Search

Behavior problems in children with autism spectrum disorder (ASD) may exacerbate parenting stress. Parenting self-efficacy and family resources may influence this association. We examined cross-sectional statistical mediation effects of parenting self-efficacy on the relationship between child behavior problems and parenting stress and hypothesized that family-level resources moderated this indirect effect. Participants included 132 underserved (Medicaid-eligible) children with ASD (ages 3-13) with racial/ethnic diversity; many (63%) had intellectual disability. Greater externalizing problems were linked with lower parenting self-efficacy, which in turn was associated with increased parenting stress. A larger mediation effect was observed for families with fewer resources. A plausible alternative model (parenting stress mediating parenting self-efficacy) exhibited poorer fit. Implications for family supports and benefits of longitudinal follow-up are discussed.

A randomized controlled trial established initial efficacy of a novel parent training (PT) intervention for improving oral hygiene and oral health in underserved children with ASD (Fenning et al., 2022), a population at risk for unmet dental needs. The present study describes our emic approach to PT development alongside treatment outcome data examining feasibility, acceptability, and engagement. Families with Medicaid-eligible children with ASD ages 3 to 13 years (85% male, 62% with intellectual disability) were assigned to receive PT (n = 60) or a psychoeducational toolkit (n = 59). Results indicate strong retention, fidelity, and adherence, with quantitative and qualitative metrics revealing high treatment satisfaction and utilization. Discussion focuses on implications for individualizing treatment to optimize engagement of underrepresented families.

Dental care received by children in the Autism Speaks Autism Treatment Network (ATN) was compared to National Survey of Children's Health (NSCH) data for children without special healthcare needs and children with parent-reported ASD. Correlates of obtained preventive dental services were examined within the ATN sample. Participants included 375 families of children ages 4 to 17 enrolled in the ATN. ATN families reported levels of preventive dental care that were similar to, or exceeded, NSCH-reported care. However, disparities in obtained preventive dental services emerged within the ATN sample. Lower intellectual functioning was the most consistent correlate of reduced access to and completion of preventive dental care. Implications for developing system-wide supports and targeted interventions are discussed.

Background: Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent-child behaviour before and after a structured parent training program for children with pervasive developmental disorders (PDD). We report on the use of this procedure in a pilot study of 12 participants with PDD. Results: Inter-rater reliability across behaviours coded ranged from 75-100% agreement. Blindly scored observations of behaviour showed medium effect sizes for changes in inappropriate child behaviour. Analyses of baseline scores revealed a moderate positive correlation between inappropriate child behaviours as measured in all four SOAP conditions and parent ratings of child noncompliance (r[subscript s] = 0.66, p less than 0.05). By contrast, the correlations of SOAP scores with parent ratings of irritability was lower (r[subscript s] = 0.40, p greater than 0.05). Conclusions: As our treatment targeted compliance, these preliminary results suggest that the SOAP provides a valid measure of noncompliant behaviour in children with PDD and is sensitive to treatment effects on inappropriate child behaviours. (Contains 3 tables.)

Scatter and heterogeneity in cognitive profiles is thought to be common in autism spectrum disorder (ASD), which may indicate differences in the construct of IQ. However, less research has investigated IQ scatter in attention‐deficit/hyperactivity disorder (ADHD). Scatter is also thought to negatively impact the predictive validity of IQ summary scores, although there is research refuting this notion. Abbreviated IQ tests, such as the Stanford‐Binet fifth edition (SB‐5) abbreviated battery IQ (ABIQ), may be especially susceptible to the influence of scatter. We tested the measurement invariance of the SB‐5 as well as the predictive validity of the ABIQ in predicting FSIQ in 1679 youth (21% female) ages 2–16 years with a clinical diagnosis of ASD or ADHD. Results indicated the SB‐5 is measuring IQ the same way in ASD and ADHD. There were no differences between diagnostic groups in scatter between ABIQ (i.e., routing) subtests. Additionally, scatter was not related to dimensional autistic traits. Higher degree of scatter was associated with poorer predictive validity of the ABIQ and a higher likelihood of overestimating FSIQ, regardless of diagnosis. Overall, we found more similarities than differences between the ASD and ADHD groups. Our results show that the SB‐5 ABIQ is generally a strong predictor of FSIQ in youth with neurodevelopmental disorders. However, the use of the SB‐5 ABIQ in research and clinical applications, without consideration of scatter on routing subtests, is potentially problematic. Lay Summary: Research is needed to know if IQ tests are equality accurate among different groups. Sometimes brief IQ tests are necessary, but they may be less accurate when subtest scores vary (scatter). In our study, we found that IQ is measured the same way in autism and ADHD. There was a strong relationship between brief and full‐length IQ scores, but less so when there was scatter. This was the same for autism and ADHD. Overall, a brief IQ test can be an accurate tool, but it has a higher chance of overestimating IQ when people have varied or scattered scores on individual test items. [ABSTRACT FROM AUTHOR]

Previous research has identified possible sex-based differences in restricted and repetitive behaviors in autism spectrum disorder (ASD). However, this finding is mixed, particularly among preschool-aged children. We investigated the presence of sex-based differences in parent-rated ASD symptomatology, using the Autism Spectrum Rating Scale (ASRS). Participants consisted of a large (n = 481,100 female), clinically-referred sample of preschoolers (ages 2–5) diagnosed with ASD (NVIQ: M = 67.11, SD = 21.79). Females had less severe symptoms on the Total, Unusual Behaviors, DSM-5, and Stereotypy scales on the ASRS. The effects were small-to-medium, but statistically significant. There was evidence of differential relationships between nonverbal IQ and ASRS scores among males and females. This study provides additional evidence of sex-based differences in ASD symptoms present from an early age. [ABSTRACT FROM AUTHOR]

This study provided preliminary validation of the Autism Detection in Early Childhood-Virtual (ADEC-V) for telehealth assessment of possible autism. Participants were 121 children (24.79% female) aged 18–47 months who completed telehealth evaluations at a large pediatric hospital in the Midwestern United States between October 2020 and February 2021. The ADEC-V showed good sensitivity (0.82) and specificity (0.78) and was significantly correlated with other ASD symptom measures (i.e., CARS-2, ADI-R). Internal consistency was acceptable (α = 0.77). These results need replication in a larger and broader sample including more children without ASD. This preliminary validation study identifies the ADEC-V as a promising measure for telehealth ASD assessments in young children. [ABSTRACT FROM AUTHOR]

CONTEXT: Anxiety is common, screening tools are available, and treatment can be effective. Recently, anxiety screening has been recommended for adolescent girls beginning at 13 years of age. OBJECTIVE: To evaluate the evidence regarding anxiety screening test accuracy in primary care for children and adolescents and assess the effectiveness of treatment of individuals identified through screening. DATA SOURCES: We searched PubMed, the Cochrane library, and references to potentially eligible studies cited in other articles. STUDY SELECTION: Screening studies were included if they were conducted in primary care or a similar population and employed a reference standard based on DSM criteria. Treatment studies were included if subjects were identified through screening and there was at least 1 comparator intervention or a placebo arm. DATA EXTRACTION: At least 2 reviewers evaluated each identified reference. RESULTS: Two screening studies (1 with low risk of bias and 1 with high risk of bias) and 1 treatment study with a low risk of bias were included. The screening study with a low risk of bias reported a sensitivity of 56% and specificity of 80%. The treatment study found individual cognitive behavioral therapy to be effective for screen-detected adolescents with social phobia. LIMITATIONS: This review only included screening or treatment studies with clear evidence that the study populations were derived from an unselected population reflective of typical primary care. Relevant studies not indexed in PubMed or the Cochrane library could have been missed. CONCLUSIONS There are significant gaps in evidence related to anxiety screening in the primary care setting. [ABSTRACT FROM AUTHOR]