The Early Start Denver Model (ESDM) is an intervention program recommended for pre-schoolers with autism ages 12–48 months. The rationale for this recommendation is the potential for intervention to ...affect developmental trajectories during early sensitive periods. We investigated outcomes of 32 children aged 18–48 months and 28 children aged 48–62 months receiving the ESDM for one year (approximately 20 h per week). Younger children achieved superior verbal DQ gains compared to their older counterparts. There were no group differences with respect to non-verbal DQ and adaptive behavior (with both age-groups undergoing significant change), or ASD severity (with neither age-group showing improvements on the ADOS). The association between verbal DQ gains and age at intake was moderated by baseline verbal level.
The Social Attention and Communication Study involved the successful implementation of developmental surveillance of the early markers of autism spectrum disorders in a community-based setting. The ...objective in the current study was to determine the most discriminating and predictive markers of autism spectrum disorders used in the Social Attention and Communication Study at 12, 18 and 24 months of age, so that these could be used to identify children with autism spectrum disorders with greater accuracy. The percentage of ‘yes/no’ responses for each behavioural marker was compared between children with autistic disorder (n = 39), autism spectrum disorder (n = 50) and developmental and/or language delay (n = 20) from 12 to 24 months, with a logistic regression also conducted at 24 months. Across all ages, the recurring key markers of both autistic disorder and autism spectrum disorder were deficits in eye contact and pointing, and from 18 months, deficits in showing became an important marker. In combination, these behaviours, along with pretend play, were found to be the best group of predictors for a best estimate diagnostic classification of autistic disorder/autism spectrum disorder at 24 months. It is argued that the identified markers should be monitored repeatedly during the second year of life by community health-care professionals.
Using data from a large-scale epidemiological sample (generously shared with us by the Norwegian Institute of Public Health), we provide initial examples of how and why such a stepped care and ...personalised health approach could be applied to address both the core features of autism and co-occurring conditions. Focused research strategies at the government or institutional level should be prioritised with an emphasis on clinical practice that can increase the understanding of what interventions work, for whom, when, how, with what general outcomes, and at what cost. Governments and services should monitor access to provision to ensure that underserved groups, including those who are minimally verbal, girls and women, minority ethnic groups, from socially disadvantaged backgrounds, or with severe co-occurring conditions, have equitable access to appropriate services. Societies in every part of the world have a duty of care to all people with autism and those who care for them, and investment in research and services needs to be targeted wisely to help them to reach better life outcomes and propel the change that makes this possible. Because it is defined by the intersection of social communication and sensory, restricted, and repetitive behaviours and interests, autism is a relatively specific disorder.
Despite behavioral markers of autism spectrum disorders (ASDs) being evident within the first year of life, there remains little research on the prospective identification of these children in a ...community-based setting before 18 months. The aim in the Social Attention and Communication Study was to identify infants and toddlers at risk of an ASD during their first 2 years.
A total of 241 Maternal and Child Health nurses were trained on the early signs of ASDs at 8, 12, 18 and 24 months. Using a developmental surveillance approach with a community-based sample, a cohort of 20,770 children was monitored on early social attention and communication behaviors. Those infants/toddlers identified as "at risk" were referred to the Social Attention and Communication Study team from 12 months for developmental and diagnostic assessments at 6 monthly intervals, until 24 months.
A total of 216 children were referred, with 110 being further assessed. Of these, 89 children were classified with an ASD at 24 months, and 20 children had developmental and/or language delays, resulting in a Positive Predictive value of 81%. The estimated rate of ASDs in the Social Attention and Communication Study cohort ranged from 1:119 to 1:233 children. Estimated sensitivity ranged from 69% to 83.8%, and estimated specificity ranged from 99.8% to 99.9%.
Developmental surveillance of social and communication behaviors, which differ according to the age at which the child is monitored, enables the accurate identification of children at risk for ASDs between 12 and 24 months. Education on the early signs is recommended for all primary health care professionals to facilitate early identification of ASDs.
This study examined age trends in anxious and depressive symptoms, from older adolescence to old age, and explored the association between anxious and depressive symptoms with gender, ASD severity, ...and socio-economic factors. Two hundred and fifty-five individuals with ASD (151 males,
M
age
= 33.52 years,
SD
age
= 14.98) took part. More than one-third of participants reported clinically significant anxiety (38.4%) or depression (38%). A slight trend for an increase in the severity of both anxiety and depression from adolescence to middle adulthood, and then a slight decline in older adulthood was found. Female gender and higher ASD severity predicted more anxiety and depression symptoms. Our findings emphasise the need to provide timely assessment and treatment of anxiety and depression in ASD.
Early research indicates that autistic burnout is a chronic, debilitating condition experienced by many autistic people across the lifespan that can have severe consequences for their mental health, ...wellbeing, and quality of life. To date, studies have focused on the lived experiences of autistic adults, and findings suggest that a lack of support, understanding, and acceptance by others can contribute to the risk of autistic burnout. The study outlined in this protocol will investigate how autistic people with and without experience of autistic burnout, their families, friends, healthcare professionals and non-autistic people understand the construct of autistic burnout to identify commonalities and gaps in knowledge.
Q methodology will be used to investigate participants' subjective understandings of autistic burnout. Q methodology is a mixed-methods design that is well-suited to exploratory research and can elucidate a holistic and comprehensive representation of multiple perspectives about a topic. Participants will complete a card sorting activity to rank how strongly they agree or disagree with a set of statements about autistic burnout and participate in a semi-structured interview to discuss their responses. A first-order factor analysis will be conducted for each participant group, followed by second-order factor analysis to compare the groups' viewpoints. The interview data will provide additional insights into the factors.
Q methodology has not previously been used to examine autistic and non-autistic people's perspectives about autistic burnout. Projected study outcomes include enhanced understanding of the characteristics, risks, and protective factors of autistic burnout. The findings will have practical implications for improving detection of autistic burnout and identifying strategies to support autistic adults with prevention and recovery. The results may also inform the development of a screening protocol and identify potential avenues for future research.
•This study examined mechanisms underpinning depression and thoughts of self-harm in Autism.•26% of participants met cut-off for depression, 21% reported thoughts of self-harm.•Loneliness acted on ...thoughts of self-harm indirectly through depression.•Highlights potential contribution of loneliness to depression and thoughts of self-harm in Autism.
Individuals with Autism Spectrum Disorder (ASD) are at increased risk of suicidal ideation and behavior. This study characterized the inter-relationships between loneliness, depression and thoughts of self-harm in adults with ASD.
Participants were 71 adults with ASD who completed questionnaires that provided information on loneliness, depression and thoughts of self-harm. Relationships between study variables were examined with correlations and a regression analysis. Two exploratory mediation models were then explored. Model 1 tested whether the relationship between depression and thoughts of self-harm was mediated through loneliness. Model 2 tested whether loneliness acted on thoughts of self-harm through depression.
Twenty-six percent of participants met the clinical cut-off for depression and 21% reported thoughts of self-harm. Depressive symptoms, loneliness, and thoughts of self-harm were significantly correlated. Only Model 2, that identified an indirect pathway from loneliness, through depression to thoughts of self-harm, was supported. The mediator for this model accounted for 56.7% of the total effect.
This study examined potential mechanisms underlying depression and thoughts of self-harm in ASD. These results highlight a possible contribution of loneliness to depression and thoughts of self-harm, suggesting treatment options that target loneliness may prove beneficial in improving mental health outcomes in ASD.
To date, the biological basis of autism spectrum disorders (ASDs) remains unknown. Thus, identification and diagnosis are reliant on behavioral presentation and developmental history. There have been ...significant advances in our knowledge of the early signs of ASD through the use of retrospective videotape analysis, parental report, screening studies, and more recently, studies on high-risk infant siblings. Despite behavioral markers being identified within the first year of life, the current average age of diagnosis for ASD remains at approximately 3 years or older. Consequently, these children are not receiving intervention in their early years, which is increasingly recognized as an important time to begin intervention. There remains little research on the prospective identification of these children in a community-based sample before 18 months. It is recommended that future prospective studies monitor behavior repeatedly over time, thereby increasing the opportunity to identify early manifestations of ASD and facilitating the charting of subtle behavioral changes that occur in the development of infants and toddlers with ASD.
An Exploratory Study of Autism Traits and Parenting Dissanayake, Cheryl; Richdale, Amanda; Kolivas, Natasha ...
Journal of autism and developmental disorders,
07/2020, Volume:
50, Issue:
7
Journal Article
Peer reviewed
The study examined the association between autism traits and parenting when raising a typically developing (TD) child, and differences in parenting needs between parents with high and low traits. ...Fifty-eight parents with a blood relative with Autism (who happened to be an offspring with ASD in all cases) and a TD child completed the Autism Quotient, demographic and psychological information, as well as reporting on Parenting Sense of Competence, the Parent–Child Relationship, and Parenting Needs. Autism traits did not uniquely contribute to parenting self-esteem, but were associated with parenting difficulties for their TD child, and some aspects of this parent–child relationship. Parents with high autism traits reported more parenting difficulties than parents with low traits. The study identified specific aspects of parenting needing support to assist parents with high autism traits prosper in their parenting role.
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