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This study examined the construct validity of the Autism Classification System of Functioning: Social Communication (ACSF). Participants included 145 parents of children with autism (2-19 years). The degree of convergent and discriminant validity between parent reported ACSF and subscales from Social Responsiveness Scale 2nd edition and Behavior Assessment System for Children, 3rd Edition were examined against a priori hypotheses. We examined construct validity in the entire sample as well as in specific age cohorts. Our findings suggest that ACSF can provide a valid classification system of social communication ability in children with autism 2-19 years of age, and its two subscales may be used to examine different aspects of social communication ability. more...

Author(s): Pat Mirenda [sup.1] , Anat Zaidman-Zait [sup.2] , Katherine Tombeau Cost [sup.3] , Isabel M. Smith [sup.4] , Lonnie Zwaigenbaum [sup.5] , Eric Duku [sup.6] , Connor Kerns [sup.1] [...], This study examined educators' descriptions of the positive character traits of students with autism spectrum disorder at ages 7-8 and 10-11, using an adapted version of the Values in Action (VIA) Classification of Strengths. The most commonly endorsed strengths at both age intervals were kindness, specific skills, self-regulation, and perseverance. Higher scores for challenging behavior were associated with a lower likelihood of endorsement for Happiness and Courage traits. Higher autism symptom severity scores were associated with a lower likelihood of endorsement for Courage traits. Few significant differences were found for endorsement of trait categories by students' educational placement or the type of curriculum they received. Results may have implications for student-teacher relationships, educational assessments, and school-based interventions that emphasize strengths and resilience. more...

Author(s): Myriam L. H. Beauchamp [sup.1] , Stefano Rezzonico [sup.2] , Terry Bennett [sup.3] , Eric Duku [sup.3] , Stelios Georgiades [sup.3] , Connor Kerns [sup.4] , Pat Mirenda [sup.4] [...], We examined the narrative abilities of bilingual and monolingual children on the autism spectrum (AS), whether bilinguals presented stronger social and pragmatic language abilities compared to monolinguals, and the link between narrative, social, and pragmatic language abilities. The narrative, social, and pragmatic language skills of school-aged bilinguals (n = 54) and monolinguals (n = 80) on the AS were assessed using normed measures. Language exposure was estimated through a parent questionnaire. Bilinguals performed similarly to monolinguals on measures of narrative, social, and pragmatic language skills. However, balanced bilinguals performed better on a nonliteral language task. Overall, results indicate that bilingual children on the AS can become as proficient in using language as monolinguals and may enjoy a bilingual advantage. more...

Research regarding autistic children's sibling relationship quality is mixed, although some literature suggests poorer quality compared to children with other disabilities or who are neurotypical. Little is known about how the clinical characteristics of autistic children relate to parent perceptions of sibling relationship quality. We drew data from a subsample of 119 children on the autism spectrum, ages 10-11 years, from an ongoing longitudinal study. Hierarchical multiple regressions tested the extent to which children's autism symptoms, behavioral difficulties, and communication abilities related to four domains of parent-rated sibling relationship quality. We also examined communication ability as a moderator of the effect of behavioral difficulties on parent-rated sibling relationship quality. More severe autism symptoms were associated with lower levels of conflict and rivalry, whereas higher communication ability was related to more relative status/power, but also conflict. Communication ability moderated the effect of behavioral difficulties such that behavioral difficulties were more closely associated with less warmth/closeness when children had weaker communication skills; behavioral difficulties were not significantly associated with other domains of sibling relationship quality. Findings underscore the importance of considering clinical characteristics and multiple domains of relationship quality to better understand how parents view the relationships between autistic children and their siblings. more...

Participation in daily activities is often linked to functional independence and well-being, yet individual variability in participation and factors associated with that variation have rarely been examined among autistic youth. We applied latent profile analysis to identify subgroups of youth based on parent-reported activity participation frequency at home, school and community, as well as associations with youth characteristics, family demographics and environmental supportiveness among 158 autistic youth (aged 11-14 years at baseline). Three-, three- and two-profile solutions were selected for home, school and community settings, respectively; the most prevalent profiles were characterized by frequent home participation (73%), low participation in non-classroom activities at school (65%) and low community participation, particularly in social gatherings (80%), indicating participation imbalance across settings. More active participation profiles were generally associated with greater environmental support, higher cognitive and adaptive functioning and less externalizing behaviour. Latent transition analysis revealed overall 75% stability in profile membership over approximately 1 year, with a different home participation profile emerging at the second time-point. Our findings highlighted the variable participation patterns among autistic youth as associated with individual, family and environmental factors, thus stressing the need for optimizing person-environment fit through tailored supports to promote autistic youth's participation across settings. more...

The Autism Classification System of Functioning: Social Communication (ACSF) describes social communication functioning levels. First developed for preschoolers with ASD, this study tests an expanded age range (2-to-18 years). The ACFS rates the child's typical and best (i.e., capacity) performance. Qualitative methods tested parent and clinician perspectives of the ACSF age expansion using content analysis. The ACSF was used twice by parents and professionals for the same child/youth. Reliabilities were assessed using weighted kappa. Content validity supported the ACSF's applicability, clarity, and usability. The ACSF adaptations did not change its original construct. Reliability were calculated from 90 parent and professional Time-1 and Time-2 ratings for children/youth (2.1-15.6 years). Results showed good-to-very good intra-rater agreement (typical) and good inter-rater agreement (capacity). more...

Mental health problems are prevalent in autistic youth, but the underpinning mechanisms are not well explored. In neurotypical youth, stressful life events are an established risk factor for mental health problems. This study tested longitudinal bidirectional associations between family-level stressful life events and mental health problems and whether these were moderated by cognitive flexibility, in a cohort of autistic children (N = 247). Family-stressful life events, assessed using the parent-reported Family Inventory of Life Events and Changes, and mental health problems, assessed using the teacher-reported Child Behavior Checklist Internalizing and Externalizing Symptoms subscales, were measured at multiple points between 7 and 11 years. Analyses showed no significant pathways from internalizing or externalizing symptoms to family-stressful life events or from family-stressful life events to internalizing or externalizing symptoms. There was some evidence of moderation by cognitive flexibility; the family-stressful life events to internalizing symptoms pathway was non-significant in the group with typical shifting ability but significant in the group with clinically significant shifting problems. Information about family-level stressful life event exposure and cognitive flexibility may be helpful in identifying autistic youth who may be at higher risk of developing mental health problems. Established risk factors for mental health problems in neurotypical populations are relevant for understanding mental health in autistic youth. [This article was written with the Pathways in ASD Study Team.] more...

In a cohort of kindergarten children in Ontario, Canada with Autism Spectrum Disorder (ASD) (n = 1522), we tested the association of age at ASD diagnosis and characteristics of (1) the child's primary care provider and, (2) the child using health administrative databases. We tested the association of primary care practice model and time from developmental delay identification to age at ASD diagnosis. Older age of diagnosis was associated with provider foreign training (vs. domestic) (adjusted Hazard Ratio [aHR] 1.17, 95% CI 1.03, 1.33) but not sex, care model, and years of practice. After developmental delay identification, children with paediatricians had longer time to diagnosis than children with providers in care models (aHR 0.68, 95% CI 0.54, 0.86). Findings can be used to inform primary care provider ASD training. more...

This study examined the trajectories of autistic symptom severity in an inception cohort of 187 children with ASD assessed across four time points from diagnosis to age 10. Trajectory groups were derived using multivariate cluster analysis. A two trajectory/cluster solution was selected. Change in trajectory slopes revealed a "turning point" marked by plateauing in symptom reduction during the period of transition to school (age 6) for one of the two trajectories. Trajectories were labelled: "Continuously Improving" (27%) and "Improving then Plateauing" (73% of sample). Children in the two trajectories differed in levels of symptom severity, language, cognitive, and adaptive functioning skills. Study findings can inform the development of more personalized services for children with ASD transitioning into the school system. more...

This study examined parental perceptions of the character traits of children with autism from early childhood to age 11. Parents (n = 153) provided descriptions of the "best things" about their children on the Child Behavior Checklist (CBCL) at ages 3-4, 7-8, and 10-11 years. Descriptions were coded using the framework of the Values in Action Classification of Strengths, with additional traits added as needed. Parent-endorsed traits included love, kindness, happiness, and humor in children across all ages and traits such as perseverance as children entered school. Higher CBCL scores were associated with a lower likelihood of endorsement for Humanity traits. Results are congruent with a contemporary neurodiversity perspective that emphasizes strengths and resilience. more...

Immigrant and refugee children and adolescents form a growing socially, culturally, and economically diverse group with the potential for wide-ranging adaptation outcomes. The goal of the study was to examine whether developmental competencies (social-emotional and academic) and sociodemographic disparities (e.g., SES and migration class) identified in kindergarten forecast the academic achievement trajectories of first- and second-generation immigrant and refugee children, from childhood to adolescence. The study used a retrospective, longitudinal, population-based design by making use of linked, individual-level administrative data from four sources (e.g., Immigration, Refugees, and Citizenship Canada and Ministry of Education; IRCC, 2014 and BC MED, 2014) to identify a study cohort of immigrant and refugee children in British Columbia, Canada (N = 9,216). We utilized an analytical approach (group-based trajectory modeling) that allowed us to capture heterogeneity in the Grade 4 to Grade 10 academic (literacy and numeracy) trajectories. The resulting literacy and numeracy achievement trajectories were wide-ranging--some children thriving, some catching up, and some falling behind over time. Children's developmental competencies assessed in kindergarten (literacy, numeracy, and social-emotional) were found to predict later trajectory group membership in significant and, at times, interacting ways. Trajectory group membership also differed by migration class (refugee/immigrant), generation status, socioeconomic status, English language learner status, and sex. The findings highlight the need for early, targeted school and community interventions that will help set all immigrant and refugee children onto long-term paths of positive adaptation. more...

Despite the availability of effective early interventions, few preschoolers with mental health issues receive these services. This situation exists partly due to challenges in the identification of emotional and behavioral issues in young children. We developed the Brief Child and Family Intake and Outcomes System for Preschoolers, which is a 60-item standardized online parent questionnaire including three externalizing scales (Regulating Attention, Impulsivity, and Activity; Cooperating; Regulating Conduct), five internalizing scales (Separating from Parents; Managing Anxiety; Managing Social Anxiety; Regulating Compulsive Behaviour; Managing Mood), and two regulating states scales (Eating; Sleeping). We conducted a normative study of 1,200 Canadian children 3-5 years old, stratified by sex, age, geographic region, and parents' marital status, income, and education. Confirmatory factor analyses demonstrated good model fit, and the relationship between items and scales did not vary significantly between boys and girls or among 3-, 4-, and 5-year-old children. Reliability estimates indicated high internal consistency and 2-month test-retest reliability for a subsample (n = 100) ranging from 0.44 to 0.73. Providing preliminary evidence of validity, scale scores had positive relations with measures of child functioning challenges, family distress, caregiver mood, and demographic risk variables. We extend earlier work by including clinically relevant emotional-behavioral scales while at the same time minimizing respondent burden and providing norms for Canadian preschoolers. The questionnaire could be used in children's mental health settings, primary care, child welfare, and day-care and school facilities, for intake, triage, and describing 3- to 5-year-old children. more...

The prevalence of Fetal Alcohol Spectrum Disorder (FASD) may be underestimated as it can be difficult to diagnose in early childhood possibly reflecting unique developmental trajectories relative to other Neurodevelopmental Disabilities (NDDs). Using data collected via the Early Development Instrument (EDI) between 2010 and 2015, we examined the prevalence of kindergarten children with FASD and their concurrent developmental outcomes. We found that the prevalence of FASD ranged from 0.01 to 0.31%. A greater percentage of children with FASD had teacher-reported home problems that interfered with their classroom functioning. Overall children with FASD had higher mean scores on the developmental domains compared to children with NDDs. Results of the current study can inform strategies and policies for early identification and intervention. more...

Despite the availability of effective early interventions, few toddlers with emotional and behavioral issues receive these services. This situation exists partly due to challenges in the identification of mental health issues in young children. We developed the Brief Child and Family Intake and Outcomes System for toddlers, which is a 36-item standardized online parent questionnaire including two externalizing scales (Cooperating; Regulating Attention, Impulsivity, and Activity), two internalizing scales (Expressing Emotion; Responding to Change), and two regulatory scales (Eating; Sleeping). We conducted a normative study of 500 Canadian children 18-36 months old, stratified by sex, age, geographic region, and parents' marital status, income, and education. Confirmatory factor analyses demonstrated good model fit, and the relationship between items and scales did not vary significantly between boys and girls or between younger and older toddlers. Reliability estimates indicated high internal consistency. Providing preliminary evidence of validity, scale scores had positive relations with measures of family distress, caregiver mood, and demographic risk variables. Analyses of latent variables revealed good evidence of discriminant validity of the scales. We extend earlier work by including scales particularly relevant to toddler emotional and behavioral regulation while at the same time minimizing respondent burden and providing norms for Canadian toddlers. The questionnaire could be used in children's mental health settings, primary care, child welfare, and daycare facilities, for intake, triage, and describing toddlers. more...

Temperament is a construct that is relatively stable over time but varies between individuals. Research suggests that children with autism spectrum disorder have a 'reactive' temperament profile when compared to peers with or without disabilities. However, our understanding of how temperament varies within children with autism and how it relates to child symptoms and outcomes is limited. This study aimed to: (1) explore the variation of individual temperament traits within a sample of school-aged children with autism to determine whether subgroups of children with similar trait profiles emerge; and (2) examine whether temperament influences the relationship between autism symptoms and adaptive functioning outcomes. Results revealed that children with autism can be classified empirically into two distinct profiles -- 'Even' and 'Reactive' temperaments. Correlational and hierarchical regression analyses indicated that both temperament profiles and baseline symptom severity predicted adaptive functioning outcomes 1 year later. There was a significant interaction between temperament and symptom severity, suggesting temperament can influence the impact of increasing symptom severity on adaptive functioning skills in children with autism. Study findings highlight the importance of considering temperament in understanding the individual differences that influence the development of daily functioning and developmental outcomes in children with autism. more...

This study investigated rates of suicidal ideation (SI) and suicidal and/or self-injurious behaviour (SSIB) reported by parents on the Child Behavior Checklist for 178 children with ASD over four annual assessments (ages 7-11 years). Analyses examined the frequency and persistence of SI and SSIB, and the association of SI and SSIB at any time point with child characteristics and internalizing and externalizing problems at age 7. SI occurred in 9.6% of children and was associated with fewer ASD symptoms and better adaptive functioning at age 7. SSIB occurred in 14.6% and was associated with poorer adaptive functioning and more externalizing behaviour at age 7. Internalizing problems were not associated with SI or SSIB at any time point. SI and SSIB rarely co-occurred (4%). more...

We used a discrete choice conjoint experiment to model the anti-bullying (AB) program preferences of 1080 junior kindergarten to Grade 8 educators. Participants chose between hypothetical AB programs that varied combinations of 12 design attributes. Multi-level latent class analysis yielded three classes: "All-in Supervisors" (21.5%) preferred that all teaching staff supervise playgrounds and hallways; "Facilitators" (61.6%) preferred that students take ownership of AB activities with 25% of educators supervising playgrounds and hallways; and "Reluctant Delegators" (16.9%) preferred delegating the supervision of playgrounds and hallways to non-teaching staff. This class reported higher dispositional reactance, more implementation barriers, and more psychological reactance to these initiatives. They were less sensitive to social influences and less intent on participating in AB activities. Multi-level analysis showed a greater proportion of "Reluctant Delegators" clustered in one of the two groups of schools. The program choices of all classes were sensitive to the support of principals, colleagues, students, and, to a lesser extent, parents. All classes preferred programs conducted from kindergarten through Grade 12 that addressed the problems underlying bullying while valuing firm and consistent consequences for all students. Educators preferred AB programs selected by individual schools, rather than governments. more...

Teachers' use of evidence-informed classroom management and behavioral health strategies may improve student behavior and classroom function. However, little is known about the extent to which teachers employ various strategies and whether strategy use varies across grades. This study aimed to determine the frequency distribution of reported use of a range of strategies in a large representative sample of teachers in Ontario, Canada, and their variation across grades (junior kindergarten to grade twelve). The teacher survey contained strategies derived from a positive behavior support questionnaire (PBSQ) and a behavioral health questionnaire (EIBHQ), eight items each. Among the PBSQ items, completed by 3004 teachers, "Expected student behaviors and routines are taught directly" was the most frequently endorsed at the "always" level (60.5%), while "Rewards are varied to maintain student interest" was the least at this same level (30.6%). Among the EIBHQ items, completed by 2801 teachers, "Provided social rewards, such as praise, encouragement, and affection, to promote desired behaviors" was the most frequently endorsed at the "daily" level (71.1%), while "Taught the student to solve problems by outlining steps, such as identifying the problem, generating multiple solutions, and selecting the best alternative" was the least frequently endorsed (24.8%). For all items, frequency of endorsement significantly decreased with increasing grade level suggesting that students in higher grades are less likely to be exposed to this particular group of strategies. Additional studies are required that incorporate a wider range of teacher strategies and verify patterns with observational data. more...

Most research regarding youth with autism spectrum disorder has not focused on their first-person perspectives providing limited insight into methodologies best suited to eliciting their voices. We conducted a synthesis of methods previously used to obtain the first-person perspectives of youth with various disabilities, which may be applicable to youth with autism spectrum disorder. Two-hundred and eighty-four articles met the inclusion criteria of our scoping review. We identified six distinct primary methods (questionnaires, interviews, group discussion, narratives, diaries, and art) expressed through four communication output modalities (language, sign language and gestures, writing, and images). A group of parents who have children with autism spectrum disorder were then presented with a synthesis of results. This parent consultation was used to build on approaches identified in the literature. Parents identified barriers that may be encountered during participant engagement and provided insights on how best to conduct first-person research with youth with autism spectrum disorder. Based on our findings, we present a novel methodological framework to capture the perspectives of youth with various communication and cognitive abilities, while highlighting family, youth, and expert contributions. more...

Possible gender differences in manifestations of autism spectrum disorder (ASD) were examined using data on production of narratives. The Expression, Reception and Recall of Narrative Instrument (ERRNI; Bishop, Expression, Reception and Recall of Narrative Instrument, Harcourt assessment, London, 2004) was administered to a sample of matched 8-year-old intellectually able boys and girls with ASD (13M, 13F), who had been selected from a large, longitudinal study. In addition, transcripts of the narratives were analyzed in detail. Significant gender differences were found in narrative production. Girls included more salient story elements than boys. On detailed language analysis, girls were also shown to tell richer stories, including more descriptors of planning or intention. Overall, our findings suggest that subtle differences in social communication may exist between intellectually able boys and girls with ASD. If reliably identifiable in young children, such gender differences may contribute to differential diagnosis of ASD. In addition, such differences may pave the way for differential approaches to intervention when the target is effective communication in sophisticated discourse contexts. more...

Background: Child growth influences future health and learning. School readiness refers to a child's ability to meet developmental expectations at school entry. The association of early growth rate and patterns with school readiness remains unknown. Objective: To determine the association of child body mass index (BMI) growth with school readiness in a cohort of young children. Methods: A prospective cohort study (2015–2022) was conducted in children 0–6 years enrolled in the TARGet Kids! research network in Toronto, Canada. Two analytical approaches were used to measure growth using child weight and height/length data between 0 and 4 years: (i) age‐ and sex‐standardised BMI (zBMI) growth rate per year using a piecewise linear model; and (ii) distinct zBMI trajectories using latent class mixed models. School readiness (4–6 years) was measured using teacher‐completed Early Development Instrument (EDI). Robust Poisson models and marginal linear models using generalised estimating equations were used adjusting for confounders identified a priori. Results: In this study of 1077 children (mean age at EDI completion: 4.8 years; 52.6% male) with 6415 zBMI measurements, mean growth rate was 0.65 zBMI units/year (0–2 years) and −0.11 zBMI units/year (2–4 years). Two distinct zBMI trajectories were identified: the stable trajectory and the catch‐up trajectory. There was insufficient evidence that zBMI growth rates (risk ratio 1.10, 95% confidence interval 0.78, 1.55 for 0–2 years; risk ratio 0.71, 95% confidence interval 0.32, 1.57 for 2–4 years) or trajectories (risk ratio 1.05, 95% confidence interval 0.82, 1.35, catch‐up trajectory vs. stable trajectory) were associated with school readiness. Conclusions: No association was found between BMI growth and school readiness. School readiness may be more impacted by factors directly related to obesity or adiposity at the time of EDI measurement rather than growth. [ABSTRACT FROM AUTHOR] more...