Relations between empathy and anxiety dimensions in inpatient adolescents

Background and objectives: A better understanding of the relationships between empathy and internalizing disorders is needed to plan therapeutic interventions for children and adolescents. Several studies have revealed positive relations of internalizing symptoms to personal distress and affective empathy. However, there is a lack of studies that take into account the multidimensional nature of anxiety in its relation to empathy.

Design: Structural equation modeling was used to test the moderated mediation model of the relations between empathy, depression and anxiety dimensions and the moderating role of gender on these associations in inpatient adolescents.

Method: A total of 403 inpatient adolescents aged 12–17 years completed the Basic Empathy Scale, the Multidimensional Anxiety Scale for Children, and the Beck Depression Inventory-II.

Results: Affective empathy was positively related to all the anxiety dimensions – most strongly to separation/panic and humiliation/rejection anxiety, whereas cognitive empathy was negatively related to social and separation/panic anxiety. Relations between affective and cognitive empathy and anxiety were partly mediated by depressive symptoms. No evidence of a moderating role of gender has been found.

Conclusions: Our results suggest that processes associated with empathy may play a role in the development or maintenance of anxiety symptoms.     

Teaching students with autism spectrum disorder to tolerate haircutting

We describe intervention with 2 adolescent male students who had autism spectrum disorder (ASD) and resisted haircutting performed by care providers at a residential school. The students were exposed to a graduated hierarchy of steps including the presence of hair clippers, and increased duration of hair clippers against their scalp and hair. Edible reinforcement was presented contingent on completion of a step without interfering behavior. Both students learned to tolerate all of the steps in the graduated hierarchy and a full haircut with maintenance at 2-, 4-, and 6-month follow-up. The study supports previous tolerance-training research with children and youth who have intellectual and developmental disabilities and resist personal care and hygiene routines.     

Use of non-directive therapy for adolescents with autism spectrum disorder: A systematic review

In this review, we systematically explored research on the use of non-directive therapies with adolescents (aged 11–18 years) with autism spectrum disorder (ASD). N = 12 studies were eligible for inclusion. The findings suggested four therapeutic components which were consistently present across all non-directive interventions and held similarities with play therapy principles: (a) collaboration between adolescent and therapist; (b) adolescent-led discussions; (c) reflection and reframing; and (d) encouragement and acceptance of the adolescent as they were. Therapeutic outcomes improved when the therapists had an understanding of ASD in order to tailor the intervention to the individual. Future primary research investigating the applicability of play therapy principles and limitations is discussed.     

The relationship between premature birth and caregiver first concern in toddlers with autism spectrum disorder: A brief report

The current study examines the relationship between premature birth and the age at which caregivers first become concerned with their child’s development in a sample of 84 toddlers with autism spectrum disorder (ASD). The participants were split into two groups: those born prematurely and those born full term. The results indicate that the age of caregiver first concern is significantly younger for those born prematurely than those born full term. The average age caregivers reported first becoming concerned about their child’s development was around 7 months for participants born prematurely and around 13 months for participants born full term. Possible explanations for the results and their implications are discussed.     

孤独症谱系障碍者的视觉-空间工作记忆缺陷及脑机制

孤独症谱系障碍(ASD)个体存在视觉-空间工作记忆加工缺陷,主要表现在4个方面,即随认知负荷增大而缺陷加重、工作记忆容量不足、工作记忆加工过程中的注意功能失调和对刺激进行整体组织的能力缺乏。神经机制研究显示,ASD个体存在明显的额-顶工作记忆网络激活异常,以及相关脑区的脑结构、白质连接异常。另外,作为基础性的认知加工过程,ASD个体的视觉-空间工作记忆各加工环节与言语工作记忆、执行功能、社会认知等因素均存在交互影响。纵观目前研究成果,未来研究可从研究手段、机制探究和干预训练三方面入手,着眼于研究方法的生态化和多元化,揭示客体和空间工作记忆的机制分离,并着力开发更具针对性的干预训练模式。     

Effects of a problem-solving strategy on the independent completion of vocational tasks by adolescents with autism spectrum disorder

Individuals with autism spectrum disorder (ASD) often have few employment opportunities and a lower job quality than individuals of typical development. Social deficits and lack of independence may contribute to underemployment and unemployment of individuals with ASD. The ability to solve problems might ameliorate some of these barriers. We taught four adolescents with ASD a problem-solving strategy (i.e., use of a textual activity schedule) to assist with independent completion of vocational tasks in the face of three types of problems (e.g., missing or broken items) and nonproblem situations. Following introduction of the problem-solving strategy, all four participants independently completed the tasks when a problem was presented and responding generalized to untaught vocational tasks.     

CHRM3基因与孤独症谱系障碍

孤独症谱系障碍是一类具有遗传基础的儿童发展障碍疾病。近些年, 研究者们从分子病理学层面发现中枢胆碱能神经系统异常与孤独症患者认知和行为异常存在相关性。尸检研究、临床案例、动物模型研究均发现毒蕈碱型(M型)乙酰胆碱受体异常和孤独症的发生有着密切的关系。在以小鼠为模型的行为学研究中, 编码毒蕈碱型乙酰胆碱受体Ⅲ亚型的CHRM3基因突变会导致小鼠出现认知障碍、刻板行为等孤独症样表现。深入了解CHRM3基因的功能将能够帮助研究者进一步解释孤独症的相关行为特征, 为孤独症儿童教育方案的制定提供新的思路和方法。     

Choice for reinforced behavioral variability in children with autism spectrum disorder

Although individuals with autism spectrum disorder (ASD) tend to behave repetitively, certain reinforcement contingencies (e.g., lag schedules) can be used to increase behavioral variability. In a lag schedule, reinforcers only follow responses that differ from recent responses. The present study was designed to promote variable play behavior in preschoolers with ASD interacting with playsets and figurines and to assess preference for variability and repetition contingencies. Data have shown a preference for variability in pigeons and college students, but this effect has not been explored in clinical populations. In this experiment, preschoolers with ASD were taught to discriminate between variability and repetition contingencies. Only play behaviors that met a lag schedule were reinforced in the presence of one color, and only repetitive behaviors were reinforced in the presence of another. After differential performance was established, participants experienced a concurrent chains schedule. Participants chose between the colors taught in training and then completed a play session with the selected contingency. One participant selected variability and repetition equally. The other participants showed a slight preference for variability. These results indicate that some individuals with ASD may play repetitively, not because they prefer repetition, but because they require additional teaching to play variably.     

Teaching children with autism spectrum disorder to tact olfactory stimuli

Research on tact acquisition by children with autism spectrum disorder (ASD) has often focused on teaching participants to tact visual stimuli. It is important to evaluate procedures for teaching tacts of nonvisual stimuli (e.g., olfactory, tactile). The purpose of the current study was to extend the literature on secondary target instruction and tact training by evaluating the effects of a discrete‐trial instruction procedure involving (a) echoic prompts, a constant prompt delay, and error correction for primary targets; (b) inclusion of secondary target stimuli in the consequent portion of learning trials; and (c) multiple exemplar training on the acquisition of item tacts of olfactory stimuli, emergence of category tacts of olfactory stimuli, generalization of category tacts, and emergence of category matching, with three children diagnosed with ASD. Results showed that all participants learned the item and category tacts following teaching, participants demonstrated generalization across category tacts, and category matching emerged for all participants.     

Caregiver-implemented toilet training procedures for children with autism spectrum disorder

Children with Autism Spectrum Disorder often exhibit deficits in daily living skills, including toileting skills. Previous studies have evaluated components of common toilet training practices, including differential reinforcement, sit schedules, fluid loading, underwear, and wet alarms. The purpose of this study was to replicate and extend previous work by delivering all coaching remotely. Three caregiver-child dyads participated in this study. A researcher coached caregivers on the implementation of the protocol using a modified behavioral skills training approach via telehealth. Caregivers submitted daily toileting data and weekly audio recordings for treatment integrity checks. The sit schedule fading was individualized to meet the needs and preferences of each family. All caregivers implemented the protocol with high integrity. Two participants met the mastery criteria at the 90-min sit schedule and maintained performance at the 1- and 6-week maintenance follow up probes. The third participant, despite an interruption of treatment, also reached mastery.     

Effects of textual prompts and feedback on social niceties of adolescents with autism spectrum disorder in a simulated workplace

Previous research demonstrates the efficacy of behavioral skills training with a textual prompt to establish greetings and conversational skills. This study examined the efficacy of a brief intervention of textual prompts with performance feedback for increasing social niceties of adolescents and young adults with autism spectrum disorder in a simulated workplace. Target social niceties included “Do you have a minute?” when a participant initiated an interaction and “Thank you for your time” when a participant ended the interaction. Results revealed this intervention was effective for 7 of 9 participants. This study expands upon previous studies by showing the efficacy of a resource-efficient training on acquisition and generalization of social niceties by people with autism spectrum disorder.     

Differential reinforcement to decrease stereotypy exhibited by an adult with autism spectrum disorder

Motor and vocal stereotypies are behaviors commonly exhibited by individuals with autism spectrum disorder (ASD). Stereotypy may impede and interfere with learning new skills and decrease work performance in employment settings. Previous research has evaluated effective interventions for stereotypy; however, they have typically focused on treating stereotypy exhibited by children in structured settings. We evaluated the practicality of implementing a simple differential reinforcement of other behavior procedure with an adult with ASD in multiple, naturalistic environments. Results showed rapid decreases in motor and vocal stereotypies upon implementation of the intervention and maintenance of low levels of behavior. These data highlighted the successful treatment of stereotypy exhibited by an adult with a long history of exhibiting these behaviors. Treatment effects were replicated across multiple, naturalistic environments.     

Bidirectional associations between affective empathy and proactive and reactive aggression

Preliminary evidence indicates that affective empathy is differentially related to proactive and reactive functions of aggression. However, additional longitudinal research is needed to understand the potential reciprocal nature of these links. The current study examined the bidirectional associations between affective empathy and proactive and reactive aggression over a 6-month period during middle childhood, with attention to potential gender differences. Data were collected from 294 elementary school children (52% girls; M = 9.25 years; SD = 0.944 years) and their homeroom teachers. Affective empathy was assessed using self-reports, and teachers provided ratings of children's functions of aggression. Data were collected during the fall and spring of one academic year. Overall, results suggest some evidence that affective empathy and functions of aggression are reciprocally linked over time. As predicted, Time 1 empathy was inversely associated with Time 2 proactive aggression and Time 1 reactive aggression was inversely associated with Time 2 empathy. Contrary to expectations, Time 1 proactive aggression was marginally positively associated with Time 2 empathy, and Time 1 empathy was not significantly associated with Time 2 reactive aggression. These prospective links did not differ according to gender. Implications and directions for future research are discussed.     

An extension of commonly used toilet-training procedures to children with autism spectrum disorder

The current study evaluated a toilet-training treatment package described by Greer et al. (2016) with children diagnosed with autism spectrum disorder (ASD). Most of the current research on toilet-training interventions for children with ASD are replications and modifications of Azrin and Foxx (1971) or (more recently) LeBlanc et al. (2005). However, these procedures are composed of components that are not included in studies with typically developing (TD) children. For example, Greer et al. evaluated the effectiveness of three typical components within a toilet-training package, mostly with TD participants: a 30-min sit schedule, placing participants in underwear, and differential reinforcement. The primary purpose of the current study was to replicate and extend the treatment package described by Greer et al. to children with ASD. A secondary purpose was to evaluate modifications necessary for individualized toilet training when the commonly used components were ineffective. The results of Greer et al. were replicated for 11 participants with ASD in the current study, suggesting that intensive toileting interventions (e.g., interventions requiring overcorrection, reprimands, and dense sit schedules) may only be necessary for a subset of individuals with ASD.     

Differential reinforcement-of-low-rate procedures: A systematic replication with students with autism spectrum disorder

Becraft, Borrero, Davis, Mendres-Smith, and Castillo (2018) studied the effects of two different types of DRL schedules (full session and spaced responding) under 2 sets of stimulus conditions (with and without signals). Reduced rates of responding maintained under both types of DRL schedules, when signals were included. The present study represents a replication of procedures by Becraft et al. involving learners with autism spectrum disorder (ASD). The results replicated those of Becraft et al. in that responding in both full-session and spaced-responding DRL schedules was low, but not eliminated. These results provide preliminary evidence to suggest that children with ASD are responsive to signals in DRL arrangements, which may set the stage for evaluation of signaled DRL arrangements for socially significant response forms.     

Using intraverbal training to increase symbolic play in children with autism spectrum disorder

We evaluated the effects of an intraverbal training procedure on the acquisition, maintenance, and generalization of object‐substitution symbolic play in three 6‐year‐old Korean boys with autism spectrum disorder. A multiple probe across four behaviors design was used. All children acquired target symbolic play behavior, and novel responses emerged in training and follow‐up conditions. Generalization of object substitutions to untaught objects occurred in all three children. Free play observations indicated that symbolic play emerged in one child, and functional play increased in all three children.     

Temporal regulation of children with autism spectrum disorder exposed to a differential-reinforcement-of low-rates schedule

This study investigated temporal adjustment of children with autism spectrum disorder under a differential-reinforcement-of-low-rates (DRL) schedule. Sixteen participants, aged 3.2 to 7 years, were exposed to two conditions, DRL 5 s and DRL 20 s. Children participated in 7 sessions in each condition, except for 1 participant who attained the adjustment criteria in the DRL 5-s schedule. Temporal adjustment was measured with the proportion of reinforced interresponse times (IRTs) and the mean IRT. The operant response was a press on a touch screen and the reinforcers were cartoons. IQ and receptive language were measured prior to the DRL sessions. Results showed that the mean proportion of reinforced IRTs was slightly higher in the DRL 5-s schedule. The mean IRT was above the IRT requirement in both conditions. However, substantial individual variability was observed. Children with higher IQ and receptive language scores presented a greater proportion of reinforced IRTs in both conditions. Moreover, participants who adjusted their responses to the DRL 5-s schedule were more likely to adjust responding to the DRL 20-s schedule. This suggests that some children might be more sensitive to reinforcement contingencies than others. This study points at future research in the field of timing in children.     

Emergent control for play responses following instructive feedback for children with autism spectrum disorder

Play provides children learning opportunities in the natural environment to acquire communication skills. While working to establish skills that may lead to additional leisure and social opportunities of children with autism spectrum disorder (ASD), procedures need to be both effective and efficient. One way to increase efficiency of teaching is through the use of instructive feedback (IF). Therefore, the purpose of the current study is to systematically replicate and extend previous research by examining if play behaviors emerge when using IF to teach conceptually related primary (i.e., tacts) and secondary targets (i.e., play skills). The results of the present study extend previous research by demonstrating the effectiveness of teaching tacts to individuals with ASD, and that using IF during tact training can help promote the acquisition of play skills.     

人工智能辅助的自闭症早期患者的筛查与诊断

自闭症谱系障碍(AutisticSpectrumDisorders,ASD)的症状早在婴幼儿期就会显现,越早发现,越早干预,治疗效果越好。传统自闭症早期筛查与诊断在评估方法、流程上存在局限,无法满足大规模筛查和诊断需求。随着人工智能技术的快速发展,使用智能化方法进行自闭症早期大规模无感筛查与诊断逐渐成为可能。近10年间,国内外对自闭症智能化识别方法的探索在经典任务行为、面部表情和情绪、眼动、脑影像、运动控制和运动模式、多模态6个领域积累了丰富的研究成果。未来研究应围绕构建国内自闭症早期智能医学筛查与诊断体系,开发针对婴幼儿患者的筛查工具,构建融合多模态数据的自闭症婴幼儿智能化识别模型,建立结合脑影像技术的自闭症精细化诊断方法等方面来开展。     

Gender variance in children and adolescents with autism spectrum disorder from the National Database for Autism Research

Previous studies suggest elevated rates of gender variance (GV), the wish to be of the other gender, in those with autism spectrum disorder (ASD). This study aimed to understand the rate of GV in children and adolescents with ASD and explore differences in sex, age, and emotional-behavioral problems relative to those referred to clinical services for mental health concerns (“referred”) and to the general population (“non-referred”). A secondary analysis of data from the National Database for Autism Research was used to explore GV using a child behavior checklist, parent report, in 176 children aged 6 to 18 year with ASD compared to referred and non-referred cohorts. GV was present in 4.0% of the ASD group, higher than for the non-referred group (0.7%) but similar to the referred group (4.0%). There were no significant sex differences in GV prevalence (males 3.7%, females 6.0%) in the ASD group. That the GV rate was elevated in ASD relative to non-referred samples but similar to clinically referred samples suggests that elevated rates of GV were not specific to ASD and may be more broadly associated with neurodevelopmental and psychiatric disorders of childhood. Further population-based research using clinical assessment for gender dysphoria is required in individuals with ASD and other neurodevelopmental disorders.