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Aim: To investigate the acceptability and feasibility of adapted group therapy for anxiety in children with autism spectrum disorder in a pilot randomised controlled trial. Method: A total of 32 children aged 9-13 years were randomised to immediate or delayed therapy using the "Exploring Feelings" manual (Attwood, 2004). Child and parent groups were run in parallel, for seven weekly sessions, under the supervision of experienced psychologists. The primary blinded outcome measures addressed change in overall functioning and in severity of the primary anxiety diagnosis after 3 months. esults: Children met diagnostic criteria for 1-6 anxiety disorders (median 3). At end point, both parents and children in the immediate therapy group were more likely to report a reduction in anxiety symptoms. Fidelity of delivery of the group therapy was high, and attendance was 91%. Conclusions: This pilot trial established that children and families were willing to be recruited and randomised, the outcome measures were acceptable, the format and content of the groups were feasible within UK child and adolescent mental health services, the intervention was appreciated by families and attrition was very small.

Restricted and repetitive behaviors (RRBs) are characteristic of autism spectrum disorders (ASD). However, compared to social and communicative impairments, less is known about their development, trajectory and etiology. This study explored RRBs in young children with ASD matched to typically developing (TD) children on non-verbal development. RRBs were coded from direct observation at three time points within 13 months of development. Children with ASD displayed higher frequency and greater diversity of RRBs at all time points, however RRBs were not unique to ASD and evident in the TD control group albeit at a reduced frequency. RRBs did not correlate with social and communicative impairments in the ASD group, suggesting dissociation between these domains.

Parents of children with autism spectrum disorders (ASD) use a wide range of interventions including poorly evidenced dietary interventions. To investigate parents' and professionals' experience of dietary interventions and attitudes towards a proposed trial to evaluate the gluten free casein free diet (GFCFD). Survey of UK parents of children with ASD, and professionals. 258 parents and 244 professionals participated. 83% of children had received a range of dietary manipulations; three quarters of professionals have been asked for advice about GFCFD. Respondents identified an inadequate evidence base for dietary interventions in ASD and suggested modifications to a proposed trial design. Both parents and professionals supported the need for further evaluation of dietary interventions in ASD.

The type, frequency and inter-relationships of emotional and behavioural problems in 863 children with autism spectrum disorder (ASD) were investigated using the population-based Database of children with ASD living in the North East of England (Daslne). A high rate of problems was reported, with 53% of children having 4 or more types of problems frequently. Sleep, toileting and eating problems, hyperactivity, self injury and sensory difficulties were greater in children with lower language level and in special schooling. However, anxiety, tantrums and aggression towards others were frequent regardless of age, ability or schooling. The frequency of co-existing conditions, including such emotional and behavioural problems, in children with ASD has implications for designing appropriate support services for children and families.

Change blindness refers to the difficulty most people find in detecting a difference between two pictures when these are presented successively, with a brief interruption between. Attention at the site of the change is required for detection. A number of studies have investigated change blindness in adults and children with autism spectrum disorders (ASD). Some have produced evidence that people with ASD find changes to social stimuli harder to detect and changes to non-social stimuli easier to detect, relative to comparison participants. However, other studies have produced entirely contradictory findings. There is a need for consistency in methodology to aid understanding of change blindness and attentional processes in ASD. Here, we replicate a change blindness study previously carried out with typically developing (TD) children and adults and with adults with ASD. Results reveal attenuated change blindness for non-social stimuli in children with ASD relative to TD norms. Our results are interpreted, alongside others' findings, as potentially indicative of a complex relationship between different influences on attention over time. (Contains 3 figures, 2 tables, and 1 footnote.)

Autism spectrum disorders (ASD) are associated with a substantial economic burden, but there is little evidence of the costs in the early years; the period in which children are increasingly likely to be diagnosed. We describe the services used by 152 children aged 24-60 months with autism, report family out-of-pocket expenses and productivity losses, and explore the relationship between family characteristics and costs. Children received a wide range of hospital and community services including relatively high levels of contact with speech and language therapists and paediatricians. Total service costs varied greatly (mean 430 British Pounds per month; range 53 British Pounds to 1,116 British Pounds), with some families receiving little statutory support. Higher costs were associated with increasing age and symptom severity.

Tests of mediation in treatment trials can illuminate processes of change and suggest causal influences in development. We conducted a mediation analysis of a previously published randomised controlled trial of parent-mediated communication-focused treatment for autism against ordinary care, with 28 children aged 2-5 years (Aldred et al. in J Child Psychol Psychiatr 45:1-11, 2004). The hypothesised mediating process, targeted by the intervention, was an increase in parental synchronous response within parent-child interaction. The results showed partial mediation, with change in synchrony accounting for 34% of the positive intervention effect on autism symptomatology (Autism Diagnostic Observation Schedule communication and social domain algorithm); the result was confirmed by bootstrap estimation. Improved parental synchronous response to child communication can alter short-term autism symptom outcome with targeted therapy.

Assessment of children's restricted and repetitive behaviours offers potential opportunities to improve early diagnosis of autism spectrum disorder (ASD) and timely access to interventions and support. To facilitate this requires understanding of the phenomenology of repetitive behaviours in ASD, including differentiating behaviours seen in ASD from other populations such as young typically developing and developmentally delayed children. A key factor in achieving understanding is valid and reliable measurement. This review considers the issues in conceptualisation of repetitive behaviours which should guide the choice of measurement tool, including definition of subtypes of repetitive behaviours, associations with age and ability, and categorisation of frequency and severity. The resulting conclusions about the requirements for measurement are applied within a systematic review of quantitative interview and questionnaire measures of repetitive behaviour used with children with ASD. The conclusions of the review lead to recommendations for existing and future research on restricted and repetitive behaviours in ASD. (Contains 1 table.)

This is the first UK study to report the reliability, validity, and factor structure of the Social Responsiveness Scale (SRS) in a general population sample. Parents of 500 children (aged 5-8 years) in North East England completed the SRS. Profiles of scores were similar to USA norms, and a single factor structure was identified. Good construct validity and internal consistency were found. Children with identified special needs were found to have significantly higher SRS scores than those without. The findings suggest the SRS performs in similar ways in UK and USA general population samples of children and can be used without modification in the UK. (Contains 1 figure and 4 tables.)

The repetitive behaviour questionnaire (RBQ) (Turner, 1995) is one of the three most commonly used interview/questionnaire measures of repetitive behaviour (Honey et al., in preparation). Despite this there is a scarcity of information concerning its structure, reliability and validity. The psychometric properties of the RBQ were examined when used with children with an autism spectrum disorder, children of typical development and children with a learning disability. The questionnaire was found to examine two valid and reliable factors of repetitive behaviour and to have good levels of concurrent and construct validity. This novel study provides researchers and clinicians with information necessary to make decisions about the RBQ's utility and for the evaluation of conclusions drawn from existing research, which has used the RBQ. (Contains 6 tables and 1 figure.)

Many individuals with autism tend to focus on details. It has been suggested that this cognitive style may underlie the presence of stereotyped routines, repetitive interests and behaviours, and both relate in some way to sensory abnormalities. Twenty-nine children with diagnosis of high functioning autism or Asperger syndrome completed the Embedded Figures Test (EFT), and their parents the Short Sensory Profile and Childhood Routines Inventory. Significant correlations were found between degree of sensory abnormalities and amount of restricted and repetitive behaviours reported. Repetitive behaviours, age and IQ significantly predicted completion time on the EFT. The results suggest a cognitive link between an individual's detail-focused cognitive style and their repetitiveness. No such relationship was found with sensory processing abnormalities, which may arise at a more peripheral level of functioning.

Repetitive behaviours are a relatively neglected area of study in autism. Previous research has concluded that repetitive behaviour is inversely related to ability and that it tends to increase over the preschool years. One-hundred and four children ages 24-48 months, with autism, autism spectrum disorder (ASD) or other disorders, were followed for 13 months. Twelve items from the Autism Diagnostic Interview (ADI-R) were analysed, as well as diagnostic algorithm scores. Ability was related to degree of repetitive behaviours, except for one cluster of relatively able children. ADI-R repetitive behaviour algorithm scores increased over time; however, when all 12 behaviours were considered, there was a general decrease in impact upon the child's and family's activities. Reasons for this decrease are discussed.

Background: Repetitive behaviours are an essential part of the diagnosis of autism but are also commonly seen in typically developing children. The current study investigated the frequency and factor structure of repetitive behaviours in a large community sample of 2-year-olds. Methods: A new measure, the Repetitive Behaviour Questionnaire (RBQ-2) was completed by 679 parents. Results: The RBQ-2 had good psychometric properties. A four-factor model provided the best fit for the data, accounting for 51% of the variance, and suggested 4 sub-scales: unusual sensory interests, repetitive motor movements, rigidity/adherence to routine and preoccupations with restricted patterns of interest. These sub-scales closely resembled repetitive behaviour subtypes within the ICD-10 criteria for autism. Repetitive behaviours of every type were frequently reported. Higher scores were found for all children, and especially boys, on the subscale relating to preoccupations with restricted patterns of interests. Conclusion: The results support the proposal that repetitive behaviours represent a continuum of functioning that extends to the typically developing child population.

To raise the literacy achievement of secondary school students, some schools train their whole faculties in general reading and writing strategies to implement across the curriculum. Content-area teachers often resist this approach, however, fearing that setting aside time for literacy instruction will dilute the academic rigor of mathematics, science, and social studies courses. An alternative approach called disciplinary literacy builds students' academic content knowledge and their reading, writing, and thinking skills simultaneously. Disciplinary literacy is based on the premise that students develop deep conceptual knowledge in a discipline by using the habits of reading, writing, talking, and thinking which that discipline values and uses. This article gives detailed classroom examples of how teachers implement the five principles of the disciplinary literacy framework: knowledge and thinking go hand in hand; learning is apprenticeship; teachers mentor student apprentices; instruction and assessment drive each other; and classroom culture socializes intelligence.

Delays in development of early social behaviors in babies with Down syndrome are likely to affect patterns of interaction with their caregivers. We videotaped 23 babies in face-to-face interaction with their mothers at 8 and 20 weeks of age and compared them to 23 typically developing infants and their mothers. Social behaviors, mothers' behaviors, and quality of interaction were rated. At 8 weeks, babies with Down syndrome were significantly less communicative and lively than the typically developing babies. Their mothers' behaviors did not differ at 8 weeks, but did at 20 weeks. Although the social behaviors of babies with Down syndrome improved over time, qualitative differences remained.

The Questionnaire on Resources and Stress (Friedrich, short form: QRS-F) has been used widely with parents of children with disabilities. However, its psychometric properties in parents of young children with autism have not been established. Here, 174 mothers and 43 fathers of children under 6 years with autism spectrum disorder were studied by two independent research teams. Each parent completed a 31-item version of the QRS-F. Factor analysis of the mothers scores on these items failed to identify an expected two- or three-factor structure. Thus, the properties of a total stress score were explored. Analyses revealed evidence of good reliability, and expected associations with social support, coping and autism severity. These analyses lend preliminary support to the convergent validity of the scale. Overall, the data support the use of a total stress score from the 31-item version of the QRS-F in research with parents of young children with autism.

Of a cohort of 104 children with Autism, PDD-NOS or specific language disorder, recruited at age 2-3 years of age, only three appeared to meet diagnostic assessment criteria for Asperger syndrome (AS). The children were followed up at 4-5 years, and assessments at both time points included the Autism Diagnostic Interview (ADI-R), the Autism Diagnostic Observation Schedule (ADOS) and the Mullen Scales of Early Learning. The paper explores the reasons why so few children with possible AS were identified early, including problems inherent in the assessment tools and the range of normal variation within characteristics required for a diagnosis. Only 10 children altogether had first words by 24 months, and abilities in the average range, and 9 were followed up. All of these able children had varied repetitive behaviours, and these increased in terms of ADI-R algorithm score over a 13 month interval. However, items concerning resistance to change and liking of routines tended to decrease in terms of reported impact on the child and family. Repetitive behaviours seem significant in the early referral of able children for a PDD diagnosis, but identification of children with AS is more likely to occur reliably once children are older and enter school.

Valued living is one of the core processes of Acceptance and Commitment Therapy (ACT). The main aim of this study is to systematically review the relationship between valued living and depression, and valued living and anxiety, and to examine how these relationships vary across different demographic characteristics and populations/clinical groups (PROSPERO ID: CRD42021236882). Literature searches were carried out using MEDLINE, EMBASE, PsycINFO, ProQuest Dissertations and Thesis Global, Social Science databases. All studies using a validated measurement of valued living (as conceptualized in ACT) and a measurement of depression and/or anxiety were considered for inclusion. The methodological quality of included studies was assessed using a risk of bias assessment tool specifically developed for this systematic review. A total of 72 studies with 78 (sub)samples were included in this review, of which 17 studies were rated as high risk of bias, while 61 were rated as low risk for bias. The primary high-risk quality issue related to small sample sizes. Most included studies were student or chronic pain samples. Meta-analyses overall showed negative correlations between both valued living and depression (r = −0.42, 95%CI [-0.45; −0.39], p <.001, k = 72, o = 14,797), and valued living and anxiety (r = −0.26, 95%CI [-0.29; −0.22], p <.001, k = 60, o = 11,628). Meta-regression analyses uncovered significant moderations suggesting that the negative correlation between valued living and depression was stronger in studies using the Valuing Questionnaire compared to those using the Valued Living Questionnaire. The inverse association between valued living and anxiety tended to be stronger in older samples and in chronic pain samples compared to the general population. The evidence overall demonstrated significant negative relationships between valued living and both depression and anxiety, with a greater effect size for the association between valued living and depression. This highlights the importance for clinicians in considering valued living as a potential mechanism of change for depression and anxiety. • There was a negative medium-to-large correlation between valued living and depression. • There was a negative small-to-medium correlation between valued living and anxiety. • Region and valued living measure were significant moderators of the relationship between valued living and depression. • Population and mean age were significant moderators of the relationship between valued living and anxiety. [ABSTRACT FROM AUTHOR]

A black medic (Medicago lupulina L.) cover crop is able to regenerate from seed annually and produce biomass at the end of each growing season, but its long‐term effectiveness on crop productivity, water use efficiency (WUE), and soil nutrient status within a no‐till cropping system is unclear. A field experiment was established in 2003 in Saskatchewan in a 3‐yr crop rotation [flax (Linum usitatissimum L.)–oat (Avena sativa L.)–wheat (Triticum aestivum L.)]. Treatments included cover crop (black medic or no medic), and N fertilizer (20, 60, and 100% of recommended N) arranged in a split‐split plot design. Over 10 yr, medic aboveground fall biomass averaged 625 kg ha–1 (range 0–1,868 kg ha–1) and was greatest at the lowest N rate, 879 kg ha–1. Medic increased grain yield at 20% N fertilizer; no effect was observed at higher N rates. Medic increased tiller density and kernel weight at 20% N, indicating that medic positively influenced the crop throughout the entire life cycle. Medic presence did not affect grain N or P status. Medic did not affect level of available soil N in fall but consistently increased level of soil available P. This extended to the 30–60 cm soil depth in the 100% vs. lower N rates, suggesting medic roots may have influenced P cycling. In oat stubble, medic increased spring soil water and WUE. In conclusion, black medic improved crop productivity at the low N rate but improved available soil P at all N rates, warranting further research. Core Ideas: This is the first North American study to evaluate long‐term effects of medic in a no‐till system.Medic had its greatest effect at 20% vs. 60 and 100% recommended fertilizer N.At the 20% N rate, medic increased grain yield (14%), grain N and P, and WUE.Medic presence increased soil P concentration at the 100% N rate and at deeper soil depths. [ABSTRACT FROM AUTHOR]