1
|
Rivera RA, Robertson MC, McCleery JP. Exercise Interventions for Autistic People: An Integrative Review of Evidence from Clinical Trials. Curr Psychiatry Rep 2025; 27:286-306. [PMID: 40075048 PMCID: PMC12003570 DOI: 10.1007/s11920-025-01597-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2025] [Indexed: 03/14/2025]
Abstract
PURPOSE OF REVIEW This review integrates recent findings from randomized controlled clinical trial (RCT) research examining the impacts of physical exercise activities on various aspects and areas of functioning for autistic individuals. RECENT FINDINGS Recent meta-analytic and clinical trials research indicates physical exercise intervention programs improve social and communication skills for autistic children and adolescents, improve executive functioning skills for autistic children, improve sleep-related behavior for autistic children and adolescents, and may be helpful for improving physical health for autistic children. There is very limited RCT research evidence on exercise intervention approaches or impacts for autistic adults, for autistic girls or women, for autistic people with co-occurring intellectual disability, and for reducing negative emotional symptoms (e.g., anxiety, depression) for any autistic population. The extant clinical trials research provides convincing, consistent evidence for positive impacts of physical exercise programs on multiple areas of functioning for autistic children and adolescents. Additional research is needed to determine and ensure potential impacts of physical exercise activity programs for important autistic sub-populations, including adults.
Collapse
Affiliation(s)
- Rachel A Rivera
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Meredith C Robertson
- Department of Psychology, Saint Joseph's University, 5600 City Avenue, Philadelphia, PA, USA
- Kinney Center for Autism Education and Support, Saint Joseph's University, Philadelphia, PA, USA
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Joseph P McCleery
- Department of Psychology, Saint Joseph's University, 5600 City Avenue, Philadelphia, PA, USA.
- Kinney Center for Autism Education and Support, Saint Joseph's University, Philadelphia, PA, USA.
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| |
Collapse
|
2
|
Lamash L, Gutman Y, Meyer S, Gal E. Aligning Perspectives: Autism Identity, Independence, Participation, and Quality of Life in Autistic Adolescents Through Self and Parental Reports. J Autism Dev Disord 2025:10.1007/s10803-025-06836-6. [PMID: 40252201 DOI: 10.1007/s10803-025-06836-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2025] [Indexed: 04/21/2025]
Abstract
This study examines the alignment between self-reports and parental reports on adolescents' autism identity, functional autonomy, social participation, and quality of life (QoL), providing insights into the relationships between these factors. Thirty dyads comprising adolescents aged 13 to 18 years and one of their parents participated in the study. Participants completed the Autism Identity Questionnaire, Daily Routine and Autonomy questionnaire, Child and Adolescent Scale of Participation-Youth, and the Pediatric Quality of Life Inventory. The findings indicated moderate agreement between self-reports and parental reports regarding autism identity, functional autonomy, and QoL. Fair agreement was found regarding social participation. Adolescents who reported higher levels of acceptance regarding their autism identity demonstrated greater autonomy and participation, which correlated with a higher QoL. Conversely, those with higher engulfment scores (feeling overwhelmed by the diagnosis) exhibited lower levels of independence, social participation, and emotional and social QoL. These findings suggest that fostering a positive autism identity may enhance autonomy and social participation while addressing feelings of engulfment could improve emotional and social outcomes.
Collapse
Affiliation(s)
- Liron Lamash
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
| | - Yael Gutman
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Sonya Meyer
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Eynat Gal
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| |
Collapse
|
3
|
Terner M, Golan O. Sex Differences in Adult Autism Screening: A Comparison of Current Self-Report and Retrospective Parent-Report Measures. J Autism Dev Disord 2025:10.1007/s10803-025-06753-8. [PMID: 40024966 DOI: 10.1007/s10803-025-06753-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2025] [Indexed: 03/04/2025]
Abstract
This study investigated sex differences in adult autism screening by comparing self-reports on current traits (Autism Spectrum Quotient; AQ) and parent-reports on childhood traits (Relatives Questionnaire; RQ). The aim was to examine the differential contribution of these distinct measures to diagnostic classification in both sexes. The study compared 102 clinically diagnosed autistic adults (30 females) and 152 non-autistic adults (60 females), aged 17-35 years. Participants completed the AQ, while their parents completed the RQ. Multivariate analysis of variance and sex-stratified discriminant analyses were employed to evaluate measurement patterns in males and in females. Significant main effects were found for diagnostic group on both measures and for sex on the RQ only. Group × sex interactions were significant for both measures. Within the autistic group, males and females showed no significant difference in AQ scores, but females scored significantly lower than males on the RQ. Discriminant analyses revealed high classification accuracies for both males (95.1%) and females (96.7%), with different weighting patterns between males (AQ = 0.597 [CI: 0.413-0.720], RQ = 0.712 [CI: 0.553-0.789]) and females (AQ = 0.763 [CI: 0.637-0.898], RQ = 0.478 [CI: 0.191-0.616]). The findings suggest that current self-report may be more central for identifying autism in females, while a more balanced combination of current-self and past-parent reports may be optimal for males. These sex-specific patterns highlight the importance of considering both current self-reported traits and developmental history in adult autism screening, with potential implications for improving diagnostic accuracy across sexes.
Collapse
Affiliation(s)
- Michael Terner
- Department of Psychology, Bar-Ilan University, Ramat- Gan, 5290002, Israel
| | - Ofer Golan
- Department of Psychology, Bar-Ilan University, Ramat- Gan, 5290002, Israel.
- OTI, The Israeli Autism Association, Giv'at-Shmuel, Israel.
| |
Collapse
|
4
|
Yon-Hernández JA, Iosif AM, Srivastav A, Solomon M. Adaptive Functioning Across Contexts: A Comparison of Parent and Self-Reported Ratings in Autistic and Non-Autistic Youth. J Autism Dev Disord 2025:10.1007/s10803-025-06756-5. [PMID: 40019621 DOI: 10.1007/s10803-025-06756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2025] [Indexed: 03/01/2025]
Abstract
Multi-informants are essential for capturing the full range of adaptive functioning abilities necessary for daily living and independence. However, discrepancies within parent-child dyads, specifically comparing parent-reports to child self-reports, can cloud interpretation from assessments and hinder support planning. This study examines discrepancies in parent-youth perceptions of adaptive functioning, focusing on the social domain, and investigates associations among parents, youth, and independent ratings, considering factors like IQ, autism severity, and parental education. The study included 132 individuals (66 autistic, 66 non-autistic) aged 16-24 years. Adaptive functioning was measured using the Adaptive Behavior Assessment System-3 across the conceptual, practical, and social domains. Agreement between reporters was assessed using paired-sample t-tests, intraclass-correlations, and Bland-Altman plots. Spearman's correlations examined associations between raters, while the effects of IQ, autism severity, and parental education on discrepancies were analyzed using linear regression. Autistic self- and parent-reports showed lower adaptive functioning than non-autistic dyads. Autistic youth reported higher social and less practical adaptive skills compared to parents. Autistic self-reports in the social domain correlated significantly with independent assessment. Increased autistic symptoms were associated with greater parent-child discrepancies. This study underscores the importance of multi-informant assessments to understand the full range of adaptive functioning in autistic individuals. Discrepancies in social and practical domains highlight the need for both perspectives, because parents may not observe all behaviors and may overlook autistic individuals' perception of support needs in the practical domain. Understanding these differences is crucial for improving supports planning and enhancing quality of life for autistic individuals.
Collapse
Affiliation(s)
- Jo A Yon-Hernández
- Department of Psychiatry and Behavioral Sciences, University of California Davis, MIND Institute, Davis, CA, USA.
- , 2825 50th Street, Sacramento, CA, 95817, USA.
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Apurv Srivastav
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, University of California Davis, MIND Institute, Davis, CA, USA
| |
Collapse
|
5
|
Cagiano R, Mancini A, Berni M, Maccarrone F, Arena B, Cosenza A, Pecini C, Igliozzi R, Calderoni S, Tancredi R. Psychiatric Comorbidities in Autistic Adolescents Without Intellectual Impairment: A Focus on Parent- and Self-Reported Psychopathological Assessment. Brain Sci 2025; 15:187. [PMID: 40002520 PMCID: PMC11853091 DOI: 10.3390/brainsci15020187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Revised: 02/10/2025] [Accepted: 02/11/2025] [Indexed: 02/27/2025] Open
Abstract
Background: Co-occurring conditions and psychiatric comorbidities are more frequently observed in autistic individuals than in typically developing populations. Objective: The present study aimed to investigate the agreement of parent- and self-reported psychopathological assessment using the Child Behavior Checklist (CBCL/6-18) and the Youth Self Report (YSR/11-18), respectively, in autistic adolescents without intellectual impairment. Methods: 54 autistic adolescents without intellectual impairment (11-18 years; M = 14.73; SD = 2.28) were assessed with a psychiatric and psychological evaluation conducted by expert clinicians also using self- and parent-reported scales and semi-structured interviews (K-SADS PL, CDI, MASC) including CBCL/6-18 and YSR/11-18. Results: According to clinical judgment, over 90% of participants had at least a comorbidity: anxiety (68.5%) and mood disorder (57.4%) were the most frequent. The results indicate significant discrepancies between parent- and self-reports across the three summary scales, which assess emotional and behavioral problems, as well as their combined presentation, often observed in youth with ASD. Specifically, differences were found in Internalizing (p < 0.001), Externalizing (p = 0.013), and Total Problems (p < 0.001) scales. Conclusions: The findings show the lack of agreement in parent- and self-reported scales in our sample. These results suggest the need for a cross- and multi-informant approach to support clinical judgment and understand psychopathological comorbidities of autistic adolescents without intellectual impairment.
Collapse
Affiliation(s)
- Romina Cagiano
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
| | - Alice Mancini
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
| | - Marta Berni
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
- University of Florence, 50121 Florence, Italy
| | - Federica Maccarrone
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Benedetta Arena
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Angela Cosenza
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
| | - Chiara Pecini
- Department of Education, Languages, Intercultures, Literatures and Psychology (FORLILPSI), University of Florence, 50121 Florence, Italy;
| | - Roberta Igliozzi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
| | - Sara Calderoni
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Raffaella Tancredi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Stella Maris Foundation, Calambrone, 56128 Pisa, Italy; (R.C.); (A.M.); (M.B.); (F.M.); (B.A.); (A.C.); (R.I.); (S.C.)
| |
Collapse
|
6
|
McQuaid GA, Strang JF, Jack A. Borderline Personality as a Factor in Late, Missed, and Mis-Diagnosis in Autistic Girls and Women: A Conceptual Analysis. AUTISM IN ADULTHOOD 2024; 6:401-427. [PMID: 40018062 PMCID: PMC11861065 DOI: 10.1089/aut.2023.0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2025]
Abstract
Autism without intellectual disability is diagnosed later and with greater difficulty in girls/women relative to boys/men. For autistic girls and women, the journey to an autism diagnosis may include one or more misdiagnoses. Misdiagnosis with borderline personality disorder (BPD) or borderline traits may be particularly common, and characteristics often observed in autistic girls and women may contribute specifically to a risk of misdiagnosis with BPD. This review draws from a burgeoning literature on autism in girls and women to provide a detailed discussion of differential diagnosis of BPD and autism in cisgender girls/women, with a focus on phenotypic traits and/or their presentation that may be more common in autistic girls/women and that may be particularly prone to miscategorization as BPD. Distinctions between autism and BPD are identified, emphasizing the need for scrutiny of an individual's clinical presentation to tease apart differences between the autism and BPD phenotypes. We highlight instances in which similar phenotypic expressions may be driven by differing underlying factors. Implications for the distinction of autism and BPD/borderline traits in informing appropriate therapeutic intervention are discussed.
Collapse
Affiliation(s)
- Goldie A. McQuaid
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| | - John F. Strang
- Gender and Autism Program, Children's National Hospital, Rockville, Maryland, USA
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Rockville, Maryland, USA
- George Washington University School of Medicine, Washington, District of Columbia, USA
- Department of Pediatrics, Psychiatry, and Behavioral Sciences, George Washington University School of Medicine, Washington, District of Columbia, USA
| | - Allison Jack
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
| |
Collapse
|
7
|
Poulsen R, Williams Z, Dwyer P, Pellicano E, Sowman PF, McAlpine D. How auditory processing influences the autistic profile: A review. Autism Res 2024; 17:2452-2470. [PMID: 39552096 PMCID: PMC11638897 DOI: 10.1002/aur.3259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 10/23/2024] [Indexed: 11/19/2024]
Abstract
We need to combine sensory data from various sources to make sense of the world around us. This sensory data helps us understand our surroundings, influencing our experiences and interactions within our everyday environments. Recent interest in sensory-focused approaches to supporting autistic people has fixed on auditory processing-the sense of hearing and the act of listening-and its crucial role in language, communications, and social domains, as well as non-social autism-specific attributes, to understand better how sensory processing might differ in autistic people. In this narrative review, we synthesize published research into auditory processing in autistic people and the relationship between auditory processing and autistic attributes in a contextually novel way. The purpose is to understand the relationship between these domains more fully, drawing on evidence gleaned from experiential perspectives through to neurological investigations. We also examine the relationship between auditory processing and diagnosable auditory conditions, such as hyperacusis, misophonia, phonophobia, and intolerance to loud sounds, as well as its relation to sleep, anxiety, and sensory overload. Through reviewing experiential, behavioral and neurological literature, we demonstrate that auditory processes interact with and shape the broader autistic profile-something not previously considered. Through a better understanding of the potential impact of auditory experiences, our review aims to inform future research on investigating the relationship between auditory processing and autistic traits through quantitative measures or using qualitative experiential inquiry to examine this relationship more holistically.
Collapse
Affiliation(s)
- R. Poulsen
- Department of Linguistics, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Z. Williams
- Medical Scientist Training Program, Vanderbilt University School of MedicineVanderbilt University School of MedicineNashvilleTennesseeUSA
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Brain InstituteVanderbilt UniversityNashvilleTennesseeUSA
- Frist Center for Autism and InnovationVanderbilt University School of EngineeringNashvilleTennesseeUSA
| | - P. Dwyer
- Center for the Mind and BrainDepartment of PsychologyMIND InstituteUniversity of CaliforniaDavisCaliforniaUSA
- Olga Tennison Autism Research Centre, School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - E. Pellicano
- Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - P. F. Sowman
- School of Psychological SciencesMacquarie UniversitySydneyNew South WalesAustralia
- School of Clinical SciencesAuckland University of TechnologyAucklandNew Zealand
| | - D. McAlpine
- Department of Linguistics, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNew South WalesAustralia
| |
Collapse
|
8
|
Kaplan-Kahn EA, Benecke RM, Guthrie W, Yerys BE, Holmes LG, Miller JS. Measurement invariance of the PROMIS emotional distress and subjective well-being domains among autistic and General Population adolescents. Qual Life Res 2024; 33:3003-3012. [PMID: 39080090 PMCID: PMC11541282 DOI: 10.1007/s11136-024-03742-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 11/07/2024]
Abstract
PURPOSE Quality of life (QoL) is identified as a clinical and research priority by the autistic community. Researchers have the responsibility to ensure that instruments used to measure QoL do so reliably and accurately among autistic participants. METHODS Our study evaluated measurement invariance of Emotional Distress (Depression, Anxiety, Anger, Psychological Stress) and Subjective Well-Being (Life Satisfaction, Positive Affect, and Meaning & Purpose) scales of the Patient-Reported Outcomes Measurement Information System (PROMIS) among groups of autistic (N=140, n per scale=132-140) and general population (N=1,224, n per scale=406-411) teenagers (14-17 years). These scales were included in the PROMIS Autism Battery-Lifespan, which uses PROMIS scales to measure QoL domains most relevant for autistic people. RESULTS Multi-group confirmatory factor analyses using permutation tests demonstrated that Depression and Positive Affect scales exhibited scalar invariance between groups, indicating that scores can be meaningfully compared across autistic and general population teens. Anger and Psychological Stress scales demonstrated metric invariance between groups, indicating that these scales measure the same latent trait in both groups, but group comparisons are not supported. CONCLUSION We provide guidance as to how these scales can be used in psychometrically supported ways to capture constructs relevant for understanding QoL among autistic teens.
Collapse
Affiliation(s)
| | - Rachel M Benecke
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- College of Education and Human Development, Temple University, Philadelphia, PA, USA
| | - Whitney Guthrie
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin E Yerys
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Graham Holmes
- Silberman School of Social Work at Hunter College, City University of New York, New York, NY, USA
| | - Judith S Miller
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
9
|
Harrop C, Bodfish J, Lecavalier L, Dallman AR, Jones D, Pritchett J, Whitten A, Boyd BA. Refining our Understanding of Anxiety in Autistic Youth: Examining the Role of Behavioral Inflexibility. J Autism Dev Disord 2024; 54:3620-3629. [PMID: 37530916 DOI: 10.1007/s10803-023-06079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
Prior research has demonstrated that cognitive inflexibility is associated with anxiety in autistic individuals. Everyday patterns of behavioral inflexibility (e.g. observable inflexible behavior in the context of the need to change or adapt and that is manifested in real-world everyday settings) is common in autism and can be distinguished from performance on discrete cognitive tasks that tap flexible attention, learning, or decision-making. The purpose of this study was to extend this prior work on inflexibility in autism but with measures specifically developed with input from stakeholders (caregivers and clinicians) for autistic youth designed to measure everyday behavioral inflexibility (BI). We characterized anxiety in a large sample of autistic (N = 145) and non-autistic youth (N = 91), ages 3 to 17 years, using the Parent Rated Anxiety Scale for Autism Spectrum Disorder (PRAS-ASD). Further, we sought to understand how BI, measured via the Behavioral Inflexibility Scale (BIS), predicted anxiety compared to other variables known to increase anxiety in youth (chronological age, IQ, autism diagnosis, assigned sex at birth). Autistic youth had higher parent-related anxiety and BI compared to non-autistic youth. BI was the strongest predictor of anxiety scores, irrespective of diagnosis. Overall, our findings highlight the importance of BI to the understanding of anxiety in autistic youth.
Collapse
Affiliation(s)
- Clare Harrop
- University of North Carolina at Chapel Hill, Bondurant Hall, Chapel Hill, NC, USA.
| | - James Bodfish
- Vanderbilt University Medical Center, Nashville, USA
| | | | | | | | | | | | - Brian A Boyd
- University of North Carolina at Chapel Hill, Bondurant Hall, Chapel Hill, NC, USA
| |
Collapse
|
10
|
Finkel E, Sah E, Spaulding M, Herrington JD, Tomczuk L, Masino A, Pang X, Bhattacharya A, Hedley D, Kushleyeva Y, Thomson P, Doppelt N, Tan J, Pennington J, Dissanayake C, Bonafide CP, Nuske HJ. Physiological and communicative emotional disconcordance in children on the autism spectrum. J Neurodev Disord 2024; 16:51. [PMID: 39232680 PMCID: PMC11373183 DOI: 10.1186/s11689-024-09567-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 08/14/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Individuals on the autism spectrum commonly have differences from non-autistic people in expressing their emotions using communicative behaviors, such as facial expressions. However, it is not yet clear if this reduced expressivity stems from reduced physiological reactivity in emotional contexts or if individuals react internally, but do not show these reactions externally to others. We hypothesized that autism is characterized by a discordance between in-the-moment internal psychophysiological arousal and external communicative expressions of emotion. METHODS Forty-one children on the autism spectrum and 39 non-autistic, typically developing (TD) children of two age groups (2-4 and 8-12 years) participated in a low-level stress task whilst wearing a wireless electrocardiogram. Children's negative emotional expressions (facial, vocal, bodily) were coded following standardized protocols. Alexithymia traits were assessed using the Children's Alexithymia Measure with school-aged children only. Data analyses involved ANOVAs, correlations, and sensitivity analyses. RESULTS There were no group differences in physiological arousal (heart rate) or in communicative expressions of stress to the stress task. For TD preschoolers, physiological arousal during the stress task was associated with vocal expressions and for TD school-aged children, they were associated with facial and bodily expressions. By contrast, for children on the autism spectrum, physiological arousal during the stress tasks was not associated with communicative expressions across age groups. CONCLUSIONS Our findings suggest that children on the autism spectrum might experience emotional disconcordance, in that their physiological arousal does not align with their communicative expressions. Therefore, the internally experienced stress of children on the autism spectrum may be inadvertently missed by teachers and caregivers and, consequently, learning opportunities for teaching emotional communication and regulation may be also missed. Our results support the use of wearable biosensors to facilitate such interventions in children on the autism spectrum.
Collapse
Affiliation(s)
- Emma Finkel
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Eric Sah
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - McKenna Spaulding
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - John D Herrington
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Liza Tomczuk
- Penn Center for Mental Health, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19146, USA
| | - Aaron Masino
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Xueqin Pang
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Anushua Bhattacharya
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Darren Hedley
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Yelena Kushleyeva
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Natalie Doppelt
- Penn Center for Mental Health, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19146, USA
| | - Jessica Tan
- Penn Center for Mental Health, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19146, USA
| | - Jeffrey Pennington
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Christopher P Bonafide
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Heather J Nuske
- Penn Center for Mental Health, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19146, USA.
| |
Collapse
|
11
|
Shea L, Cooper D, Ventimiglia J, Frisbie S, Carlton C, Song W, Salzer M, Lee B, Hotez E, Vanness DJ. Self-Reported COVID-19 Vaccine and Booster Acceptance and Hesitancy Among Autistic Adults in Pennsylvania: Cross-Sectional Analysis of Survey Data. JMIR Public Health Surveill 2024; 10:e51054. [PMID: 39196609 PMCID: PMC11391151 DOI: 10.2196/51054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/30/2024] [Accepted: 06/21/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The autistic population is rapidly increasing; meanwhile, autistic adults face disproportionate risks for adverse COVID-19 outcomes. Limited research indicates that autistic individuals have been accepting of initial vaccination, but research has yet to document this population's perceptions and acceptance of COVID-19 boosters. OBJECTIVE This study aims to identify person-level and community characteristics associated with COVID-19 vaccination and booster acceptance among autistic adults, along with self-reported reasons for their stated preferences. Understanding this information is crucial in supporting this vulnerable population given evolving booster guidelines and the ending of the public health emergency for the COVID-19 pandemic. METHODS Data are from a survey conducted in Pennsylvania from April 11 to September 12, 2022. Demographic characteristics, COVID-19 experiences, and COVID-19 vaccine decisions were compared across vaccination status groups. Chi-square analyses and 1-way ANOVA were conducted to test for significant differences. Vaccination reasons were ranked by frequency; co-occurrence was identified using phi coefficient correlation plots. RESULTS Most autistic adults (193/266, 72.6%) intended to receive or received the vaccine and booster, 15% (40/266) did not receive or intend to receive any vaccine, and 12.4% (33/266) received or intended to receive the initial dose but were hesitant to accept booster doses. Reasons for vaccine acceptance or hesitancy varied by demographic factors and COVID-19 experiences. The most significant were previously contracting COVID-19, desire to access information about COVID-19, and discomfort with others not wearing a mask (all P=.001). County-level factors, including population density (P=.02) and percentage of the county that voted for President Biden (P=.001) were also significantly associated with differing vaccination acceptance levels. Reasons for accepting the initial COVID-19 vaccine differed among those who were or were not hesitant to accept a booster. Those who accepted a booster were more likely to endorse protecting others and trusting the vaccine as the basis for their acceptance, whereas those who were hesitant about the booster indicated that their initial vaccine acceptance came from encouragement from someone they trusted. Among the minority of those hesitant to any vaccination, believing that the vaccine was unsafe and would make them feel unwell were the most often reported reasons. CONCLUSIONS Intention to receive or receiving the COVID-19 vaccination and booster was higher among autistic adults than the population that received vaccines in Pennsylvania. Autistic individuals who accepted vaccines prioritized protecting others, while autistic individuals who were vaccine hesitant had safety concerns about vaccines. These findings inform public health opportunities and strategies to further increase vaccination and booster rates among generally accepting autistic adults, to better support the already strained autism services and support system landscape. Vaccination uptake could be improved by leveraging passive information diffusion to combat vaccination misinformation among those not actively seeking COVID-19 information to better alleviate safety concerns.
Collapse
Affiliation(s)
- Lindsay Shea
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Dylan Cooper
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Jonas Ventimiglia
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Shelby Frisbie
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Conner Carlton
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Wei Song
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Mark Salzer
- College of Public Health, Temple University, Philadelphia, PA, United States
| | - Brian Lee
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Emily Hotez
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - David J Vanness
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
| |
Collapse
|
12
|
Kim SY, Lecavalier L. Stability and Validity of Self-Reported Depression and Anxiety in Autistic Youth. J Autism Dev Disord 2024:10.1007/s10803-024-06456-6. [PMID: 39001970 DOI: 10.1007/s10803-024-06456-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/15/2024]
Abstract
The aim of this study was to assess test-retest reliability and diagnostic validity of self-report instruments of depression and anxiety in autistic youth. Participants were 55 autistic youth aged 8-17 years presenting with depressive or anxiety symptoms. They were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and completed the Children's Depression Inventory, Second Edition - Self Report Short (CDI 2:SR[S]) and the Revised Child Anxiety and Depression Scale (RCADS) twice, separated by a two-week interval. Test-retest reliability was measured with intraclass correlation coefficients (ICCs), and diagnostic validity was assessed using receiver operating characteristic (ROC) curves with the summary ratings on the K-SADS-PL as the criterion. The effect of participant characteristics was analyzed through a moderation analysis. Generalized anxiety (GAD) and social anxiety disorder (SOC) were the two most prevalent disorders in the sample. Test-retest reliability for most of the subscales was good (ICC = 0.74 - 0.87), with the exception of the RCADS obsessive-compulsive disorder (OCD) and GAD. The Adaptive Behavior conceptual score was a significant moderator of the reliability of the CDI 2:SR[S]. The ROC analysis suggested the RCADS SOC and the CDI 2:SR[S] to be good screening tools with inadequate specificity when appropriately sensitive cutoff scores are used. Optimal cutoff scores in this sample were lower than originally published. The findings suggest that autistic youth can provide stable reports of anxiety and depressive symptoms over time. Diagnostic validity varied according to the construct and instrument.
Collapse
Affiliation(s)
- Soo Youn Kim
- Department of Psychology, The Ohio State University, Columbus, OH, USA
- Nisonger Center, The Ohio State University, Columbus, OH, USA
| | - Luc Lecavalier
- Department of Psychology, The Ohio State University, Columbus, OH, USA.
- Nisonger Center, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
13
|
Mahler K, Hample K, Ensor C, Ludwig M, Palanzo-Sholly L, Stang A, Trevisan D, Hilton C. An Interoception- Based Intervention for Improving Emotional Regulation in Children in a Special Education Classroom: Feasibility Study. Occup Ther Health Care 2024; 38:636-650. [PMID: 38375672 DOI: 10.1080/07380577.2024.2313527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
Interoception supports the ability to notice, interpret, and react to internal sensations and impacts emotional regulation and participation in meaningful activities. This study aimed to expand evidence regarding the efficacy of a 7-week intervention based on The Interoception Curriculum: A Guide to Developing Mindful Self-Regulation in improving interoception and emotional regulation. We purposefully sampled middle-school participants (N = 9) with several diagnoses from a special education classroom. Self-report and teacher-report measures on interoceptive awareness and emotional regulation were collected before and after implementation of the interoception intervention. Statistically significant correlations were seen between the interoceptive awareness and emotional regulation and improvements in interoceptive awareness and emotional regulation were found following the intervention. In a small one group pretest/post-test design, a seven-week intervention based on the interoception curriculum demonstrated feasibility of this approach for children in a special education classroom and outcomes showed that interoceptive awareness and emotional regulation could improve after participation in this intervention.
Collapse
Affiliation(s)
- Kelly Mahler
- Department of Occupational Therapy, Elizabethtown College, Elizabethtown, PA, USA
| | - Kerri Hample
- Department of Occupational Therapy, Elizabethtown College, Elizabethtown, PA, USA
| | - Carly Ensor
- Department of Occupational Therapy, Elizabethtown College, Elizabethtown, PA, USA
| | - Mary Ludwig
- Department of Occupational Therapy, Elizabethtown College, Elizabethtown, PA, USA
| | | | - Adelaide Stang
- Department of Occupational Therapy, Elizabethtown College, Elizabethtown, PA, USA
| | | | - Claudia Hilton
- Occupational Therapy Department, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
14
|
Cakar ME, Okada NJ, Cummings KK, Jung J, Bookheimer SY, Dapretto M, Green SA. Functional connectivity of the sensorimotor cerebellum in autism: associations with sensory over-responsivity. Front Psychiatry 2024; 15:1337921. [PMID: 38590791 PMCID: PMC10999625 DOI: 10.3389/fpsyt.2024.1337921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
The cerebellum has been consistently shown to be atypical in autism spectrum disorder (ASD). However, despite its known role in sensorimotor function, there is limited research on its association with sensory over-responsivity (SOR), a common and impairing feature of ASD. Thus, this study sought to examine functional connectivity of the sensorimotor cerebellum in ASD compared to typically developing (TD) youth and investigate whether cerebellar connectivity is associated with SOR. Resting-state functional connectivity of the sensorimotor cerebellum was examined in 54 ASD and 43 TD youth aged 8-18 years. Using a seed-based approach, connectivity of each sensorimotor cerebellar region (defined as lobules I-IV, V-VI and VIIIA&B) with the whole brain was examined in ASD compared to TD youth, and correlated with parent-reported SOR severity. Across all participants, the sensorimotor cerebellum was functionally connected with sensorimotor and visual regions, though the three seed regions showed distinct connectivity with limbic and higher-order sensory regions. ASD youth showed differences in connectivity including atypical connectivity within the cerebellum and increased connectivity with hippocampus and thalamus compared to TD youth. More severe SOR was associated with stronger connectivity with cortical regions involved in sensory and motor processes and weaker connectivity with cognitive and socio-emotional regions, particularly prefrontal cortex. These results suggest that atypical cerebellum function in ASD may play a role in sensory challenges in autism.
Collapse
Affiliation(s)
- Melis E. Cakar
- Neuroscience Interdepartmental Program, University of California Los Angeles, Los Angeles, CA, United States
| | - Nana J. Okada
- Department of Psychology, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | - Kaitlin K. Cummings
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jiwon Jung
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | - Susan Y. Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | - Mirella Dapretto
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | - Shulamite A. Green
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
15
|
Shipkova M, Butera CD, Flores GD, Kilroy E, Jayashankar A, Harrison L, Cermak SA, Aziz-Zadeh L. Caregiver and youth inter-rater assessment agreement in autism spectrum disorder, developmental coordination disorder, and typical development. Autism Res 2024; 17:610-625. [PMID: 38450955 PMCID: PMC11022856 DOI: 10.1002/aur.3110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024]
Abstract
Youth diagnosed with autism spectrum disorder (ASD) and those with developmental coordination disorder (DCD) are at heightened risk for co-occurring mental health diagnoses, especially anxiety and attention-deficit/hyperactivity disorder (ADHD). However, caregiver-child agreement on presence of related symptoms in populations with neurodevelopmental conditions is not well understood. Here, we examine the extent to which 37 ASD, 26 DCD, and 40 typically developing children and their caregivers agree on the degree of the child's symptoms of anxiety and ADHD. All caregiver-child dyads completed the Screen for Child Anxiety Related Emotional Disorders and Conners 3 ADHD Index. Across groups, intraclass correlations indicated generally poor agreement on anxiety and ADHD symptomatology. Although youth generally reported greater internalizing symptoms (i.e., anxiety), caregivers tended to report more observable externalizing behaviors (i.e., ADHD). Together, the results of this study support the need for a multi-informant approach in assessments of anxiety and ADHD in youth with neurodevelopmental disorders.
Collapse
Affiliation(s)
- Michelle Shipkova
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christiana D Butera
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Genesis D Flores
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Emily Kilroy
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Aditya Jayashankar
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Laura Harrison
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Lisa Aziz-Zadeh
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
16
|
Dwyer P, Vukusic S, Williams ZJ, Saron CD, Rivera SM. "Neural Noise" in Auditory Responses in Young Autistic and Neurotypical Children. J Autism Dev Disord 2024; 54:642-661. [PMID: 36434480 PMCID: PMC10209352 DOI: 10.1007/s10803-022-05797-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 11/27/2022]
Abstract
Elevated "neural noise" has been advanced as an explanation of autism and autistic sensory experiences. However, functional neuroimaging measures of neural noise may be vulnerable to contamination by recording noise. This study explored variability of electrophysiological responses to tones of different intensities in 127 autistic and 79 typically-developing children aged 2-5 years old. A rigorous data processing pipeline, including advanced visualizations of different signal sources that were maximally independent across different time lags, was used to identify and eliminate putative recording noise. Inter-trial variability was measured using median absolute deviations (MADs) of EEG amplitudes across trials and inter-trial phase coherence (ITPC). ITPC was elevated in autism in the 50 and 60 dB intensity conditions, suggesting diminished (rather than elevated) neural noise in autism, although reduced ITPC to soft 50 dB sounds was associated with increased loudness discomfort. Autistic and non-autistic participants did not differ in MADs, and indeed, the vast majority of the statistical tests examined in this study yielded no significant effects. These results appear inconsistent with the neural noise account.
Collapse
Affiliation(s)
- Patrick Dwyer
- Department of Psychology, UC Davis, Davis, CA, USA.
- Center for Mind and Brain, UC Davis, Davis, CA, USA.
- MIND Institute, UC Davis Health, Sacramento, CA, USA.
| | | | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Clifford D Saron
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis Health, Sacramento, CA, USA
| | - Susan M Rivera
- Department of Psychology, UC Davis, Davis, CA, USA
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis Health, Sacramento, CA, USA
- College of Behavioral and Social Sciences, University of Maryland, College Park, MD, USA
| |
Collapse
|
17
|
Neuhaus E, Bernier RA, Webb SJ. Social motivation by self- and caregiver-report: Reporter concordance and social correlates among autistic and neurotypical youth. Autism Res 2024; 17:55-65. [PMID: 37987233 PMCID: PMC10843724 DOI: 10.1002/aur.3054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023]
Abstract
Differences in social motivation underlie the core social-communication features of autism according to several theoretical models, with decreased social motivation among autistic youth relative to neurotypical peers. However, research on social motivation often relies on caregiver reports and rarely includes firsthand perspectives of children and adolescents with autism. Furthermore, social motivation is typically assumed to be constant across social settings when it may actually vary by social context. Among a sample of 58 verbally fluent youth (8-13 years old; 22 with autism, 36 neurotypical), we examined correspondence between youth and caregiver reports of social motivation with peers and with adults, as well as diagnostic group differences and associations with social outcomes. Results suggest youth and caregivers provide overlapping but distinct information. Autistic youth had lower levels of social motivation relative to neurotypical youth, and reported relatively consistent motivation toward peers and adults. Youth self- and caregiver-report were correlated for motivation toward adults, but not toward peers. Despite low correspondence between self- and caregiver-reported motivation toward peers, autistic youths' self-report corresponded to caregiver-reported social skills and difficulties whereas caregiver-report of peer motivation did not. For neurotypical youth, self- and caregiver-reported motivation toward adults was correlated, but motivation by both reporters was largely independent of broader social outcomes. Findings highlight the unique value of self-report among autistic children and adolescents, and warrant additional work exploring the development, structure, and correlates of social motivation among autistic and neurotypical youth.
Collapse
Affiliation(s)
- Emily Neuhaus
- Seattle Children’s Research Institute; Center on Child Health, Behavior and Development
- University of Washington Psychiatry & Behavioral Sciences
| | - Raphael A. Bernier
- Seattle Children’s Research Institute; Center on Child Health, Behavior and Development
- University of Washington Psychiatry & Behavioral Sciences
| | - Sara Jane Webb
- Seattle Children’s Research Institute; Center on Child Health, Behavior and Development
- University of Washington Psychiatry & Behavioral Sciences
| |
Collapse
|
18
|
DiCriscio AS, Beiler D, Smith J, Asdell P, Dickey S, DiStefano M, Troiani V. Assessment of autonomic symptom scales in patients with neurodevelopmental diagnoses using electronic health record data. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 108:102234. [PMID: 37982012 PMCID: PMC10653282 DOI: 10.1016/j.rasd.2023.102234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Background Sleep disturbances, gastrointestinal problems, and atypical heart rate are commonly observed in patients with autism spectrum disorder (ASD) and may relate to underlying function of the autonomic nervous system (ANS). The overall objective of the current study was to quantitatively characterize features of ANS function using symptom scales and available electronic health record (EHR) data in a clinically and genetically characterized pediatric cohort. Methods We assessed features of ANS function via chart review of patient records adapted from items drawn from a clinical research questionnaire of autonomic symptoms. This procedure coded for the presence and/or absence of targeted symptoms and was completed in 3 groups of patients, including patients with a clinical neurodevelopmental diagnosis and identified genetic etiology (NPD, n=244), those with an ASD diagnosis with no known genetic cause (ASD, n=159), and age and sex matched controls (MC, n=213). Symptoms were assessed across four main categories: (1) Mood, Behavior, and Emotion; (2) Secretomotor, Sensory Integration; (3) Urinary, Gastrointestinal, and Digestion; and (4) Circulation, Thermoregulation, Circadian function, and Sleep/Wake cycles. Results Chart review scores indicate an increased rate of autonomic symptoms across all four sections in our NPD group as compared to scores with ASD and/or MC. Additionally, we note several significant relationships between individual differences in autonomic symptoms and quantitative ASD traits. Conclusion These results highlight EHR review as a potentially useful method for quantifying variance in symptoms adapted from a questionnaire or survey. Further, using this method indicates that autonomic features are more prevalent in children with genetic disorders conferring risk for ASD and other neurodevelopmental diagnoses.
Collapse
Affiliation(s)
- A S DiCriscio
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - D Beiler
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - J Smith
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Geisinger Health System, Behavioral Health, Danville, PA, United States
| | - P Asdell
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Summa Health, Ohio, United States
| | - S Dickey
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
| | - M DiStefano
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Geisinger Health System, Precision Health Program, Danville, PA, United States
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - V Troiani
- Geisinger Health System, Autism and Developmental Medicine Institute (ADMI), Lewisburg, PA, United States
- Department of Imaging Science and Innovation, Center for Health Research, Danville, PA, United States
- Geisinger Neuroscience Institute, Danville, PA, United States
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, PA, United States
| |
Collapse
|
19
|
Dwyer P, Williams ZJ, Vukusic S, Saron CD, Rivera SM. Habituation of auditory responses in young autistic and neurotypical children. Autism Res 2023; 16:1903-1923. [PMID: 37688470 PMCID: PMC10651062 DOI: 10.1002/aur.3022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/16/2023] [Indexed: 09/11/2023]
Abstract
Prior studies suggest that habituation of sensory responses is reduced in autism and that diminished habituation could be related to atypical autistic sensory experiences, for example, by causing brain responses to aversive stimuli to remain strong over time instead of being suppressed. While many prior studies exploring habituation in autism have repeatedly presented identical stimuli, other studies suggest group differences can still be observed in habituation to intermittent stimuli. The present study explored habituation of electrophysiological responses to auditory complex tones of varying intensities (50-80 dB SPL), presented passively in an interleaved manner, in a well-characterized sample of 127 autistic (MDQ = 65.41, SD = 20.54) and 79 typically developing (MDQ = 106.02, SD = 11.50) children between 2 and 5 years old. Habituation was quantified as changes in the amplitudes of single-trial responses to tones of each intensity over the course of the experiment. Habituation of the auditory N2 response was substantially reduced in autistic participants as compared to typically developing controls, although diagnostic groups did not clearly differ in habituation of the P1 response. Interestingly, the P1 habituated less to loud 80 dB sounds than softer sounds, whereas the N2 habituated less to soft 50 dB sounds than louder sounds. No associations were found between electrophysiological habituation and cognitive ability or participants' caregiver-reported sound tolerance (Sensory Profile Hyperacusis Index). The results present study results extend prior research suggesting habituation of certain sensory responses is reduced in autism; however, they also suggest that habituation differences observed using this study's paradigm might not be a primary driver of autistic participants' real-world sound intolerance.
Collapse
Affiliation(s)
- Patrick Dwyer
- Department of Psychology, UC Davis, Davis, CA, USA
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis, Davis, CA, USA
| | - Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of
Medicine, Nashville, TN, USA
- Department of Hearing & Speech Sciences, Vanderbilt University
Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN,
USA
- Frist Center for Autism and Innovation, Vanderbilt University,
Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center,
Nashville, TN, USA
| | - Svjetlana Vukusic
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- Department of General Practice, Melbourne Medical School, the
University of Melbourne, Melbourne, VIC, Australia
| | - Clifford D. Saron
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis, Sacramento, CA, USA
| | - Susan M. Rivera
- Department of Psychology, UC Davis, Davis, CA, USA
- Center for Mind and Brain, UC Davis, Davis, CA, USA
- MIND Institute, UC Davis, Sacramento, CA, USA
| |
Collapse
|
20
|
Trundle G, Jones KA, Ropar D, Egan V. Prevalence of Victimisation in Autistic Individuals: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:2282-2296. [PMID: 35524162 PMCID: PMC10486169 DOI: 10.1177/15248380221093689] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Autistic individuals are at an increased risk of experiencing victimisation. Previous reviews have focussed specific types of victimisation. Thus, a clearer picture considering the range of victimisation experiences autistic people face is required. This systematic review aims to identify the prevalence of victimisation in autistic individuals considering a variety of victimisation types (e.g., bulling, sexual victimisation, and crime) in both adults and children from clinical and community settings. Through systematic searches of relevant databases, 291 studies met the criteria for review. Of those, 34 studies met the inclusion criteria: a) quantitative studies, b) involving autistic individuals, c) reporting prevalence rates of victimisation. Meta-analysis found a pooled prevalence rate of victimisation of 44% in autistic individuals. Subgroup analysis examined moderating factors as high heterogeneity was present. This found the pooled prevalence rates for bullying to be 47%, 16% for child abuse, 40% for sexual victimisation, 13% for cyberbullying, and 84% for multiple forms of victimisation in autistic individuals, though heterogeneity remained. Correction for participants' age, reporter used, and the population which the sample was recruited from did not reduce heterogeneity. Although heterogeneity impedes the definitive interpretation of the findings, this review illustrates the need for strategies and interventions to reduce the incidence of victimisation.
Collapse
Affiliation(s)
- Grace Trundle
- Centre of Family and Forensic Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katy A. Jones
- Academic Unit of Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Danielle Ropar
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Vincent Egan
- Centre of Family and Forensic Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
21
|
Rivera RA, Bennetto L. Applications of identity-based theories to understand the impact of stigma and camouflaging on mental health outcomes for autistic people. Front Psychiatry 2023; 14:1243657. [PMID: 37743980 PMCID: PMC10511883 DOI: 10.3389/fpsyt.2023.1243657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Autistic people have long been conceptualized from a deficit-based model of disability, but recent self-advocates and scholars have asserted the importance of recognizing autism as both a disability and an important part of a person's social identity. The autistic identity is subject to specific stigma and stressors beyond everyday discrimination and prejudice, which can have many downstream implications on mental health and well-being. Prior research on camouflaging has explained both quantitatively and qualitatively how autistic people conform to norms and mask their autistic traits to better fit in with non-autistic societal standards. Given this paradigm shift in understanding autistic peoples' lived experiences, researchers must also begin to reshape the theories guiding their work in order to improve diagnosis, intervention, and supports. This review examines the extant research on identity-related stigma and camouflaging and their subsequent impacts on mental health outcomes in autism. A model is proposed integrating identity-based theories-specifically the social model of disability, social identity theory, and minority stress model-to explain relationships across research areas and better explain the experiences of autistic people. We discuss how identity-based theories can be applied in autism research to better understand the impacts of stigma and camouflaging on autistic peoples' lived experiences and reduce disparities in their mental health outcomes.
Collapse
Affiliation(s)
- Rachel A. Rivera
- Department of Psychology, University of Rochester, Rochester, NY, United States
| | | |
Collapse
|
22
|
Williams ZJ, Schaaf R, Ausderau KK, Baranek GT, Barrett DJ, Cascio CJ, Dumont RL, Eyoh EE, Failla MD, Feldman JI, Foss-Feig JH, Green HL, Green SA, He JL, Kaplan-Kahn EA, Keçeli-Kaysılı B, MacLennan K, Mailloux Z, Marco EJ, Mash LE, McKernan EP, Molholm S, Mostofsky SH, Puts NAJ, Robertson CE, Russo N, Shea N, Sideris J, Sutcliffe JS, Tavassoli T, Wallace MT, Wodka EL, Woynaroski TG. Examining the latent structure and correlates of sensory reactivity in autism: a multi-site integrative data analysis by the autism sensory research consortium. Mol Autism 2023; 14:31. [PMID: 37635263 PMCID: PMC10464466 DOI: 10.1186/s13229-023-00563-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population. METHODS Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs. RESULTS All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ωH = .800) but not a supra-modal HYPO construct (ωH = .653), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ωH = .800; 4/7 modalities). Modality-specific subscales demonstrated significant added value for all response patterns. Meta-analytic correlations varied by construct, although sensory features tended to correlate most with other domains of core autism features and co-occurring psychiatric symptoms (with general HYPER and speech HYPO demonstrating the largest numbers of practically significant correlations). LIMITATIONS Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences. CONCLUSION Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations.
Collapse
Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA.
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA.
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA.
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Roseann Schaaf
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
- Jefferson Autism Center of Excellence, Farber Institute of Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA
| | - Karla K Ausderau
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Grace T Baranek
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - D Jonah Barrett
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carissa J Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachel L Dumont
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ekomobong E Eyoh
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | | | - Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Heather L Green
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shulamite A Green
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, USA
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Elizabeth A Kaplan-Kahn
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bahar Keçeli-Kaysılı
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
| | - Keren MacLennan
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Psychology, Durham University, Durham, UK
| | - Zoe Mailloux
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Elysa J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, CA, USA
| | - Lisa E Mash
- Division of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Elizabeth P McKernan
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sophie Molholm
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Dominick P. Purpura Department of Neuroscience, Rose F. Kennedy Intellectual and Developmental Disabilities Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicolaas A J Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Caroline E Robertson
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Natalie Russo
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Nicole Shea
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Division of Pulmonology and Sleep Medicine, Department of Pediatrics, Kaleida Health, Buffalo, NY, USA
| | - John Sideris
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - James S Sutcliffe
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Teresa Tavassoli
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Mark T Wallace
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Ericka L Wodka
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| |
Collapse
|
23
|
Raman N, Ringold SM, Jayashankar A, Butera CD, Kilroy E, Harrison L, Cermak SA, Aziz-Zadeh L. Relationships between Affect Recognition, Empathy, Alexithymia, and Co-Occurring Conditions in Autism. Brain Sci 2023; 13:1161. [PMID: 37626517 PMCID: PMC10452701 DOI: 10.3390/brainsci13081161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
Prior studies show differences in empathy and affect-recognition ability between those with autism spectrum disorder (ASD) and typically developing (TD) individuals. Autistic individuals also exhibit increased behavioral, gastrointestinal, and sleep issues. In the current study, we explored the differences in empathy and affect recognition between the ASD and TD groups; and we investigated their associations with conditions co-occurring in ASD. A total of 54 TD and 56 ASD children (8-17 years) were included. As compared to the TD group, the ASD group showed lower scores for affect recognition and perspective taking (PT) and higher scores for personal distress (PD). Interestingly, results from hierarchical linear regressions suggested that disparities in the PD and PT between the groups were primarily attributable to attenuated levels of alexithymia, rather than being mediated by the presence of an autism diagnosis. Differences in affect-recognition ability, however, were mediated by both an autism diagnosis and alexithymia. We also found significant correlations between empathy and affect recognition and measures of related conditions common in ASD. Alexithymia, hence, contributes to difficulties in empathy while both alexithymia and autism are associated with affect-recognition ability in ASD. Additionally, the association between affect recognition and empathic ability with co-occurring conditions in ASD needs to be considered during assessments and interventions.
Collapse
Affiliation(s)
- Nandita Raman
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Sofronia M. Ringold
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Aditya Jayashankar
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Christiana D. Butera
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Emily Kilroy
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Laura Harrison
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Sharon A. Cermak
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Lisa Aziz-Zadeh
- Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA; (N.R.); (S.M.R.); (A.J.); (C.D.B.); (E.K.); (L.H.); (S.A.C.)
- Brain and Creativity Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| |
Collapse
|
24
|
Dekker LP, van der Vegt EJM, Louwerse A, Visser K, van der Ende J, Maras A, Verhulst FC, Greaves-Lord K. Complementing or Congruent? Desired Characteristics in a Friend and Romantic Partner in Autistic versus Typically Developing Male Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1153-1167. [PMID: 36241943 PMCID: PMC10102130 DOI: 10.1007/s10508-022-02444-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 05/11/2023]
Abstract
Ideal friend and romantic partner characteristics related to self-perceived characteristics have been investigated in typically developing (TD) individuals, but not in individuals with autism spectrum disorder (ASD). Considering the autistic symptoms and challenges, investigating these concepts in autistic individuals is relevant. Given the lack of consensus, identity-first ("autistic person") and person-first ("person with autism") language are mixed throughout, to cover all preferences. This study explored (1) the association between self-perceived characteristics and desires in a friend/romantic partner, as well as (2) compare two groups (ASD and TD) in their desires for a friend/romantic partner. Two matched groups (ASD and TD) of 38 male adolescents (age 14-19 years) reported on the desire for nine characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, good looking, similar interests, and being rich) in a friend/partner, and to what extent they felt they themselves possessed seven characteristics (i.e., funny, popular, nice, cool, smart, trustworthy, and good looking). Results showed both groups sought a friend and partner similar to themselves on intrinsic characteristics (e.g., trustworthiness), but less similar on extrinsic and social status characteristics (e.g., being less cool and popular). Particularly intrinsic characteristics, more than extrinsic and social status characteristics, were valued in both partners and friends, regardless of group. No significant differences were found between groups concerning to what extent characteristics were desired. Overall, adolescents with ASD desire similar characteristics as TD adolescents in their potential romantic partners and friends. There is some indication that the match between self-perception and desired characteristics is different.
Collapse
Affiliation(s)
- Linda P Dekker
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, Room T13-24, 3000 DR, Rotterdam, The Netherlands.
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands.
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands.
| | | | - Anneke Louwerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Kirsten Visser
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Youz Child and Adolescent Psychiatry, Team Sarr Autism Expertise Centre, Rotterdam, The Netherlands
| | - Jan van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Athanasios Maras
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University MC/Sophia Children's Hospital, Rotterdam, The Netherlands
- Yulius, Organization for Mental Health, Rotterdam, The Netherlands
- Autism Team Northern-Netherlands of Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
25
|
Ratto AB, Bascom J, daVanport S, Strang JF, Anthony LG, Verbalis A, Pugliese C, Nadwodny N, Brown LX, Cruz M, Hector BL, Kapp SK, Giwa Onaiwu M, Raymaker DM, Robison JE, Stewart C, Stone R, Whetsell E, Pelphrey K, Kenworthy L. Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits. AUTISM IN ADULTHOOD 2023; 5:93-105. [PMID: 36941856 PMCID: PMC10024271 DOI: 10.1089/aut.2021.0099] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Current tools for identifying autism are critiqued for their lack of specificity and sensitivity, especially in autistic people who are older, have higher verbal ability or significant compensatory skills, and are not cisgender boys. This may reflect the following: the historical focus of autism research on White (cisgender) male, upper and middle class children; limited interest in the inner, lived experience of autism; and the predominance of a deficit-based model of autism. We report here on the first attempt of which we are aware to develop a clinical self-report measure of autistic traits as described by autistic people. We believe this is an advance in methodology because prior work in the development of autistic trait/diagnostic measures has prioritized the perspectives of nonautistic clinicians and scientists. The measure was developed under the leadership of two autistic researchers and constructed by leveraging descriptions of autism by autistic people to generate items designed to encompass the range of the autistic experience, using strength-based, accessible language. The team utilized iterative feedback from a panel of autistic experts to refine and enhance the measure, called the Self Assessment of Autistic Traits (SAAT). It is intended for people 16 years or older and uses a format that is designed to increase its accessibility and acceptability for autistic respondents. Future work will report on the preliminary psychometrics of the SAAT, with a long-term goal of advancing our understanding of the inner autistic experience and enhancing the clinical and scientific assessment of autism.
Collapse
Affiliation(s)
- Allison B. Ratto
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Julia Bascom
- Autistic Self Advocacy Network, Washington, DC, USA
| | | | - John F. Strang
- Gender and Autism Program, Children's National Hospital, Washington, DC, USA
| | - Laura G. Anthony
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Denver, CO, USA
| | - Alyssa Verbalis
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Nicole Nadwodny
- Department of Developmental Medicine, Boston Children's Hospital, Brookline, MA, USA
| | - Lydia X.Z. Brown
- Department of Disability Studies and Women's and Gender Studies, Georgetown University, Washington, DC, USA
| | - Mallory Cruz
- Private Consultant, Hitachiomiya, Ibaraki, Japan
| | | | - Steven K. Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Morénike Giwa Onaiwu
- Center for the Study of Women, Gender, and Sexuality, Rice University, & Autistic Women & Nonbinary Network, Houston, TX, USA
| | - Dora M. Raymaker
- School of Social Work, Portland State University, Portland, OR, USA
| | - John Elder Robison
- Neurodiversity Working Group, The College of William and Mary, Williamsburg, VA, USA
| | | | - Ren Stone
- Autistic Women & Nonbinary Network, Washington, DC, USA
| | | | - Kevin Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| |
Collapse
|
26
|
Williams ZJ, Schaaf R, Ausderau KK, Baranek GT, Barrett DJ, Cascio CJ, Dumont RL, Eyoh EE, Failla MD, Feldman JI, Foss-Feig JH, Green HL, Green SA, He JL, Kaplan-Kahn EA, Keçeli-Kaysılı B, MacLennan K, Mailloux Z, Marco EJ, Mash LE, McKernan EP, Molholm S, Mostofsky SH, Puts NAJ, Robertson CE, Russo N, Shea N, Sideris J, Sutcliffe JS, Tavassoli T, Wallace MT, Wodka EL, Woynaroski TG. Examining the Latent Structure and Correlates of Sensory Reactivity in Autism: A Multi-site Integrative Data Analysis by the Autism Sensory Research Consortium. RESEARCH SQUARE 2023:rs.3.rs-2447849. [PMID: 36712092 PMCID: PMC9882639 DOI: 10.21203/rs.3.rs-2447849/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population. Methods Leveraging a combined sample of 3,868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO and SEEK (sub)constructs. Results All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses unambiguously supported the validity of a supra-modal HYPER construct (ω H = .800), whereas a coherent supra-modal HYPO construct was not supported (ω H = .611), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ω H = .799; 4/7 modalities). Within each sensory construct, modality-specific subscales demonstrated substantial added value beyond the supra-modal score. Meta-analytic correlations varied by construct, although sensory features tended to correlate most strongly with other domains of core autism features and co-occurring psychiatric symptoms. Certain subconstructs within the HYPO and SEEK domains were also associated with lower adaptive behavior scores. Limitations: Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to parent-report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences. Conclusion Psychometric issues may limit the degree to which some measures of supra-modal HYPO/SEEK can be interpreted. Depending on the research question at hand, modality-specific response pattern scores may represent a valid alternative method of characterizing sensory reactivity in autism.
Collapse
|
27
|
Harris LL, Coolidge FL. The psychometric properties of a self-report inventory of autistic symptoms in individuals with autism spectrum disorder. J Clin Psychol 2023; 79:158-167. [PMID: 35579192 DOI: 10.1002/jclp.23373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/29/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND METHODS This study examined 85 parental-reports with 85 self-reports of autistic symptoms with the 84-item Coolidge Autistic Symptom Survey (CASS). The CASS covers all of the diagnostic criteria for autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as no studies to date have compared the self-reports of individuals with autism with parent- or significant-other-reports of those individuals using the complete DSM-5. RESULTS The CASS-Parental-Report and CASS-Self-Report exhibited excellent internal reliability (α = 0.97 and 0.96, respectively). There was support for the hypothesis that parental-reports and self-reports would be similar (r = 0.66, p < 0.001). DISCUSSION In conclusion, the CASS should be considered a promising tool for assessing autistic symptoms from both parent- and self-perspectives.
Collapse
Affiliation(s)
- Lani L Harris
- Department of Psychology, University of Colorado, Colorado Springs, Colorado, USA
| | - Frederick L Coolidge
- Department of Psychology, University of Colorado, Colorado Springs, Colorado, USA
| |
Collapse
|
28
|
Atypical Response to Affective Touch in Children with Autism: Multi-Parametric Exploration of the Autonomic System. J Clin Med 2022; 11:jcm11237146. [PMID: 36498717 PMCID: PMC9737198 DOI: 10.3390/jcm11237146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
This study aimed at evaluating the autonomic response to pleasant affective touch in children with Autism Spectrum Disorders (ASD) and age-matched typically developing (TD) peers, thanks to multiple autonomic nervous system (ANS) parameters and by contrasting CT (C-tactile fibers) high- vs. low-density territory stimulations. We measured pupil diameter, skin conductance, and heart rate during gentle stroking of two skin territories (CT high- and low-density, respectively, forearm and palm of the hand) in thirty 6-12-year-old TD children and twenty ASD children. TD children showed an increase in pupil diameter and skin conductance associated with a heart rate deceleration in response to tactile stimulations at the two locations. Only the pupil was influenced by the stimulated location, with a later dilation peak following CT low-density territory stimulation. Globally, ASD children exhibited reduced autonomic responses, as well as different ANS baseline values compared to TD children. These atypical ANS responses to pleasant touch in ASD children were not specific to CT-fiber stimulation. Overall, these results point towards both basal autonomic dysregulation and lower tactile autonomic evoked responses in ASD, possibly reflecting lower arousal and related to social disengagement.
Collapse
|
29
|
DiCriscio AS, Wain KE, Smith J, Beiler D, Walsh LK, Holdren K, Troiani V. Higher scores on autonomic symptom scales in pediatric patients with neurodevelopmental disorders of known genetic etiology. Brain Behav 2022; 12:e2813. [PMID: 36423250 PMCID: PMC9759134 DOI: 10.1002/brb3.2813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Features of underlying autonomic dysfunction, including sleep disturbances, gastrointestinal problems, and atypical heart rate, have been reported in neurodevelopmental conditions, including autism spectrum disorder (ASD). The current cross-sectional, between-groups study aimed to quantify symptoms of autonomic dysfunction in a neurodevelopmental pediatric cohort characterized by clinical diagnoses as well as genetic etiology. METHOD The Pediatric Autonomic Symptom Scales (PASS) questionnaire was used to assess autonomic features across a group of patients with clinical neurodevelopmental diagnoses (NPD; N = 90) and genetic etiologies. Patients were subdivided based on either having a clinical ASD diagnosis (NPD-ASD; n = 37) or other non-ASD neurodevelopmental diagnoses, such as intellectual disability without ASD, speech and language disorders, and/or attention deficit hyperactivity disorder (NPD-OTHER; n = 53). Analyses focused on characterizing differences between the NPD group compared to previously published reference samples, as well as differences between the two NPD subgroups (NPD-ASD and NPD-OTHER). RESULTS Our results indicate higher PASS scores in our NPD cohort relative to children with and without ASD from a previously published cohort. However, we did not identify significant group differences between our NPD-ASD and NPD-OTHER subgroups. Furthermore, we find a significant relationship between quantitative ASD traits and symptoms of autonomic function. CONCLUSION This work demonstrates the utility of capturing quantitative estimates of autonomic trait dimensions that may be significantly linked with psychosocial impairments and other core clinical features of ASD.
Collapse
Affiliation(s)
- Antoinette S DiCriscio
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - K E Wain
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - J Smith
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - D Beiler
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - L K Walsh
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - K Holdren
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA
| | - Vanessa Troiani
- Geisinger Health System, Autism & Developmental Medicine Institute (ADMI), Lewisburg, Pennsylvania, USA.,Department of Imaging Science and Innovation, Center for Health Research, Geisinger, Danville, Pennsylvania, USA.,Neuroscience Institute, Geisinger, Danville, Pennsylvania, USA.,Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| |
Collapse
|
30
|
Elsayed HE, Thompson KL, Conklin JL, Watson LR. Systematic Review of the Relation Between Feeding Problems and Sensory Processing in Children With Autism Spectrum Disorder. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2875-2899. [PMID: 36356224 DOI: 10.1044/2022_ajslp-21-00401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Many studies have linked sensory sensitivities to feeding problems in children with autism spectrum disorder (ASD). Despite the importance of sensory processing for a variety of mealtime and eating skills, the specific sensory processes that may impact feeding problems in children with ASD have not been comprehensively reviewed. Thus, the goal of this systematic review was to understand the associations between sensory processing and feeding difficulties in children with ASD. METHOD This systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, CINAHL Plus with Full Text (EBSCOhost), Scopus (Elsevier), and Embase (Elsevier) databases were searched from their dates of inception through the final search date of April 19, 2022, for English language studies that examined both sensory processing and feeding among children with ASD. Studies were assessed for quality using the Joanna Briggs Institute critical appraisal tools. RESULTS A total of 27 studies were included. Findings supported the existence of a relationship between sensory processing and feeding problems in children with ASD. Specifically, studies reported that overall scores on sensory processing measures as well as measures of oral sensory processing were frequently associated with feeding problems. CONCLUSIONS This review supports the development of future feeding interventions focusing on sensory processing given the relationship between sensory processing and feeding problems among children with ASD. Future research should focus on utilizing consistent feeding assessments specific to children with ASD and collect information on medical diagnoses that can impact feeding in order to report on feeding more holistically in this population. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21453909.
Collapse
Affiliation(s)
- Heba E Elsayed
- Kessler Foundation, East Hanover, NJ
- Rutgers New Jersey Medical School, Newark
- Division of Speech and Hearing Sciences, The University of North Carolina at Chapel Hill
| | - Kelsey L Thompson
- Division of Speech and Hearing Sciences, The University of North Carolina at Chapel Hill
| | - Jamie L Conklin
- Health Sciences Library, The University of North Carolina at Chapel Hill
| | - Linda R Watson
- Division of Speech and Hearing Sciences, The University of North Carolina at Chapel Hill
| |
Collapse
|
31
|
Shea LL, Becker A, Lee BK, Miller KK, Cooper D, Anderson K, Salzer MS, Vanness DJ. Self-reported COVID-19 vaccination acceptance and hesitancy among autistic adults. Vaccine 2022; 40:3288-3293. [PMID: 35484038 PMCID: PMC9023320 DOI: 10.1016/j.vaccine.2022.04.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 01/17/2023]
Abstract
Identifying factors associated with COVID-19 vaccination acceptance among vulnerable groups, including autistic individuals, can increase vaccination rates and support public health. The purpose of this study was to determine differences among autistic adults who reported COVID-19 vaccination acceptance from those who did not. In this study we describe COVID-19 vaccination status and self-reported preferences among autistic adults and identify related factors. Vaccine accepters were more likely to report increased loneliness during COVID-19, lived in more populous counties (p = 0.02), and lived in counties won by President Biden in the 2020 US presidential election (p < 0.001). Positive correlations were found between desire to protect others, concern about contracting COVID-19, and trusting vaccine safety (p < 0.001). Concern about vaccine safety was common among the vaccine hesitant, while lack of concern about COVID-19 overall was not. Identifying health promotion strategies based on self-reported, lived experiences about COVID-19 among vulnerable groups is key for public health impact.
Collapse
Affiliation(s)
- Lindsay L Shea
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Alec Becker
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Brian K Lee
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA 19104, United States.
| | - Kaitlin Koffer Miller
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Dylan Cooper
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Kristy Anderson
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, United States.
| | - Mark S Salzer
- College of Public Health, Temple University, 1101 W Montgomery Avenue, Philadelphia, PA 19122, United States.
| | - David J Vanness
- College of Health and Human Development, Penn State University, 325 Health and Human Development Building, University Park, PA 16802, United States.
| |
Collapse
|
32
|
Dwyer P, Takarae Y, Zadeh I, Rivera SM, Saron CD. A Multidimensional Investigation of Sensory Processing in Autism: Parent- and Self-Report Questionnaires, Psychophysical Thresholds, and Event-Related Potentials in the Auditory and Somatosensory Modalities. Front Hum Neurosci 2022; 16:811547. [PMID: 35620155 PMCID: PMC9127065 DOI: 10.3389/fnhum.2022.811547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Reconciling results obtained using different types of sensory measures is a challenge for autism sensory research. The present study used questionnaire, psychophysical, and neurophysiological measures to characterize autistic sensory processing in different measurement modalities. Methods Participants were 46 autistic and 21 typically developing 11- to 14-year-olds. Participants and their caregivers completed questionnaires regarding sensory experiences and behaviors. Auditory and somatosensory event-related potentials (ERPs) were recorded as part of a multisensory ERP task. Auditory detection, tactile static detection, and tactile spatial resolution psychophysical thresholds were measured. Results Sensory questionnaires strongly differentiated between autistic and typically developing individuals, while little evidence of group differences was observed in psychophysical thresholds. Crucially, the different types of measures (neurophysiological, psychophysical, questionnaire) appeared to be largely independent of one another. However, we unexpectedly found autistic participants with larger auditory Tb ERP amplitudes had reduced hearing acuity, even though all participants had hearing acuity in the non-clinical range. Limitations The autistic and typically developing groups were not matched on cognitive ability, although this limitation does not affect our main analyses regarding convergence of measures within autism. Conclusion Overall, based on these results, measures in different sensory modalities appear to capture distinct aspects of sensory processing in autism, with relatively limited convergence between questionnaires and laboratory-based tasks. Generally, this might reflect the reality that laboratory tasks are often carried out in controlled environments without background stimuli to compete for attention, a context which may not closely resemble the busier and more complex environments in which autistic people's atypical sensory experiences commonly occur. Sensory questionnaires and more naturalistic laboratory tasks may be better suited to explore autistic people's real-world sensory challenges. Further research is needed to replicate and investigate the drivers of the unexpected association we observed between auditory Tb ERP amplitudes and hearing acuity, which could represent an important confound for ERP researchers to consider in their studies.
Collapse
Affiliation(s)
- Patrick Dwyer
- Neurocognitive Development Lab, Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
- MIND Institute, University of California, Davis, Davis, CA, United States
| | - Yukari Takarae
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Iman Zadeh
- Oracle Cloud Infrastructure, Oracle Corporation, Los Angeles, CA, United States
| | - Susan M. Rivera
- Neurocognitive Development Lab, Center for Mind and Brain, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
- MIND Institute, University of California, Davis, Davis, CA, United States
| | - Clifford D. Saron
- MIND Institute, University of California, Davis, Davis, CA, United States
- Saron Lab, Center for Mind and Brain, University of California, Davis, Davis, CA, United States
| |
Collapse
|
33
|
Jolliffe R, Adams D, Simpson K. Trait Anxiety in Individuals on the Autism Spectrum: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00308-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractAlthough anxiety is commonly researched in autism, the focus has predominantly been on anxiety disorders and not upon general levels of anxiousness or trait anxiety. This review summarises research investigating trait anxiety in autism. Systematic searches yielded 1099 records, with 23 studies meeting inclusion criteria. Study participants were mainly males from Western countries, with no representation of older adults or individuals with intellectual disability. All articles used self-report questionnaire trait anxiety measures. Anxiety measure psychometric details were absent in most studies, with 21 using subjective measures that are not validated for use in autism. Results showed higher trait anxiety scores in autism versus control groups, and correlations between trait anxiety scores and other study outcomes.
Collapse
|
34
|
Abstract
PURPOSE OF REVIEW To summarize recent findings regarding anxiety and trauma-related disorders in children diagnosed with autism spectrum disorder (autism), focusing on the distinct ways in which these conditions may be expressed, as well as advances in evidence-based assessment and treatment. RECENT FINDINGS Current findings suggest both anxiety and trauma-related disorders may be more prevalent, yet more complicated to address in autistic relative to non-autistic children. Overlapping symptoms and distinct manifestations of these disorders pose challenges for the accurate identification, assessment, and treatment of anxiety and trauma-related disorders in autistic children. Emerging evidence recommends adapting traditional assessment and treatment approaches to better meet the needs of autistic children. Recent research suggests autism-centered conceptualizations, which accommodate complexity in how anxiety and trauma-related disorders are experienced and expressed by autistic people, are needed to enhance the psychiatric care of this population.
Collapse
|
35
|
Moskowitz LJ, Braconnier M. Assessing anxiety in youth with autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Megan Braconnier
- Department of Psychology St. John's University New York City New York USA
| |
Collapse
|
36
|
Kenworthy L, Verbalis A, Bascom J, daVanport S, Strang JF, Pugliese C, Freeeman A, Jeppsen C, Armour AC, Jost G, Hardy K, Wallace GL. Adding the missing voice: How self-report of autistic youth self-report on an executive functioning rating scale compares to parent report and that of youth with attention deficit hyperactivity disorder or neurotypical development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:422-433. [PMID: 34238038 PMCID: PMC8742839 DOI: 10.1177/13623613211029117] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
LAY ABSTRACT Executive functions are often impaired in autistic people and relate to important outcomes such as mental health, success in school and work, and quality of life. Evaluating executive functions helps autistic people, clinicians, and families identify targets for external supports and skill building. Youth self-report of executive function has not been studied, yet we know that self-report from autistic youth is key to understanding other cognitive/behavioral phenomena in autism such as anxiety, obsessions/compulsions, sensory sensitivities, and repetitive behaviors. We investigated self- and parent-report of executive function problems in 197 autistic youth without intellectual disability (ages 11-18 years), including the magnitude and profiles of executive function problems autistic youth report across subdomains of executive function. We compared autistic self-report with that of 114 youth with attention deficit hyperactivity disorder without intellectual disability and 197 neurotypical youth. We found that autistic youth report significant executive function problems compared to neurotypical youth and a distinctive profile of challenges in comparison to attention deficit hyperactivity disorder youth. Parents and their autistic children diverged regarding the magnitude of the youth's executive function difficulties, but both identify inflexibility as the most impaired executive function subdomain. Autistic youth and their parents were somewhat more concordant in their report of executive function problems than youth with attention deficit hyperactivity disorder and their parents, but only showed moderate concordance at best. These findings elevate the importance of asking autistic youth directly about their executive functioning when engaging them in assessment and intervention, or researching executive functions in autism.
Collapse
Affiliation(s)
- Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | - Alyssa Verbalis
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | | | | | - John F. Strang
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | | | - Charlotte Jeppsen
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | - Anna C. Armour
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | - Geneva Jost
- Center for Autism Spectrum Disorders, Children’s National, Washington, DC
| | - Kristina Hardy
- Neuropsychology Division, Children’s National, Washington, DC
| | - Gregory L. Wallace
- Deparment of Speech, Language, and Hearing Sciences, The George Washington University, Washington, DC
| |
Collapse
|
37
|
Lamash L, Ricon T, Rosenblum S. Time Organization Patterns of Adolescents: Agreement between Self- Report and Parent Report. Phys Occup Ther Pediatr 2022; 42:319-332. [PMID: 34587864 DOI: 10.1080/01942638.2021.1982839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIMS Occupational therapy services include measurement and promotion of time organization as important for adolescents' daily life management and well-being into adulthood. This study examined the internal consistency reliability of the Time Organization and Participation Scale (TOPS) among adolescents and their parents, associations between time organization and age, gender differences in time organization, and agreement levels between adolescents' and parents' perceptions of time-organization abilities. METHODS Seventy-five adolescents with typical development and their parents completed the TOPS self-report and parent versions. RESULTS Both TOPS versions showed high internal consistency (.80-.94). No significant correlations were found between age and time-organization patterns. Girls self-reported significantly more emotional response following disorganization in time. Parents' total scores explained 52.1% of the variance in their children's total scores. CONCLUSIONS Adolescence, a critical transitional period of preparing for independent adult life, involves a continual interaction between person, occupation, and environment while using skills to organize in time. The TOPS's self- and parent-reports are reliable and can raise awareness of time-organization deficiencies in daily activities and emotional consequences. The use of the TOPS to assess adolescents' time-organization abilities can inform intervention design to help adolescents develop an awareness of their time use and foster their daily performance.
Collapse
Affiliation(s)
- Liron Lamash
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Tsameret Ricon
- Educational Counseling Program, Oranim Academic College of Education, Tivon, Israel
| | - Sara Rosenblum
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| |
Collapse
|
38
|
Strang JF, Knauss M, van der Miesen A, McGuire J, Kenworthy L, Caplan R, Freeman A, Sadikova E, Zacks Z, Pervez N, Balleur A, Rowlands D, Sibarium E, Willing L, McCool MA, Ehrbar RD, Wyss SE, Wimms H, Tobing J, Thomas J, Austen J, Pine E, Griffin AD, Janssen A, Gomez-Lobo V, Brandt A, Morgan C, Meagher H, Gohari D, Kirby L, Russell L, Powers M, Anthony LG. A Clinical Program for Transgender and Gender-Diverse Neurodiverse/Autistic Adolescents Developed through Community-Based Participatory Design. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:730-745. [PMID: 32375521 PMCID: PMC11362985 DOI: 10.1080/15374416.2020.1731817] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: A series of studies report elevated rates of autism and autistic characteristics among gender-diverse youth seeking gender services. Although youth with the co-occurrence present with complex care needs, existing studies have focused on co-occurrence rates. Further, clinical commentaries have emphasized provider-centered interpretations of clinical needs rather than key stakeholder-driven clinical approaches. This study aimed to employ community-based participatory research methodologies to develop a key stakeholder-driven clinical group program.Method: Autistic/neurodiverse gender-diverse (A/ND-GD) youth (N = 31), parents of A/ND-GD youth (N = 46), A/ND-GD self-advocates (N = 10), and expert clinical providers (N = 10) participated in a multi-stage community-based participatory procedure. Needs assessment data were collected repeatedly over time from A/ND-GD youth and their parents as the youth interacted with one another through ongoing clinical groups, the curriculum of which was developed progressively through the iterative needs assessments.Results: Separate adolescent and parent needs assessments revealed key priorities for youth (e.g., the importance of connecting with other A/ND-GD youth and the benefit of experiencing a range of gender-diverse role models to make gender exploration and/or gender affirmation more concrete) and parents (e.g., the need for A/ND-related supports for their children as well as provision of an A/ND-friendly environment that fosters exploration of a range of gender expressions/options). Integration and translation of youth and parent priorities resulted in 11 novel clinical techniques for this population.Conclusions: With generally high acceptability ratings for each component of the group program, this study presents a community-driven clinical model to support broad care needs and preferences of A/ND-GD adolescents.
Collapse
Affiliation(s)
- John F. Strang
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
- George Washington University School of Medicine, George Washington University, Washington, DC
| | - Megan Knauss
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
- Alliance of Community Health Plans, Washington, DC
| | - Anna van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Jenifer McGuire
- Department of Family Social Science, University of Minnesota, Minneapolis, MD
- National Center for Gender Spectrum Health, University of Minnesota, Minneapolis, MN
| | - Lauren Kenworthy
- George Washington University School of Medicine, George Washington University, Washington, DC
- Center for Autism Spectrum Disorders, Children’s National Health System, Washington, DC
| | - Reid Caplan
- Autistic Self Advocacy Network, Washington, DC
| | - Andrew Freeman
- Department of Psychology, University of Nevada, Las Vegas, NV
| | - Eleonora Sadikova
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
| | - Zosia Zacks
- Hussman Center for Adults with Autism, Towson University, Towson, MD
| | - Noor Pervez
- Autistic Self Advocacy Network, Washington, DC
| | - Anouk Balleur
- Parnassia Psychiatric Institute, Gorinchem, The Netherlands
| | - D.W. Rowlands
- University of Maryland, Baltimore County, Catonsville, MD
| | | | - Laura Willing
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
- George Washington University School of Medicine, George Washington University, Washington, DC
| | - Marissa A. McCool
- Queer Indigenous and People of Color (QIPOC), Augsburg University, Minneapolis, MN
- V-Day, University of Pennsylvania, Philadelphia, PA
| | | | - Shannon E. Wyss
- Gender and Sexuality Education and Advocacy Program, Children’s National Medical Center, Washington, DC
- Transgender Leadership Initiative, AIDS United, Washington, DC
| | - Harriette Wimms
- Youth Gender Care Services, The Village Family Support Center of Baltimore, Baltimore, MD
| | | | - John Thomas
- Transgender and Autism Services, Falls Church Counseling, Falls Church, VA
| | - Julie Austen
- Carolina Converge Gender Affirming Services, Raleigh-Durham, NC
| | - Elyse Pine
- LGBT Health Resource Center, Chase Brexton Health Care, Baltimore, MD
| | | | - Aron Janssen
- Gender and Sexuality Service, Child Study Center, New York University Medical School, New York, NY
| | - Veronica Gomez-Lobo
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
- Division of Pediatric Gynecology, Children’s National Health System, Washington, DC
| | - Abigail Brandt
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
- Division of Hearing and Speech, Children’s National Health System, Washington, DC
| | - Colleen Morgan
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
- Division of Hearing and Speech, Children’s National Health System, Washington, DC
| | - Haley Meagher
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
| | - Dena Gohari
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
| | - Laura Kirby
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
| | - Laura Russell
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
| | - Meredith Powers
- Gender and Autism Program, Division of Neuropsychology, Children’s National Health System, Washington, DC
| | - Laura G. Anthony
- Department of Psychiatry, Pediatric Mental Health Institute, Children’s Hospital of Colorado, University of Colorado School of Medicine, Aurora, CO
| |
Collapse
|
39
|
Kim SY, Lecavalier L. Evaluating the Use of Self-reported Measures in Autistic Individuals in the Context of Psychiatric Assessment: A Systematic Review. J Autism Dev Disord 2021; 52:4355-4374. [PMID: 34643862 DOI: 10.1007/s10803-021-05323-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2021] [Indexed: 11/24/2022]
Abstract
The current review examined the use of self-report measures in autistic individuals in the context of psychiatric assessments. It focused on inter-rater agreement, internal consistency, test-retest reliability, and criterion validity with clinical diagnoses. It also gathered information on constructs measured, the nature of the samples, and the quality of the studies. Thirty-six out of 10,557 studies met inclusion criteria. We found that the majority of studies (1) targeted young people with average or above average cognitive abilities, (2) measured anxiety symptoms, and (3) evaluated parent-child agreement. More studies are needed on individuals with lower cognitive abilities, adults, and other constructs. Studies assessing criterion validity and test-retest reliability are also needed.
Collapse
Affiliation(s)
- Soo Youn Kim
- Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - Luc Lecavalier
- Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH, 43210, USA.
| |
Collapse
|
40
|
A Systematic Review of Self-Reported Stress Questionnaires in People on the Autism Spectrum. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021; 10:295-318. [PMID: 34603935 PMCID: PMC8475841 DOI: 10.1007/s40489-021-00293-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/08/2021] [Indexed: 10/26/2022]
Abstract
Background The goal of this systematic review was to provide an overview of self-report measures of stress in populations on the autism spectrum. In addition, information regarding psychometric properties was discussed as well. Methods Four databases were systematically searched following the PRISMA guidelines and using strict eligibility criteria. Risk of bias assessment was performed using the COSMIN checklist. Results Eight questionnaires were previously used in populations on the autism spectrum, reported over 31 studies. Discussion Future research should focus more on examining psychometric properties of these self-report measures in this population as current evidence is scarce. In addition, it is important to consider which concept of stress one aims to measure as not all questionnaires cover the same aspects of stress. Supplementary Information The online version contains supplementary material available at 10.1007/s40489-021-00293-4.
Collapse
|
41
|
Arora I, Bellato A, Ropar D, Hollis C, Groom MJ. Is autonomic function during resting-state atypical in Autism: A systematic review of evidence. Neurosci Biobehav Rev 2021; 125:417-441. [PMID: 33662443 DOI: 10.1016/j.neubiorev.2021.02.041] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Theories of differences in resting-state arousal in autistic individuals are influential. Differences in arousal during resting-state would impact engagement and adaptation to the environment, having a cascading effect on development of attentional and social skills. OBJECTIVES We systematically evaluated the evidence for differences in measures of autonomic arousal (heart rate, pupillometry or electrodermal activity) during resting-state in autistic individuals; to understand whether certain contextual or methodological factors impact reports of such differences. DATA SOURCES We searched PsycInfo, MEDLINE and EMBASE databases for papers published until 16th May 2019. Of 1207 titles initially identified, 60 met inclusion criteria. RESULTS AND CONCLUSIONS Of the 51 studies that investigated group differences between neurotypical and autistic participants, 60.8 % found evidence of group differences. While findings of hyperarousal were more common, particularly using indices of parasympathetic function, findings of hypo-arousal and autonomic dysregulation were also consistently present. Importantly, experimental context played a role in revealing such differences. The evidence is discussed with regard to important methodological factors and implications for future research are described.
Collapse
Affiliation(s)
- Iti Arora
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, United Kingdom.
| | - Alessio Bellato
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, United Kingdom.
| | - Danielle Ropar
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom.
| | - Chris Hollis
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, United Kingdom; NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, United Kingdom; NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, United Kingdom.
| | - Madeleine J Groom
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham, NG7 2TU, United Kingdom.
| |
Collapse
|
42
|
Williams ZJ, He JL, Cascio CJ, Woynaroski TG. A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms. Neurosci Biobehav Rev 2021; 121:1-17. [PMID: 33285160 PMCID: PMC7855558 DOI: 10.1016/j.neubiorev.2020.11.030] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022]
Abstract
Atypical behavioral responses to environmental sounds are common in autistic children and adults, with 50-70 % of this population exhibiting decreased sound tolerance (DST) at some point in their lives. This symptom is a source of significant distress and impairment across the lifespan, contributing to anxiety, challenging behaviors, reduced community participation, and school/workplace difficulties. However, relatively little is known about its phenomenology or neurocognitive underpinnings. The present article synthesizes a large body of literature on the phenomenology and pathophysiology of DST-related conditions to generate a comprehensive theoretical account of DST in autism. Notably, we argue against conceptualizing DST as a unified construct, suggesting that it be separated into three phenomenologically distinct conditions: hyperacusis (the perception of everyday sounds as excessively loud or painful), misophonia (an acquired aversive reaction to specific sounds), and phonophobia (a specific phobia of sound), each responsible for a portion of observed DST behaviors. We further elaborate our framework by proposing preliminary neurocognitive models of hyperacusis, misophonia, and phonophobia that incorporate neurophysiologic findings from studies of autism.
Collapse
Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, 221 Eskind Biomedical Library and Learning Center, 2209 Garland Ave., Nashville, TN, 37240, United States; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, United States; Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States.
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Strand Building, Strand Campus, Strand, London, WC2R 2LS, London, United Kingdom.
| | - Carissa J Cascio
- Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 2254 Village at Vanderbilt, 1500 21st Ave South, Nashville, TN, 37212, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, United States.
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, United States; Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, United States.
| |
Collapse
|
43
|
Howe SJ, Hewitt K, Baraskewich J, Cassidy S, McMorris CA. Suicidality Among Children and Youth With and Without Autism Spectrum Disorder: A Systematic Review of Existing Risk Assessment Tools. J Autism Dev Disord 2020; 50:3462-3476. [PMID: 32100237 DOI: 10.1007/s10803-020-04394-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals with autism are at heightened risk for experiencing suicidality compared to those without autism. Despite this, it is unknown what tools are used to assess suicide risk in research and clinical practice among children and youth with autism. This systematic review examined tools commonly used to measure suicidality in children and youth with and without autism spectrum disorder. Four databases were searched. We identified five tools (C-SSRS, PSS, SITBI, SIQ-JR, BSS) commonly used with youth in the general population; however, we did not identify any tools that were commonly used autistic children and youth. Results highlight the lack of available tools utilized to measure suicidality in autistic children and youth. We propose a framework to facilitate research to fill this gap.
Collapse
Affiliation(s)
- Stephanie J Howe
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Katie Hewitt
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Jessica Baraskewich
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, EDT 508, University Dr. NW, Calgary, AB, T2N1N4, Canada. .,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
44
|
Pickard H, Hirsch C, Simonoff E, Happé F. Exploring the cognitive, emotional and sensory correlates of social anxiety in autistic and neurotypical adolescents. J Child Psychol Psychiatry 2020; 61:1317-1327. [PMID: 32115711 PMCID: PMC7116440 DOI: 10.1111/jcpp.13214] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Social anxiety is common in autistic adolescents. While emerging evidence indicates the importance of several mechanisms (including intolerance of uncertainty (IU), alexithymia and sensory processing) for maintaining anxiety, limited research has explored how these factors are associated with social anxiety in autistic adolescents. METHODS We investigated whether IU, emotional and sensory processing are related to social anxiety in autistic and neurotypical adolescents, gathering experimental and questionnaire data from 61 autistic and 62 neurotypical 11- to 17-year-olds recruited to have similarly high levels of anxiety. RESULTS In autistic and neurotypical adolescents matched for social anxiety, similar significant associations were observed between social anxiety and IU, alexithymia, maladaptive emotion regulation, sensory hypersensitivity and interoceptive sensibility. Taking a dimensional approach, we found that child- and parent-reported IU, alexithymia and sensory hypersensitivity mediated the relationship between autistic traits and social anxiety symptoms in the combined group of adolescents. CONCLUSIONS Our findings indicate that similar correlates of social anxiety are evident in autistic and neurotypical youths experiencing social anxiety and further our understanding of mechanisms that may contribute towards social anxiety in both groups.
Collapse
Affiliation(s)
- H Pickard
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - C Hirsch
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - E Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - F Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| |
Collapse
|
45
|
Su WC, Culotta M, Mueller J, Tsuzuki D, Pelphrey K, Bhat A. Differences in cortical activation patterns during action observation, action execution, and interpersonal synchrony between children with or without autism spectrum disorder (ASD): An fNIRS pilot study. PLoS One 2020; 15:e0240301. [PMID: 33119704 PMCID: PMC7595285 DOI: 10.1371/journal.pone.0240301] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 09/23/2020] [Indexed: 12/16/2022] Open
Abstract
Engaging in socially embedded actions such as imitation and interpersonal synchrony facilitates relationships with peers and caregivers. Imitation and interpersonal synchrony impairments of children with Autism Spectrum Disorder (ASD) might contribute to their difficulties in connecting and learning from others. Previous fMRI studies investigated cortical activation in children with ASD during finger/hand movement imitation; however, we do not know whether these findings generalize to naturalistic face-to-face imitation/interpersonal synchrony tasks. Using functional near infrared spectroscopy (fNIRS), the current study assessed the cortical activation of children with and without ASD during a face-to-face interpersonal synchrony task. Fourteen children with ASD and 17 typically developing (TD) children completed three conditions: a) Watch-observed an adult clean up blocks; b) Do-cleaned up the blocks on their own; and c) Together-synchronized their block clean up actions to that of an adult. Children with ASD showed lower spatial and temporal synchrony accuracies but intact motor accuracy during the Together/interpersonal synchrony condition. In terms of cortical activation, children with ASD had hypoactivation in the middle and inferior frontal gyri (MIFG) as well as middle and superior temporal gyri (MSTG) while showing hyperactivation in the inferior parietal cortices/lobule (IPL) compared to the TD children. During the Together condition, the TD children showed bilaterally symmetrical activation whereas children with ASD showed more left-lateralized activation over MIFG and right-lateralized activation over MSTG. Additionally, using ADOS scores, in children with ASD greater social affect impairment was associated with lower activation in the left MIFG and more repetitive behavior impairment was associated with greater activation over bilateral MSTG. In children with ASD better communication performance on the VABS was associated with greater MIFG and/or MSTG activation. We identified objective neural biomarkers that could be utilized as outcome predictors or treatment response indicators in future intervention studies.
Collapse
Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, Delaware, United States of America
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, United States of America
| | - McKenzie Culotta
- Department of Physical Therapy, University of Delaware, Newark, Delaware, United States of America
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, United States of America
| | - Jessica Mueller
- Department of Behavioral Health, Swank Autism Center, A. I. du Pont Nemours Hospital for Children, Wilmington, Delaware, United States of America
| | - Daisuke Tsuzuki
- Department of Language Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Kevin Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, Virginia, United States of America
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, Delaware, United States of America
- Biomechanics & Movement Science Program, University of Delaware, Newark, Delaware, United States of America
- Department of Psychological & Brain Sciences, University of Delaware, Newark, Delaware, United States of America
- * E-mail:
| |
Collapse
|
46
|
Clawson A, Strang JF, Wallace GL, Gomez-Lobo V, Jack A, Webb SJ, Pelphrey KA. Parent-Child Concordance on the Pubertal Development Scale in Typically Developing and Autistic Youth. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 77:101610. [PMID: 32863862 PMCID: PMC7449027 DOI: 10.1016/j.rasd.2020.101610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Characterizing puberty in autism spectrum disorder (ASD) is critical given the direct impacts of pubertal progression on neural, cognitive, and physical maturation. Limited information is available about the utility and parent-child concordance of the self-report and parent-report Pubertal Development Scale (PDS) in ASD, an economical and easily administered measure. METHOD The primary aim of this study was to examine the concordance between self-report and parent-report PDS ratings in autistic males and females ages 8-17y compared to typically developing (TD) youth, including using the PDS to derive informant-based estimates of adrenal and gonadal development. We hypothesized that there would be greater parent-youth discrepancies in pubertal ratings among autistic males. Our second aim was exploratory; we examined whether individual characteristics impact PDS concordance and hypothesized that lower intellectual and adaptive skills, higher autistic traits, and reduced self-awareness/monitoring would correlate with lower concordance. RESULTS There were no significant diagnostic group differences in parent-youth concordance for overall PDS scores among males and females. Autistic males had significantly lower inter-item agreement with their parents than TD males and had lower agreement for both adrenal and gonadal aspects of pubertal maturation (adrenal κ=.48; gonadal κ=.55). CONCLUSIONS The PDS is a feasible measure in ASD. Greater parent-youth discrepancies in autistic males may be due to reduced parental awareness or reduced insight into pubertal maturation among autistic males. Future research is needed to further elucidate individual and/or environmental characteristics that influence youth- and parent-reported PDS scores, including differences in self-perception and insight.
Collapse
Affiliation(s)
- Ann Clawson
- Department of Neuropsychology, Children’s National
Hospital
| | - John F. Strang
- Department of Neuropsychology, Children’s National
Hospital
| | - Gregory L. Wallace
- Department of Speech, Language, and Hearing Sciences, The
George Washington University
| | | | - Allison Jack
- Department of Psychology, George Mason University
| | - Sara J. Webb
- Department of Psychology, University of Washington
| | | |
Collapse
|
47
|
Dwyer P, Wang X, De Meo-Monteil R, Hsieh F, Saron CD, Rivera SM. Defining clusters of young autistic and typically developing children based on loudness-dependent auditory electrophysiological responses. Mol Autism 2020; 11:48. [PMID: 32539866 PMCID: PMC7294610 DOI: 10.1186/s13229-020-00352-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/19/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Autistic individuals exhibit atypical patterns of sensory processing that are known to be related to quality of life, but which are also highly heterogeneous. Previous investigations of this heterogeneity have ordinarily used questionnaires and have rarely investigated sensory processing in typical development (TD) alongside autism spectrum development (ASD). METHODS The present study used hierarchical clustering in a large sample to identify subgroups of young autistic and typically developing children based on the normalized global field power (GFP) of their event-related potentials (ERPs) to auditory stimuli of four different loudness intensities (50, 60, 70, 80 dB SPL): that is, based on an index of the relative strengths of their neural responses across these loudness conditions. RESULTS Four clusters of participants were defined. Normalized GFP responses to sounds of different intensities differed strongly across clusters. There was considerable overlap in cluster assignments of autistic and typically developing participants, but autistic participants were more likely to display a pattern of relatively linear increases in response strength accompanied by a disproportionately strong response to 70 dB stimuli. Autistic participants displaying this pattern trended towards obtaining higher scores on assessments of cognitive abilities. There was also a trend for typically developing participants to disproportionately fall into a cluster characterized by disproportionately/nonlinearly strong 60 dB responses. Greater auditory distractibility was reported among autistic participants in a cluster characterized by disproportionately strong responses to the loudest (80 dB) sounds, and furthermore, relatively strong responses to loud sounds were correlated with auditory distractibility. This appears to provide evidence of coinciding behavioral and neural sensory atypicalities. LIMITATIONS Replication may be needed to verify exploratory results. This analysis does not address variability related to classical ERP latencies and topographies. The sensory questionnaire employed was not specifically designed for use in autism. Hearing acuity was not measured. Variability in sensory responses unrelated to loudness is not addressed, leaving room for additional research. CONCLUSIONS Taken together, these data demonstrate the broader benefits of using electrophysiology to explore individual differences. They illuminate different neural response patterns and suggest relationships between sensory neural responses and sensory behaviors, cognitive abilities, and autism diagnostic status.
Collapse
Affiliation(s)
- Patrick Dwyer
- Department of Psychology, UC Davis, One Shields Avenue, Davis, CA 95616 USA
- Center for Mind and Brain, UC Davis, 267 Cousteau Place, Davis, CA 95618 USA
| | - Xiaodong Wang
- Department of Statistics, UC Davis, One Shields Avenue, Davis, CA 95616 USA
| | | | - Fushing Hsieh
- Department of Statistics, UC Davis, One Shields Avenue, Davis, CA 95616 USA
| | - Clifford D. Saron
- Center for Mind and Brain, UC Davis, 267 Cousteau Place, Davis, CA 95618 USA
- MIND Institute, UC Davis, 2825 50th Street, Sacramento, CA 95817 USA
| | - Susan M. Rivera
- Department of Psychology, UC Davis, One Shields Avenue, Davis, CA 95616 USA
- Center for Mind and Brain, UC Davis, 267 Cousteau Place, Davis, CA 95618 USA
- MIND Institute, UC Davis, 2825 50th Street, Sacramento, CA 95817 USA
| |
Collapse
|
48
|
Santore LA, Gerber A, Gioia AN, Bianchi R, Talledo F, Peris TS, Lerner MD. Felt but not seen: Observed restricted repetitive behaviors are associated with self-report-but not parent-report-obsessive-compulsive disorder symptoms in youth with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:983-994. [PMID: 32168988 DOI: 10.1177/1362361320909177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
LAY ABSTRACT Youth with autism spectrum disorder often exhibit symptoms of obsessive-compulsive disorder; however, it can be difficult for parents and clinicians to tell the difference between the restricted and repetitive behaviors often seen in autism spectrum disorder and symptoms of obsessive-compulsive disorder. This difficulty in distinguishing symptoms may arise from the fact that these symptoms appear the same to observers but are typically differentiated based on whether the motivation for the behavior is to reduce stress (restricted and repetitive behaviors) or whether the behavior itself is stressful (obsessive-compulsive disorder). It is important to know the difference between these two symptoms as it may impact the treatment prescribed. The goal of this study was to better determine the difference between restricted and repetitive behaviors and symptoms of obsessive-compulsive disorder in youth with autism spectrum disorder. It was found that although parents and clinicians had trouble differentiating between the two, the children were able to provide insight as to their own motivations for behavior, and thus whether they were restricted and repetitive behaviors or symptoms of obsessive-compulsive disorder. It was also found that children may actually have subjective negative experiences when engaging in restricted and repetitive behaviors, which complicates their classification. These results provide guidance for better understanding, distinguishing, and ultimately treating obsessive-compulsive disorder behavior in youth with autism spectrum disorder.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Matthew D Lerner
- Stony Brook University, USA.,University of Virginia, Charlottesville, USA
| |
Collapse
|
49
|
Camodeca A, Todd KQ, Croyle J. Utility of the Asperger Syndrome Diagnostic Scale in the Assessment of Autism Spectrum Disorders. J Autism Dev Disord 2020; 50:513-523. [DOI: 10.1007/s10803-019-04272-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
50
|
Chien YL, Hsieh MH, Gau SSF. P50-N100-P200 sensory gating deficits in adolescents and young adults with autism spectrum disorders. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109683. [PMID: 31260720 DOI: 10.1016/j.pnpbp.2019.109683] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
Sensory symptoms are common in individuals with autism spectrum disorder (ASD). Altered sensory gating may cause sensory overload. However, whether ASD individuals have P50 gating deficits is controversial in childhood and lacks evidence in adulthood. Beyond P50, fewer studies have examined N100 or P200, although N100 is considered to be more reliable than P50. Also, the clinical correlates of these parameters are mostly unknown. This study aimed to investigate P50, N100, and P200 sensory gating in adolescents and young adults with ASD and examine their clinical correlates. In a sample of 34 ASD participants (mean age 20.6 ± 4.1, female 5.9%) and 34 sex- and age-matched typically-developing controls (TDC, mean age 20.4 ± 3.1), we investigated P50, N100, and P200 sensory gating by a paired-click paradigm, which generated the data of S1 amplitude after the first click and S2 amplitude after the second click. We found that compared to TDC, ASD participants had significant N100 suppression deficits reflected by a larger N100 S2 amplitude, smaller N100 ratio of S2 over S1, and the difference between the two amplitudes. N100 S2 amplitude was significantly associated with sensory sensitivity independent of the diagnosis. Although there was no group difference in P50 suppression, S1 amplitude was negatively associated with social deficits in ASD. P200 gating parameters were correlated with attention switching difficulty. Our findings suggest N100 gating deficit in adolescents and young adults with ASD. The relationships between P50 S1 and social deficits and between N100 S2 and sensory sensitivity warrant further investigation.
Collapse
Affiliation(s)
- Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, and Graduate Institute of Epidemiology and Preventive Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|