Showing papers in "Autism in 2015"
TL;DR: Nearly all medical conditions were significantly more common in adults with autism, including immune conditions, gastrointestinal and sleep disorders, seizure, obesity, dyslipidemia, hypertension, and diabetes.
Abstract: Compared to the general pediatric population, children with autism have higher rates of co-occurring medical and psychiatric illnesses, yet very little is known about the general health status of adults with autism. The objective of this study was to describe the frequency of psychiatric and medical conditions among a large, diverse, insured population of adults with autism in the United States. Participants were adult members of Kaiser Permanente Northern California enrolled from 2008 to 2012. Autism spectrum disorder cases (N = 1507) were adults with autism spectrum disorder diagnoses (International Classification of Diseases-9-Clinical Modification codes 299.0, 299.8, 299.9) recorded in medical records on at least two separate occasions. Controls (N = 15,070) were adults without any autism spectrum disorder diagnoses sampled at a 10:1 ratio and frequency matched to cases on sex and age. Adults with autism had significantly increased rates of all major psychiatric disorders including depression, anxiety...
683 citations
TL;DR: The meta-analysis showed that quality of life is lower for people with autism compared to people without autism, and that the mean effect is large (Cohen’s d = −0.96), and the study concerning the elderly with autism showed that the difference in quality ofLife is similar in the elderly.
Abstract: Autism is a lifelong neurodevelopmental disorder, with a known impact on quality of life. Yet the developmental trajectory of quality of life is not well understood. First, the effect of age on quality of life was studied with a meta-analysis. Our meta-analysis included 10 studies (published between 2004 and 2012) with a combined sample size of 486 people with autism and 17,776 controls. Second, as there were no studies on quality of life of the elderly with autism, we conducted an empirical study on quality of life of the elderly (age range 53-83) with autism (N = 24) and without autism (N = 24). The meta-analysis showed that quality of life is lower for people with autism compared to people without autism, and that the mean effect is large (Cohen's d = -0.96). Age did not have an effect on quality of life. The study concerning the elderly with autism showed that the difference in quality of life is similar in the elderly. Age, IQ and symptom severity did not predict quality of life in this sample. Across the lifespan, people with autism experience a much lower quality of life compared to people without autism. Hence, the quality of life seemed to be independent of someone's age.
288 citations
TL;DR: This systematic review examined the research evidence of two forms of sensory interventions, sensory integration therapy and sensory-based intervention, for children with autism spectrum disorders and concurrent sensory processing problems and found positive effects on reducing behaviors linked to sensory problems.
Abstract: Children with autism spectrum disorders often exhibit co-occurring sensory processing problems and receive interventions that target self-regulation. In current practice, sensory interventions apply different theoretic constructs, focus on different goals, use a variety of sensory modalities, and involve markedly disparate procedures. Previous reviews examined the effects of sensory interventions without acknowledging these inconsistencies. This systematic review examined the research evidence (2000-2012) of two forms of sensory interventions, sensory integration therapy and sensory-based intervention, for children with autism spectrum disorders and concurrent sensory processing problems. A total of 19 studies were reviewed: 5 examined the effects of sensory integration therapy and 14 sensory-based intervention. The studies defined sensory integration therapies as clinic-based interventions that use sensory-rich, child-directed activities to improve a child's adaptive responses to sensory experiences. Two randomized controlled trials found positive effects for sensory integration therapy on child performance using Goal Attainment Scaling (effect sizes ranging from .72 to 1.62); other studies (Levels III-IV) found positive effects on reducing behaviors linked to sensory problems. Sensory-based interventions are characterized as classroom-based interventions that use single-sensory strategies, for example, weighted vests or therapy balls, to influence a child's state of arousal. Few positive effects were found in sensory-based intervention studies. Studies of sensory-based interventions suggest that they may not be effective; however, they did not follow recommended protocols or target sensory processing problems. Although small randomized controlled trials resulted in positive effects for sensory integration therapies, additional rigorous trials using manualized protocols for sensory integration therapy are needed to evaluate effects for children with autism spectrum disorders and sensory processing problems.
267 citations
TL;DR: An in-depth understanding of autistic adults’ experiences with healthcare and their recommendations for improving care is obtained to empower patients, adequately train providers, increase the accessibility of the healthcare system, and decrease discrimination.
Abstract: Our objective was to obtain an in-depth understanding of autistic adults' experiences with healthcare and their recommendations for improving care. Our academic-community partnership used a community-based participatory research approach to conduct semi-structured, open-ended interviews with 39 autistic adults and 16 people who had experience supporting autistic adults in healthcare settings. Participants identified patient-level, autism-related factors that impact healthcare interactions, including verbal communication skills, sensory sensitivities, challenges with body awareness, slow processing speed, atypical non-verbal communication, and challenges with organization. However, the success of healthcare interactions largely depended on the interplay between patient- and provider-level factors, as well as the larger context in which patients were receiving care. Provider-level factors included providers' knowledge about autism in adults, incorrect assumptions about individual patients, willingness to allow written communication, use of accessible language, openness to providing other accommodations, and skill in appropriately incorporating supporters. System-level factors included the availability of supporters, complexity of the healthcare system, accessibility of healthcare facilities, and stigma about autism. Further efforts are needed to empower patients, adequately train providers, increase the accessibility of the healthcare system, and decrease discrimination.
263 citations
TL;DR: Results suggest that daily living skills should be a focus of treatment plans for individuals with autism spectrum disorder, particularly adolescents transitioning to young adulthood.
Abstract: Daily living skills (DLS), such as personal hygiene, meal preparation, and money management, are important to independent living. Research suggests that many individuals with autism spectrum disorder exhibit impairments in daily living skills relative to their cognitive skills. This study examined predictors of daily living skills attainment and trajectories of daily living skills in a longitudinal sample referred for possible autism spectrum disorder and followed from 2 to 21 years of age. Consistent with previous studies, participants with autism spectrum disorder and nonspectrum diagnoses showed continual development of daily living skills throughout childhood and adolescence. Early childhood nonverbal mental age was the strongest predictor of daily living skills attainment for both diagnostic groups. Group-based modeling suggested two distinct trajectories of daily living skills development for participants with autism spectrum disorder. Skill levels for both groups of young adults with autism spectru...
193 citations
TL;DR: Although two-thirds of adults with autism spectrum disorder participated in competitive employment/postsecondary education during the study, fewer than 25% maintained these activities over the study period, and women were considerably less likely than men to maintain employment/ postsecondary education over time.
Abstract: This study examined correlates of participation in postsecondary education and employment over 12 years for 73 adults with autism spectrum disorders and average-range IQ whose families were part of a larger, longitudinal study. Correlates included demographic (sex, maternal education, paternal education), behavioral (activities of daily living, maladaptive behaviors, autism symptoms), and family (size of maternal social network; maternal depressive symptoms, anxiety, and pessimism) factors. Although two-thirds of adults with autism spectrum disorder participated in competitive employment/postsecondary education during the study, fewer than 25% maintained these activities over the study period. Behavioral characteristics distinguished those who never had competitive employment/postsecondary education from those who sometimes or consistently participated in these activities. Women were considerably less likely than men to maintain employment/postsecondary education over time.
174 citations
TL;DR: The relative strengths and weaknesses of existing social communication measures for use in clinical trials are discussed and specific areas in need of further development are identified.
Abstract: Social communication impairments are a core deficit in autism spectrum disorder. Social communication deficit is also an early indicator of autism spectrum disorder and a factor in long-term outcomes. Thus, this symptom domain represents a critical treatment target. Identifying reliable and valid outcome measures for social communication across a range of treatment approaches is essential. Autism Speaks engaged a panel of experts to evaluate the readiness of available measures of social communication for use as outcome measures in clinical trials. The panel held monthly conference calls and two face-to-face meetings over 14 months. Key criteria used to evaluate measures included the relevance to the clinical target, coverage of the symptom domain, and psychometric properties (validity and reliability, as well as evidence of sensitivity to change). In all, 38 measures were evaluated and 6 measures were considered appropriate for use, with some limitations. This report discusses the relative strengths and w...
153 citations
TL;DR: Identifying factors associated with better or worse daily living skills may help shed light on the variability in adult outcome in individuals with autism spectrum disorder with average intelligence.
Abstract: Daily living skills standard scores on the Vineland Adaptive Behavior Scales-2nd edition were examined in 417 adolescents from the Simons Simplex Collection. All participants had at least average intelligence and a diagnosis of autism spectrum disorder. Descriptive statistics and binary logistic regressions were used to examine the prevalence and predictors of a "daily living skills deficit," defined as below average daily living skills in the context of average intelligence quotient. Approximately half of the adolescents were identified as having a daily living skills deficit. Autism symptomatology, intelligence quotient, maternal education, age, and sex accounted for only 10% of the variance in predicting a daily living skills deficit. Identifying factors associated with better or worse daily living skills may help shed light on the variability in adult outcome in individuals with autism spectrum disorder with average intelligence.
136 citations
TL;DR: Data on both descriptive outcomes and rated priorities converged to indicate the need for more adult research on life skills, treatments, co-occurring conditions, and vocational and educational opportunities.
Abstract: Using online survey data from a large sample of adults with autism spectrum disorder and legal guardians, we first report outcomes across a variety of contexts for participants with a wide range of functioning, and second, summarize these stakeholders’ priorities for future research. The sample included n = 255 self-reporting adults with autism spectrum disorder aged 18–71 years (M = 38.5 years, standard deviation = 13.1 years) and n = 143 adults with autism spectrum disorder aged 18–58 years (M = 25.0 years, standard deviation = 8.2 years) whose information was provided by legal guardians. Although the self-reporting subsample had much higher rates of employment, marriage/partnership, and independent living than are typically seen in autism spectrum disorder outcome studies, they remained underemployed and had strikingly high rates of comorbid disorders. Data on both descriptive outcomes and rated priorities converged across subsamples to indicate the need for more adult research on life skills, treatmen...
127 citations
TL;DR: Although parents reported no change in adolescent’s autism spectrum disorder core symptoms, they reported improved social responsiveness, social communication, social cognition, preoccupations, and social motivation, and an increased quality of life.
Abstract: Background:Despite the dramatic increase in autism spectrum disorder in youth and the extremely high costs, hardly any evidence-based interventions are available. The aim of this study is to examine the effects of mindfulness training for adolescents with autism spectrum disorder, combined with Mindful Parenting training.Method:A total of 23 adolescents with autism spectrum disorder, referred to a mental health clinic, received nine weekly sessions of mindfulness training in group format. Their parents (18 mothers, 11 fathers) participated in parallel Mindful Parenting training. A pre-test, post-test, and 9-week follow-up design was used. Data were analyzed using multi-level analyses.Results:Attendance rate was 88% for adolescents and fathers and 86% for mothers. Adolescents reported an increase in quality of life and a decrease in rumination, but no changes in worry, autism spectrum disorder core symptoms, or mindful awareness. Although parents reported no change in adolescent’s autism spectrum disorder ...
117 citations
TL;DR: The presence of an older child with typical or, especially, atypical development was associated with earlier concerns for the affected child, despite milder developmental delays.
Abstract: Symptoms of autism spectrum disorders may appear as early as 6 months, but parent concern, which can precipitate evaluation, often lags significantly. The presence of typical or atypical older siblings can change parents' sensitivity to departures from typical development. This study investigated type and age of parent's first concerns in toddlers with autism spectrum disorder, prior to diagnosis. Participants had (1) at least one older sibling with autism spectrum disorder (Sibs-ASD); (2) only typically developing older siblings (Sibs-TD), or (3) were only/oldest (No-Sibs). Specific autism spectrum disorder diagnoses and symptom severity were similar among groups. Developmentally, No-Sibs showed the largest delays, followed by Sibs-TD, followed by Sibs-ASD. Mean age of first concern was 16 months for No-Sibs, 14 months for Sibs-TD, and 10 months for Sibs-ASD. Age of first concern differed significantly by group, even after controlling for mother's age and education. Concern about language was prevalent in all groups. Thus, the presence of an older child with typical or, especially, atypical development was associated with earlier concerns for the affected child, despite milder developmental delays. These findings underscore the importance of encouraging parents to report concerns to pediatricians, routine standardized screening for autism spectrum disorder, and the need for pediatrician vigilance, especially for only or oldest children.
TL;DR: The single most important factor linked to expressive language was the child’s cognitive level, and all children classified as being nonverbal or minimally verbal had intellectual disability.
Abstract: There is uncertainty about the proportion of children with autism spectrum disorders who do not develop phrase speech during the preschool years The main purpose of this study was to examine this ratio in a population-based community sample of children The cohort consisted of 165 children (141 boys, 24 girls) with autism spectrum disorders aged 4–6 years followed longitudinally over 2 years during which time they had received intervention at a specialized autism center In this study, data collected at the 2-year follow-up were used Three categories of expressive language were defined: nonverbal, minimally verbal, and phrase speech Data from the Vineland Adaptive Behavior Scales-II were used to classify expressive language A secondary objective of the study was to analyze factors that might be linked to verbal ability, namely, child age, cognitive level, autism subtype and severity of core autism symptoms, developmental regression, epilepsy or other medical conditions, and intensity of intervention
TL;DR: Dance movement therapy–based mirroring approach seemed to address more primary developmental aspects of autism than the presently prevailing theory-of-mind approach, while future randomized control trials with bigger samples are needed.
Abstract: From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and Asperger's syndrome) with the aim to increase body awareness, social skills, self-other distinction, empathy, and well-being. We employed a manualized dance movement therapy intervention implemented in hourly sessions once a week for 7 weeks. The treatment group (n = 16) and the no-intervention control group (n = 15) were matched by sex, age, and symptom severity. Participants did not participate in any other therapies for the duration of the study. After the treatment, participants in the intervention group reported improved well-being, improved body awareness, improved self-other distinction, and increased social skills. The dance movement therapy-based mirroring approach seemed to address more primary developmental aspects of autism than the presently prevailing theory-of-mind approach. Results suggest that dance movement therapy can be an effective and feasible therapy approach for autism spectrum disorder, while future randomized control trials with bigger samples are needed.
TL;DR: Examination of reading and math achievement profiles and longitudinal growth trajectories of a nationally representative sample of children ages 6 through 9 with an autism spectrum disorder found children with hypercalculia and lower-achieving profiles were more likely to be from low socioeconomic families and have lower functional cognitive skills.
Abstract: This study examined the reading and math achievement profiles and longitudinal growth trajectories of a nationally representative sample of children ages 6 through 9 with an autism spectrum disorder. Four distinct achievement profiles were identified: higher-achieving (39%), hyperlexia (9%), hypercalculia (20%) and lower-achieving (32%). Children with hypercalculia and lower-achieving profiles were more likely to be from low socioeconomic families and had lower functional cognitive skills than the higher-achieving profile. All four profiles lost ground in passage comprehension over time. Slower improvement occurred for the higher-achieving group on letter–word identification, the hyperlexia group on conversation abilities and the hypercalculia group on calculation and functional cognitive skills relative to the lower-achieving group.
TL;DR: This synthesis-based analysis identifies and reviews studies evaluating vocational resources for adults with autism spectrum disorder and finds emerging constructs are promising in introducing the utility of vocational resources, in particular, supported employment in community settings.
Abstract: This synthesis-based analysis identifies and reviews studies evaluating vocational resources for adults with autism spectrum disorder. It is based on a larger systematic review of intervention studies in autism spectrum disorder, from which a critical interpretive synthesis was conducted on studies related to vocation and autism spectrum disorder. In total, 10 studies were found that examine employment support for youth and adults with autism spectrum disorder. Two domains of vocational intervention in the literature were found: supported employment including community placement and job coaching and media and technology-based augmentative tools. The literature is limited in volume and quality of methodology, yet emerging constructs are promising in introducing the utility of vocational resources, in particular, supported employment in community settings. These vocational approaches are examined, along with representative studies. Recommendations for advancing practice, community capacity, and research are offered.
TL;DR: VIPP-AUTI, as compared with usual care, demonstrated efficacy in reducing parental intrusiveness and parents who received VIPP-AUTi showed increased feelings of self-efficacy in child rearing.
Abstract: In a randomized controlled trial, we evaluated the early intervention program Video-feedback Intervention to promote Positive Parenting adapted to Autism (VIPP-AUTI) with 78 primary caregivers and their child (16-61 months) with Autism Spectrum Disorder. VIPP-AUTI is a brief attachment-based intervention program, focusing on improving parent-child interaction and reducing the child's individual Autism Spectrum Disorder-related symptomatology in five home visits. VIPP-AUTI, as compared with usual care, demonstrated efficacy in reducing parental intrusiveness. Moreover, parents who received VIPP-AUTI showed increased feelings of self-efficacy in child rearing. No significant group differences were found on other aspects of parent-child interaction or on child play behavior. At 3-months follow-up, intervention effects were found on child-initiated joint attention skills, not mediated by intervention effects on parenting. Implementation of VIPP-AUTI in clinical practice is facilitated by the use of a detailed manual and a relatively brief training of interveners.
TL;DR: Findings support the notion of an implicit Theory of Mind deficit in autism spectrum disorders, but give rise to the idea that anticipatory looking behaviors in autism Spectrum disorders may be affected by experience.
Abstract: This study aimed to investigate the relationship between explicit and implicit forms of Theory of Mind reasoning and to test the influence of experience on implicit Theory of Mind reasoning in individuals with autism spectrum disorders and in neurotypical adults. Results from two standard explicit Theory of Mind tasks are mixed: Individuals with autism spectrum disorders did not differ from neurotypical adults in their performance in the Strange Stories Test, but scored significantly lower on the Reading the Mind in the Eyes Test. Furthermore, in an implicit false-belief task, individuals with autism spectrum disorders differed from neurotypical adults in false belief-congruent anticipatory looking. However, this group difference disappeared by (1) providing participants with the outcome of a false belief-based action and (2) subsequently repeating this test trial. Although the tendency to fixate the false belief-congruent location significantly increased from the first to the second test trial in individuals with autism spectrum disorders, it differed in neither test trial from chance. These findings support the notion of an implicit Theory of Mind deficit in autism spectrum disorders, but give rise to the idea that anticipatory looking behaviors in autism spectrum disorders may be affected by experience. Additionally, the pattern of results from implicit and explicit Theory of Mind measures supports the theory of two independent Theory of Mind reasoning systems.
TL;DR: Results from an open-label trial pilot study in which bumetanide treatment improves emotion recognition and enhances the activation of brain regions involved in social and emotional perception during the perception of emotional faces show the usefulness of bumetAnide as a promising treatment to improve social interactions in autism.
Abstract: Clinical observations have shown that GABA-acting benzodiazepines exert paradoxical excitatory effects in autism, suggesting elevated intracellular chloride (Cl-)i and excitatory action of GABA. In a previous double-blind randomized study, we have shown that the diuretic NKCC1 chloride importer antagonist bumetanide, that decreases (Cl-)i and reinforces GABAergic inhibition, reduces the severity of autism symptoms. Here, we report results from an open-label trial pilot study in which we used functional magnetic resonance imaging and neuropsychological testing to determine the effects of 10 months bumetanide treatment in adolescents and young adults with autism. We show that bumetanide treatment improves emotion recognition and enhances the activation of brain regions involved in social and emotional perception during the perception of emotional faces. The improvement of emotion processing by bumetanide reinforces the usefulness of bumetanide as a promising treatment to improve social interactions in autism.
TL;DR: Children and adults with autism spectrum disorder uniquely misinterpreted happy faces as neutral, and were significantly more likely than typical volunteers to attribute negative valence to nonemotional faces.
Abstract: Facial emotion perception is significantly affected in autism spectrum disorder, yet little is known about how individuals with autism spectrum disorder misinterpret facial expressions that result in their difficulty in accurately recognizing emotion in faces. This study examined facial emotion perception in 45 verbal adults with autism spectrum disorder and 30 age- and gender-matched volunteers without autism spectrum disorder to identify patterns of emotion misinterpretation during face processing that contribute to emotion recognition impairments in autism. Results revealed that difficulty distinguishing emotional from neutral facial expressions characterized much of the emotion perception impairments exhibited by participants with autism spectrum disorder. In particular, adults with autism spectrum disorder uniquely misinterpreted happy faces as neutral, and were significantly more likely than typical volunteers to attribute negative valence to nonemotional faces. The over-attribution of emotions to neutral faces was significantly related to greater communication and emotional intelligence impairments in individuals with autism spectrum disorder. These findings suggest a potential negative bias toward the interpretation of facial expressions and may have implications for interventions designed to remediate emotion perception in autism spectrum disorder.
TL;DR: Preliminary findings suggest that a fundamental motor skill intervention may benefit young children with autism spectrum disorder.
Abstract: A wait-list control experimental design was employed to investigate the effectiveness of a fundamental motor skill intervention at improving the motor skills, adaptive behavior, and social skills of 4-year-old children with autism spectrum disorder (experimental n = 5, control n = 4); the impact of intervention intensity was also explored. The experimental group significantly improved their object manipulation and overall motor scores from pre- to post-intervention. The wait-list control design revealed no group-by-time interactions; however, with the groups combined time was a significant factor for all motor variables. There were no significant changes in adaptive behavior and social skills. These preliminary findings suggest that a fundamental motor skill intervention may benefit young children with autism spectrum disorder. Future research with larger samples is warranted.
TL;DR: Results from the qualitative analyses indicated that patients with autism spectrum disorder faced several challenges in the context of health-care delivery in the hospital setting, as did their families andhealth-care provider team.
Abstract: Youth with autism spectrum disorder are a vulnerable, often poorly understood patient group, who may experience periodic and chronic health challenges, in addition to their primary developmental social and communication problems. Developmental and behavioural challenges can complicate management of acute health-care needs. To date, there is an absence of empirical research exploring the hospital experiences of children and youth with autism spectrum disorder, their families and their health-care providers. Therefore, the purpose of this study was to understand these experiences in order to inform hospital-based care. A total of 42 participants were interviewed (youth with autism spectrum disorder, their parents and health-care providers) at one of two Canadian paediatric hospitals, representing 20 distinct cases of patients with autism spectrum disorder. Results from the qualitative analyses indicated that patients with autism spectrum disorder faced several challenges in the context of health-care delivery in the hospital setting, as did their families and health-care provider team. Problems identified included communication and sensory challenges, and the degree of flexibility of health-care providers and the hospital organization. Supportive health-care providers were those who acknowledged parents as experts, inquired about the requirements of patients with autism spectrum disorder and implemented strategies that accommodated the unique clinical presentation of the individual patient. These recommendations have wide-reaching utility for hospital and health-care practices involving this patient group.
TL;DR: Results suggest that cognitive-attributional symptoms of depression may be particularly prevalent in autism spectrum disorders, and validation studies of depression measures in the autism spectrum disorder population are necessary to advance research into this prevalent and impairing comorbidity.
Abstract: In a sample of 50 verbally fluent adolescents and adults with autism spectrum disorders (age: 16-31 years; verbal IQ: 72-140), we examined the pattern of response and associations between scores on common measures of depressive symptoms, participant characteristics, and clinical diagnosis of depressive disorders. Beck Depression Inventory-Second Edition item descriptives in this autism spectrum disorder sample were compared to previously published data from a large typically developing sample, with results suggesting that cognitive-attributional symptoms of depression may be particularly prevalent in autism spectrum disorder. Scores on a variety of self- and parent-report depression measures were not associated with chronological age or verbal IQ, and were relatively highly correlated with each other and with clinical diagnosis of a mood disorder. The Beck Depression Inventory-Second Edition and the Adult Self-Report "Depressive" scale best identified both depressed and non-depressed participants in this sample, though neither was particularly strong. Validation studies of depression measures in the autism spectrum disorder population are necessary to advance research into this prevalent and impairing comorbidity.
TL;DR: Both self/parent report and clinical observations appeared to report hyposensitivity to pain, whereas observations of medical procedures and experimental manipulation suggested normal or hypersensitive responses to pain.
Abstract: In addition to the diagnostic criteria for autism spectrum disorder, a number of clinically important comorbid complaints, including sensory abnormalities, are also discussed. One difference often noted in these accounts is hyposensitivity to pain; however, evidence for this is limited. The purpose of the current review therefore was to examine sensitivity to pain of individuals with autism spectrum disorder. This review is interested in reports which consider differences in subjective experience of pain (i.e. different pain thresholds) and differences in behavioural response to pain (i.e. signs of pain-related distress). Studies were included if they were conducted with human subjects, included a clearly diagnosed autism spectrum disorder population and reported data pertaining to pain experience relative to the neurotypical population. Studies were classified as being self/parent report, clinical observations, observations of response to medical procedures or experimental examination of pain. Both self/parent report and clinical observations appeared to report hyposensitivity to pain, whereas observations of medical procedures and experimental manipulation suggested normal or hypersensitive responses to pain. This review suggests that contrary to classical reports, individuals with autism spectrum disorder do not appear to have systematically altered pain responses or thresholds. More systematic experimental examination of this area is needed to understand responses to pain of individuals with autism spectrum disorder.
TL;DR: The long-term consequences of chronic stress in everyday life, as well as treatment intervention focusing on stress and coping, should be addressed in future research aswell as in the clinical management of intellectually able adults with autism spectrum disorder.
Abstract: Despite average intellectual capacity, autistic traits may complicate performance in many everyday situations, thus leading to stress. This study focuses on stress in everyday life in intellectually able adults with autism spectrum disorders. In total, 53 adults (25 with autism spectrum disorder and 28 typical adults from the general population) completed the Perceived Stress Scale. Autistic traits were assessed using the Autism Spectrum Quotient. Adults with autism spectrum disorder reported significantly higher subjective stress and poorer ability to cope with stress in everyday life, as compared to typical adults. Autistic traits were associated with both subjective stress/distress and coping in this cross-sectional series. The long-term consequences of chronic stress in everyday life, as well as treatment intervention focusing on stress and coping, should be addressed in future research as well as in the clinical management of intellectually able adults with autism spectrum disorder.
TL;DR: Overall, best, and worst met service needs, and predictors of those needs, for families of children with autism spectrum disorders are explored to help professionals, funders, and policy-makers tailor services to best meet families’ needs.
Abstract: Purpose:Increasing demand for autism services is straining service systems. Tailoring services to best meet families’ needs could improve their quality of life and decrease burden on the system. We explored overall, best, and worst met service needs, and predictors of those needs, for families of children with autism spectrum disorders.Methods:Parents of 143 children with autism spectrum disorders (2–18 years) completed a survey including demographic and descriptive information, the Family Needs Survey–Revised, and an open-ended question about service needs. Descriptive statistics characterize the sample and determine the degree to which items were identified and met as needs. Predictors of total and unmet needs were modeled with regression or generalized linear model. Qualitative responses were thematically analyzed.Results:The most frequently identified overall and unmet service needs were information on services, family support, and respite care. The funding and quality of professional support availabl...
TL;DR: Differences between the psychometric properties of the original and adapted versions were common, indicating the need to obtain normative data on populations to increase the utility of the translated tool.
Abstract: Screening children to determine risk for Autism Spectrum Disorders has become more common, although some question the advisability of such a strategy. The purpose of this systematic review is to identify autism screening tools that have been adapted for use in cultures different from that in which they were developed, evaluate the cultural adaptation process, report on the psychometric properties of the adapted instruments, and describe the implications for further research and clinical practice. A total of 21 articles met criteria for inclusion, reporting on the cultural adaptation of autism screening in 19 countries and in 10 languages. The cultural adaptation process was not always clearly outlined and often did not include the recommended guidelines. Cultural/linguistic modifications to the translated tools tended to increase with the rigor of the adaptation process. Differences between the psychometric properties of the original and adapted versions were common, indicating the need to obtain normative data on populations to increase the utility of the translated tool.
TL;DR: This work discusses three distinct actions of noise in neural networks, arguing in each case that autism spectrum disorder symptoms reflect too little, rather than too much, neural noise.
Abstract: 'Heuristic' theories of autism postulate that a single mechanism or process underpins the diverse psychological features of autism spectrum disorder. Although no such theory can offer a comprehensive account, the parsimonious descriptions they provide are powerful catalysts to autism research. One recent proposal holds that 'noisy' neuronal signalling explains not only some deficits in autism spectrum disorder, but also some superior abilities, due to 'stochastic resonance'. Here, we discuss three distinct actions of noise in neural networks, arguing in each case that autism spectrum disorder symptoms reflect too little, rather than too much, neural noise. Such reduced noise, perhaps a function of atypical brainstem activation, would enhance detection and discrimination in autism spectrum disorder but at significant cost, foregoing the widespread benefits of noise in neural networks.
TL;DR: In this paper, a systematic review was undertaken to investigate the effectiveness of social skills interventions for adults with high-functioning autism spectrum disorders (hf-ASD) -a clinical population who can present with more subtle core deficits, but comparable levels of impairment and secondary difficulties.
Abstract: Autism spectrum disorders are characterised by impairments in communication and social interaction. Social skills interventions have been found to ameliorate socio-communication deficits in children and adolescents with autism spectrum disorders. Little is known about the effectiveness of social skills interventions for adults with high-functioning autism spectrum disorders (hf-ASD) - a clinical population who can present with more subtle core deficits, but comparable levels of impairment and secondary difficulties. A systematic review was undertaken to investigate the effectiveness of social skills interventions for adults with high-functioning autism spectrum disorders. Five studies met the pre-specified review inclusion criteria: two quasi-experimental comparative trials and three single-arm interventions. There was a degree of variation in the structure, duration and content of the social skills interventions delivered, as well as several methodological limitations associated with included studies. Nevertheless, narrative analysis tentatively indicates that group social skills interventions may be effective for enhancing social knowledge and understanding, improving social functioning, reducing loneliness and potentially alleviating co-morbid psychiatric symptoms.
TL;DR: P phenomenological interviews with children with autism spectrum disorder were used to gain insights about their sensory experiences and revealed the importance of context and the multisensory nature of children’s experiences.
Abstract: First-person perspectives of children with autism spectrum disorder are rarely included in research, yet their voices may help more clearly illuminate their needs. This study involved phenomenological interviews with children with autism spectrum disorder (n = 12, ages 4-13) used to gain insights about their sensory experiences. This article addresses two study aims: determining the feasibility of interviewing children with autism spectrum disorder and exploring how they share information about their sensory experiences during the qualitative interview process. With the described methods, children as young as 4 years old and across a broad range of autism severity scores successfully participated in the interviews. The manner with which children shared information about their sensory experiences included themes of normalizing, storytelling, and describing responses. The interviews also revealed the importance of context and the multisensory nature of children's experiences. These findings contribute strategies for understanding the sensory experiences of children with autism spectrum disorder with implications for practice and future research.
TL;DR: The findings highlight the difficulties of assessing mental health problems in adults with autism and the need for appropriately validated measures.
Abstract: Data on psychiatric problems in adults with autism are inconsistent, with estimated rates ranging from around 25% to over 75%. We assessed difficulties related to mental health in 58 adults with autism (10 females, 48 males; mean age 44 years) whom we have followed over four decades. All were of average non-verbal intelligence quotient when diagnosed as children. Overall ratings of mental health problems were based on data from the Family History Schedule (Bolton et al., 1994). Informant reports indicated that many of the cohort (44%) had experienced no mental health problems in adulthood; 28% had experienced mild to moderate difficulties, 23% had severe and 5% very severe problems. Depression was the most commonly reported problem. Among those adults (n = 22) able to report on their own mental state, again many (45%) reported no mental health problems, although 27% reported very severe mental health problems related to anxiety, depression and/or obsessive–compulsive symptoms. Informant ratings of poor me...