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2. Clinically Significant Anxiety in Children with Autism Spectrum Disorder and Varied Intellectual Functioning

Author

Kerns, Connor M, Winder-Patel, Breanna, Iosif, Ana Maria, Nordahl, Christine Wu, Heath, Brianna, Solomon, Marjorie, and Amaral, David G

Subjects
Clinical and Health Psychology, Psychology, Mental Illness, Autism, Pediatric, Intellectual and Developmental Disabilities (IDD), Behavioral and Social Science, Mental Health, Anxiety Disorders, Clinical Research, Brain Disorders, 4.2 Evaluation of markers and technologies, Mental health, Adolescent, Anxiety, Autism Spectrum Disorder, Child, Cognition, Humans, Phobic Disorders, Cognitive Sciences, Developmental & Child Psychology, Applied and developmental psychology, Clinical and health psychology, Social and personality psychology
Abstract

Objective: To evaluate how distinct presentations of anxiety symptoms and intellectual impairment influence the measurement and estimated rate of clinically significant anxiety in autism spectrum disorder (ASD).Method: The sample included 75 children (ages 9-13 years) with ASD and varied IQ and 52 typically developing (TD) controls and parents. Parents completed anxiety symptom scales and a diagnostic interview, designed to (1) differentiate anxiety and ASD and (2) examine DSM-specified and unspecified ("distinct") anxiety presentations in each child, including fears of change, special interests, idiosyncratic stimuli and social confusion rather than evaluation. Children completed standard intellectual and ASD diagnostic assessments.Results: 69% of those with ASD had clinically-significant anxiety, including 21% DSM-specified anxiety disorders, 17% distinct anxiety, and 31% both. Only 8% of TD children had clinically-significant anxiety, all DSM-specified. DSM-specified anxiety disorders in children with ASD and intellectual impairment (IQ

Published
2021

3. Clinically Significant Anxiety in Children with Autism Spectrum Disorder and Varied Intellectual Functioning.

Author

Kerns, Connor M, Winder-Patel, Breanna, Iosif, Ana Maria, Nordahl, Christine Wu, Heath, Brianna, Solomon, Marjorie, and Amaral, David G

Subjects
Pediatric, Intellectual and Developmental Disabilities (IDD), Clinical Research, Autism, Behavioral and Social Science, Mental Health, Brain Disorders, 2.3 Psychological, social and economic factors, Mental health, Developmental & Child Psychology, Psychology, Cognitive Sciences
Abstract

Objective: To evaluate how distinct presentations of anxiety symptoms and intellectual impairment influence the measurement and estimated rate of clinically significant anxiety in autism spectrum disorder (ASD).Method: The sample included 75 children (ages 9-13 years) with ASD and varied IQ and 52 typically developing (TD) controls and parents. Parents completed anxiety symptom scales and a diagnostic interview, designed to (1) differentiate anxiety and ASD and (2) examine DSM-specified and unspecified ("distinct") anxiety presentations in each child, including fears of change, special interests, idiosyncratic stimuli and social confusion rather than evaluation. Children completed standard intellectual and ASD diagnostic assessments.Results: 69% of those with ASD had clinically-significant anxiety, including 21% DSM-specified anxiety disorders, 17% distinct anxiety, and 31% both. Only 8% of TD children had clinically-significant anxiety, all DSM-specified. DSM-specified anxiety disorders in children with ASD and intellectual impairment (IQ

Published
2020

5. Usual care for youth with autism spectrum disorder: Community-based providers’ reported familiarity with treatment practices

Author

Lerner, Matthew D., primary, Brown, Cynthia E., additional, Sridhar, Aksheya, additional, Tschida, Jessica E., additional, Felsman, Peter, additional, Libsack, Erin J., additional, Kerns, Connor M., additional, Moskowitz, Lauren J., additional, Soorya, Latha, additional, Wainer, Allison, additional, Cohn, Elizabeth, additional, and Drahota, Amy, additional

Published
2022
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8. Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism

Author

Tesfaye, Rackeb, Wright, Nicola, Zaidman-Zait, Anat, Bedford, Rachael, Zwaigenbaum, Lonnie, Kerns, Connor M, Duku, Eric, Mirenda, Pat, Bennett, Teresa, Georgiades, Stelios, Smith, Isabel M, Vaillancourt, Tracy, Pickles, Andrew, Szatmari, Peter, Elsabbagh, Mayada, Tesfaye, Rackeb, Wright, Nicola, Zaidman-Zait, Anat, Bedford, Rachael, Zwaigenbaum, Lonnie, Kerns, Connor M, Duku, Eric, Mirenda, Pat, Bennett, Teresa, Georgiades, Stelios, Smith, Isabel M, Vaillancourt, Tracy, Pickles, Andrew, Szatmari, Peter, and Elsabbagh, Mayada

Abstract

Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF difficulties in ASD are exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. A subsample (n = 217) from the Pathways in ASD longitudinal study was analyzed. The Children’s Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (mean = 3.5 years). Metacognition (MI) and Behavioral Regulation (BRI) indices, on the Teacher Behavior Rating Inventory of Executive Functioning, were used to measure cognitive and affective components of EF respectively at four time-points (7.8–11.8 years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (mean = 6.7 years). Sleep traits had different age-related impacts on behavioral regulation, but not metacognition. Longer sleep onset at 3.5 years was associated with a worsening BRI difficulties slope (b = 2.07, p < 0.04), but conversely associated with lower BRI difficulties at 7.7 years (b = −4.14, p = 0.04). A longer sleep onset at 6.7 years was related to higher BRI difficulties at 7.7 years (b = 7.78, p < 0.01). Longer sleep duration at 6.7 years was associated with higher BRI difficulties at age 7.7 (b = 3.15, p = 0.01), but subscale analyses revealed shorter sleep duration at age 6.7 was linked to a worsening inhibition slope (b = −0.60, p = 0.01). Sleep onset is a robust early correlate of behavior regulation in children with ASD, whereas sleep duration is a later childhood correlate.

Published
2021

9. Association of Child and Family Attributes With Outcomes in Children With Autism

Author

Szatmari, Peter, primary, Cost, Katherine Tombeau, additional, Duku, Eric, additional, Bennett, Teresa, additional, Elsabbagh, Mayada, additional, Georgiades, Stelios, additional, Kerns, Connor M., additional, Mirenda, Pat, additional, Smith, Isabel M., additional, Ungar, Wendy J., additional, Vaillancourt, Tracy, additional, Waddell, Charlotte, additional, Zaidman-Zait, Anat, additional, and Zwaigenbaum, Lonnie, additional

Published
2021
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10. Co-occurring trajectories of anxiety and insistence on sameness behaviour in autism spectrum disorder

Author

Baribeau, Danielle A., primary, Vigod, Simone, additional, Pullenayegum, Eleanor, additional, Kerns, Connor M., additional, Mirenda, Pat, additional, Smith, Isabel M., additional, Vaillancourt, Tracy, additional, Volden, Joanne, additional, Waddell, Charlotte, additional, Zwaigenbaum, Lonnie, additional, Bennett, Teresa, additional, Duku, Eric, additional, Elsabbagh, Mayada, additional, Georgiades, Stelios, additional, Ungar, Wendy J., additional, Zaidman Zait, Anat, additional, and Szatmari, Peter, additional

Published
2020
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11. Co-occurring trajectories of anxiety and insistence on sameness behaviour in autism spectrum disorder.

Author

Baribeau, Danielle A., Vigod, Simone, Pullenayegum, Eleanor, Kerns, Connor M., Mirenda, Pat, Smith, Isabel M., Vaillancourt, Tracy, Volden, Joanne, Waddell, Charlotte, Zwaigenbaum, Lonnie, Bennett, Teresa, Duku, Eric, Elsabbagh, Mayada, Georgiades, Stelios, Ungar, Wendy J., Zaidman Zait, Anat, and Szatmari, Peter

Subjects
AUTISM spectrum disorders, CHILDREN with autism spectrum disorders, CHILD Behavior Checklist, ACUTE stress disorder, ANXIETY, RESEARCH, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, COMPARATIVE studies, AUTISM, SCHOOLS, RESEARCH funding, ANXIETY disorders
Abstract

Background: Children with autism spectrum disorder (ASD) have increased susceptibility to anxiety disorders. Variation in a common ASD symptom, insistence on sameness behaviour, may predict future anxiety symptoms.Aims: To describe the joint heterogeneous longitudinal trajectories of insistence on sameness and anxiety in children with ASD and to characterise subgroups at higher risk for anxiety.Method: In a longitudinal ASD cohort (n = 421), insistence on sameness behaviour was measured using the Autism Diagnostic Interview-Revised at approximately ages 3, 6 and 11 years. Anxiety was quantified at 8 time points between ages 3 and 11 years using the Child Behavior Checklist (CBCL) (parent report). Clusters of participants following similar trajectories were identified using group-based and joint trajectory modelling.Results: Three insistence on sameness trajectories were identified: (a) 'low-stable' (41.7% of participants), (b) 'moderate-increasing' (52.0%) and (c) 'high-peaking' (i.e. increasing then stabilising/decreasing behaviour) (6.3%). Four anxiety trajectories were identified: (a) 'low-increasing' (51.0%), (b) 'moderate-decreasing' (16.2%), (c) 'moderate-increasing' (19.6%) and (d) 'high-stable' (13.1%). Of those assigned to the 'high-peaking' insistence on sameness trajectory, 95% jointly followed an anxiety trajectory that surpassed the threshold for clinical concern (T-score >65) by middle childhood (anxiety trajectories 3 or 4). Insistence on sameness and anxiety trajectories were similar in severity and direction for 64% of the sample; for 36%, incongruous patterns were seen (e.g. decreasing anxiety and increasing insistence on sameness).Conclusions: The concurrent assessment of insistence on sameness behaviour and anxiety in ASD may help in understanding current symptom profiles and anticipating future trajectories. High preschool insistence on sameness in particular may be associated with elevated current or future anxiety symptoms. [ABSTRACT FROM AUTHOR]

Published
2021
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12. Short report: Therapeutic alliance in youth with autism spectrum disorder receiving cognitive-behavioral treatment for anxiety

Author

Kerns, Connor M., Collier, Amanda, Lewin, Adam B., and Storch, Eric A

Subjects
Male, Obsessive-Compulsive Disorder, Cognitive Behavioral Therapy, Autism Spectrum Disorder, Therapeutic Alliance, Phobia, Social, behavioral disciplines and activities, Anxiety Disorders, Article, Treatment Outcome, Anxiety, Separation, mental disorders, Humans, Female, Child
Abstract

Symptoms of autism spectrum disorder may influence alliance in psychotherapy. This study examined therapeutic alliance and its relationship with child characteristics and anxiety treatment outcomes in youth with autism spectrum disorder. Youth ( N = 64) with autism spectrum disorder and co-occurring anxiety (7-16 years, IQ 70) received 16 sessions of modular cognitive-behavioral therapy. Post-treatment therapist, youth and parent ratings of alliance as well as pre- and post-treatment ratings of child behavior were gathered. Ratings of alliance were commensurate to ratings seen in children without autism spectrum disorder. Measures of treatment outcome, but not pretreatment characteristics, were significantly associated with therapist ratings of alliance strength. Data suggest that therapeutic alliance may not be impaired in anxious youth with autism spectrum disorder and may be associated with treatment outcome.

Published
2017

13. Anxiety Disorders and Obsessive-Compulsive Disorders (OCD)

Author

Maddox, Brenna B., Kerns, Connor M., Franklin, Martin E., White, Susan W., Maddox, Brenna B., Kerns, Connor M., Franklin, Martin E., and White, Susan W.

Abstract

Anxiety is known to be a commonly, co-occurring phenomenon with autism. Also, in daily practice, these symptoms often are confused with core symptoms of autism. Accurately determining OCD and anxiety from autism has important implications for treatment. This chapter reviews current methods and procedures available to help make these distinctions.

Published
2016
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14. Anxiety Disorders and Obsessive-Compulsive Disorders (OCD)

Author

Psychology, Maddox, Brenna B., Kerns, Connor M., Franklin, Martin E., White, Susan W., Psychology, Maddox, Brenna B., Kerns, Connor M., Franklin, Martin E., and White, Susan W.

Abstract

Anxiety is known to be a commonly, co-occurring phenomenon with autism. Also, in daily practice, these symptoms often are confused with core symptoms of autism. Accurately determining OCD and anxiety from autism has important implications for treatment. This chapter reviews current methods and procedures available to help make these distinctions.

Published
2016

15. Autism.

Author

Baribeau, Danielle, Smith, Isabel M., Kerns, Connor M., Bennett, Teresa, and Zwaigenbaum, Lonnie

Subjects
*NEURODIVERSITY, *SERIAL publications, *MENTAL health, *SEX distribution, *AUTISM in children
Abstract

The article offers recommendations from autism experts to pay attention on recent critical articles focused on autism including Dr. Danielle Baribeau, Dr. Isabel Smith and Professor Connor M. Kerns.

Published
2023

16. Examining clinical characteristics of autism and links with parent perceptions of sibling relationship quality

Author

Alana J McVey, Quinn Liu, Saashi A Bedford, Anat Zaidman-Zait, Peter Szatmari, Isabel M Smith, Tracy Vaillancourt, Lonnie Zwaigenbaum, Teresa Bennett, Eric Duku, Mayada Elsabbagh, Stelios Georgiades, Connor M Kerns, McVey, Alana J [0000-0001-7651-8541], Zaidman-Zait, Anat [0000-0002-2336-5147], Smith, Isabel M [0000-0001-5525-2123], Elsabbagh, Mayada [0000-0002-7311-9059], Kerns, Connor M [0000-0003-0832-8329], and Apollo - University of Cambridge Repository

Subjects
Parents, sibling relationships, behavioral difficulties, Autism Spectrum Disorder, Siblings, Developmental and Educational Psychology, school-age children, Humans, Sibling Relations, communication and language, Longitudinal Studies, Autistic Disorder, Child
Abstract

Peer reviewed: True, Funder: Sinneave Family Foundation; FundRef: https://doi.org/10.13039/100012204, Funder: alberta innovates - health solutions; FundRef: https://doi.org/10.13039/501100000145, Funder: Kids Brain Health Network; FundRef: https://doi.org/10.13039/501100015741, Funder: Government of British Columbia, Funder: Autism Speaks; FundRef: https://doi.org/10.13039/100000073, Sibling relationship quality is important for the well-being of children on the autism spectrum and their siblings. Little is known, however, about how varied behavior and abilities of children on the autism spectrum may be associated with parent perceptions of domains of sibling relationship quality. We drew data from a subsample of 119 children on the autism spectrum (ages 10-11 years), participating in an ongoing longitudinal study. We looked at how three clinical characteristics (autism symptoms, behavioral difficulties, and communication ability) related to four areas of parent-reported sibling relationship quality (warmth/closeness, conflict, relative status/power, and rivalry). We also examined whether the strength of the association between behavioral difficulties and parent-reported sibling relationship quality was influenced by communication ability. We found that more severe autism symptoms were associated with less conflict and rivalry, and higher communication ability was associated with more relative status/power. We also found that children on the autism spectrum with more behavioral difficulties and weaker communication ability had less warmth/closeness in their sibling relationships. Our findings highlight that it is important to consider autism symptoms, behavioral difficulties, and communication ability, as well as multiple domains of relationship quality, to better understand how parents view the relationships between autistic children and their siblings. Clinically, methods for improving sibling relationships may include teaching conflict resolution strategies to children on the autism spectrum with stronger communication abilities and their siblings, and fostering sibling connection for those with lower communication abilities.

Published
2023

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