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Background: As a group, autistic children with high support needs (with adaptive functioning in the range of an intellectual disability) are at risk of significant literacy difficulties. We investigated the parent‐reported home literacy environment of this group of children. Method: Sixty‐two parents of autistic children (4.5 to 18.25 years) attending an autism‐specific school completed a home literacy survey reporting on their child's: (1) alphabet knowledge, (2) interest in reading, (3) activities/interactions around books, (4) reading ability, and (5) writing ability. Results: We found significant positive correlations between parent‐reported child interest in reading and literacy‐related interactions and skills, but not with child age. Children using spoken words to communicate obtained significantly greater scores on four home‐literacy subscales, but not on reading interest. Conclusions: A better understanding of the home literacy activities of autistic children with high‐support needs is needed to inform educational practices aimed at promoting literacy development in this vulnerable population. [ABSTRACT FROM AUTHOR]

Summary: We examined the comparability of children's nocturnal sleep estimates using accelerometry data, processed with and without a sleep log. In a secondary analysis, we evaluated factors associated with disagreement between processing approaches. Children (n = 722, age 5–12 years) wore a wrist‐based accelerometer for 14 days during Autumn 2020, Spring 2021, and/or Summer 2021. Outcomes included sleep period, duration, wake after sleep onset (WASO), and timing (onset, midpoint, waketime). Parents completed surveys including children's nightly bed/wake time. Data were processed with parent‐reported bed/wake time (sleep log), the Heuristic algorithm looking at Distribution of Change in Z‐Angle (HDCZA) algorithm (no log), and an 8 p.m.–8 a.m. window (generic log) using the R‐package 'GGIR' (version 2.6‐4). Mean/absolute bias and limits of agreement were calculated and visualised with Bland–Altman plots. Associations between child, home, and survey characteristics and disagreement were examined with tobit regression. Just over half of nights demonstrated no difference in sleep period between sleep log and no log approaches. Among all nights, the sleep log approach produced longer sleep periods (9.3 min; absolute mean bias [AMB] = 28.0 min), shorter duration (1.4 min; AMB = 14.0 min), greater WASO (11.0 min; AMB = 15.4 min), and earlier onset (13.4 min; AMB = 17.4 min), midpoint (8.8 min; AMB = 15.3 min), and waketime (3.9 min; AMB = 14.8 min) than no log. Factors associated with discrepancies included smartphone ownership, bedroom screens, nontraditional parent work schedule, and completion on weekend/summer nights (range = 0.4–10.2 min). The generic log resulted in greater AMB among sleep outcomes. Small mean differences were observed between nights with and without a sleep log. Discrepancies existed on weekends, in summer, and for children with smartphones and screens in the bedroom. [ABSTRACT FROM AUTHOR]

Development of standardized diagnostic instruments has facilitated the systematic characterization of individuals with autism spectrum disorders (ASD) in clinical and research settings. However, overemphasis on scores from specific instruments has significantly detracted from the original purpose of these tools. Rather than provide a definitive "answer," or even a confirmation of diagnosis, standardized diagnostic instruments were designed to aid clinicians in the process of gathering information about social communication, play, and repetitive and sensory behaviors relevant to diagnosis and treatment planning. Importantly, many autism diagnostic instruments are not validated for certain patient populations, including those with severe vision, hearing, motor, and/or cognitive impairments, and they cannot be administered via a translator. In addition, certain circumstances, such as the need to wear personal protective equipment (PPE), or behavioral factors (e.g., selective mutism) may interfere with standardized administration or scoring procedures, rendering scores invalid. Thus, understanding the uses and limitations of specific tools within specific clinical or research populations, as well as similarities or differences between these populations and the instrument validation samples, is paramount. Accordingly, payers and other systems must not mandate the use of specific tools in cases when their use would be inappropriate. To ensure equitable access to appropriate assessment and treatment services, it is imperative that diagnosticians be trained in best practice methods for the assessment of autism, including if, how, and when to appropriately employ standardized diagnostic instruments. [ABSTRACT FROM AUTHOR]

The objectives of this study were to (1) demonstrate the application of percentiles to advance the interpretation of patient‐reported outcomes and (2) establish autism‐specific percentiles for four Patient‐Reported Outcomes Measurement Information System (PROMIS) measures. PROMIS measures were completed by parents of autistic children and adolescents ages 5–17 years as part of two studies (n = 939 parents in the first study and n = 406 parents in the second study). Data from the first study were used to develop autism‐specific percentiles for PROMIS parent‐proxy sleep disturbance, sleep‐related impairment, fatigue, and anxiety. Previously established United States general population percentiles were applied to interpret PROMIS scores in both studies. Results of logistic regression models showed that parent‐reported material hardship was associated with scoring in the moderate–severe range (defined as ≥75th percentile in the general population) on all four PROMIS measures (odds ratios 1.7–2.2). In the second study, the percentage of children with severe scores (defined as ≥95th percentile in the general population) was 30% for anxiety, 25% for sleep disturbance, and 17% for sleep‐related impairment, indicating a high burden of these problems among autistic children. Few children had scores at or above the autism‐specific 95th percentile on these measures (3%–4%), indicating that their scores were similar to other autistic children. The general population and condition‐specific percentiles provide two complementary reference points to aid interpretation of PROMIS scores, including corresponding severity categories that are comparable across different PROMIS measures. Lay Summary: Patient‐reported outcome measures are used to assess patients' health from the perspective of patients and their families, but it can be difficult to interpret scores on these measures. This study demonstrated how percentiles may help clinicians and others understand patient‐reported outcome scores for children on the autism spectrum. [ABSTRACT FROM AUTHOR]

Alexithymia refers to pronounced difficulty in identifying and describing one's own emotions and is associated with an externally oriented focus of thinking. Alexithymia is known to be much more common in adults with autism spectrum disorders (ASD) compared with the typically developing (TD) adult population. However, we know very little about alexithymia in young children with ASD and advancing our understanding of this topic may be of critical clinical and translational importance. Here, we present the first study to examine alexithymia in children with ASD. We find that alexithymia is substantially elevated in ASD on both self- and parent-report measures. Despite both measures being sensitive to on-average group differentiation, we find no evidence of correlation between such measures, indicating that children and their parents may be using different sources of information. Parent-rated alexithymia is also associated with increasing levels of autistic traits. Discrepancy between self and other alexithymia ratings are also associated with autistic traits, but only in ASD. These results underscore the idea that assessing alexithymia in ASD at younger ages may help identify important subgroups that have particular difficulties in the domain of emotion processing. Autism Res 2016, 9: 773-780. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]