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To explore associations between autism traits and family functioning over time, we studied longitudinal data of a mixed group of 168 clinically referred autistic and non-autistic children. Cross-lagged models showed a significant association between fewer autism traits at the diagnostic assessment and better family functioning 1 year later for the whole group, independently of children's internalizing or externalizing behavior. When splitting the group into autistic children (58%) and non-autistic children (42%) based on an autism diagnosis, this association was only significant in the subgroup of non-autistic children with autism traits. We hypothesized that the needs of families experiencing difficulty understanding and adjusting to their children with autism traits, but no clinical autism diagnosis, might be unmet without the training or support facilities offered to families with autistic children. Although further research is needed to explore this association, clinicians may also consider supporting families of non-autistic children with autism traits to prevent family functioning problems. Because high autism trait levels in non-autistic children may be of a different origin than autism, for example, other neurodevelopmental or mental health problems, family training or support should be tailored to the child's underlying difficulties.

Students exhibiting challenging externalizing behaviors may benefit from supportive interactions with teachers. However, if students show high levels of externalizing behaviors, this may negatively impact on student-teacher interactions, and vice versa. We therefore examined bidirectional developmental links between student-teacher interactions and externalizing behavior of male adolescents placed in special education because of psychiatric disabilities. Participants were 584 adolescents (M[subscript age] = 15.0 years, SD = 1.7) and their teachers from 14 Dutch special education schools. At 3 time points, student-reports of student-teacher interactions and teacher-reports of adolescents' externalizing behavior were collected. Using autoregressive cross-lagged models, results indicate that externalizing behavior predicted decreases in supportive interactions (ß = -0.09, p = 0.02), but not in negative interactions. Student-teacher interactions did not show a significant influence on externalizing behavior. Our results highlight externalizing behavior as an important target for interventions intended to improve student-teacher interactions.

The aim of this study was to examine developmental links between disobedience and teacher-child closeness in a sample of boys with psychiatric disorders (i.e., emotional and behavioral disorders (EBD) and autism spectrum disorders (ASD)) and special educational needs who are placed in special education. More specifically, this study examined whether developmental links were different between boys with EBD (n = 150) versus boys with ASD (n = 122). Developmental links between disobedience and teacher-child closeness were investigated by incorporating a multi-informant perspective using teacher, child, and peer ratings and analyzed using autoregressive cross-lagged models across three waves within one school year. Results showed that in general, developmental links between teacher-child closeness and disobedience were stronger for boys with EBD than for boys with ASD. Specifically, boys with EBD experiencing less teacher-child closeness showed more disobedience, which in turn negatively affected their relationship development according to teacher ratings. Surprisingly, for boys with ASD, higher levels of disobedience predicted higher levels of teacher-rated teacher-child closeness during the school year. Our results offer more insight into the differential impact of teacher-child closeness on the behavioral problems for children with EBD and ASD.

This study tested effects of a program that offers teachers universal classroom management strategies, on teachers' burnout symptoms and self-efficacy, and their teaching behaviors. Data were collected from 147 teachers (mean age = 38.4 years, SD = 10.8) in 15 special secondary education schools for students with emotional and behavioral problems, at the start and end of the school year. Schools were randomly assigned to the experimental condition or a care-as-usual condition. Results show that the program impacted beneficially on self-reported levels of emotional exhaustion, and self-efficacy in engaging students and in classroom management, but not on teaching behaviors. Implications of this study for the professional development of teachers in special education and research are discussed.

In order to shed more light on why referred girls are less likely to be diagnosed with autism spectrum disorder than boys, this study examined whether behavioral characteristics influence the probability of an autism spectrum disorder diagnosis differently in girls versus boys derived from a multicenter sample of consecutively referred children aged 2.5-10 years. Based on information from the short version of the Developmental, Dimensional and Diagnostic Interview and the Autism Diagnostic Observation Schedule, 130 children (106 boys and 24 girls) received a diagnosis of autism spectrum disorder according to "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.) criteria and 101 children (61 boys and 40 girls) did not. Higher overall levels of parent-reported repetitive and restricted behavior symptoms were less predictive of an autism spectrum disorder diagnosis in girls than in boys (odds ratio interaction = 0.41, 95% confidence interval = 0.18-0.92, p = 0.03). In contrast, higher overall levels of parent-reported emotional and behavioral problems increased the probability of an autism spectrum disorder diagnosis more in girls than in boys (odds ratio interaction = 2.44, 95% confidence interval = 1.13-5.29, p = 0.02). No differences were found between girls and boys in the prediction of an autism spectrum disorder diagnosis by overall autistic impairment, sensory symptoms, and cognitive functioning. These findings provide insight into possible explanations for the assumed underidentification of autism spectrum disorder in girls in the clinic.

To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD.

This paper provides an overview of the design and cohort characteristics of the Social Spectrum Study: a clinical cohort study that used a two-phase sampling design to identify children at risk for ASD. After screening 1281 children aged 2.5-10 years who had been consecutively referred to one of six mental health services in the Netherlands, children who screened positive for ASD (n = 428) and a random selection of screen negatives (n = 240) were invited to participate in diagnostic assessments and questionnaires regarding the child, family and society. A 1-year follow-up was also conducted. Results from this study may contribute to knowledge of the identification and characterization of children with ASD, family processes, and the impact of ASD on the family and society.

Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to implement positive behavior support strategies to elicit desired behavior in students. A total of 389 children and their 58 teachers at 11 schools for special primary education were included in the study. Using a cluster randomized controlled design, special education schools were assigned to an intervention condition or an education as usual condition. An increase in emotional and behavioral problems was found in the control group, whereas no change was seen in the intervention group, indicating a modest intervention effect. No effects were found on children's relationships with teachers or peers. The GBG affected teachers' sense of self-efficacy in engaging students in schoolwork, but no effects were found on teachers' self-efficacy in classroom management or on teachers' burnout symptoms. Thus, although children with psychiatric disorders and their teachers in special education can benefit from the GBG, given the partial effects and modest effect sizes, a longer duration program complemented with additional elements is recommended.

The Developmental Diagnostic Dimensional Interview-short version (3Di-sv) provides a brief standardized parental interview for diagnosing autism spectrum disorder (ASD). This study explored its validity, and compatibility with DSM-5 ASD. 3Di-sv classifications showed good sensitivity but low specificity when compared to ADOS-2-confirmed clinical diagnosis. Confirmatory factor analyses found a better fit against a DSM-5 model than a DSM-IV-TR model of ASD. Exploration of the content validity of the 3Di-sv for the DSM-5 revealed some construct underrepresentation, therefore we obtained data from a panel of 3Di-trained clinicians from ASD-specialized centers to recommend items to fill these gaps. Taken together, the 3Di-sv provides a solid basis to create a similar instrument suitable for DSM-5. Concrete recommendations are provided to improve DSM-5 compatibility.

The screening accuracy of the parent and teacher-reported Social Responsiveness Scale (SRS) was compared with an autism spectrum disorder (ASD) classification according to (1) the Developmental, Dimensional, and Diagnostic Interview (3Di), (2) the Autism Diagnostic Observation Schedule (ADOS), (3) both the 3Di and ADOS, in 186 children referred to six mental health centers. The parent report showed excellent correspondence to an ASD classification according to the 3Di and both the 3Di and ADOS. The teacher report added significantly to the screening accuracy over and above the parent report when compared with the ADOS classification. Findings support the screening utility of the parent-reported SRS among clinically referred children and indicate that different informants may provide unique information relevant for ASD assessment.

High and stable levels of aggression and the presence of aggressive behaviour in multiple settings according to different informants are risk factors for later problems. However, these two factors have not been investigated in early childhood. The present study investigates trajectories of parent-reported child aggression from 1.5 up to 6 years of age and their association with aggressive behaviour, attention problems and rule-breaking behaviour in a different setting, as reported by the teacher. In a longitudinal population-based cohort study, parent-reported measures of aggressive behaviour were obtained using the CBCL when children were 1.5, 3, and 6 years of age (n = 4,781). Teacher-reported problem behaviour at school was assessed at age 6.5, using the TRF questionnaire (n = 2,756). Growth mixture modelling yielded three aggression trajectories, with high increasing (3.0%), intermediate (21.3%), and low decreasing (75.7%) aggression levels. Children in trajectories with higher and increasing levels of aggression showed more teacher-reported aggressive behaviour, attention problems and rule breaking behaviour. However, parent-reported aggression at age six predicted problem behaviour at school to the same extent as did the aggression trajectories, suggesting that the incremental value of trajectories is not always self-evident.

To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD., Author(s): Linda P. Dekker [sup.1] [sup.2] , Esther J. M. van der Vegt [sup.1] [sup.2] , Jan van der Ende [sup.1] , Nouchka Tick [sup.1] [sup.2] , Anneke Louwerse [sup.1] [...]

This paper provides an overview of the design and cohort characteristics of the Social Spectrum Study: a clinical cohort study that used a two-phase sampling design to identify children at risk for ASD. After screening 1281 children aged 2.5-10 years who had been consecutively referred to one of six mental health services in the Netherlands, children who screened positive for ASD (n = 428) and a random selection of screen negatives (n = 240) were invited to participate in diagnostic assessments and questionnaires regarding the child, family and society. A 1-year follow-up was also conducted. Results from this study may contribute to knowledge of the identification and characterization of children with ASD, family processes, and the impact of ASD on the family and society., Author(s): Jorieke Duvekot[sup.1] [sup.2] , Leontine W. ten Hoopen[sup.1] , Geerte Slappendel[sup.1] [sup.2] , Jan van der Ende[sup.1] , Frank C. Verhulst[sup.1] , Ad van der Sijde[sup.2] , Kirstin Greaves-Lord[sup.1] [...]

This study evaluated the ability of the Child Behavior Checklist and the Teacher's Report Form to identify children with autism spectrum disorders (ASD), using a sample of children with ASD (n = 458), referred children without ASD (n = 1109) and children from the general population (n = 999). A ten items ASD scale was constructed using half of the sample and the ability of this scale to discriminate between children with ASD and the other children was tested for the CBCL and the TRF separately and together in the other half of the sample. Using a cut-off score of 8 the combined CBCL/TRF ASD scale demonstrated high predictive values (NPV 95%, PPV 73%) in identifying children with ASD and children in the general population sample. This might be an acceptable percentage of false positives in general screening, considering the chance that these children might have other behavioural, emotional, and developmental problems which also need psychiatric evaluation. In the referred population, using a cut-off of 13, PPV was 49% and NPV was 85%. The high NPV indicates that in a referred population the scale is especially good at identifying children who do not need evaluation with a more ASD-specific instrument.

Moffitt, Caspi, Harrington, and Milne (2002) found in a follow-up study that many of the supposedly adolescence-limited offenders had committed offenses past adolescence. This finding raises the question of whether adulthood starts later or whether there are two distinct delinquency types, adolescence limited and adolescence onset, each with its own etiology. The present study tested whether the adolescence-onset group could be predicted by childhood psychopathology, as compared to the adolescence-limited and no-offender groups. In sum, 355 boys and girls were included, who reported on their emotional and behavioral problems when they were 11 to 13 years old and on their self-reported criminal behavior 8 to 13 years later. The findings lend support to the hypothesis that adolescence-onset offenders can be distinguished from adolescence-limited offenders. (Contains 1 figure and 2 tables.)

We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) Do levels of parent-adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent-adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent-adolescent dyads within each society agree on the adolescent's deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR-CBCL discrepancy varied across societies. Cross-informant correlations for problem scale scores varied more across societies than across types of problems. Across societies, parents and adolescents tended to rate the same items as low, medium, or high, but within-dyad parent-adolescent item agreement varied widely in every society. In all societies, both parental noncorroboration of self-reported deviance and adolescent noncorroboration of parent-reported deviance were common. Results indicated many multicultural consistencies but also some important differences in parent-adolescent cross-informant agreement. Our findings provide valuable normative baselines against which to compare multicultural findings for clinical samples. (Contains 5 tables and 1 figure.)

This study aimed to establish potential mechanisms through which economic disadvantage contributes to the development of young children's internalizing and externalizing problems. Prospective data from fetal life to age 3 years were collected in a total of 2,169 families participating in the Generation R Study. The observed physical home environment, the provision of learning materials in the home, maternal depressive symptoms, parenting stress, and harsh disciplining practices were all analyzed as potential mediators of the association between economic disadvantage and children's internalizing and externalizing problem scores. Findings from structural equation modeling showed that for both internalizing and externalizing problems, the mechanisms underlying the effect of economic disadvantage included maternal depressive symptoms, along with parenting stress and harsh disciplining. For internalizing but not for externalizing problem scores, the lack of provision of learning materials in the home was an additional mechanism explaining the effect of economic disadvantage. The current results suggest that interventions that focus solely on raising income levels may not adequately address problems in the family processes that emerge as a result of economic disadvantage. Policies to improve the mental health of mothers with young children but also their home environments are needed to change the economic gradient in child behavior. (Contains 2 tables and 2 figures.)

The Developmental Diagnostic Dimensional Interview-short version (3Di-sv) provides a brief standardized parental interview for diagnosing autism spectrum disorder (ASD). This study explored its validity, and compatibility with DSM-5 ASD. 3Di-sv classifications showed good sensitivity but low specificity when compared to ADOS-2-confirmed clinical diagnosis. Confirmatory factor analyses found a better fit against a DSM-5 model than a DSM-IV-TR model of ASD. Exploration of the content validity of the 3Di-sv for the DSM-5 revealed some construct underrepresentation, therefore we obtained data from a panel of 3Di-trained clinicians from ASD-specialized centers to recommend items to fill these gaps. Taken together, the 3Di-sv provides a solid basis to create a similar instrument suitable for DSM-5. Concrete recommendations are provided to improve DSM-5 compatibility., Author(s): Geerte Slappendel[sup.1] [sup.2] , William Mandy[sup.3] , Jan van der Ende[sup.1] , Frank C. Verhulst[sup.1] , Ad van der Sijde[sup.2] , Jorieke Duvekot[sup.1] [sup.2] , David Skuse[sup.4] , Kirstin [...]