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In the last decade, the prevalence of children with autism spectrum disorder (ASD) without intellectual disability (ID) in schools has increased. However, there is a paucity of information on special education placement, service use, and relationships between service use and demographic variables for children with ASD without ID. This study aimed to describe and explore variation in type and amount of special education services provided to (N = 89) children with ASD. Results indicated that the largest percentage of children received services under the Autism classification (56.2%) and were in partial-inclusion settings (40.4%). The main services received were speech (70.8%) and occupational (56.2%) therapies, while few children received behavior plans (15.7%) or social skills instruction (16.9%). Correlates with service use are described.

This study examined the feasibility and preliminary outcomes of a comprehensive summer psychosocial treatment (summerMAXyc) for high-functioning young children, ages 4–6 years, with ASD (HFASD). The 5-week treatment, conducted 5 days per week, 6 h per day, included skills instruction and therapeutic activities targeting social/social-communication skills, facial-emotion recognition, and interest expansion. A behavioral system was implemented to increase skills acquisition and maintenance and reduce ASD symptoms and problem behaviors. Feasibility was supported in high levels of treatment fidelity and child, parent, and staff clinician satisfaction. Significant post-treatment improvements were found for 9 of 10 outcome measures including parent and staff clinician ratings of targeted social/social-communication skills, ASD symptoms, and broader adaptive social and communication skills, and staff clinician ratings of daily living skills. Results suggested that summerMAXyc was feasible and may yield positive outcomes for 4–6 year olds with HFASD.

Schools are being confronted with an increasing population of high-functioning students with autism spectrum disorder (HFASD). These students pose particular challenges to school-based practitioners and teachers given their social-communication deficits, restricted and repetitive behaviors/interests, and relative cognitive and language strengths. This article examines the impact of HFASD at the student, classroom, and district levels, and existing evidence-based strategies and techniques to improve social competence and daily functioning. It then proposes a comprehensive intervention framework for school practitioners and provides an example of a model comprehensive school-based program. Future directions and areas in need of study are also discussed.

This study extended the research on correlates of adaptive functioning of high-functioning children with autism spectrum disorder (HFASD) using the Behavior Assessment System for Children-Second Edition (BASC-2). Specifically, this study investigated the relationships between adaptive behavior and age, IQ, and ASD symptomology, in a well-characterized sample of 119 children with HFASD, ages 6-11 years. Results revealed age and IQ were not significantly correlated with adaptive ability. However, total autism symptoms [measured by the Autism Diagnostic Interview-Revised (ADI-R)], as well as ASD-social symptoms were negatively correlated with adaptive ability. Mean comparisons revealed that participants falling into the clinically-significant range of the BASC-2 Adaptive Skills Composite (ASC) displayed significantly greater levels of both overall and social ASD symptoms.

This study examined informant discrepancies for parent and teacher adaptive behavior ratings of 103 children, ages 6-12 years, with ASD (without intellectual disability). Scores on the Adaptive Behavior Assessment System, third edition (Harrison and Oakland, Western Psychological Services, Los Angeles, 2015) General Adaptive Composite (GAC) and practical, social, and conceptual domains were examined for mean differences, level of agreement, and moderators of difference scores between informant groups. Teacher scores were significantly higher (indicating better functioning) than parents for the GAC and practical domain. Parent and teacher scores were moderately correlated and Bland-Altman plots and regression analyses revealed no systematic differences in parent-teacher agreement across the range of scores. None of the tested variables moderated the parent-teacher difference scores. Implications for clinical practice are discussed.

This community effectiveness randomized clinical trial examined the feasibility and effectiveness of a comprehensive psychosocial treatment, summerMAX, when implemented by a community agency. Fifty-seven high-functioning children (48 male, 9 female), ages 7-12 years with autism spectrum disorder participated in this study. The 5-week summerMAX treatment included instruction and therapeutic activities targeting social/social-communication skills, interpretation of nonliteral language skills, face-emotion recognition skills, and interest expansion. A behavioral program was also used to increase skills acquisition and decrease autism spectrum disorder symptoms and problem behaviors. Feasibility was supported via high levels of fidelity and parent, child, and staff clinician satisfaction. Significant treatment effects favoring the treatment group over waitlist controls were found on all 5 of the primary outcome measures (i.e., child test of nonliteral language skills and parent ratings of the children's autism spectrum disorder symptoms, targeted social/social-communication skills, broader social performance, and withdrawal). Staff clinician ratings substantiated the improvements reported by parents. Results of this randomized clinical trial are consistent with those of prior studies of summerMAX and suggest that the program was feasible and effective when implemented by a community agency under real-world conditions.

This study was conducted to extend the research on the adaptive skills of 55 high-functioning children with autism spectrum disorder (HFASD) and 55 children with ASD and co-occurring intellectual disability (LFASD), ages 6–12, using the Adaptive Behavior Assessment System, Second Edition (ABAS-II). This study examined each group’s adaptive profile, compared adaptive functioning and cognitive ability, and assessed correlates (i.e., age, IQ) of adaptive skills. Results indicated children with HFASD demonstrated cognitive strengths and adaptive deficits, while children with LFASD demonstrated adaptive strengths in the areas of social and conceptual skills, and practical skills commensurate with estimated cognitive ability. Within the HFASD sample, age significantly, negatively correlated with adaptive social ability, while IQ was not significantly correlated with adaptive behavior. Conversely, in the LFASD sample, age did not correlate with adaptive ability, although IQ was significantly related to overall adaptive ability and all domains of the ABAS-II.

This study compared parent and teacher ratings of ASD-related symptoms of 120 high-functioning children, ages 6-12 years with ASD (HFASD) using the Developmental Social Disorders (DSD) scale of the BASC-2. DSD ratings (parent and teacher) were significantly higher than normative estimates. The cross-informant comparison was significantly higher for parents (vs. teachers), and correlations (ICC and Pearson) between the informant groups were significant (but low in magnitude). Agreement among parents and teachers accurately placed 81 % of cases above the at-risk cutpoint for symptoms of ASD, and agreement was highest in the at-risk range of perceived symptoms. Additional analyses indicated a significant difference in the trend across the parent-teacher discrepancies, and no significant moderators of the discrepancies. Implications for assessment are provided.

We examined anxiety and depression clinical symptom levels in 42 typically-developing (TD) siblings of children with high-functioning autism spectrum disorder (HFASD), compared to 42 TD siblings of TD children, matched on age, ethnicity, and gender. Participants were between the ages of 6 and 16. Groups were compared using the parent-report and child self-report versions of the Behavior Assessment System for Children, Second Edition, anxiety and depression clinical scales. Within-group differences were examined for parent versus child ratings. Multivariate procedures did not support clinically elevated levels of internalizing problems in siblings of children with HFASD. Results from both sources were consistent with the overall finding. The findings do not support an increased need for targeted intervention, though clinical and school-based practitioners should attend to clinical warning signs if presented.

This randomized controlled trial evaluated the efficacy of mind reading as a component of a comprehensive psychosocial treatment for 36 high-functioning children, ages 7–12 years with ASD (HFASD). All participants received the comprehensive 5-week summer treatment (summerMAX), with half randomly assigned to also receive mind reading (emotion-recognition) computer instruction as part of the treatment (summerMAX + MR). Primary analyses of proximal measures indicated significantly better performance on face emotion-recognition testing for the summerMAX + MR group (vs. summerMAX alone), and significant gains in voice emotion-recognition child testing and parent- and clinician-rated emotion recognition skills for the overall group, but no between-groups differences. Secondary analyses of distal measures indicated significant improvements on broader emotion-recognition child testing and parent and clinician ratings of program-targeted social/social-communication skills, broad social skills, and ASD-related symptoms for the overall group (summerMAX + MR and summerMAX combined) and no significant differences between the conditions (summerMAX + MR vs. summerMAX). Results suggested that mind reading may result in significant but narrow gains when included as part of this intensive psychosocial treatment for children with HFASD.

Prior studies of sex-based differences in autism spectrum disorder (ASD) have yielded mixed findings. This study examined ASD symptom severity and functional correlates in a sample of 34 high-functioning females with ASD (HFASD; M age = 8.93; M IQ = 104.64) compared to 34 matched males (M age = 8.96; M IQ = 104.44) using the Social Responsiveness Scale-Second Edition (SRS-2). Results identified non-significant and minimal differences (negligible-to-small) on the SRS-2 total, DSM-5 symptom subscale, and treatment subscale scores. Significant negative (moderate) correlations were found between the SRS-2 Social Cognition subscale and IQ and language scores and between the SRS-2 Social Motivation subscale and receptive language scores for females only; no significant correlations were found for males.

This study examined the reliability and criterion-related validity of parent ratings on the Adapted Skillstreaming Checklist (ASC) for a sample of 275 high-functioning children, ages 6-12 years, with ASD. Internal consistency for the total sample was 0.92. For two subsamples, test-retest reliability was very good at the 6-week and good at the 9-month intervals. Child age, IQ, and language abilities were unrelated to the ASC score. The ASC total score was inversely and strongly related to parent ratings of ASD symptom severity. Significant positive correlations (moderate-to-high) were found between the ASC and prosocial skills scales and significant negative correlations (low-to-moderate) with problem behavior scales on a broad measure of child functioning. Implications and suggestions for future study are discussed.

This study was conducted to extend the research on the adaptive skills of high-functioning children with autism spectrum disorder (HFASD) using the Vineland Adaptive Behavior Scales, Second Edition (VABS-II). Specifically, this study (a) examined the VABS-II adaptive profile, (b) compared adaptive functioning and cognitive ability, and (c) assessed predictors (age, IQ, ASD symptomatology) of adaptive skills of 71 children, ages 7 to 12 years, with HFASD. Results of normative comparisons indicated significant adaptive deficits on the Adaptive Behavior Composite and all three VABS-II domains (Communication, Daily Living Skills [DLS], and Socialization). Similarly, results revealed that the adaptive functioning of the sample fell significantly below their cognitive level. Regression analyses indicated that age was a significant inverse predictor of adaptive communication and socialization skills and IQ was a significant positive predictor of Communication and DLS. After accounting for age and IQ, ASD-social and ASD-communication symptoms did not predict adaptive behaviors; however ASD-restricted and repetitive symptoms was a significant inverse predictor of adaptive socialization skills.

This study evaluated the effect of a comprehensive psychosocial intervention on supplemental measures of facial emotion encoding for children with high-functioning autism spectrum disorder (HFASD) who were enrolled in prior randomized trials. A total of 60 children, ages 7 to 12 years were randomly assigned to treatment or wait-list control groups. Photographs of six posed facial expressions (happy, sad, angry, scared, surprised, and disgusted) taken at pretest and posttest were rated for encoding accuracy by naive raters. Ratings consisted of a) the extent to which the facial expression reflected each of the six possible emotions (extent rating) and b) a selection of the one emotion the raters identified as being portrayed (forced-choice). Results indicated significantly better encoding of sad at posttest for the treatment group on the extent (d = .58) and forced-choice (d = .56) ratings. Between-groups differences in encoding of the other emotions at posttest were non-significant. Implications for intervention and future research are presented.

This community effectiveness trial examined the feasibility and efficacy of a comprehensive psychosocial treatment for 28 children, aged 7 to 10 years with high-functioning autism spectrum disorders (HFASDs). Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition skills, interest expansion, and interpretation of non-literal language skills. A behavioral program was instituted to foster skills acquisition and reduce ASD symptoms and problem behaviors. Feasibility was supported in high levels of fidelity and satisfaction. Significant improvements were found for the children’s non-literal language skills and parent ratings of target social and communicative skills, broader social performance, and ASD symptoms. Secondary staff ratings corroborated parent ratings. Results suggest that the treatment, when administered by a community agency, was feasible and yielded positive outcomes similar to prior randomized clinical trials (RCTs).

Adaptive behavior rating scales are frequently used to gather information on the adaptive functioning of children with high-functioning autism spectrum disorders (HFASDs), yet little is known about the extent to which these measures yield comparable results. This study was conducted to (a) document the parent-rated VABS-II, BASC-2, and ABAS-II adaptive behavior profiles of 6- to 11-year-olds with HFASDs (including relative strengths and weaknesses); (b) examine the extent to which these measures yielded similar scores on comparable scales; and (c) assess potential discrepancies between cognitive ability and adaptive behavior across the measures. All three adaptive measures revealed significant deficits overall for the sample, with the VABS-II and ABAS-II indicating relative weaknesses in social skills and strengths in academic-related skills. Cross-measure comparisons indicated significant differences in the absolute magnitude of scores. In general, the VABS-II yielded significantly higher scores than the BASC-2 and ABAS-II. However, the VABS-II and ABAS-II yielded scores that did not significantly differ for adaptive social skills which is a critical area to assess for children with HFASDs. Results also indicated significant discrepancies between the children’s average IQ score and their scores on the adaptive domains and composites of the three adaptive measures.

Assessment of clinical symptoms requires information from multiple informants. Discrepancies between informants' ratings can have significant implications in school settings (e.g., access to services, treatment planning, progress monitoring). This study examined parent-teacher discrepancies for ratings of internalizing and externalizing symptoms, and adaptive skills of high-functioning children with autism spectrum disorder. A total of 236 Behavior Assessment System for Children-2nd Edition ratings of children with high-functioning children with autism spectrum disorder from 2 informant groups (parents and teachers) were analyzed. Each informant pair (n = 118 parents/caregivers and n = 118 teachers) rated the same child. Scores on the Internalizing Problems, Externalizing Problems, and Adaptive Skills Composites were examined for mean differences, level of agreement, linear relationship, and moderators of discrepancies. There were no significant mean differences between raters for the Internalizing and Externalizing Composites or their constituent scales (except Hyperactivity). Parent-teacher ratings on these composites and scales were significantly correlated (generally moderate), and the discrepancies were not moderated by the included child or parent variables. In contrast, teacher ratings were significantly higher than parents for the Adaptive Skills Composite and several of its constituent scales. Correlations between informants on the Adaptive Skills Composite were significant (low-to-moderate), with notable variability in the correlations among its constituent scales. The degree of parent-teacher discrepancy differed significantly across the Adaptive Skills Composite score range, but it was not moderated by the included child or parent variables. This study suggests a reduced likelihood of informant discrepancies for externalizing and internalizing symptoms, with larger discrepancies expected when assessing adaptive skills. (PsycINFO Database Record

This study examined the feasibility and initial outcomes of a comprehensive outpatient psychosocial treatment (MAXout) for children aged 7–12 years with high-functioning autism spectrum disorder. The 18-week treatment, two 90-minute sessions per week, included instruction and therapeutic activities targeting social/social communication skills, facial emotion recognition, non-literal language skills, and interest expansion. A behavioral system was implemented to reduce autism spectrum disorder symptoms and problem behaviors and increase skills acquisition and maintenance. Feasibility was supported via high levels of treatment fidelity and parent, child, and staff satisfaction. Significant post-treatment improvements were found for the children’s non-literal language skills and facial emotion recognition skills, and parent and staff clinician ratings of targeted social/social communication skills, broad social skills, autism spectrum disorder symptoms, and problem behaviors. Results suggested that MAXout was feasible and may yield positive outcomes for children with high-functioning autism spectrum disorder.

This replication randomized clinical trial examined the efficacy of a comprehensive psychosocial intervention for children aged 7 to 12 years with high-functioning autism spectrum disorders (HFASDs). Participants were randomly assigned to treatment or wait-list conditions. Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition, interest expansion, and interpretation of non-literal language. A response-cost program was used to reduce problem behaviors and increase skills acquisition. Significant treatment effects were found for five of seven primary outcome measures (parent ratings and direct child measures). Secondary measures (i.e., staff ratings) corroborated gains reported by parents. Children maintained social gains 2 to 3 months post-treatment. High levels of parent, child, and staff satisfaction were found, along with high levels of treatment fidelity. Standardized effect size estimates were predominantly in the medium and large ranges for significant outcome variables.

This study examined the feasibility and initial efficacy of a comprehensive school-based intervention (CSBI) for 12 children with high-functioning autism spectrum disorders, aged 6 to 9 years. Treatment included a 3-week summer preparation program followed by a 10-month CSBI, comprising social skills groups, therapeutic activities, face and voice emotion recognition instruction, an individual daily note, and parent training. Feasibility was supported in high levels of treatment fidelity and teacher- and parent-reported acceptability and satisfaction. Pre–post comparisons suggested that children significantly improved their knowledge of target social skills, ability to identify emotions in facial and vocal expressions taught in the program, and broader emotion recognition skills in child faces. According to parent and teacher ratings, children displayed gains in their use of target social skills and broader social performance. Parents also reported a significant reduction in autism spectrum disorder-related features.

There is a notable lack of manualized comprehensive school-based interventions (CSBIs) for children with high-functioning autism spectrum disorders (HFASDs). This pilot study examined the feasibility and initial efficacy of a CSBI for 12 children with HFASDs, aged 6 to 9 years. Treatment included a 3-week summer preparation program followed by a 10-month CSBI, composed of social skills groups, therapeutic activities, face and voice emotion recognition instruction, an individual daily note, and parent training. Feasibility was supported in high levels of treatment fidelity and teacher- and parent-reported acceptability and satisfaction. Pre–post comparisons suggested that children significantly improved their knowledge of target social skills and ability to identify emotions in facial and vocal expressions. According to parent and teacher ratings, children displayed gains in their use of target social skills and broader social performance, as well as reductions in ASD-related features.

This study investigated the relationships among stress, intrapersonal resiliency factors (self-esteem, locus of control, and optimism) and quality of life [QOL] (physical health and mental health) among caregivers of children with high functioning autism spectrum disorders (HFASDs). Participants consisted of 113 caregivers of children with HFASDs (males = 38.1%, females = 61.9%; age range = 27–62; 93.6% Caucasians) and 47 caregivers of typically developing children (males = 29.8%; females = 70.2%; age range = 30–56; 93.3% Caucasians). They completed a set of self-rating surveys on perceived locus of control, self-esteem, optimism, and QOL. Within-group inferential statistical analyses were applied. For the HFASD group analyses, two simultaneous regression analyses were used to study the independent effects of the three intrapersonal variables on the physical health and mental health QOL of the caregivers. Intrapersonal factors predicted self-reported mental health QOL but not physical health QOL in caregivers of children with HFASDs.

This study was conducted to extend the research on adaptive functioning of children, ages 7–12, with high-functioning autism spectrum disorders (HFASDs; n = 41) using the Adaptive Behavior Assessment System-II. Specific purposes included examination of (1) the ABAS-II adaptive profile; (2) relative strengths and weaknesses; and (3) predictors (age, IQ, and ASD symptomatology) of adaptive functioning for children with HFASDs. Results indicated significant deficits on overall adaptive functioning and all three adaptive composites. Relative weaknesses were found in the skill areas of social, home living, and self-direction and relative strengths in academics and community use. Analyses indicated that age and IQ did not predict ABAS-II composites, whereas total ASD symptoms negatively predicted overall adaptive functioning. Significant inverse correlations were found between the ASD symptoms of restricted and repetitive behaviors and the ABAS-II social and practical daily living skills composites. No significant correlations were found between ASD social symptoms and adaptive social skills or between ASD communication symptoms and adaptive language/communication skills.

In this pilot study, the authors evaluated a manualized administration of the Mind Reading (MR) program with in vivo rehearsal to determine the effects on emotion recognition and autism features of eleven 7- to 12-year-old children with High-Functioning Autism Spectrum Disorders (HFASD), and to determine the overall feasibility of the intervention. Following 12 sessions of MR over 6 weeks ( M = 15.87 hr per child), emotion recognition and ability to display emotion were rated to be significantly higher than pretest. Significant reductions were found on ratings of autism-associated symptoms on a standardized rating scale completed by parents. Assessment of feasibility indicated high levels of treatment fidelity and high levels of parent- and child-reported satisfaction. Effect size estimates were medium to large for scales on which significant changes were observed. Implications for more controlled studies are proposed.

The purpose of this study was to: (1) examine symptom levels of anxiety and depression in children with high-functioning autism spectrum disorders (HFASDs) compared with matched control children using child self-reports and parent ratings; and (2) examine source differences within the two condition groups. An overall multivariate effect indicated significantly elevated depression and anxiety symptoms for children with HFASDs based on parent reports; however no significant between-group differences based on child self-reports. Within-condition source comparisons (parent vs. child) revealed a significant multivariate effect indicating a significant difference in symptoms of depression and anxiety for the HFASD group but none for the control. Correlations between parent and child reports for the HFASD group suggested some positive association between child-reports and parent-reports for depressive symptoms only; however, the difference in average scores reflected a substantial discrepancy in the magnitude of symptoms by rater. Implications for clinical assessment and future research are provided.

This randomized controlled trial evaluated the efficacy of a computer software (i.e., Mind Reading) and in vivo rehearsal treatment on the emotion decoding and encoding skills, autism symptoms, and social skills of 43 children, ages 7–12 years with high-functioning autism spectrum disorder (HFASD). Children in treatment (n = 22) received the manualized protocol over 12 weeks. Primary analyses indicated significantly better posttest performance for the treatment group (compared to controls) on 3 of the 4 measures of emotion decoding and encoding and these were maintained at 5-week follow-up. Analyses of secondary measures favored the treatment group for 1 of the 2 measures; specifically, ASD symptoms were significantly lower at posttest and follow-up.