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Socialization difficulties in children with an Autism Spectrum Disorder (ASD) are often associated with peer rejection and impaired academic achievement. Schools might appear to offer an ideal setting for social-emotional skills (SES) instruction. However, common challenges to successful implementation of school-based programs include inadequate staffing and resourcing, and a lack of ASD-specific staff training. This paper describes how barriers to program implementation were overcome in a project evaluating the Secret Agent Society (SAS) SES training intervention within Autism Spectrum Australia (Aspect) specialist classes. Questionnaire data was collected from school staff over a one-year period. Findings supported the effectiveness of the adoption process used, and suggest that SAS was feasible and acceptable to school staff.

Previous research in clinical, community, and school settings has demonstrated positive outcomes for the Secret Agent Society (SAS) social skills training program. This is designed to help children on the autism spectrum become more aware of emotions in themselves and others and to 'problem-solve' complex social scenarios. Parents play a key role in the implementation of the SAS program, attending information and support sessions with other parents and providing supervision, rewards, and feedback as their children complete weekly 'home mission' assignments. Drawing on data from a school-based evaluation of the SAS program, we examined whether parents' engagement with these elements of the intervention was linked to the quality of their children's participation and performance. Sixty-eight 8-14-year-olds (M age = 10.7) with a diagnosis of autism participated in the program. The findings indicated that ratings of parental engagement were positively correlated with children's competence in completing home missions and with the quality of their contribution during group teaching sessions. However, there was a less consistent relationship between parental engagement and measures of children's social and emotional skill gains over the course of the program.

This paper investigates the role of caregiver mental health and parenting practices as predictors of attachment in children with intellectual disability/developmental delay, comparing between children with ASD (n = 29) and children with other developmental disabilities (n = 20). Parents reported that children with ASD had high levels of anxiety and stress, and attachment insecurity in children (less closeness and more conflict in attachment relationships, and more inhibited attachment behaviours) compared with children with other developmental disabilities. Children's attachment quality was associated with parenting practices and the presence of an ASD diagnosis. These results highlight the bidirectional nature of the quality of caregiving environments and attachment in children with ASD, and also provide a strong rationale for targeting children's attachment quality in early interventions. [This article represents a collaborative effort on behalf of the Mental Health of Young People with Developmental Disabilities (MHYPeDD) team.]

Background: The Secret Agent Society (SAS) Program, an intervention to enhance social-emotional skills, was provided by schools for children with autism spectrum disorder (ASD). The program was assessed to determine if it improved social skills at school and home, and whether improvements were maintained. Methods: Eighty-four students participated. Key outcomes were parent and teacher ratings of emotion regulation, social skills, and direct child social problem-solving measures. The standard school curriculum served as the control condition. Phase 1 was a two-group waitlist-control comparison of SAS versus the standard curriculum. Phase 2 was a follow up of all participants before and after the intervention and at 12-months post-intervention. Results: Parent and child measures improved after the intervention but not in the waitlist condition. Improvements in parent, child, and teacher measures were apparent at 12 months. Conclusions: The SAS Program warrants further research as a potential program for schools that serve children with ASD.

Despite well-documented attention deficits in children with intellectual and developmental disabilities (IDD), distinctions across types of attention problems and their association with academic attainment has not been fully explored. This study examines visual attention capacities and inattentive/hyperactive behaviours in 77 children aged 4 to 11 years with IDD and elevated behavioural attention difficulties. Children with autism spectrum disorder (ASD; n = 23), Down syndrome (DS; n = 22), and non-specific intellectual disability (NSID; n = 32) completed computerized visual search and vigilance paradigms. In addition, parents and teachers completed rating scales of inattention and hyperactivity. Concurrent associations between attention abilities and early literacy and numeracy skills were also examined. Children completed measures of receptive vocabulary, phonological abilities and cardinality skills. As expected, the results indicated that all groups had relatively comparable levels of inattentive/hyperactive behaviours as rated by parents and teachers. However, the extent of visual attention deficits varied as a result of group; namely children with DS had poorer visual search and vigilance abilities than children with ASD and NSID. Further, significant associations between visual attention difficulties and poorer literacy and numeracy skills were observed, regardless of group. Collectively the findings demonstrate that in children with IDD who present with homogenous behavioural attention difficulties, at the cognitive level, subtle profiles of attentional problems can be delineated.

Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4-11 years) were randomized to either an attention training (n = 38) or control program (n = 38). Both programs were completed at home over a 5-week period. Outcome measures assessed literacy, numeracy, executive functioning, and behavioral/emotional problems, and were conducted at baseline, post-training, and 3-month follow-up. No training effects were observed at post-training; however, children in the training group showed greater improvements in numeracy skills at the 3-month follow-up. These results suggest that attention training may be beneficial for children with IDD; however, the modest nature of the intervention effects indicate that caution should be taken when interpreting clinical significance.

Background: Children with intellectual and developmental disabilities (IDD) experience heightened attention difficulties which have been linked to poorer cognitive, academic and social outcomes. Although, increasing research has focused on the potential of computerised cognitive training in reducing attention problems, limited studies have assessed whether this intervention could be utilised for those with IDD. This study aimed to assess the efficacy of a computerised attention training programme in children with IDD. Methods: In a double-blind randomised controlled trial, children (n = 76; IQ < 75) aged 4-11 years were assigned to an adaptive attention training condition or a nonadaptive control condition. Both conditions were completed at home over a 5-week period and consisted of 25 sessions, each of 20-min duration. Outcome measures (baseline, posttraining and 3-month follow-up) assessed core attention skills (selective attention, sustained attention and attentional control) and inattentive/hyperactive behaviour. Results: Children in the attention training condition showed greater improvement in selective attention performance compared to children in the control condition (SMD = 0.24, 95% CI 0.02, 0.45). These improvements were maintained 3 months after training had ceased (SMD = 0.26, 95% CI 0.04, 0.48). The attention training programme was not effective in promoting improvements in sustained attention, attentional control or inattentive/hyperactive behaviours. Conclusions: The findings suggest that attention training may enhance some aspects of attention (selective attention) in children with IDD, but the small to medium effect sizes indicate that further refinement of the training programme is needed to promote larger, more global improvements.

The Melbourne Study of Psychoanalytic Psychotherapy examined the implementation, lived experience, and perceived therapeutic gains of psychoanalytic psychotherapy in a low‐cost, private‐sector community clinic. A first in Australia, this 8‐year demonstration project allowed naturalistic study of the impact and process of intensive, long‐term, time‐limited psychoanalytic psychotherapy delivered to self‐referred adults by clinicians with a common theoretical frame of practice. Presented in three papers, the research employed the RE‐AIM planning and evaluation framework, using complementary quantitative and qualitative methods, to study the psychotherapy service in terms of Reach, Effectiveness, Adoption, Implementation and Maintenance. This first paper reports the Reach of the program to be 67% for those presenting for assessment for psychoanalytic psychotherapy, with Adoption of the full 2‐year treatment program being 60%. Improvements in mental health and life functioning provided quantitative evidence of Effectiveness for those completing the 2‐year treatment program, with Maintenance at 8‐month follow‐up. Patient age, gender and personality characteristics did not modify these improvements. In‐depth qualitative exploration of patient and psychotherapist perspectives regarding the psychotherapy is reported in the second paper highlighting expectations, experience and benefits of the psychotherapy. The third companion paper presents the qualitative findings concerning factors experienced as facilitating or challenging therapeutic progress. Each of the three related papers amplifies understandings of how low‐cost, long‐term but time‐limited psychoanalytic psychotherapy can be implemented in the community with adults otherwise unable to afford such treatment, and discusses lessons learned. [ABSTRACT FROM AUTHOR]

Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was 0.84 and specificity was 0.54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria.

Difficulties with attention, impulsivity, and hyperactivity are thought to be as common among children with intellectual disability (ID) as they are in children without ID. Despite this, there is a lack of scales to specifically assess ADHD symptomatology in children and adolescents with ID. This article describes the development and evaluation of a teacher-completed measure; the Scale of Attention in Intellectual Disability (SAID). A community survey of 176 teachers of children 5-13 years of age, with ID at all levels of impairment indicated that the T-SAID is a reliable and valid measure. Integrating this scale with neuropsychological and clinical research holds exciting promise for enhancing our understanding of the nature of attention difficulties within populations with ID.

Longitudinal research has demonstrated that social outcomes for adults with autism are restricted, particularly in terms of employment and living arrangements. However, understanding of individual and environmental factors that influence these outcomes is far from complete. This longitudinal study followed a community sample of children and adolescents with autism into adulthood. Social outcomes in relation to community inclusion and living skills were examined, including the predictive role of a range of individual factors and the environment (socio-economic disadvantage). Overall, the degree of community inclusion and living skills was restricted for the majority, and while childhood IQ was an important determinant of these outcomes, it was not the sole predictor. The implications of these findings in relation to interventions are discussed.

Background: To develop effective education strategies, a detailed knowledge of the working memory profile in Down syndrome (DS) and autism with intellectual disability (ID) is required. Materials and Methods: Fifteen adolescents with DS, 11 boys with autism and ID, and 12 boys with nonspecific ID (NSID) were compared on 2 versions of a novel working memory task that varied only in modality of presentation (visual or auditory). Results: The groups with DS and with autism and ID demonstrated significantly poorer working memory performances than the group with NSID. No predictors of working memory performance were found. Conclusions: Recommendations to support the working memory difficulties of the groups with DS and autism and ID in the classroom include reducing the amount of information to be processed at a time, as well as providing visual or verbal (as appropriate) prompts and cues to reduce the need to hold information in working memory.

This study investigated the relationship between structural language skills, and communication skills, adaptive behavior, and emotional and behavior problems in pre-school children with autism. Participants were aged 3-5 years with autism (n = 27), and two comparison groups of children with developmental delay without autism (n = 12) and typically developing children (n = 20). The participants were administered standardised tests of structural language skills, and parents completed the Vineland Adaptive Behavior Scales and the Developmental Behaviour Checklist. Results indicated that for children with autism, communication skills, and in particular receptive communication skills, were associated with social and daily living skills, and behavior problems. Receptive structural language skills were associated with expressive communication skills. There were no associations found between structural language skills and social or daily living skills, nor behavior problems. The results of this study suggest that communication skills are more closely linked to functional and behavioral outcomes in autism than structural language skills. (Contains 3 tables.)

Changes to the DSM-5 Autism Spectrum Disorder (ASD) criteria raised concerns among parents and practitioners that the criteria may exclude some children with Pervasive Developmental Disorder (PDD). Few studies have examined DSM-5 sensitivity and specificity in children less than 5 years of age. This study evaluated 185 children aged 20-55 months with DSM-IV PDD or developmental delay. Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) data was assigned to DSM-5 subdomains. Children displaying the required symptomatology were classified with DSM-5 ASD. DSM-IV clinical diagnoses were compared to DSM-5 classifications. Using combined ADI-R/ADOS information, sensitivity was .84 and specificity was .54. Comorbid behaviour and emotional problems were significantly lower in children with PDD that did not meet DSM-5 criteria., Author(s): Jessica A. Christiansz[sup.1] , Kylie M. Gray[sup.1] [sup.2] , John Taffe[sup.1] , Bruce J. Tonge[sup.1] Author Affiliations: (1) Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of [...]

This paper examines the upper-limb movement kinematics of young children (3-7 years) with high-functioning autism using a point-to-point movement paradigm. Consistent with prior findings in older children, a difference in movement preparation was found in the autism group (n = 11) relative to typically developing children. In contrast to typically developing children, the presence of a visual distractor in the movement task did not appear to impact on early movement planning or execution in children with autism, suggesting that this group were not considering all available environmental cues to modulate movement. The findings from this study are consistent with the possibility that autism is associated with a difficulty using visual information to prime alternative movements in a responsive way to environmental demands.

Despite the recognized importance of emotion regulation (ER) for healthy psychological development, ER research has focused predominantly on the developmental periods of infancy, early childhood, and adulthood, while the middle childhood to adolescence years have been relatively neglected. An obstacle to ER research during these periods is the paucity of valid age-appropriate measures. This study reports on the psychometric evaluation of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), a revision of the adult measure. The ERQ-CA was evaluated with a sample of 827 participants aged between 10 and 18 years. Results indicate sound internal consistency as well as stability over a 12-month period. Sound construct and convergent validity are also demonstrated. It is concluded that the ERQ-CA is a valid age-appropriate measure for investigating the use of 2 specific strategies of ER during the childhood and adolescence developmental periods. (Contains 1 figure and 4 tables.)

High rates of behavior and emotional problems have been consistently reported in children and adolescents with autism. Elevated rates of mental health problems have also been reported in adults with autism. Little is known, however, about the longitudinal development of behavior and emotional problems in autism. This study followed a cohort of children and adolescents over 18 years. Outcomes were evaluated in terms of behavior and emotional problems and autism symptomatology. The role of childhood factors (age, gender, IQ, behavior, and emotional problems) and the environment (socioeconomic disadvantage) were considered in terms of adult outcomes. Overall, improvements in comorbid behavior and emotional problems and autism symptomatology were observed. However, rates of comorbid behavior and emotional problems in adulthood remained high.

Background: Standardised normative data for checklists of behavioural and emotional disturbance have a demonstrated usefulness for clinicians, researchers, and service providers. Method: The Developmental Behaviour Checklist for Adults (DBC-A) was the instrument used in a large-scale Australian study (n = 1,538) of emotional and behavioural disturbance. Results: To assist the field, normative data is now available on the DBC-A for adults with ID from age 18-85 years, across three levels of intellectual disability (ID). A condensed version of DBC-A normative data is presented here. Conclusions: A large population-based study provided an opportunity for further checklist development, and the utility of the DBC-A has been enhanced by the provision of normative data. (Contains 1 table.)

There is a paucity of evidence concerning the patterns of multi-informant agreement in populations with Autism Spectrum Disorders (ASD). This study compared ratings of behaviour and emotional problems and social functioning provided by 45 adolescents aged 12-18 years, with Autistic or Asperger's Disorder with ratings by their parents and teachers. Behaviour and emotional problems were measured using the "Child Behaviour Checklist" and social functioning was measured with the "Social Skills Rating System." Moderate agreement was found between adolescent and parent ratings of psychopathology and social functioning. In general, parent and teacher ratings and adolescent and teacher ratings differed significantly. These findings suggest that behaviour varies across environmental contexts. Patterns of agreement between multiple informants observed in the current study frequently differed from those previously found in non-ASD populations. Clinicians and researchers need to consider a multi-informant approach to obtain a detailed picture of behaviour and emotional problems in adolescents with autism and Asperger's Disorder. (Contains 3 tables.)

In typically developing children, boys are more commonly diagnosed than girls with disruptive behavior disorders, namely, attention-deficit/hyperactivity disorder, conduct disorder, and oppositional defiant disorder. For children with intellectual disability (ID), the evidence for this gender effect is less clear. In this report we examine gender effects on disruptive behavior in the Australian Child to Adult Development Study, a cohort of children and adolescents with ID, assessed in 4 waves. Items from the Developmental Behaviour Checklist were selected for their similarity to "Diagnostic and Statistical Manual of Mental Disorders, 4th edition" (American Psychiatric Association, 1994) criteria and their frequency compared for boys and girls after taking age and severity of ID into account, both individually and as a composite score. On 14 items, there were no significant gender differences. On 3 items, boys had significantly higher scores than girls, whereas for 1 item, girls scored higher. The extent of these differences was smaller than that reported in typically developing children. On a composite scale of all items, there was no significant effect of gender. We discuss possible explanations for the lesser effect of gender in children with ID. (Contains 3 tables.)

A 24-item short form of the 96-item Developmental Behaviour Checklist was developed to provide a brief measure of Total Behaviour Problem Score for research purposes. The short form Developmental Behaviour Checklist (DBC-P24) was chosen for low bias and high precision from among 100 randomly selected item sets. The DBC-P24 was developed from epidemiological data in the first three waves of the Australian Child to Adult Development study, and cross validated for groups with autism, fragile X, Prader-Willi, and Williams in this longitudinal study and in cross sectional Dutch, English, and Finnish samples of young people with intellectual disability. The DBC-P24 has low bias and high precision in cross-validation samples and achieves high sensitivity and specificity to full DBC-P based caseness decisions.

Longitudinal research has demonstrated that social outcomes for adults with autism are restricted, particularly in terms of employment and living arrangements. However, understanding of individual and environmental factors that influence these outcomes is far from complete. This longitudinal study followed a community sample of children and adolescents with autism into adulthood. Social outcomes in relation to community inclusion and living skills were examined, including the predictive role of a range of individual factors and the environment (socioeconomic disadvantage). Overall, the degree of community inclusion and living skills was restricted for the majority, and while childhood IQ was an important determinant of these outcomes, it was not the sole predictor. The implications of these findings in relation to interventions are discussed. Keywords Autism * Community inclusion * Living skills Adult outcomes, Introduction Studies of adult outcomes in autism have focused on broad constructs of outcome, typically including evaluations of social functioning in terms of independence, social relationships, employment status, and living [...]

The current study aims to evaluate the psychometric properties of the Emotion Regulation and Social Skills Questionnaire (ERSSQ), a rating scale designed specifically to assess the social skills of young people with Autism Spectrum Disorder (ASD). The participants were 84 children and young adolescents with ASD, aged between 7.97 and 14.16 years with a mean IQ score of 90.21 (SD = 18.82). The results provide evidence for the concurrent and criterion validity of the ERSSQ Parent form, and the concurrent validity of the ERSSQ Teacher form. The clinical and theoretical implications are discussed, including the necessity of ratings across multiple contexts and the potential use of the ERSSQ in identifying individuals most in need of intervention and for planning and assessing the outcomes of social skills interventions. Keywords ERSSQ * Social skills * Autism Spectrum Disorders ASD Validation, Introduction Autism Spectrum Disorders (ASD) are pervasive and lifelong developmental disorders that are characterized by marked impairments in social interaction, communication, and patterns of restricted/repetitive behaviors or interests (American Psychiatric [...]

This study investigated the relationship between structural language skills, and communication skills, adaptive behavior, and emotional and behavior problems in pre-school children with autism. Participants were aged 3-5 years with autism (n = 27), and two comparison groups of children with developmental delay without autism (n = 12) and typically developing children (n = 20). The participants were administered standardised tests of structural language skills, and parents completed the Vineland Adaptive Behavior Scales and the Developmental Behaviour Checklist. Results indicated that for children with autism, communication skills, and in particular receptive communication skills, were associated with social and daily living skills, and behavior problems. Receptive structural language skills were associated with expressive communication skills. There were no associations found between structural language skills and social or daily living skills, nor behavior problems. The results of this study suggest that communication skills are more closely linked to functional and behavioral outcomes in autism than structural language skills. Keywords Autism * Language * Adaptive behavior * Behavior problems, Introduction In addition to social impairments and restricted and repetitive behaviors, many children with autism also experience language deficits (Park et al. 2012), behavior problems (Baghdadli et al. 2003; Herring [...]

Developmental Behavior Checklist (DBC) was used as a key measure of psychopathology in young people with intellectual disability aged 4 to 19 years. Results provide evidence that the problem of psychopathology comorbid with intellectual disability is both substantial and persistent and suggest the need for effective mental health interventions.