High-density electroencephalography (EEG) was used to examine the utility of the P1 event-related potential (ERP) as a marker of visual motion sensitivity to luminance defined low-spatial frequency ...drifting gratings in 16 children with autism and 16 neurotypical children. Children with autism displayed enhanced sensitivity to large, high-contrast low-spatial frequency stimuli as indexed by significantly shorter P1 response latencies to large vs. small gratings. The current study also found that children with autism had larger amplitude responses to large gratings irrespective of contrast. A linear regression established that P1 adaptive mean amplitude for large, high-contrast sinusoidal gratings significantly predicted hyperresponsiveness item mean scores on the Sensory Experiences Questionnaire for children with autism, but not for neurotypical children. We conclude that children with autism have differences in the mechanisms that underlie low-level visual processing potentially related to altered visual spatial suppression or contrast gain control.
Over the past two decades, there have been increasing discussions around which terms should be used to talk about autism. Whilst these discussions have largely revolved around the suitability of ...identity‐first language and person‐first language, more recently this debate has broadened to encompass other autism‐related terminology (e.g., ‘high‐functioning’). To date, academic studies have not investigated the language preferences of autistic individuals outside of the United Kingdom or Australia, nor have they compared levels of endorsement across countries. Hence, the current study adopted a mixed‐methods approach, employing both quantitative and qualitative techniques, to explore the linguistic preferences of 654 English‐speaking autistic adults across the globe. Despite variation in levels of endorsement between countries, we found that the most popular terms were similar—the terms ‘Autism’, ‘Autistic person’, ‘Is autistic’, ‘Neurological/Brain Difference’, ‘Differences’, ‘Challenges’, ‘Difficulties’, ‘Neurotypical people’, and ‘Neurotypicals’ were consistently favored across countries. Despite relative consensus across groups, both our quantitative and qualitative data demonstrate that there is no universally accepted way to talk about autism. Our thematic analysis revealed the reasons underlying participants’ preferences, generating six core themes, and illuminated an important guiding principle—to respect personal preferences. These findings have significant implications for informing practice, research and language policy worldwide.
Lay Summary
There has been a lot of debate about what language should be used to talk about autism. In our study, we assessed the language preferences of 654 English‐speaking autistic people from multiple different countries. Based on our results, we recommend that individuals ask the autistic people they interact with (e.g., the autistic people they are working with, autistic friends or family members, etc.) about their preferences and use those terms. If in doubt, individuals should use the most popular terms (e.g., ‘Autism’, ‘Autistic person’, ‘Is autistic’, ‘Neurological/Brain Difference’, ‘Differences’, ‘Challenges’, ‘Difficulties’, ‘Neurotypical people’, and ‘Neurotypicals’), and be mindful of the ideas underlying language choices (e.g., avoiding ableist language).
Aim
To examine antenatal depression risk screening coverage under the NSW SAFE START Strategic Policy and to explore maternal and sociodemographic factors associated with under‐screening.
Methods
...Completion rates for the Edinburgh Depression Scale (EDS) were examined in a retrospective dataset of routinely collected antenatal care data including all women who birthed at public health facilities in Sydney Local Health District from 1 October 2019 to 6 August 2020. Potential sociodemographic/clinical factors associated with under‐screening were identified using univariate and multivariate logistic regression. Free‐text responses regarding reasons for EDS non‐completion were examined using qualitative thematic analysis techniques.
Results
A total of 4810 women (96.6%) in our sample (N = 4980) completed antenatal EDS screening; only 170 (3.4%) were not screened or lacked data to indicate that screening had occurred. Multivariate logistic regression analyses showed that women under certain models of antenatal care (public hospital care, private midwife/obstetrician or no formal care), non‐English speaking women who required an interpreter, and women whose smoking status during pregnancy was unknown had a higher odds of missing screening. The reasons for EDS non‐completion indicated in the electronic medical record revealed language and time/practical constraints to be the most commonly‐reported barriers.
Conclusions
Antenatal EDS screening coverage was high in this sample. Refresher training for staff involved can emphasise the need to ensure appropriate screening for women who access shared care in external services (particularly private obstetric care). Additionally, at the service level, improved access to interpreter services and foreign language resources may help minimise EDS under‐screening for culturally and linguistically diverse families.
Abstract The heterogeneity of autism spectrum disorder (ASD) clinically and aetiologically hinders intervention matching and prediction of outcomes. This study investigated if the behavioural, ...sensory, and perinatal factor profiles of autistic children could be used to identify distinct subgroups. Participants on the autism spectrum aged 2 to 17 years and their families were sourced via the Australian Autism Biobank (AAB). Latent class analysis was used to identify subgroups within this cohort, utilising twenty-six latent variables representing child’s behavioural and sensory features and perinatal factors. Four distinct subgroups within the sample ( n = 1168) distinguished by sensory and behavioural autism traits and exposure to perinatal determinants were identified. Class 2 and Class 4, which displayed the greatest behavioural and sensory impairment respectively, were associated with the highest perinatal factor exposure. Class 1, labelled “Most behavioural concerns and moderate sensory and behavioural skills concerns” had mixed exposure to perinatal determinants while Class 3, named “Least sensory and behavioural skills concerns” had the least perinatal determinant exposure, indicating a directly proportional correlation between severity of clinical features and perinatal factor exposure. Additionally, association between specific exposures such as maternal mental illness in Class 1 and significant behavioural concerns was recognised. Identifying distinct subgroups among autistic children can lead to development of targeted interventions and supports. Close monitoring of children exposed to specific perinatal determinants for developmental differences could assist early intervention and supports.
Background
Autism spectrum disorder is a neurodevelopmental disorder characterised by social communication difficulties, restricted interests and repetitive behaviours. The clinical pathway for ...children with a diagnosis of autism spectrum disorder is varied, and current research suggests some children may not continue to meet diagnostic criteria over time.
Objectives
The primary objective of this review was to synthesise the available evidence on the proportion of preschool children who have a diagnosis of autism spectrum disorder at baseline (diagnosed before six years of age) who continue to meet diagnostic criteria at follow‐up one or more years later (up to 19 years of age).
Search methods
We searched MEDLINE, Embase, PsycINFO, and eight other databases in October 2017 and ran top‐up searches up to July 2021. We also searched reference lists of relevant systematic reviews.
Selection criteria
Two review authors independently assessed prospective and retrospective follow‐up studies that used the same measure and process within studies to diagnose autism spectrum disorder at baseline and follow‐up. Studies were required to have at least one year of follow‐up and contain at least 10 participants. Participants were all aged less than six years at baseline assessment and followed up before 19 years of age.
Data collection and analysis
We extracted data on study characteristics and the proportion of children diagnosed with autism spectrum disorder at baseline and follow‐up. We also collected information on change in scores on measures that assess the dimensions of autism spectrum disorder (i.e. social communication and restricted interests and repetitive behaviours). Two review authors independently extracted data on study characteristics and assessed risk of bias using a modified quality in prognosis studies (QUIPS) tool. We conducted a random‐effects meta‐analysis or narrative synthesis, depending on the type of data available. We also conducted prognostic factor analyses to explore factors that may predict diagnostic outcome.
Main results
In total, 49 studies met our inclusion criteria and 42 of these (11,740 participants) had data that could be extracted. Of the 42 studies, 25 (60%) were conducted in North America, 13 (31%) were conducted in Europe and the UK, and four (10%) in Asia. Most (52%) studies were published before 2014. The mean age of the participants was 3.19 years (range 1.13 to 5.0 years) at baseline and 6.12 years (range 3.0 to 12.14 years) at follow‐up. The mean length of follow‐up was 2.86 years (range 1.0 to 12.41 years). The majority of the children were boys (81%), and just over half (60%) of the studies primarily included participants with intellectual disability (intelligence quotient < 70). The mean sample size was 272 (range 10 to 8564). Sixty‐nine per cent of studies used one diagnostic assessment tool, 24% used two tools and 7% used three or more tools. Diagnosis was decided by a multidisciplinary team in 41% of studies. No data were available for the outcomes of social communication and restricted and repetitive behaviours and interests.
Of the 42 studies with available data, we were able to synthesise data from 34 studies (69% of all included studies; n = 11,129) in a meta‐analysis. In summary, 92% (95% confidence interval 89% to 95%) of participants continued to meet diagnostic criteria for autism spectrum disorder from baseline to follow‐up one or more years later; however, the quality of the evidence was judged as low due to study limitations and inconsistency. The majority of the included studies (95%) were rated at high risk of bias. We were unable to explore the outcomes of change in social communication and restricted and repetitive behaviour and interests between baseline and follow‐up as none of the included studies provided separate domain scores at baseline and follow‐up. Details on conflict of interest were reported in 24 studies. Funding support was reported by 30 studies, 12 studies omitted details on funding sources and two studies reported no funding support. Declared funding sources were categorised as government, university or non‐government organisation or charity groups. We considered it unlikely funding sources would have significantly influenced the outcomes, given the nature of prognosis studies.
Authors' conclusions
Overall, we found that nine out of 10 children who were diagnosed with autism spectrum disorder before six years of age continued to meet diagnostic criteria for autism spectrum disorder a year or more later, however the evidence was uncertain. Confidence in the evidence was rated low using GRADE, due to heterogeneity and risk of bias, and there were few studies that included children diagnosed using a current classification system, such as the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) or the eleventh revision of the International Classification of Diseases (ICD‐11). Future studies that are well‐designed, prospective and specifically assess prognosis of autism spectrum disorder diagnoses are needed. These studies should also include contemporary diagnostic assessment methods across a broad range of participants and investigate a range of relevant prognostic factors.
Intranasal oxytocin therapy has been used to improve various aspects of autism spectrum disorder on the basis of tenuous results from small studies. In a randomized trial involving 290 participants 3 ...to 17 years of age with autism spectrum disorder, daily use of oxytocin did not improve measures of social interaction as compared with placebo over a period of 24 weeks.
Aim
Problematic externalising behaviours in adolescents are associated with high individual and societal burden. A school‐based multidisciplinary health clinic, Ngaramadhi Space (NS), was developed ...at Yudi Gunyi School, a specialised behavioural school in Sydney, Australia, to improve access to holistic health‐care and behavioural support. This evaluation aimed to describe the demographics, clinic attendance, health screening, recommendations made, and changes in Strengths and Difficulties Questionnaire (SDQ) scores of students attending the clinic.
Methods
Retrospective evaluation of students including changes in SDQ scores using descriptive statistics (26 July 2016 to 14 May 2019; n = 79).
Results
Prior to the assessment, few students engaged with a paediatrician or mental health professional (22.8%; 27.8%, respectively). Child protection services were involved with 76%. NS attendance was high (failure‐to‐attend = 7.6%; cancellations = 8.9%). New issues found at the assessment included: parental separation (31.6%); trauma history (27.8%); substance use (19%); emotional wellbeing concerns (16.5%), learning difficulties (12.7%), domestic violence (12.7%) and medical conditions (10.1%). SDQ teacher reports showed a significant decrease in total difficulties scores (M = 6.2, SD = 6.165, P < 0.05, eta squared = 1.013 (large effect)) and all subsets. No significant differences in parent and self‐reported SDQ.
Conclusions
Students with problematic externalising behaviour have unmet health and social needs. The NS school‐based integrated health‐care model offers a novel, convenient and innovative way to engage these students. This approach has high initial attendance rates with teacher‐reported SDQ results showing some behavioural improvement. Further qualitative studies are required.
Objective:
To examine the impact of COVID-19 restrictions among children with attention-deficit/hyperactivity disorder (ADHD).
Methods:
Parents of 213 Australian children (5–17 years) with ADHD ...completed a survey in May 2020 when COVID-19 restrictions were in place (i.e., requiring citizens to stay at home except for essential reasons).
Results:
Compared to pre-pandemic, children had less exercise (Odds Ratio (OR) = 0.4; 95% CI 0.3–0.6), less outdoor time (OR = 0.4; 95% 0.3–0.6), and less enjoyment in activities (OR = 6.5; 95% CI 4.0–10.4), while television (OR = 4.0; 95% CI 2.5–6.5), social media (OR = 2.4; 95% CI 1.3–4.5), gaming (OR = 2.0; 95% CI 1.3–3.0), sad/depressed mood (OR = 1.8; 95% CI 1.2–2.8), and loneliness (OR = 3.6; 95% CI 2.3–5.5) were increased. Child stress about COVID-19 restrictions was associated with poorer functioning across most domains. Most parents (64%) reported positive changes for their child including more family time.
Conclusions:
COVID-19 restrictions were associated with both negative and positive impacts among children with ADHD.
Elevated whole blood serotonin (WB5-HT) is a well-replicated biomarker in autism spectrum disorder (ASD). Decreased platelet serotonin receptor 5-HT.sub.2A binding has been reported in ASD. WB5-HT ...levels and platelet 5-HT.sub.2A specific binding were obtained from 110 individuals with ASD and 18 controls. Individuals with ASD had significantly higher WB5-HT levels than controls. There was no difference in the platelet 5-HT.sub.2A specific binding between groups. Multiple regression analyses revealed that platelet 5-HT.sub.2A binding significantly predicted WB5-HT in the control sample but not in the ASD sample. These results indicate that the relationship between WB5-HT and platelet 5-HT.sub.2A binding differs depending on ASD diagnosis, suggesting differences in platelet 5-HT system regulation in ASD.
Purpose: The purpose of this mixed methods study was to identify and describe the organizational socialization processes implemented by school districts to support firstyear principals. In addition, ...it was the purpose of this study to identify and describe the degree to which first-year principals perceive these processes are effective. Methodology: This study identified and described district implementation of organizational socialization supporting first-year principals enrolled in the ACSA Clear Administrative Credentialing Program. The participants completed a survey and were interviewed, which provide the data analyzed. Findings: The are several findings from this study. Only two thirds of participants experienced organizational socialization. New principals receive information around rules, laws, roles, and responsibilities the most from meetings and department leads. The special education department provided the most organizational socialization information. Information regarding the formal and informal norms was experienced the least. Most organizational socialization information came from district office leaders, school staff, and prior experience. And finally, for most organizational socialization processes are ineffective. Conclusions: Several conclusions may be drawn from the literature and findings of this study. School districts seldom use purposeful organizational socialization processes with new principals. The lack of knowledge about district culture prevents principals from becoming insiders in districts. Lack of clarity and intentional use has resulted in ineffective organizational socialization practices. District departments overseeing the implementation of state and federal laws are more likely to implement organizational socialization. New principals hired from within the district have a positive experience with organizational socialization. Lastly, organizational socialization is most effective when lead by when district administrators. Recommendations: Several recommendations for further research came from this study: a Delphi study to identify content to be included in organizational socialization processes in districts, an ethnographic study to deeply examine organizational socialization in one school district, a mixed methods study on the ways new principals received information, a correlational study comparing the experience of new principals hired from within and those hired from outside the district, a study examining the exit of new principals, and lastly, a study of how the experience of principals of color should differ.
PDF
