Adaptive skills and executive function in autism spectrum disorders.

There is active debate regarding the nature of executive dysfunction in autism. Additionally, investigations have yet to show a relationship between deficits in executive function and the everyday behavioral difficulties that may originate from them. The present study examined the relationship between executive abilities and adaptive behavior in 35 children with Autism Spectrum Disorders, using two parent reports of everyday functioning, the Vineland Adaptive Behavior Scales (VABS) and the Behavior Rating Inventory of Executive Function (BRIEF). Results found several relationships: The Initiate and Working Memory domains were negatively correlated with most domains of adaptive behavior. Also, the Communication and Socialization domains of the VABS were negatively correlated with several areas of executive functioning, suggesting that impairments in executive abilities are strongly associated with the deficits in communication, play and social relationships found in children with autism.     

Parent-child interaction and developmental outcomes in children with typical and elevated likelihood of autism

BackgroundEarly parent-child interactions have a critical impact on the developmental outcomes of the child. It has been reported that infants with a family history of autism and their parents may engage in different patterns of behaviours during interaction compared to those without a family history of autism. This study investigated the association of parent-child interactions with child developmental outcomes of those with typical and elevated likelihood of autism.MethodThis longitudinal study investigated the relationship between global attributes of parent-child interaction and the developmental outcomes of infant siblings with elevated likelihood (EL: n = 29) or typical likelihood (TL: n = 39) of developing autism. Parent-child interactions were recorded during a session of free-play when the infants were six months of age. Developmental assessments were carried out when the children were 12 and 24 months of age.ResultsThe intensity of mutuality was significantly higher in the TL group than in the EL group, and developmental outcomes were poorer in the EL group when compared to the TL group. Positive associations between parent-child interaction scores at six months and developmental outcomes at 12 months were observed only in the TL group. However, in the EL group, higher levels of infant positive affect and attentiveness paid to the caregiver is associated with lower autism symptoms. Due to the sample size and design of the study, the findings must be viewed as indicative.ConclusionThis preliminary investigation demonstrated differences in the association between parent-child interaction quality and developmental outcomes for children with typical and elevated likelihood for autism. Future studies should combine micro-analytic and macro-analytic approaches to parent-child interaction to further examine the nature of this relationship.     

Early and persistent motor difficulties in infants at-risk of developing autism spectrum disorder: A prospective study

Analyses were conducted in order to investigate motor development in younger siblings of children diagnosed with autism spectrum disorder (ASD). Infants at familial risk and low risk of developing ASD were tested longitudinally between the ages of 7 and 36 months. Data were analysed from motor scales on the Mullen Scales of Early Learning and the Vineland Adaptive Behaviour Scales at each age point. Significantly lower motor scores in at-risk infants were evident from the age of 7 months compared to the low-risk group. Infants who were later diagnosed with ASD demonstrated significantly poorer Fine Motor skills at 36 months than at-risk infants without any developmental difficulties. In addition, Gross Motor scores were highly correlated across the two measures for low-risk infants and infants who later developed ASD. Early motor difficulties may be an early indicator of a number of neurodevelopmental disorders, including ASD.     

Group Intensive Family Training (GIFT) for preschoolers with autism spectrum disorders

Early, intensive behavioral intervention is effective in treating children with autism spectrum disorders (ASDs), but can be cost prohibitive. Expenses may be defrayed if children can benefit from parents acting as therapists. This quantitative case series examines the efficacy of the Group Intensive Family Training (GIFT) program, a 12‐week (180 h, delivered 3 h each weekday) parent‐training for preschoolers with ASDs. Parents were individually mentored in the hands‐on application of behavior analytic techniques, implementing these skills in vivo within a group of six parent–child dyads. Seventy‐two parents and children (ages 25–68 months) with ASDs participated in this study. Children's cognitive and adaptive functioning was assessed before and after the intervention program. Analyses revealed average gains of eight standard score points on the Mullen Early Learning Composite and five standard score points on the Vineland Adaptive Behavior Composite after 12 weeks of treatment. Additionally, 14% and 11% of the children moved from the ‘impaired’ to ‘non‐impaired’ range on Mullen and Vineland composite scores, respectively. This preliminary investigation suggests that GIFT's behavioral, group parent‐training can lead to significant, yet cost‐ and time‐efficient gains for children with ASDs. Results must be interpreted with caution because of the absence of a control group. Copyright © 2008 John Wiley & Sons, Ltd.     

Standard errors of prediction for the vineland adaptive behavior scales

When a scale has been administered to the same person more than once, the question arises whether variation in obtained scores is due to measurement error or whether it reflects actual change in the examinee's functional level. This article offers standard errors of prediction and confidence intervals for the Vineland Adaptive Behavior Scales (VABS) that can help in making such decisions where these scales are concerned. The values presented here were derived from the normative data provided in the VABS manuals.     

Parent Report of Attention Problems Predicts Later Adaptive Functioning in Children with Brain Tumors

Children with brain tumors are at risk for psychological and behavioral difficulties. This study examined the ability of parent report of attention problems, withdrawal, anxiety, and depression, as well as IQ, to predict later adaptive functioning in 42 children treated for brain tumors. Age at diagnosis, SES, gender, and scores on the Neurological Predictor Scale (NPS) also were examined as predictors. Parent report of attention problems, SES, and NPS were significant predictors of later adaptive functioning across domains. This finding highlights the ability of parent report of attention problems to predict later adaptive functioning in children treated for brain tumors.     

Patterns of Growth in Adaptive Social Abilities Among Children with Autism Spectrum Disorders

Adaptive social skills were assessed longitudinally at approximately ages 2, 3, 5, 9, and 13 years in a sample of 192 children with a clinical diagnosis of autism (n = 93), PDD-NOS (n = 51), or nonspectrum developmental disabilities (n = 46) at age 2. Growth curve analyses with SAS proc mixed were used to analyze social trajectories over time. Both individual characteristics and environmental resources emerged as key predictors of adaptive social behavior outcome. The gap between children with autism and the other two diagnostic groups widened with time as the social skills of the latter groups improved at a higher rate. However, within diagnostic groups, improvement ranged from minimal to very dramatic. Children with autism most at risk for problems with social adaptive abilities later in life can be identified with considerable accuracy at a very young age so they can be targeted for appropriate early intervention services.     

Contributions of school classification,sex, and ethnic status to adaptive behavior assessment

This study investigated the contributions of school classification (regular, EMR) and sex and ethnic status to domain scores from the Public School Version of the AAMD Adaptive Behavior Scale. For this investigation data were available from a sample of more than 1,600 regular and EMR subjects approximately equally distributed between the sexes among white, black, and Spanish-background subjects from ages 7 to 13. The results replicated earlier findings that domain scores were valid for differentiating among children of different adaptive behavior levels as inferred from school classification status. Ethnic status was not a unique contributor to Part One domain scores when the effects of classification were accounted for. On the Part Two domains, ethnic status was a significant contributor to some domain scores, but not at all age levels. Similarly, sex made few unique contributions to domain scores on Part One of the Scale, but it was a significant factor on some domains of Part Two at some age levels.the author concluded that the Scale was valid for differentiating among pupils assigned to regular and EMR classes from ages 7 to 12. The failure of sex and ethnic status to make contributions to Part One domain scores suggests that there are common expectancies for personal independence and responsibility between boys and girls from different ethnic groups.From the analysis of the contributions of sex and ethnic status to the Part Two domains, the author inferred that difference in environmental tolerance for affective or emotional responses to the school or community environment was a more reasonable explanation than the inference that girls and boys or children grom different cultural backgrounds were inherently different with respect to these behaviors. The Public School Version of the AAMD Adaptive Behavior Scale is valid for assessing adaptive behavior of children in public school and relatively independent of effects attributable to sex or ethnic status.     

Adaptive behavior of retarded,slow-learner,and average intelligence children

Scores on the WISC-R and the AAMD Adaptive Behavior Scale, Part I, Public School Version, were obtained for 94 elementary school children referred for psychological services in a southeastern rural area. Some of the adaptive behavior scores differentiated among children classified as EMR, slow-learners, or average intelligence. Some of the domain subscores of the ABS seem of questionable validity and reliability.     

Genetic Studies of Autism: From the 1970s into the Millennium

Reviewers in the 1960s and early 1970s were skeptical about any substantial role for genetic factors in the etiology of autism. A realization that the 2% rate of autism in siblings (as estimated at that time) was far above the general population base rate, and that this suggested a possible high genetic liability, led to the first small-scale twin study of autism. The replicated evidence from both twin and family studies undertaken in the 1970s and 1980s indicated both strong genetic influences and the likelihood that they applied to a phenotype that was much broader than the traditional diagnostic category of autism. Medical and chromosomal findings also indicated genetic heterogeneity. Advances in molecular genetics led to genome-wide scans of affected relative pair samples with a positive log of the odds to base 10 score for a location on chromosome 7. The major remaining research challenges and the likely clinical benefits that should derive from genetic research are considered in relation to both current knowledge and that anticipated to emerge from research over the next decade.     

Sibling Relationships and Family Functioning in Siblings of Early Adolescents,Adolescents and Young Adults with Autism Spectrum Disorder

The purpose of the study was to investigate how family functioning (defined as the ability that family members hold to manage stressful events, and intimate and social relationships), the degree to which family members feel happy and fulfilled with each other (called family satisfaction), and the demographical characteristics of siblings (age and gender) impacted on sibling relationships. The Circumplex Model of Marital and Family Systems and Behavioral Systems constituted the theoretical frameworks that guided our study. Eighty-six typically developing adolescents and young adults having a sister or a brother with autism spectrum disorder were enrolled. Results indicated that the youngest age group (early adolescents) reported to engage more frequently in negative behaviors with their siblings with ASD than the two older age groups (middle adolescents and young adults). No significant differences were found among the three age groups regarding behaviors derived from attachment, caregiving and affiliative systems. Family satisfaction and age significantly predicted behaviors during sibling interactions. Suggestions on prevention and intervention programs were discussed in order to prevent parentification among typically developing siblings and decrease episodes of quarrels and overt conflicts between brothers and sisters with and without ASD.     

Toward a predictive model of suicidal ideation and behavior: some preliminary data in college students

Within a multivariate statistical design, the relationship of various interpersonal, emotional, and cognitive variables to suicidal ideation and behavior in college students was examined. A total of 158 subjects (58 males, 100 females) completed self-report measures of life stress, faulty cognitions, loneliness, depression, hopelessness, family cohesiveness, adaptive reasons for living, and suicidal ideation and behavior. The results of a multiple-regression analysis, forward-inclusion algorithm, indicated that a predictive equation consisting of loneliness, irrational beliefs, and low adaptive reasons for living best accounted for suicidal behavior scores. To determine the basic structures and power of the predictor variables under study, a factor analysis and composite regression were employed, resulting in a predictive equation consisting of three factors: Social/Emotional Alienation, Cognitive Distortions, and Deficient Adaptive Resources. Results are discussed in terms of an interactional model of suicidal behavior.     

Systemizing in autism: The case for an emotional mechanism

More often than others, people with autism engage in systemizing – attempts to understand and build rule-based systems. The mechanism behind the increased frequency of such behavior in autism is unknown, however. The assumption has long existed that emotions exist to motivate behavior, and there is now much evidence that people with autism tend to have stronger, more easily elicited emotions than the average person. This appears to be the cause of increased systemizing in autism – through a negative and a positive emotional pathway: There is evidence that autistic people want control more strongly than do others. This is often so, says the hypothesis, because strong negative emotions, other things equal, make lack of control feel more aversive than it does for most people. Systemizing can increase the feeling of control and hence reduce the negative emotion. Positive emotion can also motivate systemizing in autism – fascination and attraction more strongly felt and more easily elicited than in other people.     

The structure of workplace adaptive skill in a career inexperienced group

Adaptive skill is a central concept to understanding vocational behavior. In this study, a theory of behavioral functionality is proposed that describes the underlying structure of workplace adaptive skill. The propositions of the theory are formalized in a facet theory mapping sentence, then 12 adaptive skills are assessed on a group of career inexperienced individuals using a structured interview methodology. Smallest space analysis applied to the interview ratings reveals a three-dimensional structure of behavioral functionality. After refinements are made to the theoretical framework, we explore the implications of our findings for understanding the development of adaptive skills in the workplace and for contributing knowledge to the field of vocational behavior.     

Factor structure of the construct of adaptive behavior in children with and without intellectual disability

Although the presence of significant limitations in adaptive behavior constitutes one of the three necessary criteria for diagnosing intellectual disability, adaptive behavior structure has always been the subject of considerable controversy among researchers. The main goal of this study is to extend previous research results that provide further support to a multidimensional structure of conceptual, social, and practical skills compared to the unidimensional structure. One-factor and 3-correlated factors models as measured by 15 observable indicators were analyzed by means of confirmatory factor analysis (CFA), as well as their relationships with one second-order factor (i.e., adaptive behavior). To that end, 388 children with and without intellectual disabilities were assessed with the Diagnostic Adaptive Behavior Scale (DABS). Results of CFA indicated that the 3 first-order factors solution provides the best fit to the data. Reliability and validity of the multidimensional model were also analyzed through different methods such as the composite reliability and the average variance extracted. Finally, implications of these findings and possible directions for future research are discussed.     

Cognitive Behavioral Treatment of Comorbid Anxiety Disorders and Social Difficulties in Children with High-Functioning Autism: A Case Report

A substantial proportion of children with high-functioning autism (HFA) or Asperger syndrome (AS) have one or more comorbid anxiety disorders. Because anxiety disorders exacerbate the social difficulties and other functional impairments caused by an autism spectrum disorder (ASD), there is a need for efficacious treatments to address the clinical needs of youth with this comorbid presentation. This article describes an evidence-based cognitive behavioral therapy (CBT) treatment manual enhanced to address the unique characteristics and clinical needs of children with ASD. A case study is presented in which CBT was utilized in the successful treatment of an 11-year-old girl with HFA. The intervention was effective in reducing anxiety and improving social and adaptive functioning. These findings suggest that an enhanced CBT approach may be a viable intervention for children with comorbid HFA and anxiety disorders that should be further evaluated.     

Autism characteristics in children with fetal alcohol spectrum disorders

Background: Children with fetal alcohol spectrum disorders (FASD) exhibit difficulties in many cognitive and behavioral domains and also have high comorbidity with other disorders such as attention deficit/hyperactivity disorder (ADHD) and conduct disorder as well as autism. Although the FASD profile is shown to be distinct from ADHD and conduct disorder, far less is known about the commonalities with autism. The current study used a parent-rated questionnaire containing an autism subscale to explore the autistic-like features that children with FASD exhibit. Methods: Studied were 25 children with FASD (age: M = 10.3 years) and 17 normal controls (NCs; age: M = 10.2 years). As part of a larger study, all parents/caregivers completed the Social Skills Improvement System (SSIS; Gresham & Elliot, 2008), which in addition to evaluating social skills and behavior problems globally, includes an Autism subscale. Results: Between-group comparisons showed the FASD group not only scored significantly lower in social skills and significantly higher in behavior problems than the NC group but children with FASD also scored significantly higher on the Autism subscale. Item analysis revealed they showed the most difficulty in terms of social and communicative functioning and the least in repetitive and restrictive behaviors. Conclusion: Current findings signify that FASD and autism share similarities with regard to social and communicative functioning. These findings, which further our knowledge of the FASD phenotype, may be useful in specifying the particular interventions these children need.     

Associations between attentional biases to fearful faces and social-emotional development in infants with and without an older sibling with autism

During the first year of life, infants become increasingly attuned to facial emotion, with heightened sensitivity to faces conveying threat observed by age seven months as illustrated through attentional biases (e.g., slower shifting away from fearful faces). Individual differences in these cognitive attentional biases have been discussed in relation to broader social-emotional functioning, and the current study examines these associations in infants with an older sibling with autism spectrum disorder (ASD), a group with an elevated likelihood of a subsequent ASD diagnosis (ELA; n = 33), and a group of infants with no family history of ASD who are at low likelihood of ASD (LLA; n = 24). All infants completed a task measuring disengagement of attention from faces at 12 months (fearful, happy, neutral), and caregivers completed the Infant-Toddler Social and Emotional Assessment at 12, 18, and/or 24 months. For the full sample, greater fear bias in attention disengagement at 12 months related to more internalizing behaviors at 18 months, and this was driven by the LLA infants. When examining groups separately, findings revealed that LLA with a greater fear bias had more difficult behaviors at 12, 18, and 24 months; in contrast, ELA showed the opposite pattern, and this was most pronounced for ELA who later received an ASD diagnosis. These preliminary group-level findings suggest that heightened sensitivity to fearful faces might serve an adaptive function in children who later receive an ASD diagnosis, but in infants with no family history of ASD, increased biases might reflect a marker of social-emotional difficulties.     

MPS II: Adaptive Behavior of Patients and Impact on the Family System

Mucopolysaccharidosis type II (MPS II), also known as Hunter syndrome, is a chronic and progressive X-linked lysosomal disease that mainly affects males. It occurs in 1 in every 65,000 to 1 in 132,000 births. There are two distinct forms of the disease based on age of onset and clinical course: mild and severe. MPS II affects many organ systems including the nervous, cardiovascular, gastrointestinal and respiratory systems. Complications can include vision problems, progressive hearing loss, thickened and elastic skin, mental impairment, and enlarged liver and spleen. We herein focus on the adaptive behavior of individuals with MPS II, and the impact of MPS II on the family system. Outcomes from the Vineland-II Adaptive Behavior Scales showed that the MPS II patient sample experienced significantly lower functioning in communication, daily living skills, socialization, and motor skills compared to normative data. Patients with severe MPS II were found to have significantly lower adaptive functioning in all domains, as compared to those with mild MPS II. Length of time on ERT had no significant relationship to adaptive functioning. Results from the Peds QL Family Impact Module indicated that families of patients with MPS II experienced a lower overall health-related quality of life and overall lower family functioning (including lower emotional and cognitive functioning) than those with chronic illnesses residing in an inpatient setting.