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Longitudinal analyses have revealed informative patterns about health, mental health, adaptive skills, autism symptoms, and social skills during the transition to adulthood for autistic individuals. This study expands on these findings by investigating the trajectories of positive affect from age 15 to 30 years using a heterogeneous cohort (n = 253) of individuals first referred for autism at an early age. Group-based trajectory modeling was used to identify commonalities in trajectories using both caregiver-reported and self-reported positive affect. We analyzed differences between these trajectory groups on demographic and behavioral measures, as well as indices of adult functioning characterized for either higher and lower cognitive abilities. Caregiver-reported values revealed four different patterns of stability and change, and self-reported values revealed three distinct patterns of stability and change with variable intercepts. These trajectory groups differed by autism severity, intelligence quotient, daily living skills, and different indices of adult outcomes, including social relationships, work, and activity engagement. There were some differences in trajectory shape by reporter, with agreement between caregiver-report and self-report being limited after age 23 years. The results of this study have implications for how we measure subjective indices of experience across the spectrum of cognitive abilities present in autism.

Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.

Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their childs adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the service cliff experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.

Precision pharmacology aims to manipulate specific cellular interactions within complex tissues. In this pursuit, we introduce DART.2 (drug acutely restricted by tethering), a second-generation cell-specific pharmacology technology. The core advance is optimized cellular specificity-up to 3,000-fold in 15 min-enabling the targeted delivery of even epileptogenic drugs without off-target effects. Additionally, we introduce brain-wide dosing methods as an alternative to local cannulation and tracer reagents for brain-wide dose quantification. We describe four pharmaceuticals-two that antagonize excitatory and inhibitory postsynaptic receptors, and two that allosterically potentiate these receptors. Their versatility is showcased across multiple mouse-brain regions, including cerebellum, striatum, visual cortex and retina. Finally, in the ventral tegmental area, we find that blocking inhibitory inputs to dopamine neurons accelerates locomotion, contrasting with previous optogenetic and pharmacological findings. Beyond enabling the bidirectional perturbation of chemical synapses, these reagents offer intersectional precision-between genetically defined postsynaptic cells and neurotransmitter-defined presynaptic partners.

We know that many autistic people feel lonely, but we dont know whether their loneliness changes over time. Our research study followed autistic people and people with other non-spectrum neurodevelopmental disabilities from childhood through young adulthood and asked them about their loneliness. While many people told us they felt lonely or very lonely, a sizable group also told us that they do not feel lonely. We found that people who reported feeling lonely earlier in life were likely to also report feeling lonely later in life. Overall, autistic people and people with other neurodevelopmental disabilities in our study became lonelier from adolescence to adulthood. People described multiple ways they cope with feeling lonely, such as distracting themselves or reaching out to connect with another person. People who used distraction tended to be lonelier than those who did not. Our findings tell us that there is a need for greater support of social connections for many autistic people as they become adults.

Many autistic people and people with non-spectrum neurodevelopmental disabilities (e.g. intellectual disability) report feeling lonely, which can negatively impact their well-being. There is little longitudinal research, however, tracking changes in how autistic people experience, conceptualize, and cope with loneliness throughout their lives. A longitudinal sample of 114 people, which included autistic participants and participants with neurodevelopmental disabilities, characterized experiences of loneliness, perceptions of other people's loneliness, and strategies used to cope with loneliness from childhood to adulthood. Level of loneliness and coping strategies were coded from Autism Diagnostic Observation Schedule Modules 3 and 4 protocol forms. Autism Diagnostic Observation Schedule Loneliness Ratings were correlated across time and increased from adolescence to young adulthood. The most common loneliness coping strategies were Behavioral Distraction (e.g. watching TV) and Instrumental Action (e.g. seeking social contact), which were both used by more people in adulthood than childhood. Those who used Behavioral Distraction and a greater number of coping strategies had higher Autism Diagnostic Observation Schedule Loneliness-Self Ratings (i.e. were lonelier) during adolescence and adulthood. Findings highlight adulthood as a particularly vulnerable time for loneliness and indicate a need for more support and social opportunities for autistic adults and adults with neurodevelopmental disabilities who wish to make more social connections.

Adults shift their attention to the right or to the left along a spatial continuum when solving additions and subtractions, respectively. Studies suggest that these shifts not only support the exact computation of the results but also anticipatively narrow down the range of plausible answers when processing the operands. However, little is known on when and how these attentional shifts arise in childhood during the acquisition of arithmetic. Here, an eye-tracker with high spatio-temporal resolution was used to measure spontaneous eye movements, used as a proxy for attentional shifts, while children of 2nd (8 y-o; N = 50) and 4th (10 y-o; N = 48) Grade solved simple additions (e.g., 4 + 3) and subtractions (e.g., 3 - 2). Gaze patterns revealed horizontal and vertical attentional shifts in both groups. Critically, horizontal eye movements were observed in 4th Graders as soon as the first operand and the operator were presented and thus before the beginning of the exact computation. In 2nd Graders, attentional shifts were only observed after the presentation of the second operand just before the response was made. This demonstrates that spatial attention is recruited when children solve arithmetic problems, even in the early stages of learning mathematics. The time course of these attentional shifts suggests that with practice in arithmetic children start to use spatial attention to anticipatively guide the search for the answer and facilitate the implementation of solving procedures.

Neuropsychological case-studies suggested that dates and encyclopedic numbers may be processed differently than unknown numbers. However, this issue was seldom investigated in healthy participants. Therefore, it is unclear whether known dates are read like words (as lexical items), or like numbers (each position strictly defines digits' values in a base-10 system). Here, we compared dates to unknown numbers in an experiment using a paradigm from the word recognition literature. We assessed the wordsuperiority effect by testing experts (students/ teachers in History) with dates. A 4-characters stimulus (xxxx; letters or numbers, half known/unknown) was presented centrally, masked, and followed by 2 characters above and below the mask, at position 2 (xXxx) or 3 (xxXx) in an alternative-forced-choice recognition task. Both accuracy and reaction times were better for dates than unknown numbers, similarly to the results obtained with words by comparison to non-words. However, this effect was modulated by position in the string. These results show a "date-superiority effect" revealing that dates are processed differently than unknown numbers, and suggest that similar orthographical mechanisms might be used to process dates and words.

The COVID-19 pandemic-related social distancing practices that colleges implemented in Spring 2020 disrupted the typical mechanisms of propinquity (physical proximity) and homophily (shared characteristics) that physical institutions rely on to help students build and maintain relationships critical to learning and wellbeing. To explore how social distancing shaped students' academic and social networks and associated educational outcomes, we conceptualized it as a "network shock" and collected unique ego network data in April 2020. For participating students, maintaining interactions with the same set of individuals before and after social distancing was related to more positive outcomes across a range of self-reported wellbeing and learning indicators. On average, students experienced a loss of frequent academic contacts, while they maintained or replaced social interactions in their interpersonal networks after social distancing. Our investigation of the ways students experienced changes in their social and academic networks after a loss of physical proximity points to the role of interpersonal interaction network continuity for fostering wellbeing and learning in times of disruption, as well as the potential need for support in maintaining or rebuilding academic networks.

People with autism spectrum disorder (ASD) and non-spectrum developmental delays frequently exhibit maladaptive behaviors throughout the lifespan, which can have pervasive effects on quality of life. Maladaptive behaviors have been shown to change over time as a function of various individual-level factors (e.g., cognitive ability), yet research is primarily limited to parent-reported measures. To expand upon this work, the present study aimed to examine trajectories of teacher- and parent-reported maladaptive behaviors (i.e., hyperactivity, irritability, social withdrawal) and to test whether individual-level predictors (e.g., autism features, verbal intelligence quotient) and school-related predictors (e.g., teacher type, student-adult ratio, personal aide, school type) impact these trajectories among 165 individuals with ASD or non-spectrum delays from ages 9 to 18. Multilevel models revealed that, according to both teacher and parent report, participants showed the greatest improvement in hyperactivity, less but still notable improvement in irritability, and stable levels of social withdrawal over time. Higher verbal ability and fewer ASD features, in addition to mainstream school placement, emerged as important individual- and school-related differences associated with fewer maladaptive behaviors over time. The multi-informant perspective and longitudinal design provide novel insight into the manifestations of these maladaptive behaviors across different contexts and across time. Findings highlight the consistency of teacher- and parent-reported trajectories over time and further emphasize the importance of targeting maladaptive behaviors using a multisystem intervention approach in both school and home contexts.

The COVID-19 pandemic sparked a worldwide transition to providing online services overnight, highlighting the urgent need for empirically supported telehealth interventions. The current study examined the effects of PEERS® for Adolescents Telehealth, an adaptation from the original social skills intervention developed for in-person provision, among 22 autistic adolescents and their caregivers. To evaluate the intervention, caregivers completed questionnaires assessing core autistic features and frequency of get-togethers. Adolescents completed questionnaires measuring social knowledge and frequency of get-togethers. Improvements in social skills knowledge, increased get-togethers, and decreased core autistic symptoms were evident. Preliminary results suggest PEERS® for Adolescents Telehealth improves social competence, as found for the in-person version. Further research exploring the equivalence of telehealth to in-person social skills intervention is recommended.

INTRODUCTION: The high prevalence of multiple chronic conditions (MCC), multimorbidity, and frailty may affect treatment and outcomes for older adults with cancer. The goal of this study was to use three conceptually distinct measures of morbidity to examine the association between these measures and mortality. MATERIALS AND METHODS: Using Medicare claims data linked with the 2012-2016 Ohio Cancer Incidence Surveillance System we identified older adults with incident primary cancer sites of breast, colorectal, lung, or prostate (n = 29,140). We used claims data to identify their Elixhauser comorbidities, Multimorbidity-Weighted Index (MWI), and Claims Frailty Index (CFI) as measures of MCC, multimorbidity, and frailty, respectively. We used Cox proportional hazard models to examine the association between these measures and survival time since diagnosis. RESULTS: Lung cancer patients had the highest levels of MCC, multimorbidity, and frailty. There was a positive association between all three measures and a greater hazard of death after adjusting for age, sex (colorectal and lung only), and stage. Breast cancer patients with 5+ comorbidities had an adjusted hazard ratio (aHR) of 1.63 (95% confidence interval [CI]: 1.38, 1.93), and those with mild frailty had an aHR of 3.38 (95% CI; 2.12, 5.41). The C statistics for breast cancer were 0.79, 0.78, and 0.79 for the MCC, MWI, and CFI respectively. Similarly, lung cancer patients who were moderately or severely frail had an aHR of 1.82 (95% CI: 1.53, 2.18) while prostate cancer patients had an aHR of 3.39 (95% CI: 2.12, 5.41) and colorectal cancer patients had an aHR of 4.51 (95% CI: 3.23, 6.29). Model performance was nearly identical across the MCC, multimorbidity, and frailty models within cancer type. The models performed best for prostate and breast cancer, and notably worse for lung cancer. The frailty models showed the greatest separation in unadjusted survival curves. DISCUSSION: The MCC, multimorbidity, and frailty indices performed similarly well in predicting mortality among a large cohort of older cancer patients. However, there were notable differences by cancer type. This work highlights that although model performance is similar, frailty may serve as a clearer indicator in risk stratification of geriatric oncology patients than simple MCCs or multimorbidity.

Respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system activity, has been linked with sleep quality among children with neurotypical development. The current study extended examination of these processes to children with autism spectrum disorder (ASD), a group at considerable risk for sleep problems. Participants included 54 children with ASD (aged 6-10 years, 43% Hispanic). RSA data were collected via a wired MindWare system during a 3-min baseline and a 3-min challenge task. Parents reported on their childrens sleep problems and sleep duration using the Childrens Sleep Habits Questionnaire, Abbreviated. Although no significant correlations emerged between RSA indices and parent-reported child sleep, baseline RSA and RSA reactivity interacted in the prediction of sleep problems. For children with higher RSA reactivity, higher baseline RSA was associated with fewer sleep problems, but for children with lower RSA reactivity, baseline RSA was not predictive. No main effects or interactions of RSA predicted sleep duration. Findings suggest resilience against sleep problems for children with ASD presenting with higher baseline RSA and higher RSA reactivity. Implications of these results center upon directly targeting psychophysiology (i.e., parasympathetic nervous system regulation) as a possible mechanism to improve sleep in children with ASD, and developing personalized interventions based on physiological markers of risk and resilience.

Siblings play an important role in the behavioral trajectories of individuals with autism spectrum disorder (ASD). While having siblings has been associated with positive outcomes in ASD, including stronger adaptive functioning, social and non-verbal communication, and theory of mind, little is known about the impact of siblings on more negative outcomes, such as maladaptive behaviors. To address this gap, the present longitudinal study tested sibling predictors of trajectories of maladaptive behaviors (e.g., teacher- and parent-reported hyperactivity, irritability, and social withdrawal) from childhood through early adulthood among individuals with ASD and non-spectrum delays. Multilevel models revealed that, while the mere presence of a sibling did not impact maladaptive behavior trajectories apart from teacher-reported hyperactivity, the diagnostic profile of the sibling (e.g., emotional/behavioral disorder, ASD, medical condition) emerged as an important predictor. Specifically, although findings varied across teacher and parent reports, more hyperactivity and irritability across time was identified when the sibling had diagnoses of an emotional/behavioral disorder, ASD, and/or a medical condition. Overall, this study provides novel insight into the broader family-level factors that influence the presentation of maladaptive behaviors across time and across contexts.

Research shows elevated gender variance among autistic people and more autistic traits among gender diverse people, each of which is related to mental health concerns. Little work has explored broad features of these presentations in a non-clinical sample. College students (n = 174) ages 18-22 years completed questionnaires assessing the broader autism phenotype (BAP), autistic features, nonconformity to gender norms, and internalizing symptoms. Those with more BAP features or autistic communication reported more nonconformity to gender norms. Higher levels of internalizing symptoms were related to more gender nonconformity, BAP, and autistic features. Gender nonconformity marginally moderated the effect of BAP on depression but not anxiety. The BAP, autistic features, and gender nonconformity are important in understanding mental well-being.

Emotion dysregulation is common among autistic people, yet few measures have received psychometric evaluation in this population. We examined the factor structure, reliability, and validity of a commonly-used measure of emotion dysregulation, the "Difficulties with Emotion Regulation Scale" ("DERS"), in a sample of 156 autistic adolescents and adults. Data were drawn from the NIH National Database for Autism Research (NDAR) and an author's existing dataset. Results demonstrated that the factor structure generally conformed to the original 6-factor model, with modifications. Reliability analyses revealed good-to-excellent internal consistencies. Validity analyses indicated that the "DERS" was positively associated with measures of anxiety, depression, and alexithymia. Our findings provide preliminary evidence for the utility of the "DERS" in a small autistic sample, with minor modifications.

Sketchnoting is a design methodology that involves communicating concepts visually. This active learning tool has shown potential for influencing student learning but its applications have been limited. Adopting the principles of research related to the Scholarship of Teaching and Learning and employing Mayer's cognitive theory of multimedia learning, our interdisciplinary team from industrial design, biology, and education incorporated this pedagogical tool in an undergraduate upper-level ecology course and assessed its effectiveness. We found that students' perceptions of the value of using tools such as sketchnoting did not significantly change after being introduced to the tool, but over two-thirds of students found the tool valuable and would recommend it to other students. The percentages of students who used the tool never or seldom, remained similar over the semester, but a much higher percentage of students increased their use of sketchnoting. We found that there were differences in how students utilized sketchnoting for learning. Students reported the importance of using sketchnoting for communicating. Because drawings are critical ways to communicate science, teaching visual representation techniques such as sketchnoting can improve science students'ability to identify and solve problems; subsequently improving their long-term success. Additional research exploring why and how this approach could be integrated within college coursework and how it can support learning in science is needed. Framed as an example of SoTL work, our efforts also highlight the iterative nature of these projects and the importance for researchers and faculty members to embrace the multiple roles of teacher and learner.

Autistic adults commonly experience anxiety and depression. These mental health concerns are often tied to social experiences, such that mental well-being can be supported by social connection and deteriorated by loneliness. The mediating role of social and emotional loneliness (i.e. social isolation and lack of emotional attachment, respectively) between autism features and mental health has yet to be empirically tested among autistic adults. Here, 69 autistic young adults completed self-report questionnaires assessing social contact (Friendship Questionnaire), autism features (Autism Quotient), mental health (Liebowitz Social Anxiety Scale, Social Phobia Inventory, Beck Depression Inventory), and loneliness (Social and Emotional Loneliness Scale for Adults). Positive associations emerged between autism features, social loneliness, family loneliness, social anxiety, and depression. In addition, more social contact was related to less social and family loneliness and less social anxiety but was not related to depression. Mediation analyses indicated significant indirect effects of social contact and autism features on mental health through social loneliness. Indirect effects partially held substituting family loneliness for social loneliness and did not hold using romantic loneliness. In light of these results, the scientific and clinical implications of the role of loneliness for autistic young adults are discussed and recommendations provided.

The developmental course of neural tuning to visual letter strings is unclear. Here we tested 39 children longitudinally, at the beginning of grade 1 (6.45 ± 0.33 years old) and 1 year after, with fast periodic visual stimulation in electroencephalography to assess the evolution of selective neural responses to letter strings and their relationship with emerging reading abilities. At both grades, frequency-tagged letter strings were discriminated from pseudofont strings (i.e. letter-selectivity) over the left occipito-temporal cortex, with effects observed at the individual level in 62% of children. However, visual words were not discriminated from pseudowords (lexical access) at either grade. Following 1 year of schooling, letter-selective responses showed a specific increase in amplitude, a more complex pattern of harmonics, and were located more anteriorly over the left occipito-temporal cortex. Remarkably, at both grades, neural responses were highly significant at the individual level and correlated with individual reading scores. The amplitude increase in letter-selective responses between grades was not found for discrimination responses of familiar keyboard symbols from pseudosymbols, and was not related to a general increase in visual stimulation responses. These findings demonstrate a rapid onset of left hemispheric letter selectivity, with 1 year of reading instruction resulting in increased emerging reading abilities and a clear quantitative and qualitative evolution within left hemispheric neural circuits for reading.