Prevalence,structure and correlates of anxiety-depression in boys with an autism spectrum disorder

BackgroundComorbidity of anxiety and depression predicts impaired treatment outcomes, poor quality of life and increased suicide risk. No study has reported on a combined measure of anxiety-depression in boys with an Autism Spectrum Disorder.AimsTo explore the prevalence, underlying factor structure and relationships between anxiety-depression, physiological stress and symptoms of Autism Spectrum Disorder (ASD).Methods150 boys (aged 6–18 years; IQ M = 94.9, range = 73–132) with an ASD plus their parents (135 mothers, 15 fathers) completed scales about the boys’ anxiety and depression, and the boys provided samples of their saliva in the morning and afternoon. Parents also completed the ASD Behaviour Checklist about the boys’ ASD symptoms.ResultsThe two sources of ratings were not significantly different for prevalence of anxiety-depression but the factor structures varied between the parents’ and boys’ responses, with a four-factor solution for the boys’ ratings and a three-factor solution for the parents’ ratings. There were also differences in the correlations between cortisol and anxiety-depression and between ASD symptoms and anxiety depression across the boys’ and parents’ data.ConclusionsAssessment of anxiety and depression comorbidity from parents and from children with an ASD themselves could provide a valuable adjunct datum when diagnosing ASD.     

Nasal voice in boys with high-functioning autism spectrum disorder

This study compared speech samples of 29 boys aged 6–13 with high-functioning autism spectrum disorder (HFASD) to those of 29 typically developing (TD) boys matched on age and ethnicity. Ten listeners blind to speakers’ diagnoses rated speech samples for nasality and reported their perceptions of the speaker on a 6-point Likert-type scale. Results indicated significantly greater listener-perceived nasality in the HFASD than the TD group. Listeners rated the HFASD group significantly higher than the TD group on negative socially relevant adjectives, a finding which was mediated by nasality. In addition, compared to TD speakers, speakers with HFASD were rated lower on dominance and perceived age, as well as higher on perceived disability.     

Effortful control in typically developing boys and in boys with ADHD or autism spectrum disorder

Despite increased interest in the role of effortful control (EC) in developmental disorders, few studies have focused on EC in autism spectrum disorders (ASD) and no study so far has directly compared children with ASD and children with ADHD. A first aim of this study was to investigate whether typically developing (TD) boys, boys with ADHD and boys with ASD can be differentiated based on EC levels. A second aim was to evaluate the relationship between EC and symptoms of ADHD and ASD. We assessed EC in 27 TD boys, 27 boys with ADHD and 27 boys with ASD (age 10-15) using different EC questionnaires. Clinical groups scored lower than the TD group on all EC total scales, but could only be differentiated from each other by means of self-reported persistence, impulsivity and activation control. Our data suggest that although EC is useful in differentiating TD boys from clinical groups, it is less efficient in distinguishing ADHD from ASD. Also, results suggest that EC plays a role in the manifestation of symptoms of both ADHD and ASD and that high levels of EC enable children to function more adequate in daily situations.     

Using conversation analysis to explore the recurrence of a topic in the talk of a boy with an autism spectrum disorder

Some higher functioning individuals with autism spectrum disorders (ASDs) are reported to produce perseverative talk, especially around ‘special interests’. Topic perseveration is a form of pragmatic impairment captured in Prizant and Rydell's (1993) continuum of unconventional verbal behaviour in autism. Although widely reported, there is little systematic empirical research into this phenomenon. This paper considers the utility of Conversation Analysis in developing knowledge in this area, drawing upon data involving a boy with an ASD interacting with a researcher and a mobile robot platform. Although a frequency analysis of the boy's talk on a single topic may suggest that it is perseverative in nature, in a sequential analysis of both talk and non‐spoken activities this study aims to show how these may be interactionally‐embedded. It is suggested that, in considering the interactional salience of apparently perseverative talk, it can be useful to explore the participation framework in which the topic is revisited.     

Efficacy of cognitive behavior therapy-based social skills intervention for school-aged boys with autism spectrum disorders

School-aged children with Autism Spectrum Disorders (ASD) experience significant difficulty with peer interaction. Research to identify the most effective strategies to address this difficulty has increased but more evidence is needed. Cognitive behavior therapy (CBT), which focuses on changing how a person thinks about social situations as well as how he behaves, is a promising approach. This study evaluated the efficacy of a 15 week CBT-based social skills intervention for boys aged 10–12 years diagnosed with an ASD. Boys with average or better IQ and receptive language skills were randomly assigned to either a control (n = 8) or intervention condition (n = 7). During intervention, boys attended weekly 2 h long group sessions focusing on self-monitoring skills, social perception and affective knowledge, conversation skills, social problem-solving, and friendship management skills. Comparison of the outcomes using repeated measures analyses indicated that boys receiving the intervention scored significantly better on measures of social perception, peer interaction, and social knowledge than boys who had not received intervention. There were no differences on general measures of socialization. The manualized intervention used in this study shows promise but replication with larger samples is needed.     

Psychiatric symptoms in boys with fragile X syndrome: A comparison with nonsyndromic autism spectrum disorder

In the present study, we examined the profile of psychiatric symptoms in boys with fragile X syndrome (FXS) using a parent report instrument. In addition, by comparing boys with FXS to boys with nonsyndromic autism spectrum disorder (ASD) utilizing multiple matching strategies, we examined between-group differences in the types of psychiatric symptoms observed and in the strength of their concurrent associations. Across all matching strategies, symptoms of manic/hyperactive behaviors and general anxiety were more frequently reported for boys with FXS than for boys with nonsyndromic ASD. Results also indicated a positive association between social avoidance and general anxiety in FXS that was stronger than that observed in nonsyndromic ASD across all matching strategies. Theoretical and treatment implications are discussed.     

Predictors of intention to turnover in behavior technicians working with individuals with autism spectrum disorder

Employee turnover has deleterious effects on clinical services such that it hinders service quality, damages the therapeutic relationship, and compromises company infrastructure. However, little is known about predictors of turnover for behavior technicians (BTs) who implement behavioral interventions with individuals with autism. Therefore, the aim of this study was to identify factors that serve as predictors of intention to turnover and provide a bedrock for direct assessment of strategies to reduce turnover among BTs. A total of 96 BTs from 19 different agencies in Southern California completed the entire online survey. We found that level of satisfaction with training, supervision, and pay (not their actual hourly pay), along with satisfaction with different aspects of the job (e.g., opportunities for advancement, praise for doing a good job) predicted BTs’ intent of turnover. We discussed the potential implications of our findings for researchers interested in examining methods to minimize turnover and increase continuity of behavioral care for individuals with autism spectrum disorders.     

Speech intonation in children with autism spectrum disorder

Objective: The prosody of children with autism spectrum disorder (ASD) has several abnormal features. We assessed the speech tone of children with ASD and of children with typical development (TD) by using a new quantitative acoustic analysis. Methods: Our study participants consisted of 63 children (26 with ASD and 37 with TD). The participants were divided into 4 groups based on their developmental features and age. We assessed the variety of the fundamental frequency (F0) pattern quantitatively, using pitch coefficient of variation (CV), considering the different F0 mean for each word. Results: (1) No significant difference was observed between the ASD and TD group at pre-school age. However, the TD group exhibited significantly greater pitch CV than the ASD group at school age. (2) In pitch CV, range and standard deviation of the whole speech of each participant, no significant differences were observed between the type of participants and age. (3) No significant correlation was found between the pitch CV of each word and the Japanese Autism Screening Questionnaire total score, or between the pitch CV of each word and the intelligence quotient levels in the ASD group. A significant correlation was observed between the pitch CV of each word and social reciprocal interaction score. Conclusions: We assessed the speech tone of children with ASD by using a new quantitative method. Monotonous speech in school-aged children with ASD was detected. The extent of monotonous speech was related to the extent of social reciprocal interaction in children with ASD.     

Psychometric properties of the SCARED in youth with autism spectrum disorder

Children with autism spectrum disorder (ASD) are at increased risk of developing co-occurring anxiety symptoms. However, the assessment of anxiety symptoms in this population is often challenging for researchers and clinicians. This study evaluated the psychometric properties of a questionnaire measure of child anxiety symptoms, the Screen for Child Anxiety Related Emotional Disorders (SCARED), in school-aged children and adolescents with high-functioning ASD. Children and parents recruited for an anxiety treatment study completed the SCARED—parent and child versions prior to the start of treatment. Both versions demonstrated factor structures, internal reliability, and score distributions largely consistent with those from typically developing samples (Birmaher et al., 1999). The SCARED showed moderate convergent validity with a structured clinical interview and had good sensitivity and specificity. Differences were explored by child age, gender, and ethnicity. Together, these findings support the use of the SCARED as a valid assessment tool in an ASD population.     

An evaluation of wayfinding abilities in adolescent and young adult males with autism spectrum disorder

BackgroundWayfinding refers to traveling from place to place in the environment. Despite some research headway, it remains unclear whether individuals with Autism Spectrum Disorder (ASD) show strengths, weaknesses, or similarities in wayfinding compared with ability-matched typically developing (TD) controls.MethodThe current study tested 24 individuals with ASD, 24 mental-ability (MA) matched TD (MA-TD) controls, and 24 chronological-age (CA) matched TD (CA-TD) controls. Participants completed a route learning task and a survey learning task, both programmed in virtual environments, and a perspective taking task. Their parents completed questionnaires assessing their children’s everyday wayfinding activities and competence.ResultsOverall, CA-TD controls performed better than both the ASD group and the MA-TD group in both wayfinding tasks and the perspective taking task. Individuals with ASD performed similarly to the MA- TD controls on wayfinding performance except for backtracking routes. Perspective taking presented an area of deficit for people with ASD and it predicted individual differences in route learning and survey learning. Parents’ reports did not predict their children’s wayfinding performance. Two mini meta-analyses, including previous studies and the current study, showed a significant deficit in route learning, but not in survey learning for the ASD group relative to MA-TD controls.ConclusionsAlthough participants with ASD showed impairments in wayfinding relative to CA-TD controls, the impairment is not specific to their ASD, but rather due to their mental age. Nevertheless, route reversal in route learning may present unique difficulty for people with ASD beyond the effects of mental age.     

Motivational approach and avoidance in autism spectrum disorder: A comparison between real photographs and cartoons

Individuals with autism spectrum disorder (ASD) show a lack of motivation to engage in spontaneous social encounters with other human beings. However, the basis for these diminished approach-related social behaviours is still unclear. This study investigated social motivation in ASD using an approach-avoidance task. In particular, we presented a group of ASD and a group of neurotypical adolescents with a series of emotionally positive, negative, and neutral visual stimuli, comprised of real photographs and cartoons – a stimulus with incentive salience for individuals with ASD. Participants were asked to either push or pull a joystick in response to an emotionally independent feature of the stimuli (colour frame). Following the main task, participants also rated the stimuli for affective valence and arousal. Results showed a dissociation in motivational responses towards positive stimuli for the ASD group only: faster avoidance from positive real photographs, but greater approach to positive cartoons, while no differences were found between emotionally negative or neutral stimuli. By contrast, no differences between the groups were found for the self-reported affective ratings. In light of the social motivation hypothesis, these atypical motivational responses suggest a deficit in assigning reward to socio-emotional stimuli in adolescents with ASD.     

Self monitoring to promote on-task behavior by two high functioning boys with autism spectrum disorders and symptoms of ADHD

We assessed a self-monitoring procedure to promote on-task behavior in classroom by two high functioning boys with autism spectrum and attention deficit hyperactivity disorders. A second aim of the study was to reduce stereotyped behaviors for both boys. Finally, a third goal was to verify the effects of the intervention on the participant's mood. The study was conducted according to a non concurrent multiple baseline design across participants. Results show an increase of on-task behavior and indices of happiness during the intervention phase. Moreover, the stereotyped behaviors decreased during intervention phase for both boys. Participants maintained their performance during the maintenance phase, which occurred a month after the end of the intervention. The effectiveness of the rehabilitation program was confirmed by 72 university students involved in a social validation assessment as raters. Psychological and practical implications of the findings are discussed.     

Promoting constructive engagement by two boys with autism spectrum disorders and high functioning through behavioral interventions

We assessed a behavioral intervention-based strategy to promote constructive engagement and to reduce stereotyped behaviors by two boys with autism spectrum disorders and high functioning. The program included two functional activities for each participant (i.e. coloring and using a personal computer with a multimedia software for reading and writing) according to a multi-elements baseline design, during classroom. Both participants showed a preference for the computer activity during the choice phase. Results showed an increasing of constructive engagement, according to both functional activities, and a reduction of stereotyped behaviors during intervention phases for both participants. Psychological as well as practical implications of the findings are discussed.     

Treating aggression in persons with autism spectrum disorders: A review

Aggression is one of the most frequent and debilitating problems observed among persons with autism spectrum disorders (ASD). It is common and can be more problematic than many core symptoms of ASD. Thus, treating the behavior is a high priority. A surprisingly limited number of studies have addressed treatment when taken in the context of the vast ASD literature. This paper reviews many of these papers and describes the types of interventions that have been used and the characteristics of the people who have been studied.     

Role of serum levels of neurotensin in children with autism spectrum disorder

AimNeuroinflammation may play a role in the pathogenesis of autism in some patients. The aim of this study was to measure serum levels of neurotensin (NTS) in relation to the degree of the severity of autism.MethodsSerum NTS was measured in autistic children (n = 38; mean age 7.02 ± 2.03 years) and healthy, unrelated sex matched controls (n = 39); mean age 7.25 ± 1.64 years). The severity of autism symptoms was assessed using Childhood Autism Rating Scale (CARS) scores.ResultsThe serum level of NTS was significantly (P < 0.001) lower in autistic children (mean ± S.D. = 54.71 ± 12.4 pg/ml) than control group (mean ± S.D. = 77.58 ± 10.29 pg/ml). Children with severe autism had significantly lower serum NTS levels than patients with mild to moderate autism (P < 0.002). There was significant negative correlation between serum levels of NTS and CARS SCORES (r² = 0.79, P = 0.001).ConclusionsSerum NTS levels were elevated in some autistic children and they were significantly correlated with the severity of autism. However, this is an initial report that warrants further research to determine the pathogenic role of NTS and its possible link to neuroinflammation in autism.     

Patterns of autism spectrum symptomatology in individuals with Down syndrome without comorbid autism spectrum disorder

Background

Prevalence estimates of autism spectrum disorder (ASD) in Down syndrome (DS) are highly varied. This variation is partly due to the difficulty of screening for and diagnosing comorbid ASD in individuals with a syndrome that carries its own set of social communicative and behavioral difficulties that are not well documented. The aim of this study was to identify the typical range of social communicative impairments observed in children, adolescents, and young adults with DS who do not have comorbid ASD.

Methods

We examined patterns of scores from the five subscales of the Social Responsiveness Scale (SRS) in 46 individuals with DS (ages 10–21 years) without comorbid ASD relative to the published normative sample. We also explored the correlations between SRS symptomatology and age, nonverbal cognition, and receptive language.

Results

SRS scores were elevated (i.e., more ASD symptoms endorsed), with mean scores falling into the clinically significant range. Analysis by subscale revealed a specific pattern, with Autistic Mannerisms and Social Cognition scores significantly more elevated than Social Communication scores, which were significantly more elevated than Social Awareness and Social Motivation scores. Correlations between SRS scores and the other measures varied by subscale.

Conclusions

General elevated ASD symptomatology on the SRS indicates the need for developing population-based norms specific to DS. The pattern of scores across subscales should inform clinicians of the typical range of behaviors observed in DS so that individuals with atypical patterns of behavior can be more easily identified and considered for a full ASD evaluation.     

Obesity in adolescents with autism spectrum disorders

Adolescents with developmental disabilities such as autism spectrum disorder (ASD) may be particularly vulnerable to obesity due to the behavioral, physical, and psychosocial complications related to their condition. This article provides a general background related to obesity in adolescence with specific emphasis on obesity in the ASD population. A search of PubMed, CINAHL, and ProQuest databases revealed several studies which demonstrated that interventions involving physical activity with typically developing, obese adolescents can have positive effects on body mass index, weight, and body composition. However, these findings also suggest that more research is needed to help tailor these interventions to meet the needs of similar adolescents with ASD. To clarify these needs, we present a case study that illustrates the special challenges of treating an obese adolescent with ASD and then offer suggestions for future research.     

A microswitch-cluster program to enhance object manipulation and to reduce hand mouthing by three boys with autism spectrum disorders and intellectual disabilities

We assessed a microswitch-cluster program to enhance object manipulation and to reduce hand mouthing by three boys with autism spectrum disorders and severe to profound intellectual disabilities. A second goal of the study was to monitor the effect of such program on the indices of happiness of the participants. The study has been carried out according to an ABB¹AB¹ sequence, where A represented baseline phases, B represented intervention phase in which the adaptive response (i.e. object manipulation) was followed by a contingent positive stimulation irrespective of challenge behavior (i.e. hand mouthing), and B¹ indicated intervention phases in which an adaptive response was followed by a contingent positive stimulation only if it occurred with the simultaneous absence of the challenge behavior. Otherwise, positive stimulation was interrupted if the challenge behavior was exhibited during its supply. Results showed an increasing of the adaptive responses and a decrease of the challenge behavior during intervention phases. All participants spent less time with the exhibition of challenge behavior, during intervention phases, compared to baseline sessions. Finally, the indices of happiness augmented during intervention phases. Clinical, practical and psychological implications of the findings are discussed.