Showing papers in "Research in Autism Spectrum Disorders in 2011"

Abstract: Undoubtedly, one of the most frequently studied conditions in the field of mental health today is the autism spectrum disorders (ASD). One of the most controversial topics with respect to this population is the prevalence of this spectrum of disorders. The number of cases has risen dramatically, and various hypotheses have been put forward to explain this phenomenon. Among the most frequently addressed possibilities are expanded diagnostic criteria, more awareness of the disorder, diagnosis at earlier ages, and the recognition that ASD is a lifelong condition. The current paper is a review of the extant literature on this topic. Current status of prevalence research is reviewed and conclusions about the current state of the research are discussed.

Abstract: Since Kanner's first account of children with autism, there has been extensive research into the presentation of and interventions for Autistic Disorder. However, only a small proportion of this literature has focused on the progress of individuals with autism as they move from childhood and adolescence into adulthood. This paper is a critical review of the current empirical studies that have addressed prognosis in this population in terms of diagnostic severity, cognitive functioning, language, academic performance and social outcomes. The overall pattern of change is considered and factors that appear to influence or predict outcome in adulthood are reviewed. Limitations in this pool of literature and recommendations for future studies are discussed.

Abstract: Excitement and controversy have surrounded the effectiveness of Early Intensive Behavioral Intervention (EIBI) for young children with autism. The purpose of this meta-analysis was to investigate the effectiveness of EIBI based on applied behavior analysis in young children with Autism Spectrum Disorders (ASD). There were 11 studies with 344 children with ASD. Quality of studies was assessed using the Downs and Black Checklist. Experimental groups who received EIBI outperformed the control groups on IQ, non-verbal IQ, expressive and receptive language and adaptive behavior. Differences between the experimental and control groups were 4.96–15.21 points on standardized tests. These results strongly support the effectiveness of EIBI.

Abstract: This paper reviews the complex literature on language acquisition in the autism spectrum disorders (ASD). Because of the high degree of interest in ASD in the past decade, the field has been changing rapidly, with progress in both basic science and applied clinical areas. In addition, psycholinguistically-trained researchers have increasingly begun to test theories of language acquisition in studies of ASD, because it is characterized by meaningful differences in ability across a wide range of language, social, and cognitive domains. As such, ASD has served as a “natural laboratory” in which to explore a variety of theories of language acquisition. We provide an overview of the current state of knowledge of language acquisition in autism spectrum disorders, also noting gaps in our current knowledge. We also review implications of this work for theories of typical language acquisition, and discuss some promising future directions. While the pragmatic deficits that characterize autism spectrum disorders are widely acknowledged, both clinicians and researchers should consider the phonological and morphosyntactic differences that likely play an important role in language comprehension and production for affected children.

Abstract: This study examined the relationship between child symptom severity, parent broader autism phenotype (BAP), and stress and depression in parents of children with ASD. One hundred and forty-nine parents of children with ASD completed a survey of parenting stress, depression, broader autism phenotype, coping styles, perceived social support, and child symptom severity. Parents reported elevated parenting stress and depression relative to normative samples. A path analysis indicated that both child symptom severity and parent BAP were positively correlated with these outcomes. The relationship between BAP and the outcome measures was partially mediated by maladaptive coping and social support and the relationship between child symptom severity and outcomes was partially mediated by social support.

Abstract: This study investigated the utility of self-report measures to screen for psychiatric comorbidities in autism spectrum disorders (ASDs). Thirty-eight 10-17 year olds with an ASD and without mental retardation completed: the Children's Depression Inventory-Short version (CDI-S), Revised Children's Manifest Anxiety Scale (RCMAS), Conners-Wells Adolescent Self-report Scale-Short edition (CASS-S), and Short Leyton Obsessional Inventory-Child Version (SLOI-CV). Their parents were interviewed with the Autism Comorbidity Interview-Present and Lifetime (ACI-PL) to establish psychiatric diagnoses. Sensitivity, specificity, positive and negative predictive values, and reliability coefficients were calculated for each self-report and compared to values from literature. The CDI-S and CASS-S yielded a high number of false negatives, with lower sensitivities and specificities in the sample than the literature. There was a nearly significant difference in total mean RCMAS scores between participants with and without anxiety, though again the means for both groups were below the threshold of concern. The SLOI-CV yielded a high false positive rate. All four instruments had reliability coefficients comparable to literature values. Results must be considered preliminary due to sample size. However, the findings suggest that although self-report instruments may provide useful information in the diagnosis of psychiatric comorbidities in ASD, caution must be exercised in their interpretation.

Abstract: A preponderance of males with autism spectrum disorders (ASD) has been evident since the initial writings on the topic. This male predominance has consistently emerged in all ASD research to date in epidemiological as well as clinical populations. Despite this long recognized gender disparity in ASD, surprisingly there is a paucity of research addressing gender as it relates to core ASD symptom presentation. Gender differences may manifest with regard to symptom domains, severity, breadth, and so forth. The present review will discuss background (e.g., history, prevalence), assessment issues, gender differences in typically developing individuals in domains relevant to ASD, an in depth review of the literature base on the nature and etiology of gender differences in ASD, as well as future research directions and implications.

Abstract: For individuals with autism spectrum disorders (ASD), the use of technology to provide intervention, particularly targeting the core social–communication deficits of the disorder, is promising. This literature review will examine studies that have used innovative technology, such as interactive computer programs and virtual reality, to deliver direct intervention focused on the development of social and communication skills to individuals with an ASD. Given that the study and use of such programs is still relatively new, the majority of the published literature is descriptive or exploratory in nature. As such, this review will provide a summary of these initial studies and preliminary findings, and provide suggestions for the future development and evaluation of similar programs.

Abstract: Maternal ratings of anxiety, depression, and irritability were analyzed in 1390 children (6–16 years of age), including 233 children with high functioning autism (HFA, IQ ≥ 80), 117 children with low functioning autism (LFA, IQ

Abstract: Although social skills deficits represent core symptoms of Asperger Syndrome and High Functioning Autism, there is limited research investigating the empirical validity of social skills interventions currently being used with these populations. This literature review compares three types of social skills training groups: traditional, cognitive behavioral, and parent–inclusive. The studies included in this review provide preliminary evidence for the efficacy of group-based social skills interventions among children and youth diagnosed with Autism Spectrum Disorders, although few used comparison group or randomized control trial designs. Limitations within the literature, as well as future directions, are discussed.

Abstract: Multiple sleep problems have been reported in children with Autism Spectrum Disorder (ASD). The association of poor sleep with problematic daytime behaviors has been shown in small studies of younger children. We assessed the relationship between sleep and behavior in 1784 children, ages 2–18, with confirmed diagnosis of ASD participating in the Autism Treatment Network. Sleep problems were identified using the Children's Sleep Habits Questionnaire (CSHQ). The Parental Concerns Questionnaire (PCQ) was used to evaluate behavioral concerns and to define good or poor sleepers. Poor sleepers had a higher percentage of behavioral problems on all PCQ scales than good sleepers. Over three-fourths had problems with attention span and social interactions. Further delineation of this phenotype will help guide future interventions.

Abstract: Social interaction is a fundamental problem for children with autism spectrum disorders (ASD). Various types of social skills interventions have been developed and used by clinicians to promote the social interaction in children with ASD. This meta-analysis used hierarchical linear modeling (HLM) to examine the effectiveness of peer-mediated and video-modeling approaches, the two approaches that are most commonly used for social skills training of children with ASD. The two approaches, with the average effect size of 1.27 (peer-mediated approach: mean = 1.3, 95% CL = 1.10–1.50, N = 9; video-modeling approach: mean = 1.22, 95% CL = 0.65–1.78, N = 5) were found to significantly and equally improve the social performance of children with ASD. In addition, age functioned as a significant moderator in the effectiveness of the intervention. Implications of the results and limitations of this study are discussed.

Abstract: Some individuals with autism engage in physical aggression to an extent that interferes with not only their quality of life, but also that of their parents and siblings. Behavioral and psychopharmacological treatments have been the mainstay of treatments for aggression in children and adolescents with autism. We evaluated the effectiveness of a mindfulness-based procedure, Meditation on the Soles of the Feet , in helping three adolescents to manage their physical aggression. This procedure required the adolescents to rapidly shift the focus of their attention from the aggression-triggering event to a neutral place on their body, the soles of their feet. Incidents of aggression across the three adolescents ranged from a mean of 14–20 per week during baseline, 4–6 per week during mindfulness training, including zero rates during the last 4 weeks of intervention. Aggression occurred a rate of about 1 per year during a 3-year follow-up. Our results suggest adolescents with autism can learn, and effectively use, a mindfulness-based procedure to self-manage their physical aggression over several years.

Abstract: The prevalence of challenging behaviors in the autism spectrum disorders (ASD) population is often assumed to be high but relatively little research has actually been published on it. Furthermore, challenging behaviors are likely to impede progress in evidence-based treatment programs, such as early intensive behavioral intervention (EIBI). Little or no previous research has evaluated the prevalence of various topographies of challenging behavior in a population of children with ASD receiving EIBI services, nor evaluated the relationship between such behaviors and the severity of ASD symptoms. Using data from the ASD–DC and the ASD–BPC in 84 children with autism receiving EIBI services, the current study conducted a regression analysis of relations between endorsement of challenging behaviors and ASD symptom severity. Results indicated that 94% of the sample reported the presence of challenging behavior, stereotypical behaviors were the most commonly reported, and that the presence of challenging behavior was predicted by ASD severity.

Abstract: The Wisconsin Card Sorting Task (WCST) is the only cognitive flexibility task that has consistently shown deficits in individuals with an autism spectrum disorder (ASD). As this is the only task characterized by limited explicit task instructions and a high degree of disengagement required to perform the switch, we hypothesized that cognitive flexibility deficits of individuals with ASD might only become apparent in situations fulfilling these requirements. However, the WCST involves various additional cognitive processes besides switching, making it uncertain whether difficulties are indeed due to cognitive flexibility impairments. The aim of this study was to investigate whether individuals with ASD show cognitive flexibility impairments on a more controlled task-switching variant of the WCST, still fulfilling both requirements. We therefore developed such a task and administered it to 40 high-functioning children with ASD and 40 age- and IQ- matched typically developing controls. As predicted, individuals with ASD made more perseveration errors and had a significantly higher switch cost than typically developing controls, but they performed equally well on the control measures.

Abstract: Children with autism spectrum disorder show deficits in social skills such as initiating conversation, responding in social situations, social problem-solving, and others. These deficits are targeted through the use of social skills interventions, some of which use a technology-based approach as a resource-efficient alternative to common forms of instruction. The current literature review aims to (a) determine the number of empirical studies using a technology-based social skills intervention, (b) explore the features of social skills targeted in these studies, and (c) analyze the number of studies reporting reliability of the dependent and independent variables. Results indicate that a majority of the studies relied on a video or DVD to deliver the intervention (modeling or feedback), were conducted in school settings, and targeted more than one social skill. The most common social skill addressed was initiating conversation followed by play skills. All but one study included standardized assessment before treatment; however, none of the studies used a published social skills assessment. Like previous research, reliability of the dependent variables was common; however, reliability of the independent variables was infrequent.

Abstract: Cyber bullying or electronic bullying refers to bullying that occurs through the Internet or cellular phones. With the rise of technology, researchers have shown a keen interest in the topic of cyber bullying. However, that interest has not extended to individuals with special needs. To address this gap in the literature, the current study examined the prevalence of both “traditional” bullying and cyber bullying in youth with ADHD and/or Asperger's Syndrome, and assessed the social, psychological, and health effects of bullying on participants. In addition, the study addressed the disconnect between parents’ understanding of their child's online experiences and their child's actual experiences in the virtual world. Forty-two children and youth reported high rates of bullying victimization through both traditional and electronic means. Individuals not involved with bullying showed greater levels of physical and psychological health relative to those involved with bullying. Parents and children disagreed on a number of issues related to use of the Internet, indicating the need for more clear communication between parents and their children. The results are discussed in terms of theory of mind, both for self and for others.

Abstract: Little is known about the manifestation of aggressive behavior in children with autism, although it is commonly cited as a significant problem. Existing reports in autism do not emphasize subtypes of aggression, whereas distinguishing forms of aggression is commonplace in the typically developing literature. This study compared a sample of 121 children aged 3–20 years with autism spectrum disorders (ASD) to 244 children with other intellectual and developmental disabilities (IDD; age 4–21 years). Item- and subscale-level data from the Children's Scale for Hostility and Aggression: Reactive/Proactive (C-SHARP) were reported. Children with ASDs received higher ratings than those with IDD on several subscales tapping physical and reactive aggression. Within the ASD group, children with Asperger's disorder were rated significantly higher than children with autism on subscales tapping covert and verbal behaviors. Results indicate that at least some types of aggression were more common in children with ASDs than those with IDDs.

Abstract: This study reports on predictors of outcome in 332 children, aged 2–7 years, enrolled in the community-based Intensive Behavioral Intervention (IBI) program in Ontario, Canada. Data documenting children's progress were reported in an earlier publication ( Perry et al., 2008 ). The present paper explores the degree to which four predictors (measured at intake to IBI) are related to children's outcomes: age at entry, IQ, adaptive scores, and autism severity. Outcome variables examined include: post-treatment scores for: autism severity, adaptive behavior, cognitive level, rate of development in IBI, and categorical progress/outcomes (seven subgroups). All four types of predictors were related to children's outcomes, although initial cognitive level was the strongest predictor. In addition, two subgroups of the sample are examined further. Children who were most successful in the program and achieved average functioning had higher developmental levels at intake, were considerably younger than the rest of the children, and were in treatment longer than children in other outcome categories. Children who were least successful in the program and made essentially no progress did not differ appreciably from the remainder of the group. Implications of these results for decision-making are discussed.

Abstract: The purpose of our study was to determine differences in autism severity and symptoms as a function of IQ, age, SES, gender, and race while simultaneously controlling these variables in 777 children with autism using a comprehensive measure evaluating 30 core and associated symptoms of autism. The children were 1–17 years of age with IQs from 9 to 146. Results showed that autism severity (total score on the Checklist for Autism Spectrum Disorder) and the 30 CASD item scores were not related to gender or race. However, the two CASD items reflecting mood and behavior problems were significantly more common in the lower than higher SES group. Our findings revealed significant, though modest, IQ and age effects. Autism severity increased with decreasing IQ and age, as did the frequency of 14 of the 30 CASD symptoms. The direction of IQ and age effects was the opposite for five symptoms and was nonsignificant for 11. Though IQ was associated with autistic symptoms, the majority of children with both high functioning and low functioning autism had most CASD symptoms and their symptom profiles were overwhelmingly similar. This supports the DSM-V Work Group's position that autism is a single spectrum disorder.

Abstract: The literature has revealed that autistic persons of all ages show an interest in sexuality and relationships, but the poor social and communication skills found among those with autism hinders the experience of this. Unfortunately, most research to date in this domain has relied exclusively upon parental or caregiver reports. Thus there remains a need for research to be undertaken in this area based on direct reports from autistic individuals. We hypothesised that compared to Typically Developing (TD) persons, persons with High-Functioning Autism (HFA) would reveal lesser levels of sexual experience, lower levels of sexual and social behaviour, and less understanding of privacy on various subscales of the Sexualised Behaviour Scale. The results of this present study supported the hypothesis on all scales except Privacy and Sexualised Behaviour. Overall, compared to TD individuals, HFA individuals engaged in fewer social behaviours, had less sex education and fewer sexual experiences, had more pronounced concerns for the future, and showed similar levels of privacy knowledge and public sexualised behaviour. These findings suggest a need for specialised sex education programs for autistic populations; further, since social behaviour was significantly lower for autistic individuals and future concerns were higher, this suggests that sex education programs need to incorporate education about social rules to enhance social communication and understanding.

Abstract: Research in autism spectrum disorders (ASD) described individual differences in response to intervention. This study explored child and parental characteristics at baseline that predict outcomes in adaptive skills and acquisition of cognitive gains. Seventy-eight children aged 15–35 months diagnosed with ASD by standardized diagnostic tools were included. Evaluations of verbal and non-verbal abilities, adaptive skills and autism severity were obtained at pre-intervention (T1) and after one year of intervention (T2). At T2, children improved significantly in their verbal ability and the severity of autism symptoms was reduced. Outcome in adaptive skills was best predicted by baseline verbal ability and maternal age. Better verbal ability especially in those with severe autism symptoms, and older maternal age predicted better adaptive skills outcome. T1 autism severity, child's age and maternal age and educational attainment best predicted cognitive gains. Less severe autism symptoms, younger child's age at start of intervention, older maternal age and higher maternal education predicted greater cognitive gains with intervention. The study suggests biological factors including age, language abilities and autism severity and environmental factors including maternal age and education, impact the ability to benefit from early intervention in ASD.

Abstract: Symptoms of psychiatric disorders have been found to co-occur at high rates in those diagnosed with Autistic Disorder (AD). However, to date, no study has yet examined the developmental trajectory of comorbid psychiatric symptoms across the lifespan within the AD population. Therefore, the purpose of this study was to conduct a cross-sectional investigation of symptoms of anxiety across the lifespan, using a sample of individuals diagnosed with AD. This study utilizes a sample with an age range from infancy to adulthood. Endorsement rates of overlapping anxiety symptoms from measures that have been found reliable and valid for the specific purpose of examining psychiatric symptoms within the AD population are utilized for this study. Results indicate that there is a significant difference between different age cohorts on symptom endorsements of anxiety. Additionally, a cubic trend was found when examining the pattern of anxiety symptoms across the lifespan in those diagnosed with AD. That is, anxiety rises from toddlerhood to childhood, decreases from childhood to young adulthood, but again increases from young adulthood into older adulthood. Implications of these findings, limitations of this study, and future directions for research are discussed.

Abstract: The current study evaluated risk factors for the occurrence, frequency and severity of challenging behavior among a sample of individuals with a diagnosis of autism, under the age of eighteen, in Ireland. Age, gender, hours of intervention received, age at diagnosis, presence of challenging behavior at diagnosis and treatment type at diagnosis were not found to be significant predictors for the frequency or severity of challenging behavior. The participants’ IQ was found to be a significant predictor of the frequency and severity of the behaviors measured. Lower IQ predicted greater frequencies of stereotyped behavior, aggression and self-injurious behavior along with increased severity of stereotyped behavior and self-injurious behavior. The intervention participants were currently receiving was not significant in predicting the frequency of challenging behavior, nor the severity of aggressive or self-injurious behaviors. However, this variable was a significant predictor of severity of stereotyped behaviors with individuals currently in Applied Behavior Analysis interventions presenting with more severe stereotyped behavior than those currently in “eclectic” interventions. Additional findings and implications in relation to these variables are discussed.

Abstract: This literature review aims to interpret behavioural and electrophysiological studies addressing auditory processing in children and adults with autism spectrum disorder (ASD). Data have been organised according to the applied methodology (behavioural versus electrophysiological studies) and according to stimulus complexity (pure versus complex tones versus speech sounds). In line with the weak central coherence (WCC) theory of autism we aimed to investigate whether individuals with ASD show a more locally and less globally oriented processing style in the auditory modality. To avoid the possible confound of stimulus complexity, this influence was taken into account as an additional hypothesis. The review reveals that the identification and discrimination of isolated acoustic features (in particular pitch processing) is generally intact or enhanced in individuals with ASD, for pure as well as for complex tones and speech sounds. It thus appears that the local processing advantage is not influenced by stimulus complexity. Individuals with ASD are also less susceptible to global interference of speech-like material. A deficit in global auditory processing, however, is less universally confirmed. We propose that the observed pattern of auditory enhancements and deficits in ASD may be related to an atypical pattern of right hemisphere dominance. As the right and left hemisphere are relatively more specialized in spectral versus temporal auditory processing, respectively, right hemisphere dominance in ASD could provoke enhanced pitch and vowel processing, whereas left hemisphere deficiencies might explain speech perception problems and temporal processing deficits.

Abstract: The purpose of this review is to provide a systematic analysis of studies investigating computer-based interventions (CBI) to improve literacy skills (e.g., reading, writing, and vocabulary) in students with autism spectrum disorders (ASD). This review synthesizes intervention outcomes, appraises the certainty of evidence, and describes software features and system requirements for each CBI. Across studies, CBI's effect on literacy skills was inconsistent. Some studies reported significant results and large effect sizes and other studies reported no improvements. Given the heterogeneity of the participants and the wide variety of literacy skills targeted for instruction, it is not possible from the existing literature to determine the variables most likely to be associated with effective CBI. Future research addressing this area as well as the relative effectiveness of CBI versus person delivered literacy instruction is warranted.

Abstract: This study evaluated the efficacy of a 14-week aquatic program on physical fitness and aquatic skills for children with autism spectrum disorders (ASD) and their siblings without a disability. Children with ASD (n = 15) and their siblings (n = 15), between 7 and 12 years (8.55 ± 2.19 years) participated. In the first 14-week phase, 14 children (group A: ASD, n = 7; siblings, n = 7) received the aquatic program while 16 children (group B: ASD, n = 8; siblings, n = 8) did not. The arrangement was reversed in the second phase of another 14 weeks. Both groups continued their regular treatments/activities throughout the study. Improvements were seen in aquatic skills and physical fitness components except subtest body composition for group A and group B subsequent to aquatic program. The results provide evidence that intervention can be developed to promote motor skills and physical fitness components for children with ASD and their siblings.

Abstract: This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill development in children, quality of life and stress for parents. Eligible (diagnosed ASD, preschool age) participants were randomised into 2 groups HB (n = 28) and CB (n = 28). A WL (n = 29) comparison group was also recruited. HB and CB groups had 12-month programs. Pre and post assessments were conducted using formal and informal measures. Children in the CB group improved significantly more than HB and WL groups on some social and communication measures. On parent measures outcomes varied with CB group parents making the most gains in perception of competence and quality of life. The small group centre-based program combined with parent program resulted in the best most cost effective outcomes for children and families however this is not an option for all. The CB program did not suit some children and families. The heterogeneity of the autism population indicates that a range of intervention options is necessary to meet the needs of children with autism and their families.

Abstract: Communication skills have been shown to have differing effects on levels of anxiety depending on whether or not a child has an autism spectrum disorder (ASD) or is typically developing. This article examined whether or not communication deficits differentially affect children with ASD compared to those without ASD. Ninety-nine children with autistic disorder (n = 33), Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; n = 33), and no diagnosis (n = 33) were examined using the Autism Spectrum Disorders Diagnostic for Children and Comorbidity for Children scales to determine their level of anxiety and degree of communication deficits. Results indicated that anxiety decreased as communication deficits increased for those with autistic disorder compared to those with PDD-NOS or no diagnosis; however, for those with PDD-NOS anxiety increased as communication deficits increased compared to those with no diagnosis. The importance and differential impact of communication deficits on anxiety for different groups is highlighted.

Abstract: Siblings of children with autism spectrum disorders (ASD) may be at an increased risk of adjustment problems. To examine possible predictors of adjustment difficulties in siblings, 70 mothers with at least one child with ASD and one typical child completed surveys of symptom severity in the child with ASD, impact of the child with ASD on the sibling, maternal depression, and broader autism phenotype (BAP) and behavioral adjustment in the typical sibling. A path analysis indicated that symptom severity in the children with ASD was positively associated with adjustment difficulties in the typical siblings; this relationship was mediated by maternal depression, but not sibling impact. Further, greater expression of the BAP in the siblings was associated with more adjustment difficulties, and this relationship was moderated by autism severity in the children with ASD, such that the relationship was stronger at high levels of ASD severity than at lower levels. These findings highlight the importance of assessing functioning of all family members when working with individuals with ASD and their families.