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Motor skills have been linked to language and social development with implications for theory of mind. This study examined theory of mind (attribution of intentions task) in school-age children ( N = 62, mean age 8 years; 2 months, standard deviation [ SD] = 1;3) in relation to fine motor skills (grooved pegboard), receptive vocabulary (Peabody Picture Vocabulary Test), receptive grammar (Test for the Reception of Grammar), reading comprehension (Woodcock Reading Mastery Tests), verbal short-term (nonword repetition), and visual-spatial working memory (one-shape array memory). All variables except verbal short-term memory correlated with accuracy on theory of mind. In regression models, fine motor skills accounted for variance in theory of mind after controlling for age, language, and working memory. The results add to research linking fine motor skills with faux pas understanding, indicating the potentially broad impact of motor skills on social cognition. Given the cross-sectional study design, longitudinal research is warranted to address causality.

Are implicit and explicit biases related to ASD identification and/or stigma? College students (N = 493) completed two IATs assessing implicit stigma and racial biases. They evaluated vignettes depicting a child with ASD or conduct disorder (CD) paired with a photo of a Black or White child. CD was more implicitly and explicitly stigmatized than ASD. Accurately identifying ASD was associated with reduced explicit stigma; identifying CD led to more stigma. Participants who identified as White implicitly associated the White child with ASD and the Black child with CD. A trend in the reverse direction was observed among Black participants. Implicit and explicit biases were unrelated. Findings highlight a need for trainings to ameliorate biases favoring one’s in-group.

Many of the nearly six million autistic adolescents and adults in the United States require support to navigate daily life. Family members often provide the first line of support for autistic youth by providing care and coordinating services. Although considerable research has examined the perspectives of family members caring for young autistic children, comparatively less has focused on those caring for transition-age youth who often struggle to access needed services as they leave child-serving systems of care. This study examined caregiver-reported barriers to service for 174 adolescents and young adults on the spectrum (ages 16–30) and the association between such barriers and unmet service needs. Exploratory factor analysis suggested two service barrier domains: access (e.g., cost) and quality (e.g., providers not trained). Regression models indicated that caregivers whose youth were diagnosed at older ages perceived both greater access and quality barriers. Male caregivers reported fewer access barriers, and those who perceived greater caregiver burdens (daily life disruptions, financial difficulties, and worries) reported more access barriers. Caregivers whose youth lived with them reported fewer quality barriers. Greater access–but not quality–service barriers predicted greater unmet service needs. Findings have implications for service delivery to autistic youth and specific directions for future research. Lay Abstract Prior studies have described the roadblocks, or barriers, to needed services experienced by families with young autistic children, but less research has focused on those faced by autistic adolescents and young adults. In this study, we wished to understand the barriers to service experienced by autistic adolescents and young adults and their families. We surveyed 174 caregivers of autistic youth between 16 to 30 years old. We found that caregivers who felt more caregiving burden had more difficulty accessing services for their youth. Specifically, caregivers who felt more strongly that their daily lives had been disrupted, felt more financial strain, and worried more about their youth well-being experienced more roadblocks to getting services for the youth. Male caregivers also reported fewer difficulties related to service access. Importantly, the older the youth was when they had been diagnosed with autism, the more service barriers their caregivers reported. We did not see any differences in the level of barriers experienced by youth who lived in urban versus suburban settings, or between white and non-white families. However, when youth lived with their caregivers (rather than, for example, in a group home), fewer quality-related barriers to services were reported. Finally, greater access (but not quality) barriers were linked to youth having more unmet service needs. These findings can help to reduce the barriers to service experienced by autistic adolescents and young adults and their families.

Autistic university students face stigma. Online trainings have been used to improve explicit autism stigma (social distance) and knowledge among university students in different countries. However, autistic university students have not typically been involved in developing such trainings. We developed two autism trainings: a participatory training (developed in collaboration with autistic university students) and a non-participatory training. We evaluated these trainings with undergraduate students in the United States and Lebanon. A pilot study revealed improvements in implicit biases (measured with an Implicit Association Test) and knowledge following both trainings, but no clear benefit of the participatory training in particular. Feedback revealed that participants found the Implicit Association Test tedious, suggesting that it might have dampened effects by boring participants. To increase engagement, we removed the Implicit Association Test and conducted a cross-university training comparison which revealed evidence that the participatory training was more effective than the non-participatory training at improving autism knowledge, explicit stigma, and attitudes toward inclusion. Autistic co-authors coded participant feedback and identified three key themes to guide future training development and adaptation: an (inter)personal element, accessibility, and clarity of information. These studies provide empirical support for the oft-cited, but rarely directed tested, benefits of involving autistic people in research about autism. Lay abstract Autistic university students are often left out because people do not understand autism. We wanted to help people understand autism. Most autism trainings are not made by autistic people. Autistic people know what it is like to be autistic. So autistic people may be the best teachers when it comes to teaching about autism. Autistic students and non-autistic professors made an autism training. The students made videos for the training. They also helped make questions to see what people learned from the trainings. Professors who are not autistic made a training on their own. Students in New York City tried out the trainings. After they answered questions, they did either the training the autistic students helped make or the training made by only professors. Then, they answered questions again. We learned from the students how to make our trainings better. Then, students from two universities in the United States and one university in Lebanon did our trainings and questions. Both trainings made hidden feelings about autism better. The training autistic students helped make taught students more than the training professors made on their own. The autistic-led training also helped students accept autism more. These studies show that autistic students can make autism research and trainings better. At the end of this article, autistic students share their ideas for how to make autism trainings even better in the future.

Background: Student perceptions of inclusion have been predicted by rapport, and belongingness in face-to-face courses, although these relationships have not been studied across course delivery formats. Objective: This study clarified relationships among course multimedia characteristics, student–professor rapport, instructor and student presence, classroom climate, quality of teaching behaviors, and perceptions of an inclusive classroom in varied course delivery formats. Method: A total of 479 students from two universities completed an online survey assessing their course delivery format, multimedia characteristics, rapport, instructor and student presence, classroom climate, teaching behaviors, and perceptions of an inclusive classroom. Results: Students’ perceptions of inclusion were predicted by course multimedia characteristics (e.g., videos), student–professor rapport, instructor presence, course structure, course clarity, student connectedness, and the quality of teaching behaviors. Conclusion: Inclusive classrooms reflect a myriad of instructor-, student-, and classroom-level characteristics and behaviors. However, the predictive value of these characteristics can change based on the course delivery format. Teaching Implications: Faculty professional development opportunities for inclusive pedagogy should include skill development for course design (multimedia characteristics, structure), professor–student rapport-building and classroom community building, and high-quality teaching behaviors that align with specific course delivery formats.

Background The ongoing COVID-19 pandemic has thus far resulted in substantial worldwide mortality. As of November 2020, COVID-19 vaccines became available following Emergency Use Authorization (EUA) issued by the FDA. Recent longitudinal studies published as of March 2021 demonstrated that vaccine hesitancy remains high despite improvements compared to 2020. This study sought to explore the perceptions, beliefs, attitudes, and knowledge surrounding COVID-19 and identify determinants uniquely associated with vaccine hesitancy. Methods A cross-sectional electronic survey was created based on CDC & IDSA recommendations. The survey was distributed from March 2021 until June 2021 randomly to faculty members, healthcare workers, and students (≥18 years old) across 3 major academic centers (Case Western Reserve University, Spectrum Health, and the American University of Beirut Medical Center [AUBMC]). Data collected included socio-economic characteristics, demographics, knowledge, and attitudes pertaining to COVID-19 and vaccination. A multivariable regression model was utilized to evaluate for independent associations between variables and vaccination willingness/hesitancy as the primary outcome. Results In total, 7,197 participants completed the survey with an overall response rate of 94%. Females constituted 75.7% of the study population. Overall, 87.8% of the study cohort indicated willingness to get vaccinated. Factors associated independently with vaccination hesitancy included: younger age, lower attained education, lower knowledge score, physician recommendation against vaccination, not receiving the influenza vaccine annually, and other beliefs and attitudes as reported in table 1. Table 1. Independent predictors of COVID-19 vaccine hesitancy among study respondents Conclusion Most survey respondents indicated willingness to receive COVID-19 vaccination. The perception or belief that vaccination is more harmful than COVID-19 disease represented an especially robust barrier against vaccination. Since recommendations made by healthcare providers were strongly associated with either vaccination hesitancy or willingness to get vaccinated, developing educational strategies at this level could enhance vaccine acceptance in an effort to curb the pandemic. Disclosures Robert A. Bonomo, MD, entasis (Research Grant or Support)Merck (Grant/Research Support)NIH (Grant/Research Support)VA Merit Award (Grant/Research Support)VenatoRx (Grant/Research Support)

Are implicit and explicit biases related to ASD identification and/or stigma? College students (N = 493) completed two IATs assessing implicit stigma and racial biases. They evaluated vignettes depicting a child with ASD or conduct disorder (CD) paired with a photo of a Black or White child. CD was more implicitly and explicitly stigmatized than ASD. Accurately identifying ASD was associated with reduced explicit stigma; identifying CD led to more stigma. Participants who identified as White implicitly associated the White child with ASD and the Black child with CD. A trend in the reverse direction was observed among Black participants. Implicit and explicit biases were unrelated. Findings highlight a need for trainings to ameliorate biases favoring one's in-group.

Purpose Play is a critical aspect of children's development, and researchers have long argued that symbolic deficits in play may be diagnostic of developmental disabilities. This study examined whether deficits in play emerge as a function of developmental disabilities and whether our perceptions of play are colored by differences in language and behavioral presentations. Method Ninety-three children participated in this study (typically developing [TD]; n = 23, developmental language disorders [DLD]; n = 24, attention-deficit/hyperactivity disorder [ADHD]; n = 26, and autism spectrum disorder [ASD]; n = 20). Children were videotaped engaging in free-play. Children's symbolic play (imagination, organization, elaboration, and comfort) was scored under conditions of both audible language and no audible language to assess diagnostic group differences in play and whether audible language impacted raters' perception of play. Results Significant differences in play were evident across diagnostic groups. The presence of language did not alter play ratings for the TD group, but differences were found among the other diagnostic groups. When language was audible, children with DLD and ASD (but not ADHD) were scored poorly on play compared to their TD peers. When language was not audible, children with DLD were perceived to play better than when language was audible. Conversely, children with ADHD showed organizational deficits when language was not available to support their play. Finally, children with ASD demonstrated poor play performance regardless of whether language was audible or not. Conclusions Language affects our understanding of play skills in some young children. Parents, researchers, and clinicians must be careful not to underestimate or overestimate play based on language presentation. Differential skills in language have the potential to unduly influence our perceptions of play for children with developmental disabilities.

This study examines the extent to which a measure of multidimensional schizotypy is associated with experiences of social defeat. Based on the social defeat hypothesis of psychosis, which suggests that chronic stressful experiences leading to social defeat increase risk for psychotic-like experiences, we expect that individual differences on a schizotypy measure would be explained by differences in social defeat. We hypothesized that racial and ethnic minorities would report higher rates of schizotypy relative to non-minorities and that social defeat would explain those differences. Participants included a community sample of English-speaking adults ages 18 and older, recruited from online social media platforms (N = 501; M age = 28.06). Demographic information was collected, as well as the Multidimensional Schizotypy Scale–Brief (Kwapil et al., 2018) and the Defeat Scale (Gilbert & Allan, 1998). Analyses revealed that social defeat and schizotypy scores are highly correlated. Examination of group differences revealed that racial and ethnic minorities reported higher rates of schizotypy and higher rates of social defeat than non-minorities. ANCOVA analyses revealed that, after controlling for social defeat scores, racial and ethnic status was no longer significantly associated with schizotypy scores.

Purpose We aimed to determine whether individual differences in manual dexterity are associated with specific language skills (nonword repetition, receptive vocabulary, and receptive grammar) after controlling for nonverbal abilities (visual–spatial working memory and intelligence). Method We assessed manual dexterity using the pegboard task and examined relationships with verbal and nonverbal abilities in a diverse community sample of children ( N = 63, mean age = 8;2 [year;months], range: 6;0–10;8) varying in language ability (Comprehensive Evaluation of Language Fundamentals–Fourth Edition core language score M = 105, range: 62–126; Semel, Wiig, & Secord, 2003). Results Correlational analyses indicated significant relationships between manual dexterity and performance on tests of nonword repetition, receptive vocabulary, receptive grammar, and nonverbal intelligence, after controlling for multiple comparisons. In regression analyses, manual dexterity remained a significant predictor of nonword repetition after controlling for nonverbal abilities and age. In contrast, manual dexterity was no longer significant in predicting receptive vocabulary or grammar when nonverbal intelligence was included as a factor in the model. Conclusions These findings build on prior work implicating poor fine motor control in child language disorders by identifying a robust relationship between manual dexterity and nonword repetition. Relationships between manual dexterity and receptive language abilities appear to be indirect and mediated by nonword repetition. For clinicians, the results underscore the importance of screening children with poor fine motor control for concomitant language impairments.

Research has shown that plagiarism is on the increase in higher education. Some state that this is due to poor knowledge rather than intentional cheating. Other researchers explain that plagiarism is on the rise due to increased competitiveness in college and easy access to work that has already been completed. In this study, we show how a 2-hr intervention in a research methods classes, available free online, successfully reduced plagiarism in a sample of undergraduate students registered in a research methods in psychology class across three semesters. The implications of this study are that students need specific training and knowledge, not simply the threat of being caught, before their plagiarism is reduced.

Although stigma negatively impacts autistic people globally, the degree of stigma varies across cultures. Prior research suggests that stigma may be higher in cultures with more collectivistic orientations. This study aimed to identify cultural values and other individual differences that contribute to cross-cultural differences in autism stigma (assessed with a social distance scale) between college students in Lebanon ( n = 556) and those in the United States ( n = 520). Replicating prior work, stigma was lower in women than men and in the United States relative to Lebanon. Heightened autism knowledge, quality of contact with autistic people, openness to experience, and reduced acceptance of inequality predicted lower stigma. Collectivism was not associated with heightened stigma. Findings highlight the need to address structural inequalities, combat harmful misconceptions, and foster positive contact to combat stigma.

Over the past decade, there has been a rise in the prevalence of developmental disabilities. Early diagnosis and access to healthcare services are essential for children with developmental delays to optimize development. For families living in poverty, accessing specialized assessment/intervention services for children with developmental disabilities is often a formidable task. In this study, we provide preliminary evidence for the implementation of a developmental risk assessment screening questionnaire using a telehealth format to address the gap in access to services in a community clinic serving a low-income urban neighborhood. Ninety-seven caregivers of children between 12 months and 7 years of age participated in this study. Caregivers completed the risk assessment screening questionnaire using an iPad that was available to them at the clinic. Results showed that while only 11% of caregivers indicated they were initially concerned about their child's overall development, completion of the focused risk assessment resulted in a completely different picture. Fifty percent of caregivers reported that their child had three or more concerns in at least one area of development that would warrant further evaluation. Alerting both families and professionals to these concerns as early as possible may position the family and child to receive the much-needed services that have the potential to mitigate more serious developmental problems. This article discusses the promising role that Telehealth can play in providing screening services for all families, but especially low-income urban households.

The increasingly complex relationship between individuals and online environments has prompted research exploring the potential for compulsive Internet use (CIU) in varying populations. Identification of the determinants of CIU, such as offline social difficulties associated with autism spectrum disorder (ASD), could clarify whether individuals compensate for offline difficulties through online interactions. In Study 1, 597 undergraduates took an online survey measuring CIU, social symptoms of ASD, restricted interests and repetitive behaviors (RIRB), self-esteem, and Facebook behaviors. A relationship between CIU and autistic traits was attributable to non-social characteristics (RIRB) and a relationship was identified between RIRB and information-seeking behaviors. These results complicate the social compensation hypothesis by suggesting that non-social personality characteristics contribute more strongly to CIU than individuals’ attempts to compensate for offline social challenges. Study 2 matched a sample of students with ASD (n = 33) to neurotypical students (n = 33) and uncovered no significant differences in CIU scores between the matched samples. These results suggest that findings observed by measuring autistic traits in neurotypical samples may not replicate with autistic samples.

Background In the United States, bloodstream infections (BSIs) are predominated by Staphylococcus aureus . The proportion of community-acquired methicillin-resistant S aureus (MRSA) BSI is on the rise. The goal of this study is to explore the epidemiology of BSI caused by S aureus within Staten Island, New York. Methods This is a case-case-control study from April 2012-October 2014. Cases were comprised of patients with BSI secondary to MRSA and methicillin-sensitive S aureus (MSSA). The control group contained patients who were hospitalized during the same time period as cases but did not develop infections during their stay. Two multivariable models compared each group of cases with the uninfected controls. Results A total of 354 patients were analyzed. Infections were community acquired in 76% of cases. The major source of BSI was skin-related infections (n = 76). The first multivariable model showed that recent central venous catheter placement was an independent infection risk factor (odds ratio [OR] = 80.7; 95% confidence interval [CI], 2.2-3,014.1). In the second model, prior hospital stay >3 days (OR = 4.1; 95% CI, 1.5-5.7) and chronic kidney disease (OR = 3.0; 95% CI, 1.01-9.2) were uniquely associated with MSSA. Persistent bacteremia, recurrence, and other hospital-acquired infections were more likely with MRSA BSI than MSSA BSI. Conclusion Most infections were community acquired. The presence of a central venous catheter constituted a robust independent risk factor for MRSA BSI. Patients with MRSA BSI suffered worse outcomes than those with MSSA BSI.

What motivates selfie-posting on social media? Although several studies suggest that narcissistic traits predict online behaviors, different types of narcissism may influence specific online behaviors. In the existing literature, two types of narcissism are frequently considered, overt (externally directed) and covert (internally directed) narcissism, where overt narcissism is the better-known construct. The utility of using the broader construct of overt narcissism, as opposed to specific sub-components, is a matter of ongoing debate in the literature and little research has explored the factor structure of covert narcissism at all. The subcomponents of both types of narcissism are used to explore participants' motivations for selfie-posting, in addition to community membership (i.e. culture) and demographics. Therefore, the current study investigated whether selfie-posting could be predicted by narcissism, demographics, and community membership. Participants from the Midwest US (n = 194), Northeast US (n = 276), and the Lebanese Republic (n = 260) took an online survey. Results supported a two-component structure for covert narcissism, suggesting that this variable should be considered multidimensional in nature. Selfie-posting frequency was predicted by gender, geographic community, and grandiose narcissism. Participants who were female, from the Northeast, and reported more grandiose narcissism posted selfies more frequently. Findings suggest that selfie-posting is favored by those with more histrionic tendencies (grandiose narcissism) and that community norms, including those which shape gendered behavior, likely play a role in the active use of social media sites.

Reduced cognitive empathy may put autistic people at risk for bullying. We compared interpretations of bullying provided by 22 autistic and 15 non-autistic college students. Autistic (and non-autistic) students reported less severe bullying in college relative to earlier in development. Chronic bullying was associated with improvements in self-descriptions and self-acceptance. Autistic students who were chronically bullied were more likely to self-identify as autistic when asked to explain their disability. Autistic and non-autistic students demonstrated similar levels of cognitive empathy, providing no evidence that a "double empathy problem" contributes to bullying for all autistic individuals. Findings suggest that recovery from bullying can contribute to resilience and that autistic people gain insights about bullying and how to overcome it with development.

The present study examined the effects of coping styles, social support, and child's behavioral symptoms on the well-being of 65 mothers of children with Autism Spectrum Disorders (ASD) in Lebanon. Comparisons to the well-being of 98 mothers of typically developing children were also drawn. Regression analyses showed that disengagement and distraction coping predicted poor well-being, whereas cognitive reframing showed a correlation with better well-being levels. A significant correlation was found between child's behavioral problems and maternal well-being. T -test analyses revealed that mothers of children with ASD differed in terms of coping styles used. Additionally, mothers of children with ASD showed lower levels of perceived social support. Well-being was significantly better for mothers of typically developing children. Study limitations and implications are discussed.

Purpose The cross-modal picture–word interference task is used to examine contextual effects on spoken-word production. Previous work has documented lexical–phonological interference in children with specific language impairment (SLI) when a related distractor (e.g., bell ) occurs prior to a picture to be named (e.g., a bed). In the current study, the authors examined whether interference also arises with nonwords as distractors. Method In Study 1, children with SLI ( N = 20; ages 7;1 [years;months] to 11;0) and age-matched controls named pictures accompanied by (a) phonologically related nonwords, (b) unrelated nonwords, or (c) the word go (baseline). Stimulus asynchrony (SA) varied across blocks with distractors occurring prior to (−300 ms, −100 ms) or after (+100 ms, +300 ms) the pictures. In Study 2, a cross-sectional sample of children ( N = 48, 5;3 to 10;9) and adults ( N = 16) performed the same task. Results Child and adult control participants showed phonological priming (not interference) at early and late SAs, whereas children with SLI showed priming only at late SAs. Effect sizes correlated with language skills (Clinical Evaluation of Language Fundamentals–Fourth Edition scores; Semel, Wiig, & Secord, 2003). In the cross-sectional sample, anticipatory priming at SA −300 varied with age, with larger effects in older children. Conclusions Children with SLI utilize phonological information when it is available just in time for word production but fail to anticipate upcoming stimuli. Poor anticipatory processing may adversely affect language fluency in children with SLI.

Although misconceptions associated with ASD are apparent worldwide, they may differ across cultures. This study compares knowledge and stigma associated with ASD in a country with limited autism resources, Lebanon, and a country with substantial autism resources, the United States (US). College students in the US (N = 346) and Lebanon (N = 329) completed assessments of knowledge and stigma associated with ASD before and after an online ASD training. Although students in the US exhibited higher overall knowledge and lower stigma towards ASD, certain misconceptions were more apparent in the US than in Lebanon. Participation in the training was associated with decreased stigma and increased knowledge in both countries. Thus, online training may be useful for increasing understanding about ASD internationally.