Title: A review of cultural adaptations of screening tools for autism spectrum disorders
Authors: Soto, Linas, Jacobstein, Biel, Migdal and Anthony
DOI: 10.1177/1362361314541012
Lay abstract: Screening children to determine their risk for autism spectrum disorders has become more common in various countries. The purpose of this review is four-fold: (a) identify autism screening tools that have been adapted for use in cultures different from that in which they were developed, (b) evaluate the way in which these tools have been adapted for the culture in which they were used (termed the “cultural adaptation process”), (c) report on how valid and reliable the adapted instruments are, and (d) describe the implications for further research and clinical practice. In this review, 21 articles were studied. Articles reported on the cultural adaptation of autism screening in 18 countries and in nine languages. The cultural adaptation process was not always clearly reported and often did not follow all of the guidelines that exist on this topic. Cultural/linguistic modifications to the translated tools tended to increase with greater adherence to the pre-established guidelines. Differences between the validity and reliability of the original and adapted tools were common, indicating the need to obtain more data on populations to increase the utility of the translated tool.
Title: Evidence-based, parent-mediated interventions for young children with autism spectrum disorder: The case of restricted and repetitive behaviors
Authors: Harrop
DOI: 10.1177/1362361314545685
Lay abstract: Restricted and repetitive behaviors (RRBs) are a core symptom of autism spectrum disorder (ASD). RRBs are defined as the expression of repetitive body mannerisms, overriding preoccupations with objects/parts of objects, sensory behaviors, and strict adherence to routines and rituals. Research has shown that RRBs interfere with learning opportunities and social engagement and have a profound impact on family life. Despite this, little is known about how RRBs develop or about successful intervention strategies to reduce them. Involving parents as therapists within early intervention has become increasingly popular in ASD research. Yet, interventions rarely have the primary aim of reducing RRBs, and as such, improvement in these behaviors is seldom measured. This review reports how 29 interventions (which were facilitated by parents) approached the management, treatment, and measurement of RRBs, and presents recommendations for research and practice.
Title: Profile and predictors of service needs for families of children with autism spectrum disorders
Authors: Hodgetts, Zwaigenbaum and Nicholas
DOI: 10.1177/1362361314543531
Lay abstract: The demand for services for people diagnosed with autism spectrum disorder (ASD) is rising, which is straining service systems and funders. Tailoring services to best meet the needs identified by families could improve their quality of life and decrease burden on the system. We explored overall, plus best and worst met, service needs, and whether specific things about a child diagnosed with ASD or his or her family predicted those needs. Parents of 143 children with ASD (2–18 years) completed a survey about the child and family, the services they received, and the services that families thought were important. We used this information to determine what influenced the services that families thought were important, and whether families’ service needs were met. The most frequently identified overall and unmet service needs were for information on services, family support, and respite care. Most parents were satisfied with the funding and quality of professional support available. Having a younger child diagnosed with ASD, a lower income, and being an older mother predicted more total needs. Having an older child or mother, lower income, and disruptive behaviors predicted more total unmet needs. However, only disruptive behaviors predicted the number of unmet needs proportional to total needs. A child’s language or intellectual abilities did not predict needs. Findings can help professionals, funders, and policy makers tailor services to best meet families’ needs.
Title: The longitudinal relation between childhood autistic traits and psychosexual problems in early adolescence: The Tracking Adolescents’ Individual Lives Survey study
Authors: Dekker, Hartman, van der Vegt, Verhulst, van Oort and Greaves-Lord
DOI: 10.1177/1362361314547114
Lay abstract: During adolescence, many physical, emotional, and social changes occur. These changes are especially challenging for individuals with autistic traits owing to limited social skills and insight. These difficulties make it harder to meet the high demands of adolescence in terms of healthy psychosexual functioning (i.e. sexual socialization, selfhood, and behavior) because this requires significant interest in others, peer-relations, and very finely adapted behavior to implicit rules. In a study of 1687 individuals from the general population (Tracking Adolescents’ Individual Lives Survey; TRAILS), autistic traits in childhood (age 10–12 years) and psychosexual problems (e.g. excessive sexual thoughts or excessive masturbation) in early adolescence (age 12–15 years) were determined by means of parent-reported questionnaires. We investigated, in the individuals who displayed no psychosexual problems in childhood, whether childhood autistic traits predicted the presence of psychosexual problems in adolescence while taking into account pubertal development and conduct problems. The results indicate that higher levels of autistic traits in childhood significantly predicted psychosexual problems in adolescence, above and beyond the effects of pubertal development and conduct problems. Particularly, two dimensions of autistic traits were significant predictors; that is, “reduced contact/social interest” and “not optimally tuned to the social situation.” Children with autistic traits—especially those with limited social interest and/or social regulation problems—had a higher risk of developing psychosexual problems in early adolescence, as reported by their parents. Although autistic traits predicted psychosexual problems, the psychosexual problems reported were mild. Autistic traits should be regarded as only one of multiple predictors of psychosexual problems.
Title: Services for children with autism spectrum disorder in three, large urban school districts: Perspectives of parents and educators
Authors: Iadarola, Hetherington, Clinton, Dean, Reisinger, Huynh, Locke, Conn, Heinert, Kataoka, Harwood, Smith, Mandell and Kasari
DOI: 10.1177/1362361314548078
Lay abstract: The goal of this study was to examine perceptions of services for students with autism spectrum disorder (ASD) in school districts with limited resources. Facilitators conducted focus groups with parents, educators, and school administrators in three large, urban school districts (Los Angeles, Philadelphia, and Rochester, NY). They asked open-ended questions to explore participants’ views on the strengths and limitations of existing services and factors that would facilitate or inhibit the process of introducing new interventions. Three primary themes were identified: (a) tension between participant groups (teachers and paraprofessionals, staff and administration, teachers and parents, special education and general education teachers), (b) the need for ASD-specific and behavioral training for school personnel, and (c) desire for a school culture of accepting difference. These themes highlight the importance of developing training that addresses the needs of a diverse audience, that focus on practical interventions, and that enhance communication and relationships of school personnel with one another and with families. Strategies that might help achieve these objectives include creating web-based or video trainings, re-designing interventions in order to ease implementation by school personnel (e.g. separating interventions into modules that can be individually selected for each student with ASD), and providing ongoing opportunities for professional development.
Title: The role of anger rumination and autism spectrum disorder–linked perseveration in the experience of aggression in the general population
Authors: Pugliese, Fritz and White
DOI: 10.1177/1362361314548731
Lay abstract: The present research sought to explain why social anxiety may lead to hostility or aggression in some individuals with greater characteristics of autism spectrum disorders (ASD). In a survey study of young adults, we first examined how anger rumination (i.e. thinking perseveratively about experiences that have provoked anger) may explain the association between social anxiety and the experience of anger, hostility, and aggression in the general population. Next, we evaluated how characteristics of ASD affect these relationships. Finally, we explored whether problems with social cognition (the ability to think about others’ thoughts, feelings, or experiences) and perseveration (getting “stuck” on a thought or topic), which are characteristic of ASD, affected the relationships. We found that among socially anxious people, those who engaged in more perseveration experienced more aggression. Thus, cognitive styles commonly seen in ASD may exacerbate the influence of social anxiety on problems with hostility and aggression. Clinically, it may be important to target anger rumination in young adults with higher traits of ASD who are highly socially anxious in order to reduce hostility or aggression. For such individuals, it may be helpful to teach them to reinterpret situations in a more positive manner or redirect perseverative thoughts to a more soothing topic.
Title: A sustainable model for training teachers to use pivotal response training
Authors: Suhrheinrich
DOI: 10.1177/1362361314552200
Lay abstract: To be successful in educating children with autism, special educators need adequate training in teaching practices that are supported by research evidence (referred to as “evidence-based practice”). One training method that may maximize the limited training resources of public school systems is the train-the-trainer model. In this model, supervisors or trainers receive initial training in an intervention practice, then subsequently train other staff in their organization. This study measured the effectiveness of training school staff to train teachers in Pivotal Response Training (PRT; a play-based and child initiated intervention that can be effectively used in the field of autism), and evidence-based practice for children with autism. Three autism specialists, nine teachers, and 18 students participated in this study. The autism specialists learned to use PRT and trained teachers to use PRT. A majority of the teachers learned to use PRT and maintained these skills 3 months later. These results provide some support for the train-the-trainer model as an effective way to train special educators in evidence-based practices.
Title: Parental mediation of television viewing and videogaming of adolescents with autism spectrum disorder and their siblings
Authors: Kuo, Magill-Evans and Zwaigenbaum
DOI: 10.1177/1362361314552199
Lay abstract: Adolescents with autism spectrum disorder (ASD) spend a great amount of time watching TV and playing video games. Parents play an important role in shaping adolescents’ media activities. This study: (a) explored the strategies that parents of adolescents with ASD used to manage TV and video game use, and whether these strategies changed over time; (b) examined whether parents used different strategies for adolescents with ASD versus siblings; and (c) explored factors that created stress related to managing media use. Parents of 29 adolescents with ASD completed surveys at two time points. Parents of 16 families also completed surveys for a sibling. Parents most frequently watched TV with the adolescents and restricted videogaming. They used similar strategies for siblings, but more frequently applied restrictive (e.g. limiting the amount of time that adolescents can play video games) and instructive strategies (e.g. explain the TV contents to the adolescents) for adolescents with ASD than for their siblings. Parents reported that restrictive strategies were effective. They emphasized consistent use of rules, indicating consequences for ignoring the rules. Strategies did not change over the 1-year period of this study. Parents’ stress was related to the adolescents’ behavioral and emotional responses to restrictions. Parents can use the same rules for TV viewing and videogaming for their adolescent with and without ASD. However, they may have to be more involved in the videogaming of adolescents with ASD by using restrictive strategies. Professionals need to be aware that managing media use may be stressful for parents and that support may be needed.
Title: A comparison of WISC-IV and SB-5 intelligence scores in adolescents with autism spectrum disorder
Authors: Baum, Shear, Howe and Bishop
DOI: 10.1177/1362361314554920
Lay abstract: In autism spectrum disorders (ASD), results of cognitive testing inform clinical care, theories of brain development, and research study design. The Wechsler Intelligence Scale for Children (WISC) and the Stanford–Binet (SB) are two measures of intelligence that are commonly used in ASD evaluations. These tests give several intelligent quotient (IQ) scores, including verbal IQ, nonverbal IQ, and an overall score, or full-scale IQ. Furthermore, scores from these tests have been shown to be highly correlated in typically developing populations. However, these measures have not been compared in individuals with ASD, whose core symptoms can make testing challenging, potentially compromising the reliability of the tests. We evaluated the relationship between the WISC-IV and SB-5 in 40 youths (ages 10–16 years) with ASD. Corresponding intelligence scores on the two tests were highly correlated, but overall (full-scale) IQ and verbal IQ scores differed between the two tests. Most participants obtained higher overall IQ scores on the SB-5 compared with WISC-IV, with 14% scoring significantly higher. In contrast, verbal IQ scores were higher on the WISC-IV. A difference score between verbal and nonverbal IQ scores is often calculated to determine a child’s cognitive profile. These scores were only consistent for 60% of the sample. Comparisons of IQ test scores in ASD and other special needs groups is important, as it cannot necessarily be assumed that the reliability of tests (as determined by typically developing children and adolescents) holds true across all populations.
Title: Oral health among preschool children with autism spectrum disorders: A case-control study
Authors: Du, Yiu, King, Wong and McGrath
DOI: 10.1177/1362361314553439
Lay abstract: We conducted a survey to assess and compare the oral health status of preschool children with and without autism spectrum disorders (ASD). A total of 347 preschool children with ASD were recruited from 19 Special Child Care Centers in Hong Kong. A group of children without ASD (of a similar age and who had a similar gender ratio) was recruited from mainstream preschools as a comparison group. The children ranged in age from 32 to 77 months and 84% were boys. Oral examination (dental checkup) was provided to children with and without ASD to assess and compared their oral health status: tooth decay, gum diseases, tooth wear (associated with by tooth grinding), malaligned (crooked) teeth, tooth injuries, and sores in their mouth. Among 347 children with ASD, 74% (257) of them were cooperative with a comprehensive oral examination. Children with ASD had better oral hygiene and less gum diseases than children without ASD. Children with ASD had less tooth decay experiences than children without ASD. Children with and without ASD had similar experience in tooth wear, crooked teeth, tooth injuries, and mouth sores. We concluded that differences in oral health status exist among preschool children with and without ASD. Preschool children with ASD exhibited lower tooth decay experiences and better gum health than children without ASD.
Title: High self-perceived stress and poor coping in intellectually able adults with autism spectrum disorder
Authors: Hirvikoski and Blomqvist
DOI: 10.1177/1362361314543530
Lay abstract: Although some adults with autism spectrum disorder (ASD) have average or above-average intellectual abilities, high levels of autistic traits may complicate many everyday situations, including social interactions and communication in different situations (e.g. work, leisure, and family). Thus, autistic traits may be associated with experiences of stress in everyday life. This study explored stress in the everyday life in 25 intellectually able adults with ASDs and 28 typical adults. Aspects of stress (subjective distress and self-perception of coping ability) were measured with a questionnaire called the Perceived Stress Scale, and autistic traits were measured using the Autism Spectrum Quotient (AQ) questionnaire. Adults with ASD reported significantly higher subjective distress and a poorer ability to cope with stress in everyday life, as compared with typical adults. Autistic traits were associated with both subjective stress/distress and coping. Thus, individuals who reported more autistic traits also reported more distress and a poorer coping ability. Future research and clinical work with adults with ASD should focus on possible long-term consequences of chronic stress in everyday life, as well as treatment intervention focusing on stress reduction and improved coping skills.
Title: Phenotypic differences in individuals with autism spectrum disorder born preterm and at term gestation
Authors: Bowers, Wink, Pottenger, McDougle and Erickson
DOI: 10.1177/1362361314547366
Lay abstract: Past research suggests that being born preterm (before 37 weeks gestation) is associated with developing an autism spectrum disorder (ASD). The objective of this study was to describe characteristics of individuals with ASD who were born preterm compared with individuals with ASD who were born at term (from 37 weeks gestation). Of the 883 individuals with ASD in this study, 115 (13%) were born preterm. Among males with ASD, when you compare individuals who were born preterm with those born at term, more of those born preterm had sleep apnea (a sleep disorder characterized by pauses in breathing or shallow/infrequent breathing), seizure disorders, and attention-deficit/hyperactivity disorder. Among females with ASD, individuals born preterm were more likely to be nonverbal compared with females born at term. Owing to the size of our study, we were unable to directly compare differences between males and females born at preterm or term. In summary, several differences between individuals with ASD born preterm compared with term were observed, especially among males. The results may help understand some of the challenges specific to individuals with ASD who were born preterm and the results may contribute to the development of focused treatments for ASD among children born preterm.
