their students on their journey towards more self-generated speech. Main Contribution: Prior research in the field of echolalia has generally been segmented into opposing viewpoints. A paucity of work in the echolalia field has meant that there is limited work that has sought to view how a communicative function to echolalia has been ascribed from across multiple disciplines and fields. As such, there is limited literature to guide the practice of classroom educators. This review combines communicative models from across various disciplines with the view to supporting classroom educators by providing guidance on how they might assist their students with echolalia. This review represents the first contribution to the research literature in this area. Conclusions and Implications: Research into echolalia did not originally emanate from the field of education; however, anecdotes from classroom educators were cited as the primary impetus for the creation of some of the communicatively functional models. We found that although there are many techniques that researchers have used to attribute a communicative function to echolalia, some of these can be easily employed by educators in their practice. By adopting these techniques, educators are placed in a position that may assist with the identification of communicative echolalia; subsequently they are better placed to acknowledge and respond to their students. [ABSTRACT FROM AUTHOR]

This study explored youth with Autism Spectrum Disorder (ASD) learning social competence in the context of innovative 3D virtual learning environment and the effects of gaming as a central element of the learning experience. The empirical study retrospectively compared the social interactions of 11 adolescents with ASD in game-and nongame-based 3D collaborative learning activities in the same social competence training curriculum. We employed a learning analytics approach - association rule mining to uncover the associative rules of verbal social interaction and nonverbal social interaction contributors from the large dataset of the coded social behaviors. By comparing the rules across the game and nongame activities, we found a significant difference in youth with ASD's social performance. The results of the group comparison study indicated that the co-occurrence of verbal and nonverbal behaviors is much stronger in the game-based learning activities. The game activities also yielded more diverse social interaction behavior patterns. On the other hand, in the nongame activities, students' social interaction behavior patterns are much more limited. Furthermore, the impact of game design principles on learning is then discussed in this paper. [ABSTRACT FROM AUTHOR]

Autism is called "spectrum" disorder because there is a wide variation in the type and the severity of symptoms that people experience. India has a vast population, diverse cultures, and multiple languages, making it crucial to under- stand the unique challenges faced by individuals with autism spectrum disorder in the Indian context. This narrative review explores the current state of knowledge about autism spectrum disorder in the Indian context. Databases such as PubMed, Google Scholar, Sage journals, and other sources were searched with relevant terms for preparing this review. All published literature till January 2023 was studied and those which met the inclusion criteria were included. The resources included were original research articles, review articles, web pages, and book chapters addressing the purpose of the paper. Forty-eight such studies which met the inclusion criteria were included in the study. Results showed that the prevalence of autism varied across different studies in India. The study found advanced paternal age, fetal distress, gestational respiratory infections, labor complications, preterm birth, neonatal jaundice, delayed birth cry, birth asphyxia, late initiation of breastfeeding, neonatal seizures, use of maternal hormonal intervention, and consanguinity as some of the identified risk factors of autism spectrum disorder. Parents and families of children with autism have to go through a complex negative experience, both in the family and the community. This negative experience is further compounded by the lack of awareness and access to appropriate professional help and resources. It can be concluded that there is an urgent need for services that help parents cope with the stress of parenting a child with autism. [ABSTRACT FROM AUTHOR]

Self-concept develops during adolescence, but little is known about self-concept in adolescents with autism. This behavioral neuroimaging study investigated (1) self-concept positivity across three domains (academic, physical appearance, and prosocial) and (2) from the perspective of self (direct self-concept) and the perceived perspective of peers (reflected self-concept) in 12- to 16-year-old adolescent males with (n = 35) and without autism (n = 34). These behavioral and neural measures of self-concept were additionally related to autism traits and alexithymia traits across groups. Results showed no general group differences, but more autism traits were related to less positive self-concept ratings in the physical appearance and prosocial domains. More autism traits were also associated with less similarity between direct and reflected prosocial self-concept ratings. Lower self-esteem was additionally explained by alexithymia, specifically the difficulty to identify ones feelings. Participants showed medial prefrontal cortex activation in response to evaluating self-traits in both groups. Region-of-interest analyses revealed that medial prefrontal cortex and right temporal–parietal junction activation were differentially related to alexithymia traits. Together, this study provides a comprehensive understanding of self-concept and self-esteem in adolescents with varying levels autism and alexithymia traits. Developing a positive view of the self is important for maintaining a good mental health, as feeling negative about the self increases the risk of developing internalizing symptoms such as feelings of depression and anxiety. Even though autistic individuals regularly struggle with these internalizing feelings, and both self-concept and internalizing feelings are known to develop during adolescence, there is a lack of studies investigating the development of positive self-concept and self-esteem in autistic adolescents. Here, we studied academic, physical, and prosocial self-concept as well as self-esteem in adolescent males with and without autism on both the behavioral and neural level. We additionally focused on similarities in one's own and peers' perspectives on the self, and we assessed a potential role of alexithymia (i.e. having trouble identifying and describing one's feelings) in developing a more negative view of the self. Results showed that there were no group differences in self-esteem, self-concept, or underlying neural activation. This shows that autistic adolescent males use the same neural processes when they evaluate their traits. However, regardless of clinical diagnosis, a higher number of autism traits was related to a less positive physical and prosocial self-concept, whereas more difficulty identifying one's feelings was related to lowered self-esteem and less activation in medial prefrontal cortex during self-evaluations. Therefore, in treatment of autistic adolescents with low self-esteem, it is important to take into account and possibly aim to improve alexithymic traits as well. [ABSTRACT FROM AUTHOR]

The broad autism phenotype is the phenotypic expression of the primary characteristics of autism. However, currently available tests do not agree with the two-domain operationalization of broad autism phenotype or autism, and their internal structure has shown instability across applications. This study presents the Broad Autism Phenotype–International Test, the first such test designed to target a two-domain operationalization in Spain and the United Kingdom. A broad pilot study was conducted in three community samples, two from Spain (ES1, N = 970; ES2, N = 460) and one from the United Kingdom (N = 530). The Broad Autism Phenotype–International Test consists of 20 items distributed into the SOCIAL-BAP and RIRE-BAP dimensions, representing the seven autistic subdomains. Common factor approaches were used to find a simple and invariant factor structure between countries. The Broad Autism Phenotype–International Test presents full metric invariance between two Spanish samples, partial invariance between countries, and adequate omega reliability estimation. Evidence-based results on the relationships of the SOCIAL-BAP and RIRE-BAP to other variables (the Social Responsiveness Scale-2 and the Broad Autism Phenotype Questionnaire) support the interpretation of its scores for the intended uses. The evidence provided in this article shows that the Broad Autism Phenotype–International Test functions adequately compared to other available broad autism phenotype tests, such as the Broad Autism Phenotype Questionnaire. The broad autism phenotype refers to a group of behaviors related to autism spectrum disorder, but that appear to a lesser extent. Its assessment has been performed through outdated broad autism phenotype/autism spectrum disorder definitions and tests. To address this problem, this study presents the development of a new test, the Broad Autism Phenotype–International Test, a 20-item measure consisting of two dimensions, SOCIAL-BAP and RIRE-BAP, targeting the two-domain operationalization of autism spectrum disorder in Spain and the United Kingdom. Unlike the Broad Autism Phenotype Questionnaire, this test received empirical support as a quick and effective broad autism phenotype measure that can facilitate both broad autism phenotype/autism spectrum disorder research and interventions. This is the first step to studying the BAP in several Spanish and English-speaking countries. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) screening tools for autism are gaining in prevalence, and have benefits such as video content and direct resources linkage. However, it is unclear whether such tools will ameliorate autism inequities or will help only those already advantaged in autism care. To investigate this issue, we conducted semi-structured qualitative interviews with 18 primary care and Early Intervention/Early Childhood Special Education providers in six US states. Providers were given hypothetical scenarios in which a family presents to care with results from one of 9 mHealth autism screening tools. Providers discussed their clinical approach and assessed the tool's fit with their patient/client population. Each transcript was audio-recorded, transcribed, and coded; a phenomenological approach was used to develop key themes. 4 themes and 18 subthemes emerged. These included Clinical and business factors (e.g. scope of practice concerns and clinical efficiency), Validity and trustworthiness (e.g. familiarity, data privacy/security), Family interaction quality (e.g. supporting family advocacy, provision of information, affecting family anxiety, and emotional support), and Accessibility (e.g. English proficiency/language issues, cultural inclusivity, and literacy/educational level). Providers suggested modifications to enhance equity, such as portraying diverse families, reducing the reading level of text, and making tools shorter to better fit clinical context. Families may find information about autism online, and health care and education providers may use online tools to screen for autism. However, we do not know if online autism screening tools are easily used by families and providers. We interviewed primary care and educational providers, asking them to review results from online tools that screen for autism. Providers had concerns about how usable and accessible these tools are for diverse families and suggested changes to make tools easier to use. [ABSTRACT FROM AUTHOR]

Background: Early detection of autism spectrum disorder (ASD) has the potential to significantly reduce the impact of the condition, however previous reviews have found little evidence to support screening programs for ASD in young children. Methods: We conducted a review with the aim of updating evidence on 3 aspects: (a) diagnostic stability of ASD in young children; (b) accuracy of ASD screening tools in young children; and (c) the benefits of early interventions in screen-detected young children with ASD. Results: A total of 33 studies were included in our review. Five studies looking at diagnostic stability reported estimates ranging from 71.9% to 100%, however the majority only included a follow-up of 24 months and all studies raised concerns regarding the risk of bias due particularly to lack of blinding, sample size, and patient flow. A total of 25 studies, reported in 26 articles, were identified that reported accuracy data on 11 screening tools. Most of the reports were concerned with versions of M-CHAT, reporting sensitivity estimates from 0.67 to 1.0; however, many of these were deemed to be of high risk of bias due to lack of blinding and follow-up. Four studies reported on early interventions in screen-detected children; however, the majority did not find significant improvements on the relevant outcomes. Conclusions: Overall, the evidence on screening for ASD in young children captured by this review is not conclusive regarding the 3 aspects of screening in this population. Future studies should attempt to ensure blinded diagnostic assessments, include longer follow-up periods and limit attrition. [ABSTRACT FROM AUTHOR]

There is a need to investigate the diagnostic utility of autism diagnostic questionnaires in school-age children, who are increasingly being referred for autism assessment. Aside from the standardization sample, little research has been conducted on the Autism Spectrum Rating Scales, particularly regarding teacher reports. This study investigated the criterion validity of the Autism Spectrum Rating Scales-Teacher report for ages 6–18 (ASRS-T6-18) in a well-characterized community sample of 409 children (autism [AUT] n = 122; non-autism [NOT] n = 287; X ¯ age = 9.91) evaluated with the Autism Diagnostic Observation Schedule-2, a well-validated autism diagnostic measure. Significant mean differences with small to moderate effect sizes (d = 0.28–0.56) were observed for all scores except Self-Regulation, Adult interaction, and Attention. Logistic Regression and Receiver Operating Characteristic analyses conducted for the Summary, ASRS, and two Treatment scales (Peer and Social-Emotional Reciprocity) indicated low ORs (< |1.08|) and AUCs in the poor range (<.67). Total and Unusual Behavior emerged as comparatively stronger scales with covariates (age and IQ); other scales were generally similar with/without control variables. Sensitivity and specificity could not be optimized. The suggested 60 t -cutpoint had fair or good sensitivity (76.23–83.61) for all examined scales except Unusual Behavior (68.03). However, specificity was poor (46.93–54.36), with high false positive rates (45.64%–63.07%). In complex community samples, the ASRS-T6-18 behaves more like a screener as opposed to a diagnostic measure. [ABSTRACT FROM AUTHOR]

This study examined the response of two students in the Southwestern United States with autism spectrum disorder and IQ in the intellectual disability range to a comprehensive, text-based reading intervention. The intervention, Friends on the Block, includes multiple strands of literacy providing explicit instruction in phonics, phonemic awareness, high-frequency irregular or temporarily irregular words, decoding, vocabulary, oral language, and comprehension. Multiple supports for students with intensive needs are embedded within the intervention, such as specially designed multi-criteria books, extensive scaffolding, and intensive cumulative review. Teachers customize the program to address the varying needs of students. We used single-case multiple baselines across levels of instruction design to assess growth on a measure of reading (words read correctly). Results indicated a positive, functional relation between reading intervention and word reading. Both students also demonstrated modest growth on measures of phonemic awareness, letter–sound knowledge, and word identification from pre- to post-intervention. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) engage in challenging behavior that can result in missing out on potential reinforcers. A common intervention for challenging behavior is functional communication training (FCT). In FCT, the clinician reinforces an appropriate communicative response using the same reinforcer maintaining the challenging behavior. In some cases, the challenging behavior is too severe for traditional FCT procedures to efficiently teach a new response. In this case study, we treated a 4-year-old boy with ASD referred to as Mostafa using a modified version of FCT. We did not include a typical component of traditional FCT procedures – the removal of the putative reinforcer prior to the trial. Instead, we provided components of toys and games contingent on the appropriate communication response. None of the components had to be removed to continue conducting learning trials. Mostafa's communication increased and challenging behavior decreased as a result of this modification. This modification may be useful for other cases in which the removal of a tangible item interferes with learning a communication response. [ABSTRACT FROM AUTHOR]

Background and aims: This study was conducted in a clinical setting with the aim of replicating previously used procedures for teaching receptive vocabulary. Researchers increased the number of vocabulary words and maintained use of match-to-sample (MtS), prompting, and reinforcement procedures. Researchers were also interested in the efficacy of the intervention from caregivers' perspectives. Methods: Using a concurrent multiple baseline design, two autistic preschoolers with receptive language impairment were taught to identify 30 common objects. MtS, prompting, and reinforcement procedures were individualized to support each child. Maintenance checks and generalization probes were completed after a predetermined number of intervention sessions (i.e. three or four clinic sessions). A social validity questionnaire was completed by parents following the final maintenance check. Results: Receptive object identification improved significantly for both participants. Despite exposure to vocabulary targets for only three or four sessions, they generalized the vocabulary targets to non-identical pictures and maintained words at maintenance checks. Participants were most successful when researchers individualized prompting and reinforcement. Conclusion: MtS, prompting, and reinforcement were effective procedures for improving object identification, even with a limited number of intervention sessions. To support varying learner profiles, modifying prompting and reinforcement procedures was necessary. Caregivers of both participants reported positive improvements in areas such as communication, attention, and behaviors. Implications: This replicated study provides support for MtS, prompting, and reinforcement as means of teaching receptive vocabulary to autistic preschoolers in a clinical setting. The materials used were simple and cost-effective. Overall, this study outlines and supports a flexible and effective evidence-based practice to teach receptive language to autistic children. [ABSTRACT FROM AUTHOR]

Measurement concepts are an essential foundation for more advanced mathematical concepts. To address the challenges of students with autism spectrum disorder (ASD) in learning measurement concepts, this study investigated the effects of using a combination of explicit instruction and virtual manipulatives (VMs) to teach measurement concepts to students with ASD in China. Using a single-case multiple-probe across skills design, researchers examined whether the intervention could support the acquisition and maintenance of measurement concepts in students with ASD. Based on visual analysis, a functional relation was found between the independent variable (i.e., explicit instruction with VMs) and student performance on solving measurement concepts problems. Implications for practice and research are discussed. [ABSTRACT FROM AUTHOR]

There is a dearth of research into the experience of adult diagnosis of autism spectrum disorder, and targeted research is needed to understand the needs of these adults. The aim of this coproduced review was to assess existing qualitative data on the lived experience of receiving an autism spectrum disorder diagnosis, identify recurring themes, and synthesize them into a visual model representing the journey through diagnosis. Using thematic analysis, we analyzed qualitative data from 24 studies of adult experiences of autism spectrum disorder diagnosis from PsycINFO, Embase, MEDLINE, and CINAHL. Thirty-two "descriptive" themes and three superordinate themes were identified. These themes represented how factors relating to identity and relationships are impacted by the diagnosis of autism spectrum disorder and the role of adaptation and assimilation. While the diagnostic process was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the diagnosis process explicitly considers needs in relation to: the impact of the diagnosis on identity, interactions with other people, choices regarding disclosure, and whether and how to make informed adaptations. There is little research looking at the experience of individuals diagnosed with autism spectrum disorder as adults. Adults diagnosed with autism spectrum disorder face different challenges than children, and more research is needed to better understand those challenges. For this review, autistic and non-autistic researchers looked at research on the experience of receiving a diagnosis of autism spectrum disorder as an adult. We looked for themes in people's experience leading up to diagnosis, going through the diagnostic process, and living their life after diagnosis. We analyzed 24 studies and found three overarching themes that captured thirty-two themes describing the experience of diagnosis. The three overarching themes expressed issues with identity and relationships before and after the diagnosis and identified that the diagnosis of autism spectrum disorder in adulthood impacted people's adaptation to and assimilation (i.e. the making sense of and internalizing the diagnosis) of autism spectrum disorder. While the diagnostic process itself was confusing and disappointing for many, it often led to a sense of relief and clarity regarding past experiences and had effects on identity and self-esteem. It created opportunities to connect with other autistic individuals and to access services, though appropriate supports were widely lacking. Recommendations are made that the impact of the diagnosis on people's identity and choices about telling others about their diagnosis, and whether and how people want to make adaptations, should be discussed and thought through in the process of diagnosis. [ABSTRACT FROM AUTHOR]

Background and aims: Although autism spectrum disorder (ASD) has not traditionally been associated with morphosyntactic impairments, some children with ASD manifest significant difficulties in this domain. Sentence Repetition (SRep) tasks are highly reliable tools for detecting morphosyntactic impairment in different languages and across various populations, including children with ASD. This study is among the first to evaluate morphosyntactic abilities of Palestinian-Arabic (PA) speaking children using a PA SRep task. Methods: A total of 142 PA-speaking children, aged 5-11, participated in the study: 75 children with typical language development (TLD) and 67 children with ASD. The PA SRep task targeted morphosyntactic structures of varying complexity (simple subject-verb-object [SVO] sentences, biclausal sentences, wh - questions, relative clauses). Children's accuracy scores were assessed across these structures and error patterns encompassing morphosyntactic and pragmatic aspects were analyzed. Results: Two subgroups of ASD emerged: 43% showed age-appropriate language skills (ASD + NL) pairing up with TLD peers, while 57% showed signs of morphosyntactic impairment (ASD + LI). Children in both groups exhibited a higher frequency of morphosyntactic errors than pragmatic ones. Children with ASD + LI showed difficulties with producing complex morphosyntactic structures, such as relative clauses and object wh-questions. Error analysis revealed that children in the ASD + LI group produced sentence fragments and simplified constructions when complex structures were targeted. Conclusions: The current study extends the cross-linguistic evidence of the heterogeneity of morphosyntactic profiles in children with ASD to Arabic-speaking children. Error analysis indicates that poor morphosyntax, rather than pragmatics, challenges children's performance on the SRep task. Implications: Our results emphasize the importance of comprehensive language assessment in children with ASD and underscore the need for tailored intervention plans targeting impaired morphosyntactic structures in some children with ASD. [ABSTRACT FROM AUTHOR]

Being a typically developing sibling to a child with autism spectrum disorder (ASD-Sib) can be associated with several behavioral and mental health problems. With this understanding, researchers are beginning to focus on sibling-oriented interventions. This review seeks to evaluate the current literature on such interventions. We searched digital databases and identified eight relevant studies. The sample (n = 247) had an age range of 4–16 years. The outcomes were generally positive, with improvements in different facets of ASD-Sibs. Results differed due to varied intervention styles, outcome variables, methods, and samples. Our findings highlight the potential for improvement in ASD-Sib's knowledge of autism and their psychological functioning and hence call for further research with robust methods. [ABSTRACT FROM AUTHOR]

Children with Autism face several significant challenges, including deficits in both verbal and nonverbal communication, difficulties with concentration, limited interest in their surroundings, non-responsiveness, and struggles with adapting to new situations. It is imperative to consider and address these challenges when implementing technological interventions aimed at enhancing the skills of children with Autism. This study aims to identify the research emphasis on the following four determinants of technological interventions for children with Autism - (i) involvement of caregivers, (ii) design considerations, (iii) persuasive technology, (iv) psychological and physiological effects of technologies. These determinants address their deficiencies in communication, coping with new situations, responsiveness and effects of using technologies respectively. A total of seventy six review articles from 2010 to 2022 have been selected through PRISMA guidelines for this study. Most of the selected review articles have not evaluated these four determinants in their studies. This study discusses this research scope and presents future research directions to bridge this gap to develop effective technological solutions to upskill the children with Autism. [ABSTRACT FROM AUTHOR]

Objective: The study involved 17 children with Autism Spectrum Disorder (ASD), 21 with ADHD, 30 with both (ASD + ADHD), and 28 typically developing children (TD). Methods: The amplitude of low-frequency fluctuations (ALFF) was measured as a regional brain function index. Intrinsic functional connectivity (iFC) was also analyzed using the region of interest (ROI) identified in ALFF analysis. Statistical analysis was done via one-way ANCOVA, Gaussian random field (GRF) theory, and post-hoc pair-wise comparisons. Results: The ASD + ADHD group showed increased ALFF in the left middle frontal gyrus (MFG.L) compared to the TD group. In terms of global brain function, the ASD group displayed underconnectivity in specific regions compared to the ASD + ADHD and TD groups. Conclusion: The findings contribute to understanding the neural mechanisms underlying ASD + ADHD. [ABSTRACT FROM AUTHOR]

Objective: This article will review the use of the CBCL to diagnose youth with psychopathological disorders focusing on: ADHD, Mood Disorders, Autism Spectrum disorders, and Disruptive Disorders. Method: Using a narrative review approach, we investigate the usefulness of the CBCL as a screening tool to detect childhood onset psychopathology across different diagnostic syndromes. Results: The available literature supports the use of the CBCL for ADHD screening and as a measure of ADHD severity. While some studies support a specific profile linked with childhood bipolar disorder, replication studies for this profile found mixed results. The CBCL was also found to be useful in screening for patients presenting with Autism Spectrum Disorders, Conduct Disorder, and Childhood Bipolar Disorder all of which presents with more severely impaired scores. Conclusion: The CBCL holds promise as a screening tool for childhood psychopathology. [ABSTRACT FROM AUTHOR]

The current study examined vocalizations that occurred during training of the Picture Exchange Communication System for three U.S. preschool-age participants with autism spectrum disorder. In Phase IV, the protocol incorporates a delay to reinforcement in an effort to encourage vocalizations; however, the manual does not suggest additional strategies to try when vocalizations do not occur during the delay to reinforcement. Researchers evaluated a vocal model prompt following the delay to reinforcement and continued to measure vocalizations when the delay to reinforcement alone did not increase vocalizations. Two of the three participants increased independent vocalizations after the addition of the vocal model. Implications for practitioners and future research are discussed. [ABSTRACT FROM AUTHOR]

Preschool classrooms provide a unique context for supporting the development of children with social-communication challenges. This study is an uncontrolled clinical trial of an adapted professional development intervention for preschool teachers (Social Emotional Engagement-Knowledge & Skills-Early Childhood). Social Emotional Engagement-Knowledge & Skills-Early Childhood is a low-resource-intensive, transdiagnostic intervention to address the learning needs of children with social-communication challenges and consists of four asynchronous online modules and three synchronous coaching sessions. The current research evaluated the feasibility and acceptability of intervention and research procedures, implemented in authentic early childhood education settings. Participants included one teacher and one target child with social-communication challenges from 25 preschool classrooms, sampled to maximize variability. Overall, the current research revealed high levels of feasibility, with 9 out of 10 benchmarks met: (a) procedures for participant recruitment reliably identified a neurodiverse sample of children with teacher-reported social-communication challenges; (b) teachers showed high levels of program engagement and Social Emotional Engagement-Knowledge & Skills-Early Childhood completion (76%); and (c) results revealed a robust pattern of gains in Social Emotional Engagement-Knowledge & Skills-Early Childhood classrooms and associations among key outcome measures (including active engagement, student teacher relationship, social-communication competencies). Implications for the design of a subsequent, larger effectiveness-implementation hybrid trial (Type 1) are discussed. Preschool classrooms provide a unique context for supporting the development of children with social-communication challenges. This study evaluates the feasibility and acceptability of an adapted professional development intervention for preschool teachers (Social Emotional Engagement-Knowledge & Skills-Early Childhood). Social Emotional Engagement-Knowledge & Skills-Early Childhood is a low-resource-intensive, transdiagnostic intervention to address the learning needs of children with a broad range of social-communication challenges in authentic preschool classrooms. The intervention consists of four asynchronous online modules and three synchronous coaching sessions. Participants included one teacher and one target child with social-communication challenges from 25 preschool classrooms from private childcare, Head Start, and public Pre-K programs. Results reveal high levels of Social Emotional Engagement-Knowledge & Skills-Early Childhood feasibility, with 9 out of 10 feasibility benchmarks met: (a) procedures for participant recruitment reliably identified a neurodiverse sample of children with teacher-reported social-communication challenges; (b) teachers showed high levels of program engagement and Social Emotional Engagement-Knowledge & Skills-Early Childhood completion (76%); and (c) results revealed a robust pattern of gains in Social Emotional Engagement-Knowledge & Skills-Early Childhood classrooms and associations among key outcome measures (including active engagement, student–teacher relationship, social-communication competencies). This research prepares a subsequent, larger effectiveness-implementation hybrid trial (Type 1) that investigates the effectiveness of Social Emotional Engagement-Knowledge & Skills-Early Childhood for improving child outcomes and explores facilitators and barriers of program implementation and sustainability. [ABSTRACT FROM AUTHOR]

Background: Parents of children with autism spectrum disorder (ASD) face unique challenges in raising their children, and they are at higher risk for depression compared to parents of children with typical development (TD) and other disabilities. Aims: (1) To compare prevalence of depressive symptoms among mothers of children with ASD (n = 101), Down syndrome (DS, n = 101), and TD (n = 43) and (2) to describe the relationships among depression, self-efficacy, and family functioning, and describe the mediating role of maternal child care self-efficacy between depressive symptoms and child behavior. Methods: In this cross-sectional study, mothers completed the Social Communication Questionnaire, Aberrant Behavior Checklist, Patient Health Questionnaire-9 (PHQ-9), Family Assessment Device General Functioning Scale, and Maternal Self-Efficacy Scale. Results: Mothers of children with ASD had significantly higher mean PHQ-9 scores (p <.001), higher proportion of positive depression screening (p <.001), and lower family functioning (p <.001). Better family functioning is associated with less depression, better self-efficacy, and less severe ASD symptoms and behaviors. Self-efficacy mediated the relationship between depression and child ASD symptoms, and problematic behavior. Conclusions: The rates of reported history of depression and low family functioning in mothers of children with ASD are twice the rate in mothers of children with DS and TD. Maternal child care self-efficacy is protective against maternal depression, even in the presence of severe child problematic behaviors and ASD symptoms. Interventions that increase child care self-efficacy and family functioning may be helpful in addressing depression in mothers of children with ASD. [ABSTRACT FROM AUTHOR]

Awareness of the importance of assessing social cognition skills under conditions showing atypical social behaviours has increased over the years. However, the evaluation of the psychometric properties of the measures and the availability of normative values for the clinical context are still limited. This study aims to revise, provide normative values, and evaluate the clinical validity of the Italian version of three social cognition measures: Advanced Theory of Mind (A-ToM) task, the Emotion Attribution Task (EAT), and the Social Situation Task (SST). Measures were administered to 580 adolescents and adult healthy controls (age range 14–50). We performed differential item functioning and Rasch analysis to revise each task, so normative data of the revised measures were calculated. Moreover, the revised measures were administered to 38 individuals with autism spectrum disorder (ASD) and 35 individuals with schizophrenia spectrum disorders (SSD): ASD and SSD were matched by age, gender, and IQ with a control sample to evaluate clinical validity. ROC analysis showed that the SST is the best measure differentiating between healthy and clinical groups, compared to the A-ToM (AUCASD = 0.70; AUCSSD = 0.65) and EAT (AUCASD = 0.67; AUCSSD = 0.50), which showed poorer performance. For SSD diagnosis, two SST subscales (Violation and Gravity score) indicated the best accuracy (AUCs of 0.88 and 0.84, respectively); for the ASD diagnosis, we propose a combined score between the SST subscale and A-ToM (AUC = 0.86). The results suggest that the proposed measures can be used to support the diagnostic process and clinical practice. [ABSTRACT FROM AUTHOR]

Young adults with autism spectrum disorder are an underserved population. Evidence-based guidelines for physical activity programs to address the lifelong needs of this population are presently unavailable. Our systematic review critically appraises the research to date on the effects of physical activity/exercise-based interventions on physical fitness, motor skills, core autism symptoms, and functional participation in young adults with autism spectrum disorder between 19 and 30 years. We reviewed 22 experimental and quasi-experimental studies that assessed the effects of physical activity/exercise-based interventions in 763 young adults with autism spectrum disorder. Evidence is strongest for improvements of medium-to-large size in physical fitness followed by medium-to-large improvements in motor outcomes, medium-to-large improvements in psychological function, and small-to-large improvements in quality of life. Aerobic, resistance, and movement skill/sport-specific training can improve cardiovascular function and muscular strength/endurance in young adults. Movement/sport training can help improve fundamental motor skills. Finally, holistic interventions combining elements of physical activity, diet, and lifestyle modifications are effective in improving outcomes related to body composition and quality of life in young adults. There is presently insufficient evidence for improvements in physical activity engagement or core autism symptoms following exercise interventions. We provide recommendations for assessment and intervention for clinicians working with young adults with autism spectrum disorder. Young adults with autism spectrum disorder over 18 years of age are an underserved population, and there is presently limited evidence examining the effects of physical activity programs in this population. Our review synthesizes the evidence to date from studies that have assessed the effects of physical activity/exercise programs in young adults with autism spectrum disorder between 19 and 30 years. We reviewed 22 studies that included a total of 763 young adults with autism spectrum disorder. There is the strongest evidence for improvements in physical fitness, followed by motor skills, psychological function, and quality of life following physical activity interventions in young adults with autism spectrum disorder. Specifically, aerobic and resistance training as well as programs focused on movement skill and sport-specific training lead to improved physical fitness and movement performance. Holistic interventions focusing on physical activity, dietary changes, and lifestyle modifications lead to improvements in body composition and quality of life of young adults with autism spectrum disorder. There is presently limited evidence to support the use of exercise/activity programs to improve physical activity levels and core autism symptoms in young adults with autism spectrum disorder. Based on our review results, we also provide practical recommendations for clinicians working with young adults with autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Multidimensional theory of mind assessments should include items assessing both explicit theory of mind (theory of mind knowledge) and applied theory of mind (application of theory of mind knowledge in real-life contexts). However, the two theory of mind scores cannot be interpreted collectively to identify children having mismatched explicit and applied theory of mind due to the lack of links between the two scores. To map the information between two theory of mind scores, data of 221 autistic children aged 3–12 years were extracted. Items of the Theory of Mind Task Battery and Theory of Mind Inventory-2 were used to respectively assess the explicit and applied theory of mind. Rasch analysis and correlation coefficients were used to examine the model fits/dimensionality and relationships. After the removal of misfit items, the remaining 45 items showed satisfactory model fits (infit and outfit mean squares < 1.35). Large correlation (r = 0.63) was found between the Rasch scores of the two theory of mind constructs. The scatter plots highlighted that each applied theory of mind score could reflect multiple explicit ToM scores. Accordingly, the information from each theory of mind measure is unique and irreplaceable. Moreover, cutoff scores for identifying children with mismatched explicit and applied theory of mind were proposed to determine the priority of interventions. Theory of mind is an ability to infer others' mental states, which is a foundation for generating appropriate social responses. Theory of mind can be conceptually divided into two related but distinguishable constructs: explicit theory of mind (conceptual knowledge/information about others' mental states) and applied theory of mind (the ability to use theory of mind skills in real-life contexts). Although these two theory of mind scores can be described by the percentages of children in the early, basic, and advanced developmental stages, the resulting information may not be sufficient to determine the corresponding relationships between these two theory of mind constructs or identify children with mismatched theory of mind abilities (e.g. children who have difficulty in effectively applying their theory of mind knowledge in real-life contexts). To resolve these limitations, methods for simultaneously interpreting the relationships between the two theory of mind scores are proposed. Based on the findings, each applied theory of mind score can reflect multiple scores of explicit theory of mind. In particular, the results do not take measurement error into consideration, which would make them more ambiguous. Therefore, the scores of applied theory of mind should be interpreted carefully, given that children who have the same applied theory of mind score may actually have high or low explicit theory of mind. Regarding the method for joint interpretation, cutoff scores were selected to identify children who have mismatched theory of mind abilities (high explicit theory of mind with low applied theory of mind or low explicit theory of mind with high applied theory of mind) and determine the priority for interventions. [ABSTRACT FROM AUTHOR]

Background & aims: Communicative and sensory differences are core autistic traits, yet speech-perception abilities and difficulties among autistic individuals remain poorly understood. Laboratory studies have produced mixed and inconclusive results, in part because of the lack of input from autistic individuals in defining the hypotheses and shaping the methods used in this field of research. Little in-depth qualitative research on autistic experiences of speech perception has been published, yet such research could form the basis for better laboratory research, for improved understanding of autistic experiences, and for the development of interventions. Existing qualitative research describes widespread autistic listening differences with significant impacts, but these results rely on data gathered via oral interviews in a small sample. The present study addresses these limitations and employs a mixed-methods approach to explore autistic listening experiences. Methods: We gathered survey data from 79 autistic individuals aged 18–55 without diagnosed hearing loss. The questionnaire included 20 closed-set questions on listening abilities and difficulties and three free-text questions on listening experiences. The free-text questions underwent deductive content analysis using a framework composed of themes from previous interview data on listening experiences (including auditory differences, contributing factors, impacts, and coping strategies). Concepts in the free-text data that were not part of the analysis framework were analyzed inductively. Results: In the closed-set data, participants reported listening difficulties in most specified environments, but complex background sounds and particularly background voices caused the most difficulty. Those who reported listening difficulties expressed having substantially greater difficulties than other people the same age. Participants indicated multiple impacts from listening difficulties, most prominently in their social lives. Concepts in the free-text data strongly supported previous interview data on listening differences and factors that affect listening ability, especially the diversity of types of listening difficulties. Consistent with the closed-set data, background-sound complexity and concurrent voices were especially troubling. Some concepts in the free-text data were novel, particularly difficulties with remote, broadcast, and recorded audio, prompting the creation of new themes. Conclusions: Both forms of data indicate widespread listening differences—predominantly listening difficulties—affecting most autistic adults. Diverse types of listening difficulty are evident, potentially indicating heterogeneous underlying mechanisms, and complexity of background noise is consistently identified as an important factor. Listening difficulties are said to have substantial and varied impacts. Autistic adults are keen to share coping strategies, which are varied and usually self-devised. Implications: Based on both the quantitative and qualitative results, we provide recommendations to improve future research and support the autistic community. The data-revealing types of listening difficulties can guide better quantitative research into underlying mechanisms. Such research should take into account potential heterogeneity in listening difficulties. Suggestions for optimized collection of self-report data are also offered. Additionally, our results could be used to improve societal understanding of autistic listening differences and to create beneficial interventions for and with autistic individuals. Moreover, given the willingness of the autistic community to share coping strategies, systematic collation of these strategies could form the basis for self-help and clinical guidance. [ABSTRACT FROM AUTHOR]

Background: As no scales are currently available to assess the social-emotional reciprocity (SER) between children with autism spectrum disorder (ASD) and their parents, we aimed to develop a questionnaire for this. Methods: Both quantitative and qualitative techniques were used for content validation. All stages of this study used purposive sampling to choose various groups of experts, mental health professionals, and parents of children with ASD to participate in the development, judgment-quantifying, and pretest stages. Data from 30 parents of children with ASD were gathered for the field test. Results: Thirty items were retained after content validation. The proportion of consensus regarding the comprehensiveness of the entire questionnaire was 1.00. The scale-level content validity index (CVI) by averaging calculation method and universal agreement calculation method were 0.95 and 0.50, respectively. Following the pretest, a total of 23 questions, on a five-point scale, were retained. Conclusion: Given the significance of SER between children with ASD and their parents, mental health practitioners should use this questionnaire to understand it to maximize the efficacy of any intervention. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder is a growing public health concern in low-and middle-income countries that has prompted a World Health Organization resolution on ' comprehensive and coordinated efforts for management of autism spectrum disorder'. Despite being a signatory of the resolution, South Africa does not have any national policies to guide the management of autism spectrum disorder services. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their proposed solutions to meet the needs of autistic children and their families. The overarching theme that emerged was 'We are doing damage control'. Government stakeholders acknowledged that autism spectrum disorder services were falling between the 'cracks' caused by competing societal demands on government resources. Participants shared perspectives about autism spectrum disorder services in three categories: a cracked society, siloed service systems and gap-filling strategies. Findings from this study highlighted the need for collaborative efforts between government departments and civil society to develop a strategy for autism spectrum disorder in line with the World Health Organization resolution. Multistakeholder engagement to break down barriers, strengthen systems and develop innovative solutions to improving services for children with autism spectrum disorder and their families is recommended. Autism spectrum disorder is a growing public health concern in low- and middle-income countries like South Africa where there are no plans or policies in place for autism spectrum disorder management. Many children with autism spectrum disorder in South Africa are out of schools and waiting for school placement to become available. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their suggestion for improving services for these children and their families. Semi-structured interviews were conducted with government stakeholders from the Western Cape Department of Education, Department of Health and the Department of Social development. The main theme that emerged was 'We are doing damage control'. Government stakeholders acknowledged that autism spectrum disorder services were being overlooked because of other demands on government resources. Finding from this study highlighted the need for government departments to work together to develop a strategy for autism spectrum disorder management. Engagement between government and civil society to break down barriers, strengthen systems and develop solutions to improving access to services for children with autism spectrum disorder and their families is recommended. [ABSTRACT FROM AUTHOR]

Background & aims: Although the Picture Exchange Communication System (PECS) has been demonstrated to be an effective intervention to teach people diagnosed with autism spectrum disorder a functional communication system, the research indicates variability in PECS outcomes across people and studies. Therefore, the purpose of the current study was to explore child characteristics and treatment variables that may explain the variation in, and potentially predict, PECS outcomes. Method: A total of 22 children and youth diagnosed with autism or a related developmental disorder, all of whom scored substantially below average on standardized measures of cognitive and adaptive abilities, participated in a PECS intervention. Results: Participants who achieved high phases of PECS (≥PECS phase IIIb) differed significantly from those who mastered lower PECS phases (≤PECS phase IIIa) in terms of overall, verbal, and nonverbal mental age, matching abilities, and adaptive behavior level. Stimulus generalization was also associated with significant variation in PECS outcome. PECS outcomes could be predicted with good accuracy using a combination of these child characteristics and treatment variables. Conclusions: The findings from the current study suggest that children with relatively higher cognitive and adaptive skill levels are more likely to achieve higher phases of PECS; further, approaches to generalization training also play a role. Factors such as autism symptom severity and parental ratings of maladaptive behavior were not associated with significant differences in PECS outcomes. However, more research is needed. Implications: Gaining a better understanding of predictors of PECS outcomes is important to inform intervention, provide more accurate outcome expectations for families, and guide PECS teaching procedures. Although participants were more likely to achieve higher phases of PECS if they had a higher mental age, adaptive skill level, and matching skills, the average scores for these measures were well below those expected for same age peers. These results indicate that PECS is appropriate for use with children with clinically significant deficits in cognitive and/or adaptive abilities. Further, results suggest that even children who demonstrate more severe symptoms of autism and exhibit more challenging behavior can achieve higher phases of PECS. [ABSTRACT FROM AUTHOR]

Background and aims: Research on the psychological impact of the coronavirus disease 2019 pandemic has highlighted its negative and positive effects on children with autism spectrum disorder and their families. However, little is known about the neutral effects that remain the same, even in particular circumstances, and how children with autism spectrum disorder and their parents perceive each other. We explored how children with autism spectrum disorder and their mothers perceived and experienced the pandemic in Japan. Methods: A mixed-methods design was employed. Thirteen children with autism spectrum disorder and 12 mothers participated. Data were collected through online semi-structured interviews and analyzed using thematic analysis. Similarities and differences in perceptions were compared. Results: The results revealed six broad themes and 27 categories. Regarding neutral effects, some mothers reported no substantial impact because there were no changes in their jobs or other dramatic life changes. In addition, some children were not affected because they had had no social contact before the pandemic or because their lives had not changed dramatically. Regarding the perceptions of children/mothers, most expressed that they/their children enjoyed spending time with their families. At home, mothers made various efforts to interact with their children. However, mothers and children differed in their perceptions, such as regarding the emergence of anxiety about conducting school events and the resolution of study-related concerns. Conclusions: There were negative, neutral, and positive effects on both children with autism spectrum disorder and their mothers; specifically, they were striving to move forward to overcome the problems posed by the pandemic. Both parties tapped into their resilience by enhancing family interactions, such as cooking together or discussing children's interests. Implications: These findings have important implications for developing more creative solutions to the challenges of coping and resilience in future crises. [ABSTRACT FROM AUTHOR]

Autism research tends to exclude racially and ethnically minoritized autistic individuals, limiting the quality of the evidence base for characterizing and diagnosing language impairment in racially and ethnically minoritized autistic individuals. This systematic review examines reporting practices for participant socio-demographics in studies pertaining to language impairment in autistic school-age individuals using age-referenced assessments. This review was preregistered (PROSPERO: CRD42021260394) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Database searches took place in August of 2021 in Linguistics and Language Behavior Abstracts, PsycINFO, PubMed, and the Directory of Open Access Journals, for publications during 1980–2021. Search terms included three essential concepts: autism, language, and age. Two coders independently screened and evaluated articles. Of qualifying studies (n = 59), 17 (29%) reported any information on participant race and ethnicity; in these studies, participants were at least 77% white. Thirty-two studies (54%) reported gender or sex; just 10 studies (17%) reported socio-economic status using multiple indicators. These findings indicate insufficient adherence to reporting guidelines and systematic exclusion of racially and ethnically minoritized. Future work must address replicable reporting and inclusion in autism research. Although exclusion of racially and ethnically minoritized autistic individuals from research is a long-standing issue, we have yet to determine how exclusion impacts areas of autism research important for identifying language impairment. Diagnosis depends on the quality of the evidence (i.e. research) and is often the pathway to gaining access to services. As a first step, we examined how research studies related to language impairment in school-age autistic individuals report participant socio-demographics. We analyzed reports using age-referenced assessments in English (n = 60), which are commonly used by both practitioners and researchers to diagnose or identify language impairment. Findings showed only 28% of studies reported any information on race and ethnicity; in these studies, most (at least 77%) of the participants were white. In addition, only 56% of studies reported gender or sex and specified what they were reporting (gender, sex, or gender identity). Just 17% reported socio-economic status using multiple indicators. Altogether, findings indicate broad issues with underreporting and exclusion of racially and ethnically minoritized individuals, which might overlay with other aspects of identity including socio-economic status. It is impossible to determine the extent and precise nature of exclusion without intersectional reporting. To ensure that language in autism research is representative of the autistic population, future research must implement reporting guidelines and broaden inclusion of who participates in research studies. [ABSTRACT FROM AUTHOR]

Teaching children with autism spectrum disorder (ASD) academic skills supports their future opportunities. For example, early number sense skills are predictive of future mathematical success for all children including children with ASD. Yet, research on foundational early childhood mathematics skills of children with ASD is limited. This study used an adapted version of Number Talks to increase the number sense skills of preschool children with ASD. Number Talks is a constructivist approach that was combined with systematic instruction (i.e., system of least prompts and modeling) in this study. A multiple probe across participants design established a functional relation between using an adapted version of Number Talks and the early number sense skills of preschool children with ASD. Findings suggest using an adapted version of Number Talks can increase the early number sense skills of preschool children with ASD. Implications for practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Developmental language disorder (DLD) is a common neurodevelopmental disorder. It had been suggested that public awareness is low for DLD, especially in comparison with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and dyslexia. This study investigated awareness of DLD, ASD, ADHD, and dyslexia, as well as specific language impairment (SLI) in Australia. An online survey about awareness and knowledge of DLD, SLI, ASD, ADHD, and dyslexia was completed by 272 people in Australia. People had low awareness of DLD (19.9%) compared with ASD (97.4%), ADHD (97.7%), and dyslexia (98.5%). The former label for the disorder, SLI, had an even lower level of awareness (9.4%). People have heard about DLD from a wide range of sources and were likely to have incorrect knowledge about DLD as well as believing ASD or ADHD to be the most prevalent disorders. Awareness and knowledge of DLD appear to be low. More targeted approaches to increasing public awareness of DLD are needed. [ABSTRACT FROM AUTHOR]

Autism is often considered to reflect categorically ‘different brains’. Neuropsychological research on autism spectrum disorder (ASD) however, has struggled to define this difference, or derive clear-cut boundaries between autism and non-autism. Consequently, restructuring or disbanding the ASD diagnosis is becoming increasingly advocated within research. Nonetheless, autism now exists as a salient social construction, of which ‘difference’ is a key facet. Clinical and educational professionals must influence this cautiously, as changes to autism’s social construction may counterproductively affect the quality of life of autistic people. This paper therefore reviews ASD’s value as both neuropsychological and social constructs. Although lacking neuropsychological validity, the autism label may be beneficial for autistic self-identity, reduction of stigma, and administering support. Whilst a shift away from case-control ASD research is warranted, lay notions of ‘different brains’ may be preserved. [ABSTRACT FROM AUTHOR]

Cognition and brain homeostasis depends on cerebral blood flow to secure adequate oxygen and nutrient distribution to the brain tissue. Altered cerebral blood flow has previously been reported in individuals diagnosed with autism spectrum condition in comparison to non-autistics. This phenomenon might suggest cerebral blood flow as a potential biomarker for autism spectrum condition. Major technological advancement enables the non-invasive and quantitative measurement of cerebral blood flow via arterial spin labeling magnetic resonance imaging. However, most neuroimaging studies in autistic individuals exploit the indirect blood oxygen level dependent functional magnetic resonance imaging signal instead. Therefore, this review examines the use of arterial spin labeling to further investigate the neurobiology of the autism spectrum condition. Followed by a comparison of results from molecular imaging and arterial spin labeling studies and a discussion concerning the future direction and potential of arterial spin labeling in this context. We found that arterial spin labeling study results are consistent with those of molecular imaging, especially after considering the effect of age and sex. Arterial spin labeling has numerous application possibilities besides the quantification of cerebral blood flow, including assessment of functional connectivity and arterial transit time. Therefore, we encourage researchers to explore and consider the application of arterial spin labeling for future scientific studies in the quest to better understand the neurobiology of autism spectrum condition. Brain function and health depend on cerebral blood flow to secure the necessary delivery of oxygen and nutrients to the brain tissue. However, cerebral blood flow appears to be altered in autistic compared to non-autistic individuals, potentially suggesting this difference to be a cause and potential identification point of autism. Recent technological development enables precise and non-invasive measurement of cerebral blood flow via the magnetic resonance imaging method referred to as arterial spin labeling. However, most neuroimaging studies still prefer using the physiologically indirect measure derived from functional magnetic resonance imaging. Therefore, this review examines the use of arterial spin labeling to further investigate the neurobiology of autism. Furthermore, the review includes a comparison of results from molecular imaging and arterial spin labeling followed by a discussion concerning the future direction and potential of arterial spin labeling. We found that arterial spin labeling study results are consistent with those of molecular imaging, especially after considering the effect of age and sex. In addition, arterial spin labeling has numerous application possibilities besides the quantification of cerebral blood flow. Therefore, we encourage researchers to explore and consider the application of arterial spin labeling for future scientific studies in the quest to better understand the neurobiology of autism. [ABSTRACT FROM AUTHOR]

Approximately 30% of autistic children are considered minimally verbal. The field lacks an efficient and reliable measure of communicative capacity among minimally verbal autistic children. Improved methods are needed to determine which children are at greatest risk for minimally verbal outcomes to better target interventions. Here, we present the Low Verbal Investigatory Survey (LVIS), a brief parent-report measure designed to assess communicative capacity among minimally verbal autistic children. The 36-item easy-to-complete LVIS was developed to capture the atypical language trajectories associated specifically with autism. We report pilot results from a sample of 147 children (1–8 years) whose caregivers completed the LVIS as part of other studies. Principal components analysis was used to assess dimensionality of the LVIS; composite scores were compared with existing measures of communicative capacity, all of which take significantly more time and training to administer and score. Scores on the LVIS were strongly correlated with existing gold-standard measures of communication. Presence of atypical vocalizations was determined to be particularly relevant for symptoms of autism as well as language and cognitive abilities. These findings provide initial validation of a tool designed to capture multiple dimensions of communicative capacity in children with minimal or low verbal skills. Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of "minimally verbal." Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1–8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child's communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children. [ABSTRACT FROM AUTHOR]

Community participation and the formation of social networks are crucial for a qualitative life. To this end, transportation plays an essential role. Many autistic people rely on public transportation for their mobility needs. However, research shows that it is not always easy for them to use it. The issues they face when using public bus transport have not yet been thoroughly studied. The current case study in Flanders aimed to give autistic people the opportunity to express the issues they face while using public bus transportation. A qualitative hermeneutic phenomenological study was carried out. Semistructured interviews were conducted with 17 autistic individuals. The interviews were analyzed based on the interpretative phenomenological analysis method. Three main themes emerged: creating predictability, limiting stimuli, and open and accessible communication. In addition, various coping strategies were described, such as the use of noise-canceling headphones. The results of this study may lead to a more autism-friendly public transportation environment. Transportation plays an essential role in daily life, allowing people to participate in the community and form social relationships. Many autistic people rely on public transportation to meet their mobility needs. However, research shows that it is not always easy for them to use it. The exact issues autistic individuals face when traveling with public transportation and how public transportation can be made more autism-friendly have yet to be researched. The current study allowed autistic individuals to express themselves regarding issues they face while traveling by public bus transportation, to raise awareness for making public transportation more autism-friendly. We interviewed 17 autistic individuals about their experiences riding the bus. Three main themes emerged from the results: creating predictability, limiting stimuli, and open and accessible communication. If transport companies take initiatives related to these themes, autistic people traveling by bus can have a more pleasant experience. Participants also described coping strategies for stressful or uncomfortable situations while using public bus transportation, such as using noise-cancelling headphones or digital applications for real-time route tracking, etc. These findings may lead to a more autism-friendly public transportation. [ABSTRACT FROM AUTHOR]

The educational services available for fully included middle schoolers with autism spectrum disorder (ASD) in the general education setting in the United States are not well known. Even less is known about how the executive functioning (EF) deficits of such youth are addressed in the classroom. The current study sought to identify the challenges, including EF, that middle schoolers with ASD face, determine the services that they receive on their Individualized Education Program (IEP), and also explore specific strategies used to build EF skills at school. A convenience data sample was obtained from focus groups with educational personnel (n = 15), and qualitative analyses of IEPs were conducted in middle schoolers with ASD with EF deficits (n = 23). Results confirmed that social communication and EF challenges are common. Multiple services and accommodations were identified, although EF challenges were rarely targeted on IEPs. Factors that may facilitate the success of EF strategies in the classroom are discussed. [ABSTRACT FROM AUTHOR]

Joint attention, or shared attention to an object or event, is a pivotal skill for the development of social interactions and social communication. Joint attention typically develops in natural contexts within the first year of life. Children with autism spectrum disorder (ASD) and related developmental disabilities often experience difficulty developing joint attention. Clinical interventions to increase joint attention exist. However, there are limited studies investigating methods to incorporate joint attention interventions in inclusive preschool classrooms with peers as social partners. For young children in preschool settings, peer-mediated social skills interventions reflect natural contingencies and may promote generalization. In this study, we employed a single-case multiple baseline across child–peer dyads design to evaluate the effects of a peer-mediated joint attention intervention for children with or at risk for ASD on response to joint attention (RJA) from peer bids and initiations of joint attention (IJA) from target children with ASD. The intervention included direct instruction with a social narrative to teach three peers to initiate bids for joint attention to measure target children's responses. Target children later received the same direct instruction to increase IJA to same-age-peers. Results indicate increased target child RJA and IJA to peers. Limitations and implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

While the effectiveness of parent-mediated interventions in the field of autism spectrum disorder is well documented, information on the experience of parents involved in parent-mediated interventions is limited. We performed a systematic review with qualitative evidence synthesis to explore the experience of parent-mediated interventions in parents of children with autism spectrum disorder. PubMed, Scopus, PsycINFO, CINAHL, and Sociology Collection were searched from the date of their creation until 25 February 2022. Qualitative studies reporting parents' experience of parent-mediated interventions were included. Two independent reviewers assessed the risk of bias. The findings of the selected studies were extracted and synthesized using the meta-aggregation method. The results are reported according to PRISMA and ENTREQ guidelines. A total of 23 studies were synthesized representing 345 participants. We found 34 categories that were summarized in four synthesized themes: barriers to implementation and logistical issues, feeling overwhelmed and stressed (a need for support), facilitators of implementation, and empowerment in the parent and improvement in the child. Parents' experience of parent-mediated interventions in autism spectrum disorder is balanced between positive outcomes for them and their child, emotional struggles, and some difficulties in implementing parent-mediated interventions. Based on these results, we propose new ways to improve implementation of parent-mediated interventions and research in the field. The effectiveness of parent-mediated interventions in the field of autism spectrum disorder is well documented but information on the experience of parents involved in parent-mediated interventions is limited. This study is the first synthesis of evidence concerning the experience of parents involved in parent-mediated interventions. It synthesizes the voice of 345 parents across the world into four general themes: barriers to implementation and logistical issues, feeling overwhelmed and stressed (a need for support), facilitators of implementation, and empowerment in the parent and improvement in the child. The findings of our study provide evidence that parent-mediated interventions should be adapted to the needs of each family. Specific care and support should be offered to parents in addition to parent-mediated interventions. Our study, however, highlights which outcomes are important to parents and should be considered in future studies. [ABSTRACT FROM AUTHOR]

Melatonin is one of the most used pharmacologic treatments for sleep problems in autism spectrum disorder, though its relationship with circadian and sleep parameters is still not well stablished. A naturalistic study was conducted in children with autism spectrum disorder, previously drug-naïve, before and after treatment with immediate-release melatonin. Circadian rhythms and sleep parameters were studied using an ambulatory circadian-monitoring device, and saliva samples were collected enabling determination of dim light melatonin onset. Twenty-six children with autism spectrum disorder (age 10.50 ± 2.91) were included. Immediate-release melatonin modified circadian rhythm as indicated by wrist skin temperature, showing an increase at night. A positive correlation was found between time of peak melatonin and sleep efficiency improvement values. Sleep-onset latency and efficiency improved with immediate-release melatonin. Immediate-release melatonin could be an effective treatment to improve sleep onset and restore a typical pattern of wrist temperature, which appears to be lost in autism spectrum disorder. [ABSTRACT FROM AUTHOR]