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Autistic individuals are at particular risk of experiencing mental health problems during the COVID-19 pandemic, yet little is known about personal characteristics that may underlie this vulnerability. This longitudinal questionnaire study with 149 autistic and 147 non-autistic adults investigated the association between perceived stress and anxiety and depressive symptoms, measured 4 months later. In addition, the moderating impact of intolerance of uncertainty and coping styles on this association was examined. Confirming previous studies, autistic adults reported poorer mental health than non-autistic individuals. Results demonstrated similar moderation models across individuals with versus without autism. Perceived stress at timepoint 1 was associated with anxiety and depression at timepoint 2. Across both participant groups, individuals with maladaptive coping strategies and higher levels of intolerance of uncertainty at timepoint 1 showed more internalizing symptoms at timepoint 2. The findings demonstrate the burden of the pandemic on the mental health of autistic adults, especially on those with high levels of perceived stress, maladaptive coping strategies, or intolerance of uncertainty. Interventions to support autistic adults during and after the pandemic might involve providing psychoeducation about the impact of stress, coping, and intolerance of uncertainty on internalizing symptoms, and teaching more adaptive ways to cope with difficult circumstances.

Using a mixed methods design, this study aimed to examine the impact of the COVID-19 pandemic on autistic and non-autistic adults. We conducted an online survey with 196 autistic and 228 non-autistic adults from Belgium, the Netherlands and the United Kingdom focusing on their experiences during the first period of the pandemic. Our results indicate rather diverse experiences within the group of autistic participants across all domains of life. In comparison with non-autistic adults, autistic adults reported less negative impact on their social life and more negative impact on health and support services. In the autism group, stress was mainly related to changing and unclear measures. A wide range of coping strategies were described as helpful in reducing stress during the pandemic.

Using a mixed methods design, this study aimed to examine the impact of the COVID-19 pandemic on autistic and non-autistic adults. We conducted an online survey with 196 autistic and 228 non-autistic adults from Belgium, the Netherlands and the United Kingdom focusing on their experiences during the first period of the pandemic. Our results indicate rather diverse experiences within the group of autistic participants across all domains of life. In comparison with non-autistic adults, autistic adults reported less negative impact on their social life and more negative impact on health and support services. In the autism group, stress was mainly related to changing and unclear measures. A wide range of coping strategies were described as helpful in reducing stress during the pandemic., Author(s): Jarymke Maljaars [sup.1] [sup.2] [sup.3] , Eef Gijbels [sup.1] , Kris Evers [sup.1] [sup.2] [sup.3] , Debbie Spain [sup.4] , Freya Rumball [sup.4] [sup.5] , Francesca Happé [sup.4] , [...]

Background & aims: Due to the complexity of early diagnostic decision making, we examined the predictive value of an early diagnostic classification and early abilities on later best estimate diagnosis for 22 clinically referred children with language difficulties. Methods and procedures: Four years after initial evaluation (Time 1), the clinical files of these children were reviewed. A best-estimate (BE) diagnosis of language disorder (LD), intellectual disability (ID), or autism spectrum disorder (ASD) was established, with ASD being most common. Outcomes and results: Early clinical classifications were relatively unstable or difficult to establish at a young age. The magnitude of children's cognitive and receptive language delay was a significant predictor of a later BE diagnosis of ID and LD respectively. A BE diagnosis of ASD, by contrast, could not be predicted from children's early social communication problems nor the presence of restricted and repetitive behaviors and interests. Conclusions: Taken together, the results of this study suggest that language difficulties can be an early marker of a neurodevelopmental disorder which is often not identified at the age of first referral. Implications: Eligibility for treatment should, therefore, be based on biopsychosocial case formulation rather than DSM or ICD diagnostic classification. What this paper adds?: In this study a dimensional approach was used to characterize the abilities of young children referred with mild to profound receptive and/or expressive language difficulties. Later on, a categorical approach was adopted to establish best estimate diagnoses. Our clinical, broadly defined sample reflects the heterogeneous intake of young children referred for diagnostic assessment. Other studies on diagnostic stability often only focus on one diagnostic category (and are explicitly excluding children with specific other diagnoses), not taking into account the difficulties of early differential diagnostic decision making and stability across different categories over time. Investigations of differential diagnosis within a clinical group, instead of only differentiating children with a specific diagnosis from typically developing children, may be more informative for clinicians.

This study examines how fostered individuals, foster carers, bio-legal children of foster carers and birth parents use discourse to construct and maintain family identity and what may influence this use. Focus group and interview data show how family terminology may create a sense of family, affirm and strengthen ties, erase distinctions, promote inclusion and conformity and protect, refute and explain ties to in- and outsiders. Family terminology use is dynamic and can be influenced by (conflicting) beliefs about who is entitled to these terms and the difficulty of sharing terms. Stakeholders showed many commonalities. Practice and research implications are discussed. [ABSTRACT FROM AUTHOR]

Two semi-structured parental interviews are available with algorithms developed to measure DSM-5 criteria of ASD, namely the Developmental, Dimensional and Diagnostic Interview (3di) and the Diagnostic Interview for Social and Communication Disorders (DISCO-11). The main aim of this study was to examine the agreement between classification according to both interviews, and their convergence with the clinical diagnosis. Therefore, the 3di and DISCO-11 were administered from three groups of parents of a 4-18 year old. Results showed 75% agreement between both instruments, but in the ASD group only 16% of the children scored above threshold on both instruments. Exploratory analyses suggested that the 3di failed to detect rigid and repetitive behaviors, whereas the DISCO-11 was insufficiently sensitive in detecting socio-communicative problems.

Here, we explored the structure of the 'Parenting Strategies Questionnaire', a new scale designed to measure parenting strategies for problem behaviour in ASD. We then examined links between child behaviour and parenting in a sample of 222 predominantly-UK parents of ASD children exhibiting behaviour found difficult or challenging. Analysis revealed three parenting subscales: "Accommodation," "Reinforcement Approaches" and "Reducing Uncertainty." Both "Accommodation" and "Reducing Uncertainty" were linked to child problem behaviour. Child factors explained up to 29% of the variance in "Accommodation," with "Socially Inflexible Non-compliance" the strongest predictor, and up to 24% of the variance in "Reducing Uncertainty," with "Intolerance of Uncertainty" the strongest predictor. Child factors were not related to "Reinforcement Approaches." Longitudinal studies investigating these relationships are needed.

The rate of diagnosis of autism in adults has increased over recent years; however, the profile of behaviours in these individuals is less understood than the profile seen in those diagnosed in childhood. Better understanding of this profile will be essential to identify and remove potential barriers to diagnosis. Using an abbreviated form of the Diagnostic Interview for Social and Communication Disorders, comparisons were drawn between the profile of a sample of able adults diagnosed in adulthood and the profile of a sample of able children. Results revealed both similarities and differences. A relative strength in non-verbal communication highlighted a potential barrier to diagnosis according to DSM-5 criteria for the adult sample, which may also have prevented them from being diagnosed as children.

Two semi-structured parental interviews are available with algorithms developed to measure DSM-5 criteria of ASD, namely the Developmental, Dimensional and Diagnostic Interview (3di) and the Diagnostic Interview for Social and Communication Disorders (DISCO-11). The main aim of this study was to examine the agreement between classification according to both interviews, and their convergence with the clinical diagnosis. Therefore, the 3di and DISCO-11 were administered from three groups of parents of a 4-18 year old. Results showed 75% agreement between both instruments, but in the ASD group only 16% of the children scored above threshold on both instruments. Exploratory analyses suggested that the 3di failed to detect rigid and repetitive behaviors, whereas the DISCO-11 was insufficiently sensitive in detecting socio-communicative problems., Author(s): Kris Evers [sup.1] [sup.2] [sup.3] , Edward Debbaut [sup.2] [sup.3] [sup.4] , Jarymke Maljaars [sup.1] [sup.2] [sup.3] , Jean Steyaert [sup.2] [sup.3] [sup.4] , Ilse Noens [sup.1] [sup.2] Author [...]

Here, we explored the structure of the 'Parenting Strategies Questionnaire', a new scale designed to measure parenting strategies for problem behaviour in ASD. We then examined links between child behaviour and parenting in a sample of 222 predominantly-UK parents of ASD children exhibiting behaviour found difficult or challenging. Analysis revealed three parenting subscales: Accommodation, Reinforcement Approaches and Reducing Uncertainty. Both Accommodation and Reducing Uncertainty were linked to child problem behaviour. Child factors explained up to 29% of the variance in Accommodation, with Socially Inflexible Non-compliance the strongest predictor, and up to 24% of the variance in Reducing Uncertainty, with Intolerance of Uncertainty the strongest predictor. Child factors were not related to Reinforcement Approaches. Longitudinal studies investigating these relationships are needed., Author(s): Elizabeth O'Nions [sup.1] [sup.2] [sup.3] , Eva Ceulemans [sup.4] , Francesca Happé [sup.5] , Paul Benson [sup.6] , Kris Evers [sup.1] [sup.2] [sup.7] , Ilse Noens [sup.1] [sup.2] Author [...]

The rate of diagnosis of autism in adults has increased over recent years; however, the profile of behaviours in these individuals is less understood than the profile seen in those diagnosed in childhood. Better understanding of this profile will be essential to identify and remove potential barriers to diagnosis. Using an abbreviated form of the Diagnostic Interview for Social and Communication Disorders, comparisons were drawn between the profile of a sample of able adults diagnosed in adulthood and the profile of a sample of able children. Results revealed both similarities and differences. A relative strength in non-verbal communication highlighted a potential barrier to diagnosis according to DSM-5 criteria for the adult sample, which may also have prevented them from being diagnosed as children., Author(s): Sarah J. Carrington [sup.1] [sup.2] , Sarah L. Barrett [sup.2] , Umapathy Sivagamasundari [sup.3] , Christine Fretwell [sup.4] , Ilse Noens [sup.5] [sup.6] , Jarymke Maljaars [sup.5] [sup.6] [sup.7] [...]

Previous research suggested that adolescents with autism spectrum disorder are better than typically developing children in detecting local, non-social details within complex visual scenes. To better understand these differences, we used the image database by Sareen et al., containing the size and on-screen location information of all changes in the images, in a change blindness paradigm. In this task, an original and a modified real-world scene, separated by a gray blank, alternate repeatedly until observers detect the change. Our results indicated that participants with and without autism spectrum disorder performed similarly when scenes were presented upright, but that only the performance of the typically developing adolescents became worse in the inverted scene condition. In this condition, the correlation between performance and both image difficulty and change predictability was significantly weaker in autism spectrum disorder than in typically developing participants. We suggest that these findings result from a more locally biased search strategy in people with autism spectrum disorder, compared to typically developing participants, in tasks in which the rapid processing of global information does not help to improve change detection performance. Finally, although we found change location, change size, and age to influence participant performance, none of these was directly linked to the observed group-level differences.

Local and global visual processing abilities and processing style were investigated in individuals with autism spectrum disorder (ASD) versus typically developing individuals, children versus adolescents and boys versus girls. Individuals with ASD displayed more attention to detail in daily life, while laboratory tasks showed slightly reduced global processing abilities, intact local processing abilities, and a more locally oriented processing style. However, the presence of these group differences depended on particular task and sample (i.e., age and gender) characteristics. Most measures of local and global processing did not correlate with each other and were not associated with processing style. Significant associations between local-global processing and ASD symptom severity were observed, but the causality of these associations remains unclear.

Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety; and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD.

The multiple object tracking (MOT) paradigm has proven its value in targeting a number of aspects of visual cognition. This study used MOT to investigate the effect of object-based grouping, both in children with and without autism spectrum disorder (ASD). A modified MOT task was administered to both groups, who had to track and distinguish four targets that moved randomly amongst four distracters, irrespective of the grouping condition. No group difference was revealed between children with and without ASD: both showed adequate MOT abilities and a similar amount of grouping interference. Implications of the current result are considered for previous MOT studies, the developmental trajectory of perceptual grouping, and the idea of heightened sensitivity to task characteristics in ASD.

Because of a better understanding of autism spectrum disorder (ASD) in all stages of life and the improvement of support of students with ASD in primary and secondary education, an increasing number of students with ASD are accessing higher education. Previous research suggests that these students have fewer opportunities in higher education due to a number of functioning and participation problems. However, literature regarding students with ASD in higher education is rather scarce. This article presents an overview of recent studies in a literature review describing the functioning and participation problems of young adults with ASD. This literature review is complemented by focus groups with student mentors and interviews with students with ASD to connect the insights from the literature review to the context of higher education and to check whether all functioning and participation problems are covered by the existing literature. The review showed that little is known about the functioning and participation problems of students with ASD in higher education. However, knowledge about the full spectrum of problems can be the first step towards a better match between the individual problems and the offered reasonable accommodations to increase the participation chances and success rate of these students in higher education.

This short report presents recommendations to promote health and well-being relating to sexuality and gender diversity in autistic individuals. The recommendations were developed based on the latest available scientific knowledge coupled with a community-driven approach. An international group of autistic and non-autistic experts in the fields of autism, sexuality, and gender diversity and autistic advocates worked together to develop the initial recommendations; these recommendations were subsequently checked within the wider community through an online survey. Out of the original 11 recommendations, eight were rated above a consensus threshold. The final recommendations cover three themes: (1) providing education and information on sexuality, relationships, and gender diversity to autistic individuals and their families; (2) improving expertise in and accessibility to healthcare for sexuality, relationships, and gender-related questions, with specific attention to prevention of and support after sexual victimization; and (3) meaningful inclusion of the autism community in future research that addresses well-being related to sexuality, relationships, and gender diversity. The recommendations emphasize the need for additional awareness and offer cues to parents, professionals, and policymakers to promote sexual health and well-being of autistic individuals. In this article, we propose recommendations on what we can do to promote that autistic people can enjoy their sexuality and gender identity, because that contributes to overall well-being. First, we briefly summarize the existing research on sexuality and gender diversity in autistic individuals. Next, we propose recommendations for how to promote sexual and gender diversity-related health and well-being. Based on what is known about sexuality, gender diversity, and relationships in autistic adolescents and adults, we convened an international group of autistic and non-autistic researchers, advocates, parents, and professionals to develop recommendations to promote sexual and gender health in autistic people. The resulting recommendations were checked through an online survey distributed to autistic people across the world. The online participants endorsed the importance of eight final recommendations related to: 1. Providing education and information on sexuality, relationships, and gender diversity to autistic individuals and their families; 2. Improving expertise in and accessibility to healthcare for sexuality, relationships, and gender-related questions, with specific attention to prevention of and support after sexual victimization; and 3. Meaningfully including the autism community in future research that addresses well-being relating to sexuality, relationships, and gender diversity. These community-driven recommendations aim to promote sexual health and well-being in autistic individuals internationally. [ABSTRACT FROM AUTHOR]

While most typically developing (TD) participants have a coarse-to-fine processing style, people with autism spectrum disorder (ASD) seem to be less globally and more locally biased when processing visual information. The stimulus-specific spatial frequency content might be directly relevant to determine this temporal hierarchy of visual information processing in people with and without ASD. We implemented a semantic priming task in which (in)congruent coarse and/or fine spatial information preceded target categorization. Our results indicated that adolescents with ASD made more categorization errors than TD adolescents and needed more time to process the prime stimuli. Simultaneously, however, our findings argued for a processing advantage in ASD, when the prime stimulus contains detailed spatial information and presentation time permits explicit visual processing.

Studies using hierarchical patterns to test global precedence and local-global interference in individuals with ASD have produced mixed results. The current study focused on stimulus variability and locational uncertainty, while using different attentional modes. Two groups of 44 children with and without ASD completed a divided attention task as well as a global and local selective attention task. The results revealed global-to-local and local-to-global interference in ASD, to the same extent as in the TD group. Both groups struggled with the same type of stimuli (i.e., ignoring the global level information) and performed similar in all three tasks. Future studies on (visual) information processing in ASD should pursue the impact of stimulus noise and trial-by-trial uncertainty further.

Students with autism spectrum disorder (ASD) experience various functioning and participation problems in higher education, which may cause difficulties such as drop out or low grade point averages. However, it remains unclear how often and during which teaching and evaluation methods the functioning and participation problems occur and which reasonable accommodations are effective in dealing with them. These gaps in the literature are addressed in this survey-based study. In total, 43 students with ASD, 30 student counsellors and 43 students without a disability of institutions of higher education in Flanders (Belgium) participated in the study. The results show that students with ASD most frequently experience problems with verbal and non-verbal communication, are oversensitive to change and have difficulty distinguishing the gist of the syllabus from the details. Furthermore, it is shown that, on average, these problems arise mostly during classical teaching and evaluation methods. Finally, the perceived effectiveness of reasonable accommodations is dependent on the functioning and participation problem experienced by the student with ASD in higher education. In conclusion, both personal and environmental characteristics should be taken into account when selecting and implementing reasonable accommodations for these students.

Students with ADHD struggle in higher education as a result of various functioning and participation problems. However, there are remaining gaps in the literature. First, it remains unclear how often and during which teaching and evaluation methods problems arise. Second, we do not yet know which reasonable accommodations are most effective to deal with the functioning. And third, we do not know which accommodations are most effective to address participation problems of students with ADHD in higher education. This study addresses these three gaps in literature. In total, 86 students with ADHD, 42 student counsellors and 86 students without a disability participated in a survey-based study. The results show that students with ADHD most frequently experience problems with sustaining and focusing attention and it is demonstrated that most problems arise during classical teaching or evaluation methods. Finally, the perception of the effectiveness of reasonable accommodations is strongly dependent on which problems students experience in higher education. These findings suggest that it is important to consider both personal and environmental characteristics when selecting and implementing reasonable accommodations.

The multiple object tracking (MOT) paradigm has proven its value in targeting a number of aspects of visual cognition. This study used MOT to investigate the effect of object-based grouping, both in children with and without autism spectrum disorder (ASD). A modified MOT task was administered to both groups, who had to track and distinguish four targets that moved randomly amongst four distracters, irrespective of the grouping condition. No group difference was revealed between children with and without ASD: both showed adequate MOT abilities and a similar amount of grouping interference. Implications of the current result are considered for previous MOT studies, the developmental trajectory of perceptual grouping, and the idea of heightened sensitivity to task characteristics in ASD., Author(s): Ruth Van der Hallen [sup.1] [sup.2] [sup.3] , Kris Evers [sup.1] [sup.2] [sup.3] , Lee de-Wit [sup.1] , Jean Steyaert [sup.2] [sup.3] , Ilse Noens [sup.3] [sup.4] [sup.5] , [...]

Although there is increasing research interest in the parenting of children with ASD, at present, little is known about everyday strategies used to manage problem behaviour. We conducted a meta-synthesis to explore what strategies parents use to manage irritability, non-compliance, challenging behaviour and anxiety in their children with ASD. Approaches included: (1) accommodating the child; (2) modifying the environment; (3) providing structure, routine and occupation; (4) supervision and monitoring; (5) managing non-compliance with everyday tasks; (6) responding to problem behaviour; (7) managing distress; (8) maintaining safety and (9) analysing and planning. Results suggest complex parenting demands in children with ASD and problem behaviour. Findings will inform the development of a new measure to quantify parenting strategies relevant to ASD., Author(s): Elizabeth O'Nions [sup.1] [sup.2] [sup.3] [sup.4] , Francesca Happé [sup.3] , Kris Evers [sup.1] [sup.2] [sup.5] , Hannah Boonen [sup.1] [sup.2] , Ilse Noens [sup.1] [sup.2] Author Affiliations: (Aff1) [...]