Experiences of father carers of children with Autism Spectrum Disorder: An exploratory study

This study aimed to explore the carer experiences of fathers of children with Autism Spectrum Disorder (ASD). A total of eight South African fathers between the ages of 38 and 45 years were the interview informants. They cared for at least one child with ASD each and their children with ASD were within the age range of five to nine years (n=9, males=7, females=2, Low functioning=4, Moderately functioning=4, High functioning=1).The father carers completed a semi-structured interview. The data were analysed thematically. Four primary themes emerged from the analysis pertaining to aspects of rescoping their futures to include the care of a child with ASD, relationship issues, access to and management of resources, information and support, and carer compassion and satisfaction. The fathers shared a view that caring for their children with ASD was both stimulating and enriching, and that with time, they were able to adapt, and better respond, to the specific needs of their child.     

Caregivers of School-aged Children with Autism: Social Media as a Source of Support

Support groups provide parents of children with Autism Spectrum Disorder (ASD) with additional support which they may not receive from health care professionals. Rapid technological growth has increased the opportunity for parents to access information and support. In this study, we used a qualitative phenomenological design to explore the use of a social media support group, on WhatsApp, to provide support to parents of children with ASD. We used convenience sampling to select six participants who had a child diagnosed with ASD who was in the foundation or intermediate phase at school and between the ages of 5 and 12 years, had been a part of the WhatsApp support group for 6 months or longer, and lived in KwaZulu-Natal, South Africa. Data analysis revealed eight emergent themes, (a) communication support, (b) behavior support, (c) feeding support, (d) emotional support, (e) informational support, (f) the presence of a professional, (g) positive experiences in the group, and (h) limitations of the group. Findings indicate managing behavioral difficulties and emotional support for caregivers were the core functions of the group, and having a professional on the group served as a valuable resource. The use of a social media support group on WhatsApp provided ongoing support to parents of children with ASD, implying that such a group may have clinical significance for use by practitioners as well as the creation of similar groups on other platforms.     

Links between social and linguistic processing of speech in preschool children with autism: behavioral and electrophysiological measures

Data on typically developing children suggest a link between social interaction and language learning, a finding of interest both to theories of language and theories of autism. In this study, we examined social and linguistic processing of speech in preschool children with autism spectrum disorder (ASD) and typically developing chronologically matched (TDCA) and mental age matched (TDMA) children. The social measure was an auditory preference test that pitted 'motherese' speech samples against non-speech analogs of the same signals. The linguistic measure was phonetic discrimination assessed with mismatch negativity (MMN), an event-related potential (ERP). As a group, children with ASD differed from controls by: (a) demonstrating a preference for the non-speech analog signals, and (b) failing to show a significant MMN in response to a syllable change. When ASD children were divided into subgroups based on auditory preference, and the ERP data reanalyzed, ASD children who preferred non-speech still failed to show an MMN, whereas ASD children who preferred motherese did not differ from the controls. The data support the hypothesis of an association between social and linguistic processing in children with ASD.     

Mathematical Abilities in Elementary School Children with Autism Spectrum Disorder

Although clinical practitioners often express concerns about the mathematical functioning of children with autism spectrum disorder (ASD), the field of mathematics remains a relatively unexplored topic in individuals with ASD. Moreover, research findings are fragmentary and hold inconclusive results. The present study aimed to examine whether grade 1 (aged 6–7 years) to 4 (aged 9–10 years) elementary school children with ASD scored significantly different from age‐adequate norms on mathematics. To this end, a multi‐componential approach of mathematics was used. Four domains of mathematics were assessed in 121 children with ASD: procedural calculation, number fact retrieval, word/language problems, and time‐related competences. All children attended general education classrooms, following the standard curriculum, and were coached by integrated educational services. Children with ASD showed a strength in word/language problems in second and fourth grade. There was evidence of a weakness for procedural calculation in first grade and for time‐related competences in first and third grade. In all other cases, average scores were shown. As such, results revealed a profile of strengths, average abilities, and weaknesses in mathematics and highlighted the importance of focusing on different domains of mathematics. Because a high variability in mathematical performance could be observed, we recommend an individual assessment when considering the mathematical trajectory of children with ASD. Copyright © 2015 John Wiley & Sons, Ltd.     

An interest‐based intervention package to increase peer social interaction in young children with autism spectrum disorder

The literature suggests that children with autism spectrum disorder (ASD) educated in inclusive settings generally do not interact with typically developing classmates during social activities. This study assessed whether an intervention package consisting of interest‐based structured play activities involving adult instruction, modeling, and response to child questions would result in an increase in social interaction with typically developing peers. A multiple baseline design across four participants with an embedded reversal was used to demonstrate the effects of the intervention on social interaction during structured play sessions. Initiations, responses, and interactive play increased for all participants. Generalization to novel peers was observed, and treatment gains were maintained during 6‐week follow‐up sessions. Recommendations for practitioners working with children with ASD in inclusive settings and potential areas of future research are discussed.     

Parent Perspectives of an Evidence-Based Intervention for Children with Autism Served in Community Mental Health Clinics

Research suggests that improvements to community mental health (CMH) care for children with autism spectrum disorders (ASD) are needed. Recent research examining the feasibility of training CMH therapists to deliver a package of evidence-based practice intervention strategies (EBPs) targeting challenging behaviors for school-age children with ASD offers initial support for such efforts to improve care. Specifically, quantitative data from a recent pilot study indicate that CMH therapists with limited ASD experience can deliver an EBP intervention with fidelity and perceive it as useful to their practice. Further, client attendance is high and children demonstrate improvement on standardized measures. To further understand the feasibility and impact of training CMH therapists to deliver EBPs, this mixed-methods study examined parent perspectives of the process and impact of outpatient psychotherapy for 13 parents of children ages 5–13 with ASD whose therapists were trained to deliver the EBP intervention. Results complement and expand previously reported quantitative data on psychotherapy process indicating that parents are highly involved in treatment for their children, perceive a strong therapeutic alliance with their children’s therapist, and highlight that treatment was different once therapists began delivering the intervention. Results also indicate themes related to parents’ perceptions of positive child and parent outcomes that provide important details on the specific gains that were observed during treatment. Study findings underscore the importance of parent perspectives in understanding the process and impact of implementing EBPs in CMH settings for families of children with ASD.     

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.     

Psychiatric Comorbidity in Children with Autism Spectrum Disorders: A Comparison with Children with ADHD

The present study was conducted with the aim to identify comorbid psychiatric disorders in children with autism spectrum disorders (ASD) (n = 40) and to compare those comorbidity rates to those in children with attention deficit hyperactivity disorder (ADHD) (n = 40). Participants were clinically referred children aged 7–18 years. DSM-IV classifications were used for the primary diagnosis (ASD/ADHD), while comorbid psychiatric disorders were assessed using a structured diagnostic interview, the structured clinical interview for DSM-IV, childhood diagnoses (KID-SCID). Twenty-three children with ASD (57.5 %) had at least one comorbid disorder, whereas 16 children with ADHD (40.0 %) were classified as having at least one comorbid disorder. No group differences were found with respect to this comorbidity rate or for the rate of comorbid externalizing disorders (ODD and/or CD). However, children with ASD had more comorbid internalizing disorders compared to children with ADHD. More specifically, children with ASD had higher rates of anxiety disorders, but not mood disorders. No associations between comorbidity and age or between comorbidity and the intelligence quotient was found. It is important for clinicians to always be aware of, and screen for, comorbidity, and to consider treatment for these comorbid disorders. In addition, research should focus on establishing valid and reliable screening tools as well as effective treatment options for these comorbid disorders.     

Multi-family Psychoeducational Psychotherapy (MF-PEP) for Children with High Functioning Autism Spectrum Disorder

This article describes the development and methodology of a novel psychosocial intervention for children with high functioning autism spectrum disorder (HFASD). Originally developed as an adjunctive treatment for children with mood disorders, Multi-Family Psychoeducational Psychotherapy (MF-PEP) has been adapted for children with ASD (MF-PEP-ASD). Consisting of eight sessions, children with ASD and their parents receive psychoeducation and social support, and learn coping, problem-solving, communication, and symptom-management skills in separate and joint sessions. Core treatment components of MF-PEP-ASD include psychoeducation, social skills treatment, cognitive-behavioral therapy, and parent training and involvement. Preliminary qualitative data from parent and child participants have indicated positive and promising findings. Continued evaluation of this treatment using comprehensive outcome and treatment fidelity measures is warranted.     

Use of Computer-Based Interventions to Teach Communication Skills to Children with Autism Spectrum Disorders: A Systematic Review

The purpose of this review is to provide a systematic analysis of studies involving the use of computer-based interventions (CBI) to teach communication skills to children with autism spectrum disorders (ASD). This review evaluates intervention outcomes, appraises the certainty of evidence, and describes software and system requirements for each included study. This review has three main aims: (a) to evaluate the evidence-base regarding CBI, (b) to inform and guide practitioners interested in using CBI, and (c) to stimulate and guide future research aimed at improving the efficiency and effectiveness of CBI in communication for individuals with ASD. Results suggest that CBI should not yet be considered a researched-based approach to teaching communication skills to individuals with ASD. However, CBI does seem a promising practice that warrants future research.     

Attention to low- and high-spatial frequencies in categorizing facial identities, emotions and gender in children with autism

This study was aimed at investigating face categorization strategies in children with autistic spectrum disorders (ASD). Performance of 17 children with ASD was compared to that of 17 control children in a face-matching task, including hybrid faces (composed of two overlapping faces of different spatial bandwidths) and either low- or high-pass filtered faces. Participants were asked to match faces on the basis of identity, emotion or gender. Results revealed that children with ASD used the same strategies as controls when matching faces by gender. By contrast, in the identity and the emotion conditions, children with ASD showed a high-pass bias (i.e., preference for local information), contrary to controls. Consistent with previous studies on autism, these findings suggest that children with ASD do use atypical (local-oriented) strategies to process faces.     

Ambiguous figure perception and theory of mind understanding in children with autistic spectrum disorders

Researchers in early social‐cognition have found that the ability to reverse an ambiguous figure is correlated with success on theory of mind tasks (e.g. Gopnik & Rosati, 2001 ). The present experiment examined children with autistic spectrum disorders (ASD) without mental delay to see whether a similar relationship existed. Ropar, Mitchell, and Ackroyd (2003) demonstrated that children with ASD with mental delay were impaired on theory of mind tasks, but were as likely as mentally delayed controls to generate both interpretations of an ambiguous figure when informed of its ambiguity. The present study replicated this finding on children with ASD without mental delay. However, overall perception of ambiguous figures was different. These children were less likely to spontaneously generate both interpretations of the figure, and more likely to perseverate on a single interpretation than the comparison children. Like Ropar et al., we found no correlation between theory of mind and informed reversals, but spontaneous reversals were correlated with performance on an advanced theory of mind task. These data suggest that reversals of ambiguous figures are linked to higher‐level representational abilities, which might also be involved in social functioning, and impaired in children with ASD.     

Comparison of two discrimination methods in teaching Chinese children with autism

In teaching conditional discriminations to children with autism spectrum disorder (ASD), practitioners may progress from simple to conditional discriminations or may teach conditional discriminations from the onset of instruction. Some research indicates that teaching simple discriminations first may be unnecessary and that teaching may more efficiently focus on conditional discriminations exclusively. This study replicated comparisons of simple-to-conditional and conditional-only discrimination training methods in teaching audio-visual conditional discriminations to Chinese preschoolers with ASD. Results indicated the conditional-only training method appeared to be more efficient in teaching these skills.     

自闭症谱系障碍儿童在多重线索下习得词语的眼动研究

本文利用眼动追踪技术在基线、一致和矛盾3种实验条件下考察感知觉线索和社会性线索在自闭症谱系障碍儿童词语习得中的相对作用。行为数据结果表明, 此类儿童在矛盾条件下选择枯燥物体作为新异词语的所指对象, 这说明社会性线索较之于感知觉线索具有优势作用; 而他们在基线和一致条件下选择有趣物体作为新异词语的所指对象, 且一致条件的词语习得成绩优于基线条件, 这说明社会性线索较之于感知觉线索具有促进作用。眼动数据结果表明, 此类儿童在脸部注视模式和视线追随行为上与普通儿童存在差异。这说明, 虽然社会性线索在此类儿童与普通儿童的词语习得中具有相同的相对作用, 但他们获取社会性信息的方式与普通儿童存在差异。     

Parents' Involvement in ASD Treatment: What Is Their Role?

The rising prevalence of autism spectrum disorders (ASD) warrants a greater level of clinical attention to best treat those with ASD. The characteristics of ASD lead to impairment for both the child with the disorder and his/her family. To effectively treat children with ASD, parents need to be included in intervention efforts. Research suggests that parental involvement in treatment improves the generalizability of skills and increases the amount of intervention the child receives. Numerous benefits have been found in child and parent outcomes when parents are included in treatment. The purpose of this paper is to discuss the impact ASD can have on the parent-child relationship, the factors that influence treatment outcome, and the advantages of including parents in treatment. The different roles parents can have in treatment will also be discussed along with providing clinicians guidance on practical ways to involve parents in the treatment of children with ASD.     

Parent Perspectives on Community Mental Health Services for Children with Autism Spectrum Disorders

The community mental health (CMH) system provides treatment for behavioral and psychiatric problems in children with autism spectrum disorders (ASD). Although parent stakeholder perspectives are important to improving care, these perspectives have not been systematically examined for this population in the CMH sector. Twenty-one semi-structured qualitative interviews were conducted with parents of children with ASD who received services in CMH clinics. Themes related to child clinical histories, service access and experiences with the CMH system revealed a specific trajectory of service need identification, obtaining a diagnosis, and experience with services. Each trajectory stage was marked by high parent stress. Results provide information about the characteristics of children with ASD served in community mental health clinics and direction for targeted improvement efforts.     

The Autism Detection in Early Childhood Tool: Level 2 autism spectrum disorder screening in a NICU Follow-up program

ObjectiveChildren born preterm are at increased risk for autism spectrum disorder (ASD). However, early diagnosis of ASD is challenging because conventional screening Level 1 tools are less reliable in this population. We sought to determine whether the Autism Detection in Early Childhood (ADEC) and Child Behavior Checklist (CBCL) could accurately identify children at risk for ASD in a NICU Follow-up setting and thus facilitate referral for formal ASD evaluation.MethodChildren aged 18–36 months were recruited from a NICU Follow-up program. All children received presumptive diagnoses based on DSM-5 criteria and were screened for ASD risk with the ADEC and CBCL. Children scoring in the “at risk” range on either tool were referred for a full diagnostic ASD evaluation.ResultsSixty-nine patients (median birth weight 1140 g; median gestational age 28 weeks) were included with 18 designated “at risk” for ASD. Nine (13 %) scored “at risk” on the ADEC and 12 (17 %) on the CBCL. Thirteen children underwent diagnostic ASD evaluation with 9 receiving a formal diagnosis of ASD. The ADEC demonstrated the best performance (sensitivity 89 %, specificity 98 %). The CBCL was less sensitive (sensitivity 50 %, specificity 90 %). Requiring elevated scores on both the CBCL and ADEC was specific but not sensitive (sensitivity 33 %, specificity 100 %).ConclusionThe ADEC performed well in identifying children at risk for ASD within this high-risk NICU cohort, adding benefit as an autism-specific screening tool over the CBCL alone.     

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.     

注意和记忆对孤独症儿童词汇发展滞后的影响

孤独症语言障碍的表现之一是词汇发展滞后, 可能与其注意和记忆损伤有关。当前研究结果表明, 孤独症儿童在学习词汇时难以利用社会注意提供的有效信息, 且其注意易受到无关刺激干扰, 这可能导致其形成的物体-词汇的联结不稳定, 影响其进一步将这种联结整合到心理词典并保存在记忆中。未来研究应探究联合注意影响孤独症儿童词汇学习的发展轨迹和机制, 儿童的词汇知识对其词汇记忆的影响, 并关注自然场景中孤独症儿童的词汇学习过程和个体差异。