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BackgroundIn Australia, the average time between a first concern of autism spectrum disorder (ASD) and diagnosis is over 2 years. After referral for assessment, families often wait 6-12 months before their appointment. This can be a time of uncertainty and stress for families. For some families, other forms of assistance are not accessible and thus timely intervention opportunities are missed. There is little evidence about how to provide the best support for children or caregivers while on assessment waiting lists. ObjectiveThe aim of this study is to determine whether use of a coaching intervention called Occupational Performance Coaching (OPC) combined with service navigation support is feasible for families waiting for ASD assessment, as a crucial first step in planning a randomized controlled trial. MethodsA pilot and feasibility study will be conducted using recommended constructs and associated measures, which will be reported using CONSORT (Consolidated Standards or Reporting Trials) guidance. Participants will be child and caregiver dyads or triads, recruited within 4 months of their child (aged 1-7 years) being referred to one of two services for an ASD assessment in Victoria, Australia. A blinded randomization procedure will be used to allocate participants to one of three trial arms: (1) coaching and support intervention delivered face to face, (2) coaching and support intervention via videoconference, and (3) usual care. Descriptive statistics will be used to describe the sample characteristics of parents and children, inclusive of service access at baseline and follow up. Recruitment rates will be reported, and retention rates will be evaluated against a predicted rate of 70%-80% in each intervention arm. Goal attainment, using the Canadian Occupational Performance Measure, will indicate preliminary evidence for efficacy within the intervention arms, with an increase of 2 or more points on a 10-point performance and satisfaction scale considered clinically significant. ResultsThe study was approved by The Royal Children’s Hospital Research Ethics and Governance Department in September 2018. As of October 2020, 16 families have been recruited to the study. Data analysis is ongoing and results are expected to be published in 2021. ConclusionsStudy findings will support planning for a future randomized controlled trial to assess the efficacy of OPC and service navigation support for caregivers of children awaiting ASD assessment. Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12620000164998; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378793&isReview=true International Registered Report Identifier (IRRID)DERR1-10.2196/20011

Aim: To determine whether short-phase Occupational Performance Coaching combined with service navigation support is feasible for families waiting for autism assessment. Method: A pilot feasibility study was conducted using a blinded randomization procedure that allocated participants to one of three trial arms: (1) face-to-face coaching, (2) videoconference coaching, and (3) usual care. Outcomes included a retention aim of 70-80%, goal attainment and secondary standardised measures of adaptive behaviour, social skills, parenting stress, service access and family quality of life. Results: Caregivers and children (n = 16, child mean age of 3 years 7 months) were recruited following referral for an autism assessment. Retention was 75%, with change scores in performance and satisfaction of selected goals higher in the intervention groups than the usual care group. Interpretation: Findings support progression to a future randomized controlled trial assessing intervention efficacy.

Interventions and programmes to support the development of preschool children's social and emotional skills are commonly used in early childhood education and care (ECEC) settings. Research suggests the physical and sensory ECEC environment can influence children's social and emotional development. The aim of this paper was to evaluate the effectiveness of physical and sensory ECEC environment interventions, delivered by ECEC educators, to support children's social and emotional development. Relevant studies were identified through a systematic search of PsycINFO, ERIC, Medline, and other sources; seven papers, published since 2000, were included in this review. The interventions used in ECEC settings, include: nature-based programmes, playground redevelopment, background music, indoor toy arrangement and sensory cushions. The results show the effectiveness of physical and sensory environment interventions is mixed, but shows promise. This paper outlines recommendations for future research and practice, including the need to further explore the characteristics of supportive sensory ECEC environments.

Aim To determine whether short-phase Occupational Performance Coaching combined with service navigation support is feasible for families waiting for autism assessment. Method A pilot feasibility study was conducted using a blinded randomization procedure that allocated participants to one of three trial arms: (1) face-to-face coaching, (2) videoconference coaching, and (3) usual care. Outcomes included a retention aim of 70-80%, goal attainment and secondary standardised measures of adaptive behaviour, social skills, parenting stress, service access and family quality of life. Results Caregivers and children (n = 16, child mean age of 3 years 7 months) were recruited following referral for an autism assessment. Retention was 75%, with change scores in performance and satisfaction of selected goals higher in the intervention groups than the usual care group. Interpretation Findings support progression to a future randomized controlled trial assessing intervention efficacy., Author(s): Charmaine Bernie [sup.1] [sup.2] [sup.3] [sup.4] , Katrina Williams [sup.1] [sup.4] [sup.5] [sup.6] , Fiona Graham [sup.7] , Tamara May [sup.1] [sup.4] [sup.6] Author Affiliations: (1) grid.1008.9, 0000 0001 [...]

Mental health and developmental challenges that emerge in early childhood can be associated with difficulty in social interactions and behavioural regulation. With educational policies increasingly promoting inclusion in early learning settings, educators are being called upon to support children's social-emotional competence through evidence-informed practice. A narrative review was undertaken to explore the breadth and summarize research findings related to educator-led Tier 3 social and emotional learning intervention for children with diagnosed mental health conditions or developmental delays. Nineteen evaluation studies were reviewed and synthesized into four themes: (1) instruction embedded into daily routines and activities; (2) direct skill instruction; (3) peer-mediated interventions; and (4) individualized assessment-based approaches. Interventions targeted children with neurodevelopmental disorders, and developmental, social and communication delays, with findings suggesting improvement in children's social skill during or post intervention. Evidence of maintenance and generalization were, however, inconsistent. There is a paucity of peer-reviewed research examining interventions for young children experiencing anxiety or mood disorders.

A growing body of research evidence suggests universal (Tier 1) Social and Emotional Learning (SEL) interventions in early childhood education and care settings can improve children's social and emotional development. Less is known however about the effectiveness of targeted (Tier 2) programmes for preschoolers experiencing social, emotional or behavioural challenges. A systematic literature review was conducted to examine the outcomes associated with targeted (Tier 2) SEL interventions; 19 studies were captured in the review. Findings revealed that while evidence for targeted SEL programming is still emerging, it may offer a promising early intervention approach to strengthen aspects of children's social and behavioural functioning. Based on the evidence reviewed, the impact of targeted SEL intervention on emotional competencies could not be established. Programmes were predominately directed to preschoolers with externalizing problems and there appears to be a dearth of approaches focused on internalizing behaviour. Implications for practice and research are discussed.

The aim of this novel review and meta-analysis was to clarify the effects of group-based organised physical activity (OPA) for social and communicative outcomes in children with Autism Spectrum Disorder (ASD). Searches yielded 4347 articles. Eleven were identified for review and seven for meta-analysis. Pooled statistical results revealed a non-significant effect for communication (k = 4; g = 0.13, CI [- 0.12, 0.38], p = 0.13) and a significant small-medium improvement in overall social functioning (k = 6; g = 0.45, CI [0.19, 0.72], p = 0.001). Despite acknowledged limitations, these findings are important in the context of a growing clinical and consumer-driven demand for research that determines the role of OPA as a non-medical and inclusive treatment for children with ASD.

Few studies have examined growth and predictors of receptive vocabulary in children with autism spectrum disorder. Here we aimed to compare receptive vocabulary from 4 to 8 years and identify predictors of receptive vocabulary, at 8 years, in children with and without autism spectrum disorder. Participants were drawn from a nationally representative population-based study with two cohorts recruited at birth (N = 4983) and kindergarten (N = 5107). Receptive vocabulary growth was compared for children with and without autism spectrum disorder at 4 (n = 188, n = 7136), 6 (n = 215, n = 7297) and 8 (n = 216, n = 7408) years. Predictors of receptive vocabulary were analysed. Estimated mean receptive vocabulary scores for children without autism spectrum disorder were 2.3 units higher than the autism spectrum disorder group across three time points. This difference was significant (p = 0.004; 95% confidence interval 0.769-3.927). Children with and without autism spectrum disorder progressed at a similar pace. There was no significant difference between the proportions of children with and without autism spectrum disorder who had stable, improving and declining trajectories. Age was the only significant predictor of greater receptive vocabulary growth in children with autism spectrum disorder. Baseline receptive language and nonverbal IQ were significant predictors of receptive vocabulary ability at 8 years. These findings inform prognostic advice given to families on language outcomes.

Recent evidence suggests the male predominance in Autism Spectrum Disorder (ASD) may be decreasing. Secondary analyses of Australian Medicare data (paediatrician/child psychiatrist items for diagnosing ASD before age 13) were used (N = 73,463 unique children from 1-July-2008 to 30-June-2016). Cumulative incidence of ASD in 4-year-olds in 2015/2016 was 1.10% [95% CI 1.06-1.14], males 1.66% [95% CI 1.60-1.72] and females 0.51% [95% CI 0.47-0.55]. New diagnoses significantly increased in older (5-12 years) males and females but not younger (0-4 years) children, from 2010/2011 to 2015/2016. The M:F ratio decreased in older children (4.1-3.0), but not significantly in younger children (4.2-3.5). Identification of older males and females is contributing to the increased in ASD in Australia and proportionally more older females are being diagnosed.

Secondary data analyses from the Longitudinal Study of Australian Children Kindergarten cohort were performed to understand any alterations in pubertal timing in Autism Spectrum Disorder (ASD) in a population sample. Timing of parent-reported pubertal events (ages 8-9, 10-11, 12-13 years), and self-report (14-15 years; N = 3454 no ASD, N = 94 with ASD) included breast development, menses, skin changes, growth spurt, body hair, deepening voice and facial hair. Survival analyses and Cox regression controlling for covariates showed no evidence of altered pubertal onset amongst males with ASD. In contrast to some past studies, there was also no difference in pubertal timing in females with ASD. These exploratory findings suggest typical puberty timing in a population representative group of young people with ASD.

This study utilised a longitudinal population-based study to explore mother and child mental health trajectories over time from child age 0 to 14 years, between children with ASD, ADHD, or ASD + ADHD. It explored whether a bidirectional relationship between mother psychological distress and child emotional and behavioural problems (EBPs) existed. The birth cohort from the Longitudinal Study of Australian Children was used. Child EBPs were assessed using the Strengths and Difficulties Questionnaire; and mother emotional distress using the Kessler K6. Generalised estimating equations and structured equation modelling was used to understand changes over time, differences between groups and bidirectional relationships. As expected, children with ASD, ADHD or ASD + ADHD had higher EBPs than children without, and their mothers had higher levels of psychological distress across most time points, but with differing trajectories. Mothers of children with ASD (with or without ADHD) showed increasing psychological distress over time, while mothers of children with ADHD had reducing distress. The bidirectional relationship between mother and child mental health found in children without diagnoses was only partially present in children with ASD/ADHD. Findings highlight support needs and discuss implications for transactional models of parent/child emotional problems in children with neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

Past research suggests more variation in sexual attraction in Autism Spectrum Disorder (ASD) using clinical samples. This study utilised a population representative group of 14/15 year olds from the Longitudinal Study of Australian Children. Ninety-four adolescents (73 males, 21 females) with ASD and 3454 (1685 males, 1675 females) without self-reported on sexual attraction and past sexual relationships. Females with ASD reported lower rates of heterosexual preference (adjusted odds ratio: 0.14, p < 0.001), higher rates of bisexuality (adjusted odds ratio: 6.05, p < 0.001) and uncertainty in attraction (adjusted odds ratio: 10.44, p < 0.001) compared with non-ASD females. ASD males reported fewer prior boyfriends/girlfriends. Findings confirm female adolescents with ASD have differences in sexual attraction compared with non-ASD females.

The aim of this novel review and meta-analysis was to clarify the effects of group-based organised physical activity (OPA) for social and communicative outcomes in children with Autism Spectrum Disorder (ASD). Searches yielded 4347 articles. Eleven were identified for review and seven for meta-analysis. Pooled statistical results revealed a non-significant effect for communication (k = 4; g = 0.13, CI [- 0.12, 0.38], p = .13) and a significant small-medium improvement in overall social functioning (k = 6; g = 0.45, CI [0.19, 0.72], p = .001). Despite acknowledged limitations, these findings are important in the context of a growing clinical and consumer-driven demand for research that determines the role of OPA as a non-medical and inclusive treatment for children with ASD., Author(s): Katherine Howells [sup.1] , Carmel Sivaratnam [sup.1] , Tamara May [sup.1] , Ebony Lindor [sup.1] , Jane McGillivray [sup.1] , Nicole Rinehart [sup.1] [sup.2] Author Affiliations: (Aff1) grid.1021.2, 0000 [...]

Children with autism spectrum disorder (ASD) have high levels of anxiety. It is unclear whether they exhibit threat-related attentional biases commensurate with anxiety disorders as manifest in non-ASD populations, such as facilitated attention toward, and difficulties disengaging engaging from, threatening stimuli. Ninety children, 45 cognitively able with ASD and 45 age, perceptual-IQ, and gender matched typically developing children, aged 7-12 years, were administered a visual dot probe task using threatening facial pictures. Parent-reported anxiety symptoms were also collected. Children with ASD showed similarly high levels of anxiety compared with normative data from an anxiety disordered sample. Children with ASD had higher levels of parent-reported anxiety but did not show differences in disengaging from, or facilitated attention toward, threatening facial stimuli compared with typically developing children. In contrast to previously published studies of anxious children, in this study there were no differences in attentional biases in children with ASD meeting clinical cutoff for anxiety and those who did not. There were no correlations between attentional biases and anxiety symptoms and no gender differences. These findings indicate the cognitive mechanisms underlying anxiety in cognitively able children with ASD could differ from those commonly found in anxious children which may have implications for both understanding the aetiology of anxiety in ASD and for anxiety interventions.

Secondary data analyses from the Longitudinal Study of Australian Children Kindergarten cohort were performed to understand any alterations in pubertal timing in Autism Spectrum Disorder (ASD) in a population sample. Timing of parent-reported pubertal events (ages 8-9, 10-11, 12-13 years), and self-report (14-15 years; N = 3454 no ASD, N = 94 with ASD) included breast development, menses, skin changes, growth spurt, body hair, deepening voice and facial hair. Survival analyses and Cox regression controlling for covariates showed no evidence of altered pubertal onset amongst males with ASD. In contrast to some past studies, there was also no difference in pubertal timing in females with ASD. These exploratory findings suggest typical puberty timing in a population representative group of young people with ASD., Author(s): Tamara May [sup.1] [sup.2] [sup.3] , Ken C. Pang [sup.2] [sup.3] [sup.4] [sup.5] [sup.6] , Michele A. O'Connell [sup.3] [sup.7] , Katrina Williams [sup.2] [sup.3] [sup.8] Author Affiliations: (1) [...]

Past research suggests more variation in sexual attraction in Autism Spectrum Disorder (ASD) using clinical samples. This study utilised a population representative group of 14/15 year olds from the Longitudinal Study of Australian Children. Ninety-four adolescents (73 males, 21 females) with ASD and 3454 (1685 males, 1675 females) without self-reported on sexual attraction and past sexual relationships. Females with ASD reported lower rates of heterosexual preference (adjusted odds ratio: 0.14, p < .001), higher rates of bisexuality (adjusted odds ratio: 6.05, p < .001) and uncertainty in attraction (adjusted odds ratio: 10.44, p < .001) compared with non-ASD females. ASD males reported fewer prior boyfriends/girlfriends. Findings confirm female adolescents with ASD have differences in sexual attraction compared with non-ASD females., Author(s): Tamara May [sup.1] [sup.2] , Ken C. Pang [sup.1] [sup.2] [sup.3] [sup.4] [sup.5] , Katrina Williams [sup.1] [sup.2] [sup.6] Author Affiliations: (1) 0000 0001 2179 088Xgrid.1008.9Department of Paediatrics, University [...]

Gender differences in autism spectrum disorder (ASD) symptoms and associated problem behaviours over development may provide clues regarding why more males than females are diagnosed with ASD. Fifty-six high-functioning children with ASD, and 44 typically developing controls, half of the participants female, were assessed at baseline (aged 7-12 years) and one-year later, collecting measures of autism, attention and anxiety symptoms, school placement and support information. Findings indicated no gender differences in autistic symptoms. Males were more hyperactive and received more integration-aide support in mainstream schools, and females were more socially anxious. Overall, similar gender profiles were present across two time points. Lower hyperactivity levels in females might contribute to their under-identification. Implications are discussed using a biopsychosocial model of gender difference.

Academic attainment in children with Autism Spectrum Disorder (ASD) is under-studied, with associated factors largely undetermined. Parent-reported attention symptoms, attentional-switching and sustained-attention tasks were examined to determine relationships with mathematics and reading attainment in 124 children aged 7-12 years; sixty-four with high-functioning ASD, half girls, and sixty age- and gender-matched typical children (TYP). With full-scale IQ controlled there were no differences in mathematics, reading, attentional switching or sustained attention. In regression analysis, attentional switching was related to mathematics achievement in ASD but not TYP children. Findings highlight attentional switching difficulties are linked with poorer mathematics outcomes in ASD.