Doctor of Medicine, University Of Nis (2007)
Doctor of Philosophy, Cardiff University (2014)
Parental education accounts for variability in the IQs of probands with Down syndrome: A longitudinal study.
American journal of medical genetics. Part A
2018; 176 (1): 29–33
Recent work has demonstrated that variability in probands' phenotypes, including physical features, cognitive abilities, social functioning, and other developmental domains, is influenced by parental traits. Here we examine the role of parental education as a factor contributing to the variability of intelligence quotient (IQ) of offspring with trisomy 21. Participants were 43 probands with trisomy 21, aged 4-21 years of age, and their parents. Data were collected on parental education, and a bi-parental mean education score (BMES) was calculated. Probands' cognitive abilities were assessed by the Stanford-Binet 4th edition at baseline (T1), and again 24 months later (T2). Probands were placed into one of two age groups: 4-12 years and 13-21 years. Results indicated higher parent-proband correlations in Age Group 2 (mean r = .47) relative to Age Group 1 (mean r = .33) and increasing parent-proband correlations across time, with mean correlations of Age Group 1, T1: r = .26, T2: 39; Age Group 2 T1: r = .49, T2: r = 46. Despite the expected IQ deficits observed in trisomy 21 probands, parental education may still contribute to the variability of probands' cognitive abilities. These findings are consistent with the literature noting increasing heritability of IQ with development.
View details for DOI 10.1002/ajmg.a.38519
View details for PubMedID 29159970
Brief report: Poor self-regulation as a predictor of individual differences in adaptive functioning in young children with autism spectrum disorder.
Autism research : official journal of the International Society for Autism Research
The present study examined the link between poor self-regulation (measured by the child behavior checklist dysregulated profile [DP]) and core autism symptoms, as well as with developmental level, in a sample of 107 children with autism spectrum disorder (ASD) aged 19-46 months. We further examined the utility of DP in predicting individual differences in adaptive functioning, relative to the influence of ASD severity, chronological age (CA), and developmental level. Poor self-regulation was unrelated to CA, developmental level, and severity of ADOS-2 restricted and repetitive behaviors, but was associated with lower ADOS-2 social affect severity. Hierarchical regression identified poor self-regulation as a unique independent predictor of adaptive behavior, with more severe dysregulation predicting poorer adaptive functioning. Results highlight the importance of early identification of deficits in self-regulation, and more specifically, of the utility of DP, when designing individually tailored treatments for young children with ASD. Autism Res 2018. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.This study explored the relationship between poor self-regulation and age, verbal and non-verbal developmental level, severity of autism symptoms and adaptive functioning in 107 children with autism under 4 years of age. Poor self-regulation was unrelated to age, developmental level, and severity of restricted and repetitive behaviors but was associated with lower social affect severity. Importantly, more severe self-regulation deficits predicted poorer adaptive functioning.
View details for DOI 10.1002/aur.1953
View details for PubMedID 29624924
Risk and protective factors underlying depression and suicidal ideation in Autism Spectrum Disorder.
Depression and anxiety
People with Autism Spectrum Disorder (ASD) are at significantly increased risk of suicidal thoughts and behavior. Given that social difficulties in ASD often lead to social isolation, which can in turn increase the risk for depression, this study examined loneliness and social support as potential risk and protective factors associated with depression and suicidal ideation.The sample comprised 185 people (92 females) with ASD aged 14 to 80 years who were participating in a national survey.Forty-nine percent of participants returned scores in the clinical range for depression and 36% reported recent suicidal ideation. Females, comprising almost 50% of the sample, returned higher depression scores than males, however no differences were identified between males and females in terms of suicidal ideation. Regression analyses revealed that loneliness, satisfaction with social support, and ASD traits predicted depression scores. Satisfaction with social support predicted suicidal ideation, however, it was no longer a significant predictor after the effects of depression were taken into account. Path analysis showed that ASD trait severity was independently related to depression, that the effect of number of social supports on depression was mediated by loneliness and satisfaction with social support, and that effects of loneliness and satisfaction with social support on suicidal ideation were mediated by depression. The pattern of relationships was nearly identical for males and females.This study supports a model whereby loneliness and social support operate respectively as protective and risk factors for depression and suicidal ideation in ASD.
View details for DOI 10.1002/da.22759
View details for PubMedID 29659141
Brief report: Cross-sectional interactions between expressive suppression and cognitive reappraisal and its relationship with depressive symptoms in autism spectrum disorder
Research in Autism Spectrum Disorders
2018; 45: 1-8
View details for DOI 10.1016/j.rasd.2017.10.002
Understanding depression and thoughts of self-harm in autism: A potential mechanism involving loneliness
Research in Autism Spectrum Disorders
2018; 46: 1-7
View details for DOI 10.1016/j.rasd.2017.11.003
The measurement properties of the spence children's anxiety scale-parent version in a large international pooled sample of young people with autism spectrum disorder.
Anxiety-related difficulties are common in ASD, but measuring anxiety reliably and validly is challenging. Despite an increasing number of studies, there is no clear agreement on which existing anxiety measure is more psychometrically sound and what is the factor structure of anxiety in ASD. The present study examined the internal consistency, convergent, divergent, and discriminant validity, as well as the factor structure of the Spence Children's Anxiety Scale-Parent Version (SCAS-P), in a large international pooled sample of 870 caregivers of youth with ASD from 12 studies in the United Kingdom, United States, and Singapore who completed the SCAS-P. Most were community recruited, while the majority had at least one measure of ASD symptomatology and either cognitive or adaptive functioning measures completed. Existing SCAS-P total scale and subscales had excellent internal consistency and good convergent, divergent and discriminant validity similar to or better than SCAS-P properties reported in typically developing children, except for the poorer internal consistency of the physical injury subscale. Confirmatory Factor Analysis (CFA) of the existing SCAS-P six-correlated factor structure was a poor fit for this pooled database. Principal component analysis using half of the pooled sample identified a 30-item five correlated factor structure, but a CFA of this PCA-derived structure in the second half of this pooled sample revealed a poor fit, although the PCA-derived SCAS-P scale and subscales had stronger validity and better internal consistency than the original SCAS-P. The study's limitations, the use of the SCAS-P to screen for DSM-derived anxiety problems in ASD and future research directions are discussed. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
View details for DOI 10.1002/aur.1809
View details for PubMedID 28574646
Heterogeneity of sensory features in autism spectrum disorder: Challenges and perspectives for future research.
2017; 10 (5): 703-710
Pronounced heterogeneity is apparent across every facet of autism spectrum disorder (ASD) and it remains difficult to predict likely future potential among individuals who share a common diagnosis of ASD on the basis of early presentation. In this commentary we argue that a fine-grained understanding of individual differences in sensory features and their influence across the life span can constrain noted clinical heterogeneity in ASD. We organize our discussion around the following three critical themes: (a) considering sensory features as dimensional construct; (b) taking an "individual differences" approach; and (c) adopting a comprehensive, multidimensional and multimodal approach to measurement of sensory features. We conclude that future research will need to investigate individual differences in sensory features via: (1) multidimensional and cross-disciplinary examination, (2) prospective longitudinal designs, and (3) dimensional and developmental frameworks that emphasize the potential value of early individual variability as indicators of later outcomes, not only in relation to the categorical diagnostic outcome status but also the presence of other clinical features. This is a key time for sensory-related research and in this commentary we provide some of the steps that, in our opinion, can shape future research in this area. Autism Res 2017, 10: 703-710. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
View details for DOI 10.1002/aur.1747
View details for PubMedID 28266796
Relationship between early motor milestones and severity of restricted and repetitive behaviors in children and adolescents with autism spectrum disorder.
This study explored the relationships between the later age of achievement of early motor milestones, current motor atypicalities (toe walking), and the severity of restricted and repetitive behaviors (RRBs) in individuals with autism spectrum disorder (ASD). Parents of 147 children and adolescents with ASD (Mage = 8.09 years, SD = 4.28; 119 males) completed an early developmental milestones questionnaire and the Social Responsiveness Scale as a measure of Insistence on Sameness (IS) and Repetitive Mannerisms (RM). Two hierarchical regression analyses were conducted to test whether RM and IS behaviors were predicted by early motor milestones, or current toe walking. The final model predicting RM accounted for 15% of the variance (F = 3.02, p = .009), with toe walking as a unique and independent predictor of RM scores (t = 3.568, p = .001). The final model predicting IS accounted for 19.1% of variance in IS scores (F = 4.045, p = .001), with chronological age (CA) (t = 2.92, p = .004), age when first standing (t = 2.09, p = .038), and toe walking (t = 2.53, p = .013) as unique independent predictors. Toe walking (t = 2.4, p = .018) and age when first sitting (t = 2.08, p = .04) predicted the severity of RRBs on the Autism Diagnostic Observation Schedule (F = 2.334, p = .036). Our study replicates previous findings on the relationship between concurrent motor impairments and RRBs, and provides the first evidence for the association between RRBs and age of attainment of early motor milestones. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1163-1168. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
View details for DOI 10.1002/aur.1763
View details for PubMedID 28301081
Transition to work: Perspectives from the autism spectrum.
To improve employment outcomes for adults with autism spectrum disorder, it is necessary to identify factors associated with successful transition to work from the perspectives of the individual and from those who work with or support them. This study involved focus groups with adults with autism spectrum disorder ( n = 9) participating in a 3-year employment and training programme, as well as focus groups with family members ( n = 6), support staff ( n = 7) and co-workers ( n = 6). The aim was to gain better understanding of the experience of transition to work, barriers and also the factors that promote workplace success. Main themes included factors that facilitated success at work ( Enablers), barriers to success ( Challenges) and programme outcomes ( Outcomes). Organisation support, advice from co-workers, supportive leadership, allowance of environmental modifications and presence of a consultant were identified as enablers that most facilitated success at work. Challenges included task-related difficulties, individual factors, social difficulties and distractibility, not managing work-related stress, and being perceived to be too frank. Outcomes were rated as positive and encompassed work-related outcomes, as well as outcomes related to sense of purpose, achieving personal independence and improvements in social relationships, both with work colleagues and within families.
View details for DOI 10.1177/1362361316687697
View details for PubMedID 28387577
Relationship between repetitive behaviour and fear across normative development, autism spectrum disorder, and down syndrome.
2017; 10 (3): 502-507
The present study had two aims: first to compare levels of restricted and repetitive behaviours (RRB) across two groups of typically developing (TD) children, and two disorders: Autism Spectrum Disorder (ASD) and Down syndrome (DS), and second to explore the relationship between fear and repetitive behaviours in these four groups. Parents of 41 offspring with ASD (Mage = 123.39 months, SDage = 27.67), 38 offspring with DS (Mage = 125.37 months, SDage = 45.71), 45 typically developing children matched to the mental age (MA) of the DS group (TD MA; Mage = 51.13 months, SDage = 22.1), and 42 chronological age (TD CA; Mage = 117.93 months, SDage = 22.91) matched TD children, completed measures of RRB and fear. ANOVAs revealed differences across the four groups on the RRB subscale scores: "Just Right" F(3,162) = 16.62, P < 0.001; Rigid Routines F(3,162) = 52.76, P < 0.001; Sensory behaviours F(3,162) = 23.26, P < 0.001. Post-hoc comparisons revealed that children with ASD had the highest RRB levels followed by DS, TD MA, and TD CA children. In children with ASD, higher levels of fear were related to higher RRB levels. Similar, albeit less strong, patterns of associations was found among DS and TD MA children but not in older TD CA children. This study provided evidence of a fear-RRB association in children with ASD, DS, and two groups of TD children. Autism Res 2017, 10: 502-507. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
View details for DOI 10.1002/aur.1674
View details for PubMedID 27459229
- Relationship between repetitive behaviour and fear across normative development, autism spectrum disorder, and down syndrome AUTISM RESEARCH 2017; 10 (3): 502-507
Attention to novelty versus repetition: Contrasting habituation profiles in Autism and Williams syndrome.
Developmental cognitive neuroscience
Abnormalities in habituation have been documented in Autism Spectrum Disorder (ASD) and Williams syndrome (WS). Such abnormalities have been proposed to underlie the distinctive social and non-social difficulties that define ASD, including sensory features and repetitive behaviours, and the distinctive social phenotype characterizing WS.We measured habituation in 39 preschoolers with ASD, 20 peers with WS and 19 typically developing (TD) children using an eye-tracking protocol that measured participants' duration of attention in response to a repeating stimulus and a novel stimulus presented side by side across multiple trials.Participants in the TD group and the WS group decreased their attention toward the repeating stimulus and increased their attention to the novel stimulus over time. Conversely, the ASD group showed a similar attentional response to the novel and repeating stimuli. Habituation was correlated with social functioning in the WS but not in the ASD group. Contrary to predictions, slower habituation in ASD was associated with lower severity of repetitive behaviours.Habituation appears to be intact in WS and impaired in ASD. More research is needed to clarify the nature of the syndrome-specific patterns of correlations between habituation and social and non-social functioning in these neurodevelopmental disorders.
View details for DOI 10.1016/j.dcn.2017.01.006
View details for PubMedID 28130077
Interrelationship between insistence on sameness, effortful control and anxiety in adolescents and young adults with autism spectrum disorder (ASD)
2017; 8: 36
View details for DOI 10.1186/s13229-017-0158-4
- Employment and Living with Autism: Personal, Social and Economic Impact Inclusion, Disability and Culture. Inclusive Learning and Educational Equity Springer. 2017: 295–311
Development of Two Dimensional Measures of Restricted and Repetitive Behavior in Parents and Children
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
2017; 56 (1): 51-58
Restricted and repetitive behaviors (RRBs) are a heterogeneous set of behaviors common across a wide range of neurodevelopmental disorders (NDDs) and neuropsychiatric disorders (NPDs) that extend well into the general population. This study introduces 2 dimensional measurements of RRBs for use in typical and clinical populations from infancy to adulthood.The Childhood Routines Inventory-Revised (CRI-R) and the Adult Routines Inventory (ARI) were created and administered online to a nationally representative cohort of 3,108 parents with 3,032 children (range 12 months to 17 years 11 months). Twenty-six percent of children and 36% of adults had at least 1 NDD or NPD.Principal axis factoring exploratory analysis showed a 2-factor structure for the 2 instruments (motor behaviors/compulsions and rigidity/insistence on sameness). Analyses for convergent and discriminant validity, internal consistency (Cronbach α ≥ 0.94), and test-retest reliability (r ≥ 0.87) indicated strong psychometric properties. Item response theory analyses indicated strong reliability across the score range for the 2 instruments. RRB rates varied across development, peaking between the preschool and school years. Children with NDDs or NPDs (particularly those with autism spectrum disorder, schizophrenia/bipolar disorder, or obsessive-compulsive disorder/tic disorders) had increased RRBs compared with those with no diagnosis. Parent-child (0.69-0.84) and sibling-sibling (0.76-0.87) intraclass correlations indicated high heritability. Children of parents with an NDD or an NPD exhibited more RRBs compared with children of parents without NDDs or NPDs.The CRI-R and ARI are open-source instruments with excellent psychometric properties and will be useful for developmental, clinical, and family genetic studies and for the identification of prodromal conditions involving RRBs.
View details for DOI 10.1016/j.jaac.2016.10.014
View details for Web of Science ID 000390974600008
View details for PubMedID 27993229
Initiatives that diminish the biases of recruiters against people who disclose or demonstrate a diagnosed mental disorder
Equality, Diversity and Inclusion: An International Journal
2017; 36 (1): 2-16
View details for DOI 10.1108/EDI-05-2016-0037
Development of restricted and repetitive behaviors from 15 to 77 months: Stability of two distinct subtypes?
2017; 53 (10): 1859–68
A community sample of 192 parents reported on their children's restricted and repetitive behaviors (RRBs) at mean ages 15 months (N = 138), 26 months (N = 191), and 77 months (N = 125) using the Repetitive Behavior Questionnaire-2 (RBQ-2). Consistent with previous factor analytic research, 2 factors were found at each age: 1 comprising repetitive sensory and motor behaviors (RSM), and the other comprising insistence on sameness behaviors including rigidity, routines, and restricted interests (IS). Regression analyses indicated that RSM and IS subtypes develop independently. RSM at 77 months was predicted only by RSM behaviors at 26 months and not by IS behaviors at either 15 or 26 months nor by RSM behaviors at 15 months. IS at 77 months was predicted by IS behaviors at both 15 and 26 months, but not by RSM behaviors at either 15 or 26 months. Our findings provide evidence that there is stability of 2 independent subtypes of RRBs, RSM and IS, across early childhood and that these subtypes develop independently of each other. (PsycINFO Database Record
View details for DOI 10.1037/dev0000324
View details for PubMedID 28758781
Dimensional assessment of schizotypal, psychotic, and other psychiatric traits in children and their parents: development and validation of the Childhood Oxford-Liverpool Inventory of Feelings and Experiences on a representative US sample.
Journal of child psychology and psychiatry, and allied disciplines
Healthy functioning relies on a variety of perceptual, cognitive, emotional, and behavioral abilities that are distributed throughout the normal population. Variation in these traits define the wide range of neurodevelopmental (NDD) and neuropsychiatric (NPD) disorders. Here, we introduce a new measure for assessing these traits in typically developing children and children at risk for NDD and NPD from age 2 to 18 years.The Childhood Oxford-Liverpool Inventory of Feelings and Experiences (CO-LIFE) was created as a dimensional, parent-report measure of schizotypal and psychotic traits in the general population. Parents of 2,786 children also self-reported on an adapted version of the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE-US).The CO-LIFE resulted in continuous distributions for the total score and for each of three factor analytically-derived subscales. Item response theory (IRT) analyses indicated strong reliability across the score range for the O-LIFE-US and the CO-LIFE. Internal consistency and test-retest reliability were high across all scales. Parent-child intraclass correlations were consistent with high heritability. The scales discriminated participants who reported a lifetime psychiatric diagnosis from those who reported no diagnosis. The O-LIFE-US and CO-LIFE scores correlated positively with the Social Responsiveness Scale 2 (SRS-2) indicating good convergent validity.Like the original O-LIFE, the O-LIFE-US and the CO-LIFE are valid and reliable tools that reflect the spectrum of psychiatric and schizotypal traits in the general population. Such scales are necessary for conducting family studies that aim to examine a range of psychological and behavioral traits in both children and adults and are well-suited for the Research Domain Criteria (RDoC) initiative of the NIMH.
View details for DOI 10.1111/jcpp.12827
View details for PubMedID 29083029
Language profiles in young children with autism spectrum disorder: A community sample using multiple assessment instruments.
Autism : the international journal of research and practice
This study investigated language profiles in a community-based sample of 104 children aged 1-3 years who had been diagnosed with autism spectrum disorder using Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnostic criteria. Language was assessed with the Mullen scales, Preschool Language Scale, fifth edition, and Vineland-II parent-report. The study aimed to determine whether the receptive-to-expressive language profile is independent from the assessment instrument used, and whether nonverbal cognition, early communicative behaviors, and autism spectrum disorder symptoms predict language scores. Receptive-to-expressive language profiles differed between assessment instruments and reporters, and Preschool Language Scale, fifth edition profiles were also dependent on developmental level. Nonverbal cognition and joint attention significantly predicted receptive language scores, and nonverbal cognition and frequency of vocalizations predicted expressive language scores. These findings support the administration of multiple direct assessment and parent-report instruments when evaluating language in young children with autism spectrum disorder, for both research and in clinical settings. Results also support that joint attention is a useful intervention target for improving receptive language skills in young children with autism spectrum disorder. Future research comparing language profiles of young children with autism spectrum disorder to children with non-autism spectrum disorder developmental delays and typical development will add to our knowledge of early language development in children with autism spectrum disorder.
View details for DOI 10.1177/1362361317726245
View details for PubMedID 29126347
Predictors of Mental Health in Chinese Parents of Children with Autism Spectrum Disorder (ASD).
Journal of autism and developmental disorders
The aim of this study was to explore the influence of parental intolerance of Uncertainty (IU), sensory sensitivity (SS) and Broader Autism Phenotype (BAP), as well as the severity of their children's autism symptoms and co-morbid symptoms, on the mental health of Chinese parents of children with autism spectrum disorder (ASD). One hundred and twenty-two parents (86.9% mothers; M age = 35.64 years, SD = 4.21) of children with ASD took part. Regression and mediation analyses showed that children's internalizing difficulties, parental BAP and IU had a direct effect, and SS had an indirect effect through IU, on parental mental health. We did not find a significant relationship between parental mental health and children's ASD severity. Our findings emphasise the need to focus on parental traits when considering their well-being and mental health, and have implications for the design of evidence-based services to support the needs of parents.
View details for DOI 10.1007/s10803-017-3364-1
View details for PubMedID 29127642
Brief Report: Social Support, Depression and Suicidal Ideation in Adults with Autism Spectrum Disorder.
Journal of autism and developmental disorders
2017; 47 (11): 3669–77
Adults with autism spectrum disorder (ASD) are at increased risk of suicide compared to the general population. Research has yet to identify the mechanisms underlying this increased risk. This study examined perceived social support as a potential protective factor for depressive symptoms and suicidal ideation in 76 adults with ASD. Twenty-five percent of participants were in the clinical range for depression, and 20% reported recent suicidal ideation. Social support in the form of appraisal and belonging was not associated with depression or ideation; however the perceived availability of tangible (material) support indirectly acted on ideation through depression. The findings suggest that tangible support, but not appraisal or belonging, may act as an indirect protective factor against suicidality in ASD.
View details for DOI 10.1007/s10803-017-3274-2
View details for PubMedID 28861661
Prenatal maternal stress events and phenotypic outcomes in Autism Spectrum Disorder.
Autism research : official journal of the International Society for Autism Research
2017; 10 (11): 1866–77
There is significant heterogeneity amongst individuals with Autism Spectrum Disorder (ASD) in symptom presentation and severity. An understanding of the factors that contribute to and modulate symptom severity are critical to informing prognosis, stratification, and treatment decisions. Maternal prenatal stress exposure is a nonspecific risk factor for a wide array of neurodevelopmental outcomes in subsequent offspring. Emerging evidence suggests that prenatal maternal stress may increase ASD risk and contribute to variability in autism-like traits in the general population. In the current study, we aimed to determine whether prenatal maternal exposure to stressful life events is associated with symptom severity amongst individuals with ASD. We performed multiple regression analyses to examine associations between retrospectively recalled maternal prenatal stressful life events and the severity of ASD-associated symptoms in 174 children with ASD (Mage = 9.09 years; SD = 3.81). ASD-related symptom severity was measured using the Social Responsiveness Scale and communication abilities were measured using the Children's Communication Checklist. Exposure to prenatal stressful life events was a significant predictor of ASD-related symptom severity (t = 2.014; P = .048) and communication abilities (t = -2.925; P = .004) amongst children with ASD, even after controlling for a range of sociodemographic and obstetric variables. Follow-up analyses demonstrated significant increases in symptom severity only in the context of multiple (two or more) prenatal stressful life events. Together, these findings indicate that ASD, in the context of prenatal maternal stress exposure, may be associated with a more severe phenotype, particularly when there are multiple prenatal exposures. Autism Res 2017, 10: 1866-1877. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.There is emerging evidence that prenatal maternal stress may increase the risk for Autism Spectrum Disorder (ASD) and contribute to variability in autism-like traits in the general population. Here, we found that more stressful life events experienced during pregnancy was associated with more severe ASD-related symptoms and poorer communication abilities amongst children with ASD. The results from this study suggest that prenatal maternal stress exposure and its sequelae may contribute to variability in symptom severity amongst children with ASD.
View details for DOI 10.1002/aur.1830
View details for PubMedID 28681538
Brief Report: Inter-Relationship between Emotion Regulation, Intolerance of Uncertainty, Anxiety, and Depression in Youth with Autism Spectrum Disorder.
Journal of autism and developmental disorders
The aim of this study was to examine the inter-relationship between emotion regulation (ER), intolerance of uncertainty (IU), and symptoms of anxiety and depression in adolescents and young adults diagnosed with autism spectrum disorder (ASD). Sixty-one individuals aged 14-24 years (M age = 18.19; SD age = 2.19) completed the ER Questionnaire, IU Scale-12, Diagnostic and Statistical Manual of Mental Disorders-5 Dimensional Anxiety Scales, Patient Health Questionnaire-9, and Autism-Spectrum Quotient-Short. Correlation and mediation analyses were conducted. Results indicated all key variables were associated with each other and IU mediated the relationships between ER and symptoms of anxiety and of depression. Findings have implications for the design of future interventions targeting affective disorders in ASD.
View details for DOI 10.1007/s10803-017-3318-7
View details for PubMedID 28980172
The Hospital Anxiety and Depression scale: Factor structure and psychometric properties in older adolescents and young adults with autism spectrum disorder.
Autism research : official journal of the International Society for Autism Research
Despite the high frequency of anxiety and depression symptoms in individuals with Autism Spectrum Disorder (ASD) and a significant impact of these comorbidities on both individuals with ASD and their families, research on the validity of anxiety and depression measures in the ASD population is currently lacking. The aim of this study was to explore the psychometric properties of the Hospital Anxiety and Depression Scale [HADS; Zigmond & Snaith, ] in a sample of older adolescents and young adults with ASD. One hundred and fifty one participants (UK Transition longitudinal study: N = 106; 75 males, Mage = 16.04 years, SD = 1.28; Longitudinal Study of Australian Schools Leavers with ASD: N = 45, 30 males; Mage = 18.35 years, SD = 2.55) completed the HADS and a range of mental health and well-being measures. Combination of the Principal Component Analysis and Parallel Analysis indicated two factors as an optimal solution in our sample, accounting for 43.77% of variance with factors being identical in terms of content with the structure found in the general population. Internal consistency was good for the HADS anxiety scale (HADS-A; .82-.84) and acceptable for the HADS depression scale (HADS-D; .60-.72). Convergent validity of both HADS-A and HADS-D scales was excellent and divergent validity was acceptable. Our study represents a significant contribution to the literature by providing an initial validation of the HADS in older adolescents and younger adults with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.Research on the validity of measurement of anxiety and depression in ASD is currently lacking. The aim of this study was to explore the properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of 151 young people with ASD. Participants completed HADS and a range of mental health and well-being measures. Encouragingly, our findings suggest that HADS provides a reliable and valid assessment of anxiety and depression in ASD.
View details for DOI 10.1002/aur.1872
View details for PubMedID 28922575
Neural substrates of a schizotypal spectrum in typically-developing children: Further evidence of a normal-pathological continuum
BEHAVIOURAL BRAIN RESEARCH
2016; 315: 141-146
Schizophrenia represents the extreme end of a distribution of traits that extends well into the general population. Using a recently developed measure of psychotic-like traits in children, we examined the neural substrates of psychotic (and other psychiatric) symptoms using structural magnetic resonance imaging (MRI). Twenty-eight typically-developing children (14 males) between the ages of 6-17 years underwent a 3T MRI scan. Parents completed the Psychiatric and Schizotypal Inventory for Children. Results revealed that caudate, amygdala, hippocampal and middle temporal gyrus volumes were associated with quantitative dimensions of psychiatric traits. Furthermore, results suggest a differential a sexually-dimorphic pattern of brain-schizotypy associations. These findings highlight brain-behavior continuities between clinical conditions such as schizophrenia and normal trait variation in typical development.
View details for DOI 10.1016/j.bbr.2016.08.034
View details for Web of Science ID 000383942000016
View details for PubMedID 27555534
- ADOS-2 Toddler and Module 1 standardized severity scores as used by community practitioners RESEARCH IN AUTISM SPECTRUM DISORDERS 2016; 32: 84-95
Practitioner Review: Multilingualism and neurodevelopmental disorders - an overview of recent research and discussion of clinical implications
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY
2016; 57 (11): 1205-1217
Language and communication skills are essential aspects of child development, which are often disrupted in children with neurodevelopmental disorders. Cutting edge research in psycholinguistics suggests that multilingualism has potential to influence social, linguistic and cognitive development. Thus, multilingualism has implications for clinical assessment, diagnostic formulation, intervention and support offered to families. We present a systematic review and synthesis of the effects of multilingualism for children with neurodevelopmental disorders and discuss clinical implications.We conducted systematic searches for studies on multilingualism in neurodevelopmental disorders. Keywords for neurodevelopmental disorders were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categories as follows; Intellectual Disabilities, Communication Disorders, Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, Motor Disorders, Other Neurodevelopmental Disorders. We included only studies based on empirical research and published in peer-reviewed journals.Fifty studies met inclusion criteria. Thirty-eight studies explored multilingualism in Communication Disorders, 10 in ASD and two in Intellectual Disability. No studies on multilingualism in Specific Learning Disorder or Motor Disorders were identified. Studies which found a disadvantage for multilingual children with neurodevelopmental disorders were rare, and there appears little reason to assume that multilingualism has negative effects on various aspects of functioning across a range of conditions. In fact, when considering only those studies which have compared a multilingual group with developmental disorders to a monolingual group with similar disorders, the findings consistently show no adverse effects on language development or other aspects of functioning. In the case of ASD, a positive effect on communication and social functioning has been observed.There is little evidence to support the widely held view that multilingual exposure is detrimental to the linguistic or social development of individuals with neurodevelopmental disorders. However, we also note that the available pool of studies is small and the number of methodologically high quality studies is relatively low. We discuss implications of multilingualism for clinical management of neurodevelopmental disorders, and discuss possible directions for future research.
View details for DOI 10.1111/jcpp.12596
View details for Web of Science ID 000387125800002
View details for PubMedID 27443172
Brief Report: Empathic Responsiveness of High Functioning Children with Autism to Expressed and Anticipated Distress
JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS
2016; 46 (10): 3338-3343
The majority of studies that have investigated empathic responsiveness of individuals with Autism spectrum disorder (ASD) have used heterogeneous groups in terms of age, cognitive level and gender which significantly impact the results. Our aim in this study was to explore responsiveness of a more homogenous sample of 21 children with ASD and 17 typically developing controls, aged 8-12 years to both overt (or expressed) and anticipated distress. In the anticipated distress task, groups were not differentiated in their response towards the experimenter who had her drawing torn. In the expressed distress task, groups were again similar in expressing concern and acting prosocially towards an experimenter who pretended to lose her watch. The theoretical and clinical implications of these findings are discussed.
View details for DOI 10.1007/s10803-016-2862-x
View details for Web of Science ID 000386783300013
View details for PubMedID 27436192
Sensory subtypes and anxiety in older children and adolescents with autism spectrum disorder
2016; 9 (10): 1073-1078
This study aimed to identify sensory subtypes in older children and adolescents with Autism Spectrum Disorders (ASD) and examine the relationship of sensory subtypes with anxiety levels in this group. Mothers of 57 children and adolescents with ASD aged 11-17 years (Mean age = 14 years. 2.4 months, SD = 1.81) completed the short sensory profile and Spence anxiety scales. Model-based cluster analysis was applied to sensory profile scores to identify sensory subtypes. Three sensory subtypes, sensory adaptive (N = 19), sensory moderate (N = 29) and sensory severe (N = 9) were identified. The results indicated that the differences between the subtypes were well characterised by the severity of sensory symptoms and were not attributable to sensory modality or varying types of sensory-related behaviors. Children and adolescents from the adaptive subtype had significantly lower anxiety scores when compared with other two subtypes. There were no differences between subtypes based on chronological age, expressive language, or severity of autism diagnostic features as measured by the social communication questionnaire (SCQ total score). This is the first study to identify the existence of sensory subtypes among older children and adolescents with ASD and explore their association with anxiety levels. Autism Res 2016, 9: 1073-1078. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
View details for DOI 10.1002/aur.1602
View details for Web of Science ID 000386576100005
View details for PubMedID 26765165
Treatment-related changes in children's communication impact on maternal satisfaction and psychological distress
RESEARCH IN DEVELOPMENTAL DISABILITIES
2016; 56: 128-138
Parents of children with autism have been found to have reduced psychological well-being that has usually been linked to the stress related to managing their child's symptoms. As children's behavior and cognitive functioning are subject to change when suitable early intervention programs are put in place, it is plausible that positive treatment-related changes in the child will have a positive impact on parental distress.We undertook an individual differences study to investigate whether maternal psychological distress is affected by the outcomes of children receiving intervention.The participants comprised 43 mothers of preschool children with ASD enrolled in an early intervention program for 12 months.Child and family factors were linked to maternal psychological distress. However treatment-related changes in children's communication, as assessed on the Vineland Adaptive Behavior Scales II, and parenting satisfaction uniquely contributed to psychological distress above and beyond other factors. A mediation analysis indicated that mothers whose children make treatment gains in communication skills experience lower levels of psychological distress as a consequence of higher levels of parenting satisfaction.The findings highlight improvements in everyday adaptive communication skills in children with ASD impact on mothers' satisfaction and distress.
View details for DOI 10.1016/j.ridd.2016.05.021
View details for Web of Science ID 000379370000012
View details for PubMedID 27295207
Employment programmes and interventions targeting adults with autism spectrum disorder: A systematic review of the literature.
Individuals with autism spectrum disorder face significant challenges entering the workforce; yet research in this area is limited and the issues are poorly understood. In this systematic review, empirical peer-reviewed studies on employment programmes, interventions and employment-related outcomes in individuals with autism spectrum disorder over 18 years with and without intellectual disability were identified and evaluated. The review was prefaced by a summary of previous systematic reviews in the area. Web of Science, Medline, PsychINFO, ERIC and Scopus databases were systematically searched through to October 2015. From 32,829 records identified in the initial search, 10 review and 50 empirical articles, comprising N = 58,134 individuals with autism spectrum disorder, were included in the review. Selected articles were organised into the following themes: employment experiences, employment as a primary outcome, development of workplace skills, non-employment-related outcomes, assessment instruments, employer-focused and economic impact. Empirical studies were limited by poor participant characterisation, small sample size and/or a lack of randomisation and use of appropriate controls. Poor conceptualisation and measurement of outcomes significantly limited study quality and interpretation. Future research will require a multidisciplinary and multifaceted approach to explore employment outcomes on the individual, the family system, co-workers and the employer, along with the impact of individual differences on outcome.
View details for PubMedID 27542395
The Relationship Between Clinicians' Confidence and Accuracy, and the Influence of Child Characteristics, in the Screening of Autism Spectrum Disorder
JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS
2016; 46 (7): 2340-2348
The study examined the confidence accuracy relationship, and the influence of child characteristics on clinician confidence, when predicting a diagnosis of Autism Spectrum Disorder during screening of 125 referred children aged under 3.5 years. The diagnostic process included observation, interview, language and developmental testing. Clinical judgement accuracy was compared against final diagnosis for high and low confidence levels (with confidence assessed on a 0-100 % scale). We identified a significant CA relationship with predictive accuracy highest at confidence levels of 90-100 %. Parent report of unusual behaviors was the only significant independent predictor of confidence. Clinicians' confidence may be important when evaluating decisions to refer, or not to refer, children for further diagnostic assessment.
View details for DOI 10.1007/s10803-016-2766-9
View details for Web of Science ID 000379547700007
View details for PubMedID 26975451
Short report: relationship between restricted and repetitive behaviours in children with autism spectrum disorder and their parents
Restricted and repetitive behaviours (RRBs) constitute a core symptom domain of autism spectrum disorder (ASD). However, the nature of RRBs in the context of the Broader Autism Phenotype (BAP) is not well understood. In particular, the relationship between RRBs in ASD probands and their parents remains largely unexplored. The current study explored the link between parental RRBs, measured via Interest in Patterns and Resistance to Changes subscales of the Autism Quotient and their children's RRBs, measured via Autism Diagnostic Observation Schedule RRB standardized domain score.Having both parents within the top 20% of their RRB scores was associated with an increase of RRB scores for their children; however, no parent-of-origin effects were identified. Although the trend was observed for both Interest in Patterns and Resistance to Changes subscale, it was only statistically significant for Interest in Patterns.This paper provides significant contribution to our understanding of association between RRBs in parents and their children with ASD. Future work should also address the BAP in distinct genetic subtypes (whole chromosome aneuploidies, single gene mutations, copy number variations) of neurodevelopmental and neuropsychiatric disorders that involve RRBs.
View details for DOI 10.1186/s13229-016-0091-y
View details for Web of Science ID 000380187600001
View details for PubMedID 27303619
View details for PubMedCentralID PMC4906972
Knowledge acquisition and research evidence in autism: Researcher and practitioner perspectives and engagement
RESEARCH IN DEVELOPMENTAL DISABILITIES
2016; 51-52: 126-134
Government policy and national practice guidelines have created an increasing need for autism services to adopt an evidence-based practice approach. However, a gap continues to exist between research evidence and its application. This study investigated the difference between autism researchers and practitioners in their methods of acquiring knowledge.In a questionnaire study, 261 practitioners and 422 researchers reported on the methods they use and perceive to be beneficial for increasing research access and knowledge. They also reported on their level of engagement with members of the other professional community.Researchers and practitioners reported different methods used to access information. Each group, however, had similar overall priorities regarding access to research information. While researchers endorsed the use of academic journals significantly more often than practitioners, both groups included academic journals in their top three choices. The groups differed in the levels of engagement they reported; researchers indicated they were more engaged with practitioners than vice versa.Comparison of researcher and practitioner preferences led to several recommendations to improve knowledge sharing and translation, including enhancing access to original research publications, facilitating informal networking opportunities and the development of proposals for the inclusion of practitioners throughout the research process.
View details for DOI 10.1016/j.ridd.2016.01.011
View details for Web of Science ID 000370465700011
View details for PubMedID 26826464
Anxiety in Autism Spectrum Disorder
Psychiatric Symptoms and Comorbidities in Autism Spectrum Disorder
Springer. 2016: 21–38
View details for DOI 10.1007/978-3-319-29695-1_2
- Interventions for anxiety in school-aged children with autism spectrum disorder (ASD) Campbell Collaboration 2016
Brief Report: Effects of Sensory Sensitivity and Intolerance of Uncertainty on Anxiety in Mothers of Children with Autism Spectrum Disorder
JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS
2016; 46 (1): 315-319
This study examined the relations between anxiety and individual characteristics of sensory sensitivity (SS) and intolerance of uncertainty (IU) in mothers of children with ASD. The mothers of 50 children completed the Hospital Anxiety and Depression Scale, the Highly Sensitive Person Scale and the IU Scale. Anxiety was associated with both SS and IU and IU was also associated with SS. Mediation analyses showed direct effects between anxiety and both IU and SS but a significant indirect effect was found only in the model in which IU mediated between SS. This is the first study to characterize the nature of the IU and SS interrelation in predicting levels of anxiety.
View details for DOI 10.1007/s10803-015-2557-8
View details for Web of Science ID 000367883500028
View details for PubMedID 26254895
The Adult Repetitive Behaviours Questionnaire-2 (RBQ-2A): A Self-Report Measure of Restricted and Repetitive Behaviours
JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS
2015; 45 (11): 3680-3692
In two studies we developed and tested a new self-report measure of restricted and repetitive behaviours (RRB) suitable for adults. In Study 1, The Repetitive Behaviours Questionnaire-2 for adults (RBQ-2A) was completed by a sample of 163 neurotypical adults. Principal components analysis revealed two components: Repetitive Motor Behaviours and Insistence on Sameness. In Study 2, the mean RBQ-2A scores of a group of adults with autism spectrum disorder (ASD; N = 29) were compared to an adult neurotypical group (N = 37). The ASD sample had significantly higher total and subscale scores. These results indicate that the RBQ-2A has utility as a self-report questionnaire measure of RRBs suitable for adults, with potential clinical application.
View details for DOI 10.1007/s10803-015-2514-6
View details for Web of Science ID 000363066900025
View details for PubMedID 26155763
View details for PubMedCentralID PMC4608982
The effects of bilingual exposure for children with autism spectrum disorders: Current knowledge and future directions
Bilingual Landscape of the Contemporary World
Peter Lang. 2015
View details for DOI 10.3726/978-3-653-06391-2
First evidence of sensory atypicality in mothers of children with Autism Spectrum Disorder (ASD)
Atypical reactions to sensory stimuli show heritability in the general population and are a known risk factor for affective disorders. As sensory problems are highly prevalent in individuals with ASD and their siblings, and the occurrence of affective disorders is elevated in parents of children with ASD, investigating sensory symptoms in parents is important both from clinical and theoretical standpoints.Fifty mothers of children and adolescents with ASD completed the Adolescent and Adult Sensory Profile (AASP). The AASP is a norm-referenced questionnaire that provides scores for four types of responses to sensory stimuli (sensory quadrants): hypo-sensitivity, hyper-sensitivity, sensation seeking, and sensory avoiding.Mothers' scores were compared with AASP norms. Ninety eight percent of mothers had sensory scores at least one standard deviation (SD) above the normative mean and 44% were two or more SDs above the mean for at least one sensory quadrant.This study provides the first evidence for sensory atypicality in parents of children with ASD. Further research is needed to elucidate the contribution of genetic and environmental influences on the expression of sensory problems in ASD.
View details for DOI 10.1186/2040-2392-5-26
View details for Web of Science ID 000334719600001
View details for PubMedID 24694290
View details for PubMedCentralID PMC3975853
- Relations among restricted and repetitive behaviors, anxiety and sensory features in children with autism spectrum disorders RESEARCH IN AUTISM SPECTRUM DISORDERS 2014; 8 (2): 82-92
Imitating the Child with Autism: A Strategy for Early Intervention?
View details for DOI 10.4172/2165-7890.1000124
Recognition of Emotions in Autism: A Formal Meta-Analysis
JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS
2013; 43 (7): 1517-1526
Determining the integrity of emotion recognition in autistic spectrum disorder is important to our theoretical understanding of autism and to teaching social skills. Previous studies have reported both positive and negative results. Here, we take a formal meta-analytic approach, bringing together data from 48 papers testing over 980 participants with autism. Results show there is an emotion recognition difficulty in autism, with a mean effect size of 0.80 which reduces to 0.41 when a correction for publication bias is applied. Recognition of happiness was only marginally impaired in autism, but recognition of fear was marginally worse than recognition of happiness. This meta-analysis provides an opportunity to survey the state of emotion recognition research in autism and to outline potential future directions.
View details for DOI 10.1007/s10803-012-1695-5
View details for Web of Science ID 000320507200003
View details for PubMedID 23114566
Restricted and Repetitive Behaviors in Autism Spectrum Disorders: A Review of Research in the Last Decade
2011; 137 (4): 562-593
Restricted and repetitive behaviors (RRBs) are a core feature of autism spectrum disorders. They constitute a major barrier to learning and social adaptation, but research on their definition, cause, and capacity for change has been relatively neglected. The last decade of research has brought new measurement techniques that have improved the description of RRBs. Research has also identified distinctive subtypes of RRBs in autism spectrum disorders. Research on potential causal origins and immediate triggers for RRBs is still at an early stage. However, promising new ideas and evidence are emerging from neurobiology and developmental psychology that identify neural adaptation, lack of environmental stimulation, arousal, and adaptive functions as key factors for the onset and maintenance of RRBs. Further research is needed to understand how these factors interact with each other to create and sustain atypical levels of RRB. The literature indicates that RRBs have the potential to spontaneously reduce across time, and this is enhanced for those with increased age and cognitive and language ability. Research on interventions is sparse. Pharmacological treatments can be helpful in some children but have adverse side effects. Behavioral intervention methods provide the better intervention option with positive effects, but a more systematic and targeted approach is urgently needed. Evidence suggests that we will learn best from the last decade of research by taking a developmental perspective, by directing future research toward subtypes of RRBs, and by implementing early intervention targeted to improve RRBs before these behaviors become entrenched.
View details for DOI 10.1037/a0023341
View details for Web of Science ID 000292407700003
View details for PubMedID 21574682
- Functions of certain brain structures in the perception and expression of emotions Godišnjak za psihologiju 2008; 5 (6-7): 41-61