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Expert face processes are refined and tuned through a protracted development. Exposure statistics of the daily visual experience of neurotypical adults (the face diet) show substantial exposure to familiar faces. People with autism spectrum disorder (ASD) do not show the same expertise with faces as their non-autistic counterparts. This may be due to an impoverished visual experience with faces, according to experiential models of autism. Here, we present the first empirical report on the day-to-day visual experience of the faces of adults with ASD. Our results, based on over 360 h of first-person perspective footage of daily exposure, show striking qualitative and quantitative differences in the ASD face diet compared with those of neurotypical observers, which is best characterized by a pattern of reduced and atypical exposure to familiar faces in ASD. Specifically, duration of exposure to familiar faces was lower in ASD, and faces were viewed from farther distances and from viewpoints that were biased toward profile pose. Our results provide strong evidence that individuals with ASD may not be getting the experience needed for the typical development of expert face processes., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.) more...

This study aimed to investigate the phonological awareness (PA) skills of school age autistic children (age range = 6-12) in two parts: (1) comparing their performance on a PA task to non-autistic children with groups matched on chronological age, verbal and non-verbal cognitive skills, and (2) exploring the role of cognitive skills and autism characteristics on PA skills. Results revealed that the groups did not differ in their PA skills (study 1) and that perceptual reasoning skills are associated with the PA skills of autistic participants (study 2). Results highlight the role of non-verbal cognitive skills in literacy development for autistic children and suggest that their perceptual reasoning abilities likely contribute a great deal when learning to read., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) more...

Difficulties in various face processing tasks have been well documented in autism spectrum disorder (ASD). Several meta-analyses and numerous case-control studies have indicated that this population experiences a moderate degree of impairment, with a small percentage of studies failing to detect any impairment. One possible account of this mixed pattern of findings is heterogeneity in face processing abilities stemming from the presence of a subpopulation of prosopagnosic individuals with ASD alongside those with normal face processing skills. Samples randomly drawn from such a population, especially relatively smaller ones, would vary in the proportion of participants with prosopagnosia, resulting in a wide range of group-level deficits from mild (or none) to severe across studies. We test this prosopagnosic subpopulation hypothesis by examining three groups of participants: adults with ASD, adults with developmental prosopagnosia (DP), and a comparison group. Our results show that the prosopagnosic subpopulation hypothesis does not account for the face impairments in the broader autism spectrum. ASD observers show a continuous and graded, rather than categorical, heterogeneity that span a range of face processing skills including many with mild to moderate deficits, inconsistent with a prosopagnosic subtype account. We suggest that pathogenic origins of face deficits for at least some with ASD differ from those of DP., (© 2023 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.) more...

Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) more...

Background: Oxytocin is a neuropeptide hormone that plays a key role in social behavior, stress regulation, and mental health. Synthetic oxytocin administration is a common obstetrical practice, and importantly, previous research has suggested that intrapartum exposure may increase the risk of neurodevelopmental disorders, such as autism spectrum disorder., Objective: This study aimed to examine the association between synthetic oxytocin exposure during labor and autism spectrum disorder diagnosis in the child., Study Design: This population-based retrospective cohort study compared 2 cohorts of children: (1) all children born in British Columbia, Canada between April 1, 2000 and December 31, 2014 (n=414,336 births), and (2) all children delivered at Soroka University Medical Center in Be'er-Sheva, Israel between January 1, 2011 and December 31, 2019 (n=82,892 births). Nine different exposure groups were examined. Cox proportional hazards models were used to estimate crude and adjusted hazard ratios of autism spectrum disorder in both cohorts on the basis of induction and/or augmentation exposure status. To further control for confounding by indication, we conducted sensitivity analyses among a cohort of healthy, uncomplicated deliveries and among a group that was induced only for postdates. In addition, we stratified our analyses by infant sex to assess for potential sex differences., Results: In the British Columbia cohort, 170,013 of 414,336 deliveries (41.0%) were not induced or augmented, 107,543 (26.0%) were exposed to oxytocin, and 136,780 (33.0%) were induced or augmented but not exposed to oxytocin. In the Israel cohort, 51,790 of 82,892 deliveries (62.5%) were not induced or augmented, 28,852 (34.8%) were exposed to oxytocin, and 2250 (2.7%) were induced or augmented but not exposed to oxytocin. On adjusting for covariates in the main analysis, significant associations were observed in the Israel cohort, including adjusted hazard ratios of 1.51 (95% confidence interval, 1.20-1.90) for oxytocin-augmented births and 2.18 (95% confidence interval, 1.32-3.57) for those induced by means other than oxytocin and not augmented. However, oxytocin induction was not significantly associated with autism spectrum disorder in the Israel cohort. In the Canadian cohort, there were no statistically significant adjusted hazard ratios. Further, no significant sex differences were observed in the fully adjusted models., Conclusion: This study supports that induction of labor through oxytocin administration does not increase the risk of autism spectrum disorder in the child. Our international comparison of 2 countries with differences in clinical practice regarding oxytocin administration for induction and/or augmentation suggests that previous studies reporting a significant association were likely confounded by the underlying indication for the induction., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.) more...

Lay Abstract: The experiences of coping in parents of autistic children have been extensively studied in the literature. While this research has identified both effective and ineffective coping strategies used by caregivers, no studies to date have examined how coping strategies used by parents might be linked to family quality of life outcomes. Furthermore, few studies exist examining both coping strategies and family quality of life in culturally and linguistically diverse populations. Thus, this study aimed to address both limitations. A total of 12 Korean immigrant parents of autistic children, 6 representing the high family quality of life group and 6 representing the low family quality of life group, shared their experiences related to coping and managing stress. Responses fell under three broad categories (problem-focused, emotion-focused, and adjustment-focused) with differences observed when comparing the high versus low family quality of life groups. A better understanding of the link between coping strategies and family quality of life outcomes may help identify effective and culturally sensitive supports for caregivers and families to improve their quality of life and well-being. more...

Decreased sound tolerance (DST) is the most common sensory difficulty experienced by autistic individuals. Parents of 88 autistic children and young adults between the ages of 3 and 30 described coping strategies and physical and emotional responses used to deal with distressing sounds, and their impact on daily activities. Loud, sudden, and high-pitched sounds were most commonly endorsed as distressing, most often causing autistic children and young adults to cover their ears or yell, while producing stress, irritation, fear, and anxiety. Parents reported warning their child, providing breaks, or avoiding noisy settings as the most used coping strategies. Overall, findings indicate that DST leads to fewer opportunities for autistic children and young adults to participate at home, at school, and in the community. Further, results suggest hyperacusis, misophonia, and phonophobia, subtypes of DST, are present in autistic children and young adults., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) more...

Children with autism spectrum disorder (ASD) experience difficulties with social communication, making it challenging to interpret contextual information that aids in accurately interpreting language. To investigate how the brain processes the contextual information and how this is different in ASD, we compared event-related potentials (ERPs) in response to processing visual and auditory congruent and incongruent information. Two groups of children participated in the study: 37 typically developing children and 15 children with ASD (age range = 6 to 12). We applied a language task involving auditory sentences describing congruent or incongruent images. We investigated two ERP components associated with language processing: the N400 and P600. Our results showed how children with ASD present significant differences in their neural responses in comparison with the TD group, even when their reaction times and correct trials are not significantly different from the TD group., (© 2022. The Author(s).) more...

Lay Abstract: Perceptions and experiences of culturally and linguistically diverse groups in accessing autism services in Canada are extremely limited. Thus, this study partnered with a community member to explore Korean immigrant parents' perceptions of barriers and facilitators to accessing autism services in British Columbia, Canada. Interviews were conducted with 20 Korean parents of autistic children. Barriers and facilitators at the system, provider, and family/cultural level were identified. Barriers at the system level included delays and waitlists for services, and ineffective school policies to address child behavioral challenges. At the provider level, barriers included a lack of qualified professionals, negative attitudes, and lack of guidance navigating services. For family/cultural-related barriers, these included language and communication difficulties, out-of-pocket costs, and stigma impeded service access. Facilitators at the system level included family-centered care and prioritization of mental health supports. At the provider level, strengths included culturally competent and bilingual professionals. The family/cultural-related facilitators identified were informal support networks, characteristics of the parent, and connections to cultural community organizations. The findings emphasize the need to understand and consider diverse experiences, preferences, and values in the design and provision of autism services for families and their children. more...

Lay Abstract: The purpose of this study was to compare Korean immigrant families and Canadian families of children with autism in their perceptions and definitions of family quality of life. Interviews were done with 13 Korean immigrant parents and 12 Canadian parents of children with autism living in BC, Canada. For Korean immigrant families, three themes were identified: family cohesiveness, value orientation, and acceptance from society. For Canadian families, themes comprising family interactions, support, emotional well-being, individual characteristics, and comparisons to other families were essential elements in defining their family quality of life. The findings emphasize how differences in culture may impact how we understand and assess family functioning and quality of life. If research informing the development of these tools lacks cross-cultural perspectives, service providers and professionals may fail to address these families' unique needs. more...

This study examined involuntary capture of attention, overt attention, and stimulus valence and arousal ratings, all factors that can contribute to potential attentional biases to face and train objects in children with and without autism spectrum disorder (ASD). In the visual domain, faces are particularly captivating, and are thought to have a 'special status' in the attentional system. Research suggests that similar attentional biases may exist for other objects of expertise (e.g. birds for bird experts), providing support for the role of exposure in attention prioritization. Autistic individuals often have circumscribed interests around certain classes of objects, such as trains, that are related to vehicles and mechanical systems. This research aimed to determine whether this propensity in autistic individuals leads to stronger attention capture by trains, and perhaps weaker attention capture by faces, than what would be expected in non-autistic children. In Experiment 1, autistic children (6-14 years old) and age- and IQ-matched non-autistic children performed a visual search task where they manually indicated whether a target butterfly appeared amongst an array of face, train, and neutral distractors while their eye-movements were tracked. Autistic children were no less susceptible to attention capture by faces than non-autistic children. Overall, for both groups, trains captured attention more strongly than face stimuli and, trains had a larger effect on overt attention to the target stimuli, relative to face distractors. In Experiment 2, a new group of children (autistic and non-autistic) rated train stimuli as more interesting and exciting than the face stimuli, with no differences between groups. These results suggest that: (1) other objects (trains) can capture attention in a similar manner as faces, in both autistic and non-autistic children (2) attention capture is driven partly by voluntary attentional processes related to personal interest or affective responses to the stimuli., Competing Interests: The authors have declared that no competing interests exist. more...

Alexithymia is characterized by difficulties identifying and describing one's own emotions and the emotions of others. These challenges with understanding emotions in people with alexithymia may give rise to difficulties with social interactions. Given that alexithymia frequently co-occurs with autism spectrum disorder (ASD), and that both populations have difficulties with social interactions, it is of interest to determine whether alexithymia can help to parse some of the heterogeneity in social competence in autistic and nonautistic individuals. The caregivers of 241 children (6-14 years old), including 120 autistic, and 121 nonautistic, rated their child's social competence using the Multidimensional Social Competence Scale (MSCS), autism traits using the Autism Spectrum Quotient (AQ), and alexithymia traits using the Children's Alexithymia Measure (CAM). Regression analyses indicated that age, IQ, sex, AQ, and CAM scores accounted for 40.2% of the variance in autistic children's, and 68.2% of the variance in nonautistic children's, parent-reported social competence. Importantly, after controlling for age, IQ, sex, and AQ scores, CAM scores alone accounted for an additional 16.2% of the variance in autistic children's, and 17.4% of the variance in nonautistic children's social competence. These results indicate that higher alexithymia traits predict lower levels of social competence, suggesting that increased difficulty in identifying and describing one's own emotions and the emotions of others is associated with poorer social competence. Furthermore, CAM scores were found to partially mediate the relationship between autistic traits and social competence, suggesting that comorbid alexithymia traits may be partially responsible for poor social competence in individuals with high autistic traits. This research contributes to the understanding of the factors associated with the development of social competence and highlights alexithymia as a potential target for identification and intervention to improve social competence. LAY SUMMARY: Alexithymia is a condition where people find it hard to think and talk about their (and others') feelings. About 50% of autistic people have alexithymia. This might be why they have social and emotional difficulties. Parents answered questions about alexithymia and social difficulties their children have. Children with more alexithymia problems had poorer social skills. Thus, alexithymia may be related to social problems faced by autistic and nonautistic children., (© 2021 International Society for Autism Research, Wiley Periodicals LLC.) more...

Lay Abstract: Using self-report questionnaires is an important method in the assessment and treatment of children with autism. Self-reports can provide unique information about children's feelings and thoughts that is not available through other methods such as parent-reports. However, many clinicians are not sure whether children with autism can provide accurate self-reports. To study this, we examined 139 children and youth with and without autism aged 8-17 years. We looked at the effect of having autism, as well as other factors such as age, intelligence quotient, and attention problems on the validity of self-reports in these children. We examined if the children gave overly negative or positive answers and if they responded to the questions randomly or without paying attention. We found that children with autism can provide acceptable self-reports. However, they have more validity problems compared to their peers without autism. Our findings showed that this difference might be related to having attention problems in addition to autism, rather than having autism by itself. Children, with and without autism spectrum disorder, with fewer attention problems and higher intelligence quotient scores and those in the older age group, showed better validity. This article suggests that clinicians can use self-report measures for children with autism, but they should pay attention to important factors such as children's intelligence quotient and attention problems. more...

We present this article as a testament to Ed Zigler's commitment to science in the service of humanity and to policy based on conceptually compelling theory and methodologically rigorous science. In doing so, we highlight ways that Ed's universal and inclusive developmental world view, early training as a behaviorist, exacting scientific standards, concern for others, and appreciation of his own roots and upbringing all transformed the way that many different groups of people of all ages and backgrounds are studied, viewed, and intervened with by researchers, policy makers, and society at large. Ed's narrative of development rather than defect, universality rather than difference, and holistic rather than reductionist continues to compel us in the quest for a kinder, more inclusive, and enabling society. Conversely, Ed's behaviorist training as a graduate student also influenced him throughout his career and was essential to his career-long commitment to systemic action in the service of improving the lives of others. We cite the lessons that we, as his descendants, learned from Ed and apply them to our own areas of research with populations that Ed did not study, but had considerable interest in - persons with autism spectrum disorder and Indigenous youth. more...

Lay Abstract: The study of resilience among individuals with disabilities and their families represents a paradigmatic shift from a deficits orientation towards a more holistic and contextualized approach focused on strength and adaptation. The current study investigated whether informal supports could help improve families' capacity for resilience. We recruited 153 caregivers of children aged between 2 and 18 years who all had a diagnosis of autism. Participants were asked to complete surveys assessing resilience in their families as well as their satisfaction with informal supports (e.g. friends and family). Families more likely to report higher satisfaction with their informal support networks demonstrate greater resilience. The results suggest that informal social supports are a valuable resource for families in strengthening their capacity for resilience. The findings may help inform the development of interventions and services that work collaboratively and innovatively with families and their social networks to provide assistance and support in meaningful and effective ways. more...

"Joint action"-the ability to coordinate actions with others-is critical for achieving individual and interpersonal goals and for our collective success as a species. Joint actions require accurate and rapid inferences about others' goals, intentions, and focus of attention, skills that are thought to be impaired in individuals with autism spectrum disorder (ASD). Research to date has not investigated joint action abilities in individuals with ASD during real-world social interactions. We conducted an experimental study that required children with ASD and typically developing children to move tables by themselves or collaboratively through a maze. This involved developing innovative methodologies for measuring action coordination-a critical component of the joint action process. We found that children with ASD are less likely to benefit from the collaboration of a peer than are typically developing children, and they are less likely to synchronize their steps when moving the table. However, these differences were masked when scaffolded by an adult. There was no evidence that ASD differences were due to gross motor delays in the participants with ASD. We argue that action coordination is a highly adaptive social process that is intrinsic to successful human functioning that manifests as atypical synchronization of mind and body in children with ASD. more...

All children with autism spectrum disorder (ASD) experience social difficulties but they differ with regard to the type and severity of their challenges. Potentially powerful interventions targeting social skills in children with ASD may have limited effectiveness if they are not tailored to the child's specific needs. One factor that may influence social competence is executive functioning (EF). EF may impact social competence by facilitating higher-order strategies such as emotional and cognitive regulation which are necessary for social interactions. Participants included 132 children and adolescents, aged 7-13, including 77 with ASD (M = 10.11, SD = 1.94), and 55 without ASD (M = 9.54, SD = 1.67). Caregivers completed the Behavior Rating Inventory of Executive Functioning, Version 2 (BRIEF-2) Parent Form, assessing everyday EF skills, and the Multidimensional Social Competence Scale (MSCS). Hierarchical multiple regression analyses were conducted separately for the group without ASD and the group with ASD, with MSCS entered as the dependent variables and EF indices and scales of the BRIEF-2 as the main predictor variables. EF deficits in emotional control predicted poor emotion regulation for both children with and without ASD. For the group without ASD, better emotional control and initiation skills predicted empathic concern and social knowledge, respectively. Challenges in self-monitoring significantly predicted difficulties with social inferencing and social knowledge for children with ASD. The findings highlight the importance of targeting specific EF skills that contribute to various aspects of social competence to increase the effectiveness of interventions for children with ASD. Autism Res 2020, 13: 1856-1866. © 2020 International Society for Autism Research and Wiley Periodicals LLC LAY SUMMARY: We examined whether parents' ratings of their children's higher-order thinking skills (e.g., paying attention, organizing and planning, initiating tasks, regulating emotions, self-monitoring) predicted social competence among children with and without autism spectrum disorder (ASD). For children without ASD, emotional control and initiation skills were strongly linked to their displays of empathy and social knowledge, respectively. For children with ASD, their abilities to be aware of their own behaviors and its impact on others were strongly related to their ability to interpret social cues and their social knowledge. For both groups, the ability to regulate their emotions were important predictors of their ability to modulate their emotions in social contexts., (© 2020 International Society for Autism Research and Wiley Periodicals LLC.) more...

Autism spectrum disorder (ASD) is a developmental disorder characterized by persistent deficits in social communication and interaction. Speech is an important form of social communication. Prosody (e.g. vocal pitch, rhythm, etc.), one aspect of the speech signal, is crucial for ensuring information about the emotionality, excitability, and intent of the speaker, is accurately expressed. The objective of this study was to gain a better understanding of how auditory information is used to regulate speech prosody in autistic and non-autistic children, while exploring the relationship between the prosodic control of speech and social competence. Eighty autistic (M = 8.48 years, SD = 2.55) and non-autistic (M = 7.36 years, SD = 2.51) participants produced vocalizations while exposed to unaltered and frequency altered auditory feedback. The parent-report Multidimensional Social Competence Scale was used to assess social competence, while the Autism-Spectrum Quotient and the Autism Spectrum Rating Scales were used to assess autism characteristics. Results indicate that vocal response magnitudes and vocal variability were similar across autistic and non-autistic children. However, autistic children produced significantly faster responses to the auditory feedback manipulation. Hierarchical multiple regressions indicated that these faster responses were significantly associated with poorer parent-rated social competence and higher autism characteristics. These findings suggest that prosodic speech production differences are present in at least a subgroup of autistic children. These results represent a key step in understanding how atypicalities in the mechanisms supporting speech production may manifest in social-communication deficits, as well as broader social competence, and vice versa. Autism Res 2020, 13: 1880-1892. © 2020 International Society for Autism Research and Wiley Periodicals LLC LAY SUMMARY: In this study, autistic and non-autistic children produced vowel sounds while listening to themselves through headphones. When the children heard their vocal pitch shifted upward or downward, they compensated by shifting their vocal pitch in the opposite direction. Interestingly, autistic children were faster to correct for the perceived vowel sound changes than their typically developing peers. Faster responses in the children with ASD were linked to poorer ratings of their social abilities by their parent. These results suggest that autistic and non-autistic children show differences in how quickly they control their speech, and these differences may be related to the social challenges experienced by autistic children., (© 2020 International Society for Autism Research and Wiley Periodicals LLC.) more...

Purpose: Due to the nature and complexity of autism spectrum disorder (ASD), which typically requires coordination among various treatments targeting different areas of need, the entire family is impacted. Family quality of life (FQOL) research has emerged to address the range of adaptation families experience when raising a child with ASD. One factor that is likely to impact FQOL relates to families' service use to support their child's needs. The goal of the present study was to examine the relations between specific domains of FQOL and service usage type among families of children with ASD., Methods: A total of 164 caregivers of children diagnosed with ASD were asked which autism services they were currently using and completed the Beach Center Family Quality of Life Scale and the Nisonger Child Behaviour Rating Form., Results: Findings revealed that service usage type significantly predicted families' satisfaction with their emotional well-being, physical/material well-being, and disability-related support. Specifically, families using a combination of mental health services and ADL therapies reported greater satisfaction in these FQOL domains., Conclusion: Present findings underscore that families need access to a sufficiently broad range of child services and supports in order to benefit their FQOL. more...

Autism spectrum disorder (ASD) is diagnosed more often in males with a ratio of 1:4 females/males. This bias is even stronger in neuroimaging studies. There is a growing evidence suggesting that local connectivity and its developmental trajectory is altered in ASD. Here, we aim to investigate how local connectivity and its age-related trajectories vary with ASD in both males and females. We used resting-state fMRI data from the ABIDE I and II repository: males (n = 102) and females (n = 92) with ASD, and typically developing males (n = 104) and females (n = 92) aged between 6 and 26. Local connectivity was quantified as regional homogeneity. We found increases in local connectivity in participants with ASD in the somatomotor and limbic networks and decreased local connectivity within the default mode network. These alterations were more pronounced in females with ASD. In addition, the association between local connectivity and ASD symptoms was more robust in females. Females with ASD had the most distinct developmental trajectories of local connectivity compared with other groups. Overall, our findings of more pronounced local connectivity alterations in females with ASD could indicate a greater etiological load for an ASD diagnosis in this group congruent with the female protective effect hypothesis., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) more...

Individuals diagnosed with autism spectrum disorder (ASD) have difficulty perceiving and expressing emotions. Since prosodic changes in speech (i.e. changes in intonation, stress, rhythm, etc.) are crucial for extracting information about the emotional state of a speaker, an inability to perceive and interpret these prosodic changes may be related to impairments in social communication. This study used non-verbal emotional voice-clips to examine the ability of autistic and typically-developing children (7-13 years old) to extract affect from changes in prosody. This research also explored whether difficulty extracting affective intent from changes in prosody may be related to social competence. Autistic (n = 26) and typically-developing (n = 26) children accurately matched emotional voice-clips to emotion words, suggesting autistic children can accurately extract the affective meaning conveyed by changes in prosody. Autistic children were less accurate at matching the voice-clips to emotional faces, suggesting that autistic children may struggle to make use of prosodic information in a social context. Across both autistic and typically-developing children, prosody-face matching accuracy was found to predict overall social competence, as well as social inferencing abilities, suggesting that the inability to utilize affective information derived from a speaker's voice may interfere with effective social communication. more...

Despite average or above cognitive and verbal abilities, many children with autism spectrum disorder (ASD) experience difficulties in functional and social communication. Executive functioning (EF) may be the cognitive and regulatory mechanism that underlies these difficulties. Parents rated 92 children with ASD as demonstrating significantly more challenges than 94 typically developing children on measures of EF (Behavior Rating Inventory of Executive Function; BRIEF), functional communication (FC), and verbal conversation (VC) skills. For both groups, the BRIEF metacognition scale emerged as a strong predictor of FC, while the BRIEF behavior regulation and the inhibit scale were predictive of VC skills. These findings suggest that targeting EF domains specifically may improve FC and VC skills in children with ASD. more...

Lay Abstract: Symptoms characteristic of autism spectrum disorder were initially believed to protect individuals with autism spectrum disorder from developing substance abuse. However, recent studies suggest that up to 36% of individuals with autism spectrum disorder may have a co-occurring issue with substance abuse. In addition, substance abuse may worsen the difficulties with daily functioning some individuals with autism spectrum disorder experience. It is important to understand occurrence rates, and risk, protective and positive treatment factors of co-occurring autism spectrum disorder and substance abuse in order to promote the best possible support for this special population. This review aimed to find and synthesize evidence regarding risk, protective and treatment factors, and determine a general prevalence rate of co-occurring autism spectrum disorder and substance abuse from all studies on substance use and abuse in individuals with autism spectrum disorder. The review also aimed to assess study quality and identify a diagnostic measure for substance abuse in individuals with autism spectrum disorder. Twenty-six studies on substance use and abuse in autism spectrum disorder were included in the review. The rates of substance abuse among those with autism spectrum disorder identified by included studies ranged from 1.3% to 36%, but due to large differences in study methods, a general prevalence rate could not be determined. Risk and protective factors, recognized in the general population, such as familial substance abuse and co-occurring mental health issues, and factors which may be more likely to occur in individuals with autism spectrum disorder, such as limited social resources and low sensation-seeking, were identified. No diagnostic measures specific to individuals with autism spectrum disorder and substance abuse were identified. This review identified only one exploratory study on an adapted intervention for co-occurring autism spectrum disorder and substance abuse. However, there were many methodological challenges in this study that limit the conclusions that can be drawn from the data. More research, using consistent methods, is needed to understand risk and protective factors and to determine the prevalence of substance abuse among individuals with autism spectrum disorder. The potential for co-occurring autism spectrum disorder and substance abuse should be considered by professional working in both autism spectrum disorder and substance abuse services, as finding suggests substance abuse is possible among individuals with autism spectrum disorder and may occur more frequently than previously believed. In addition, autism spectrum disorder and substance abuse service providers should be sensitive to specific risk and protective factors identified by the review that may impact substance abuse course and outcomes. more...

Autism spectrum disorder (ASD) is an increasingly common neurodevelopmental disorder that affects 1 in 59 children. The cognitive profiles of individuals with ASD are varied, and the neurophysiological underpinnings of these developmental difficulties are unclear. While many studies have focused on overall group differences in the amplitude or latency of event related potential (ERP) responses, recent research suggests that increased intra-subject neural variability may also be a reliable indicator of atypical brain function in ASD. This study aimed to identify behavioral and neural variability responses during an emotional inhibitory control task in children with ASD compared to typically developing (TD) children. Children with ASD showed increased variability in response to both inhibitory and emotional stimuli, evidenced by greater reaction time variability and single-trial ERP variability of N200 and N170 amplitudes and/or latencies compared to TD children. These results suggest that the physiological basis of ASD may be more accurately explained by increased intra-subject variability, in addition to characteristic increases or decreases in the amplitude or latency of neural responses. Autism Res 2020, 13:221-229. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The cognitive functions including memory, attention, executive functions, and perception, of individuals with ASD are varied, and the physiological underpinnings of these profiles are unclear. In this study, children with ASD showed increased intra-subject neural and behavioral variability in response to an emotional inhibitory control task compared to typically developing children. These results suggest that the physiological basis of ASD may also be explained by increased behavioral and neural variability in people with ASD, rather than simply characteristic increases or decreases in averaged brain responses., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.) more...

Parent mediated interventions have the potential to positively influence the interactions and developmental outcomes of children with autism spectrum disorder (ASD). However, a range of factors relating to children, parents and caregivers, and study design may impact on outcomes and thus the generalizability of these interventions to the broader community. The objective of this review was to examine factors that may influence the feasibility, appropriateness, effectiveness, and generalizability of parent mediated interventions for children with ASD. We conducted a systematic review, yielding 41 articles. There was substantial variability in the intervention type, intensity, and study quality. Notably, 46 different inclusion/exclusion criteria were reported across studies including factors relating to children's development, access to other services, comorbidities, parental factors, and access to the intervention. Fifteen articles included examination of 45 different factors potentially associated with, or influencing, intervention outcomes including child (e.g., language skills, ASD severity, cognition) and parent (e.g., adherence and fidelity, education) factors. Although there is clear evidence for an increasingly sophisticated (e.g., systematic phased research for some interventions) and diverse (e.g., studies in geographical diverse contexts including low-resource communities) approach to research examining parent mediated interventions, there remains a need for improved study quality and measurement consistency in research, including a detailed examination of factors that may predict, moderate, and mediate intervention effectiveness for children and their parents. Autism Res 2019, 12: 1304-1321. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Parent mediated interventions-in which parents adapt their own behavior or deliver interventions to help their children learn-appear to be effective for some children with autism spectrum disorder. In this review, we identified a range of child, parent, and study design factors that may influence intervention outcomes and ultimately the uptake of these approaches in the community. We suggest that research in this area could be further improved by ensuring that studies include diverse groups of children and parents, and by using study designs that help to establish not only if interventions work, but for whom they work best and why., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.) more...

Background: The family system represents a critical context within which children develop. Although raising a child with a disability may represent a challenge to this dynamic system, research demonstrates that families have the capacity to demonstrate both maladaptation and resilience in the face of related stressors. In the current study, we examined the psychometric properties of the Family Resilience Assessment Scale (FRAS) among families of children with autism spectrum disorder (ASD). This tool is the only measure of family resilience that seeks to identify within-family protective factors, including the extent to which they rely on adaptive belief systems, organizational patterns, and communication processes. Identifying protective processes utilized by those who show resilience is critical within both clinical practice and research, as it aligns with a strength-based perspective that builds on what families are doing well., Methods: Participants included 174 caregivers of individuals with ASD (84% mothers). Caregivers completed the FRAS, as well as the Beach Center Family Quality of Life Scale. The 54-item FRAS was submitted to an exploratory factor analysis, using the iterated principal factor method with a promax rotation., Results: Fifty-one items across 3 factors (Family Communication and Problem Solving, Utilizing Social and Economic Resources, Family Spirituality) were retained, explaining 52% of the total variance. The final scale demonstrated convergent validity with the Family Quality of Life assessment tool., Conclusions: It is our hope that identifying the optimal scale structure will encourage other researchers to utilize this measure with families of children with ASD, thus continuing to advance the study of family resilience within this unique context. more...

It has been proposed that autism spectrum disorder (ASD) may be characterized by an extreme male brain (EMB) pattern of brain development. Here, we performed the first investigation of how age-related changes in functional brain connectivity may be expressed differently in females and males with ASD. We analyzed resting-state functional magnetic resonance imaging data of 107 typically developing (TD) females, 114 TD males, 104 females, and 115 males with ASD (6-26 years) from the autism brain imaging data exchange repository. We explored how interhemispheric homotopic connectivity and its maturational curvatures change across groups. Differences between ASD and TD and between females and males with ASD were observed for the rate of changes in connectivity in the absence of overall differences in connectivity. The largest portion of variance in age-related changes in connectivity was described through similarities between TD males, ASD males, and ASD females, in contrast to TD females. We found that shape of developmental curvature is associated with symptomatology in both males and females with ASD. We demonstrated that females and males with ASD tended to follow the male pattern of developmental changes in interhemispheric connectivity, supporting the EMB theory of ASD., (© 2018 Wiley Periodicals, Inc.) more...

Individuals with autism spectrum disorder (ASD) often have difficulties with processing identity and expression in faces. This is at odds with influential models of face processing that propose separate neural pathways for the identity and expression domains. The social-motivation hypothesis of ASD posits a lack of visual experience with faces as the root cause of face impairments in autism. A direct prediction is that identity and expression abilities should be related in ASD, reflecting the common origin of face impairment in this population. We tested adults with and without ASD ( ns = 34) in identity and expression tasks. Our results showed that performance in the two domains was significantly correlated in the ASD group but not in the comparison group. These results suggest that the most likely origin for face impairments in ASD stems from the input stage impacting development of identity and expression domains alike, consistent with the social-motivation hypothesis. more...

Individuals with autism spectrum disorder (ASD) demonstrate challenges with executive function (EF), adaptive behavior, and mental health, all of which place long-term wellbeing at risk. In the current study we examined the relation between parent-rated EF and adaptive functioning and internalizing symptoms (anxiety, depression), as we expected that identifying the specific EF domains most closely related to these indices of functioning would illuminate opportunities for targeted intervention. Participants included 59 children and adolescents with ASD (M = 10.1 years) and 67 who were typically developing (TD) (M = 9.4 years) matched on age, IQ, mental age, and maternal education. Caregivers completed the Behavior Rating Inventory of EF (BRIEF) and Behavior Assessment System for Children, Second Edition (BASC-2). Parents rated children with ASD as demonstrating significantly more challenges across most of the examined BRIEF and BASC-2 indices and scales, with the exception of organization of materials (BRIEF) and anxiety (BASC-2). For both groups, metacognitive EF processes emerged as strongly associated with practical, conceptual, and social skills, though different BRIEF scales emerged as significant across the component subdomains. In terms of the relation with mental health, BRIEF index scores were unrelated to anxiety for both groups. Behavior regulation, however, was significantly associated with depression symptoms for children with and without ASD. The findings highlight the possibility that targeting particular EF domains among individuals with and without ASD may not only have direct benefit for behavior regulation and metacognitive abilities, but may also extend to other areas of life, including adaptive behavior and concomitant internalizing symptomatology. Autism Res 2018, 11: 284-295. © 2017 International Society for Autism Research, Wiley Periodicals, Inc., Lay Summary: We examined whether parents' ratings of their children's flexibility and ability to monitor their behavior predicted adaptive skills (e.g., ability to complete day-to-day personal tasks, communicate, and socialize) and symptoms of anxiety and depression among children with and without autism spectrum disorder. For both groups, children's abilities to manage and monitor their behavior were strongly related to adaptive skills. Children's flexibility and ability to inhibit inappropriate behavior and control their emotions was associated with depression symptoms for both groups., (© 2017 International Society for Autism Research, Wiley Periodicals, Inc.) more...

Generalized anxiety and depression symptoms may be associated with poorer social outcomes among children with Autism Spectrum Disorder (ASD) without intellectual disability. The goal of this study was to examine whether generalized anxiety and depression symptoms were associated with social competence after accounting for IQ, age, and gender in typically developing children and in children with ASD. Results indicated that for the TD group, generalized anxiety and depression accounted for 38% of the variance in social competence and for children with ASD, they accounted for 29% of the variance in social competence. However, only depression accounted for a significant amount of the variance. The findings underscore the importance of assessing the social impact of internalizing symptoms in children with ASD. more...

Objective: The current study investigated executive function (EF) in young children with and without autism spectrum disorder (ASD) using multiple methods of assessment., Method: Young children (M = 63.2 months) with and without ASD, matched on age, IQ, and maternal education, were assessed on computerized measures of working memory, inhibition, flexibility, and planning. Parents completed a behavior rating scale assessing children's EF within everyday contexts., Results: There were no significant group differences on working memory, inhibition, flexibility, or planning. The mean difference on one aspect of the planning task (number of correct trials), however, approached significance and showed a medium to large effect size. There was also a significant difference between groups on the EF behavior rating scale, indicating that participants with ASD demonstrated greater executive dysfunction, as indexed by parent report., Conclusions: The results suggest that in young children with ASD, EF difficulties may only become apparent when situational demands require coordinating multiple abilities, as assessed with scales indexing children's abilities to manage their day-to-day EF-related behavior. We suggest that multiple methods are needed to achieve a comprehensive and valid EF assessment in young children with ASD. more...

Using a novel naturalistic paradigm allowing participants the freedom to spontaneously select and follow gaze cues in their environment, this study extends previous research conducted with younger children to determine whether school-age children with autism spectrum disorder (ASD, n = 17) demonstrate abnormal gaze following relative to typically developing (TD, n = 15) children. The participant and experimenter played a series of games, during which the experimenter pseudorandomly averted her gaze toward a social target (person) or a nonsocial target (object). A significant finding was that, relative to TD children, children with ASD were slower to follow the experimenter's gaze relative to the start of the trial (social targets d = -.93 [-1.70, -.16], nonsocial targets d = -1.05 [-1.88, -.20]). When we analyzed the duration of glances to the experimenter, we found that the ASD group made longer glances relative to TD children, but only in the nonsocial target condition (social targets d = .01 [-.68, .71], nonsocial targets d = -.81 [-1.53, -.08]). Other analyses revealed patterns of gaze selection and following that may help interpret the main findings. Despite the differences in the timing of gaze selection and following, the most common type of responder in both groups was one who followed the experimenter's gaze on over half of the trials. This pattern of results argues against a clear deficit in social attention in school-age children with ASD and underscores the importance of measuring both the timing of distinct mechanisms of social attention and the context in which these behaviors occur. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).) more...

Parents and professionals are concerned that second language exposure may delay communication in children with ASD. In this study 174 youth (6-16 years) with and without ASD, exposed to a second language, were compared on executive function (EF) and functional communication (FC) with their peers without exposure. There were no significant differences between groups on age, IQ, and socioeconomic status. Parents reported on language exposure and rated EF and FC skills within everyday social contexts. The findings indicated that second language exposure in children with ASD is not associated with delay in cognitive and functional communication skills rather there was evidence of a reduced clinical impact as indexed by a lower percentage of children whose FC and EF ratings fell within the clinical range. more...

It has been suggested that enhanced perceptual processing underlies some of the social difficulties associated with autism spectrum disorder (ASD). While a variety of visual tasks have been reported in which individuals with ASD outperform neurotypical individuals in control groups, the precise origin of such effects within the visual pathway remains unclear. It has recently been established that visual acuity is intact yet unremarkable in ASD. This suggests that the earliest levels of retinal processing are an unlikely candidate as the source of differences. The next potential levels for divergent visual processing are those involved in processing simple aspects of visual stimuli, such as orientation and spatial frequency, considered to be functions of early visual cortex. Here we focused on the basic processing of orientation. In three experiments, we assessed three basic aspects of orientation processing-discrimination, veridical perception, and detection-in participants with ASD in comparison to age-, gender-, and IQ-matched adults without ASD. Each experiment allowed for both qualitative and quantitative comparisons between the two groups. These provided a dense array of data indicating that participants with ASD perceive orientation of low-level stimuli in a qualitatively (as well as quantitatively) similar manner to participants without ASD in control groups, with no evidence of superior processing in detection, precision, or accuracy aspects of orientation perception. These results suggest that the source for altered perceptual abilities should be sought elsewhere, possibly in specific subgroups of people with ASD, other aspects of low-level vision such as spatial frequency, or subsequent levels of visual processing. more...