Pre- and perinatal factors in high-functioning females and males with autism

Pregnancy and delivery complications as indicated in medical records and maternal reports for 23 high-functioning autistic females and 23 high-functioning males of similar IQ and age were compared with those of 54 of their normally developing siblings. Autistic subjects of both sexes had higher non-optimality scores than their siblings. Much of this difference was accounted for by a higher incidence of firstborns and fourth- or later-borns in the autistic group. Of factors found in previous research with mentally handicapped, autistic samples, only estimated weeks of gestation greater than 42 occurred more often in autistic subjects than siblings. The only sex difference specific to the autistic group was that autistic males came from larger families than females. These data provide slight support for the contribution of nonspecific pre- and perinatal factors to other etiological bases of autism. It is proposed that pre- and perinatal factors may play less of a role in autism in high-functioning individuals than suggested in studies of autism associated with severe retardation.     

Overlap of autistic and schizotypal traits in adolescents with Autism Spectrum Disorders

This study addresses the unraveling of the relationship between autism spectrum and schizophrenia spectrum traits in a population of adolescents with Autism Spectrum Disorders (ASD). Recent studies comparing isolated symptoms of both spectrum disorders as well as diagnostic criteria for each (DSM-IV-TR) suggest resemblances in the clinical phenotype. A group of 27 adolescents with ASD (11 to 18 years) and 30 typically developing adolescents, matched for age and gender, participated in this study. Within the ASD group 11 adolescents satisfied DSM-IV-TR criteria for schizotypal personality disorders. Autistic and schizotypal traits were identified by means of well validated questionnaires (Autism Questionnaire, AQ and Schizotypal Personality Questionnaire-Revised, SPQ). Significantly more schizotypal traits in adolescents with ASD were found than in typically developing controls. Besides high levels of negative symptoms, adolescents with ASD also displayed high levels of positive and disorganized symptoms. There appeared to be a relationship between the mean level of autistic symptoms and schizotypal traits, as well as specific associations between autistic symptoms and negative, disorganized and positive schizotypal symptoms within individuals. Schizotypal symptomatology in all sub dimensions that are reflected by the SPQ scores, was most prominently associated with attention switching problems of the autism symptoms from the AQ. These findings indicate that patients diagnosed with an ASD show schizophrenia spectrum traits in adolescence. Although other studies have provided empirical support for this overlap in diagnostic criteria between both spectrum disorders, the present findings add to the literature that behavioral overlap is not limited to negative schizotypal symptoms, but extends to disorganized and positive symptoms as well.     

Self-disclosure to the best friend: friendship quality and internalized sexual stigma in Italian lesbian and gay adolescents

This study is the first contribution to the understanding of gender differences in best friendship patterns of adolescents sexual minorities. We explored friendship patterns, self-disclosure, and internalized sexual stigma in an Italian sample of lesbian (N?=?202) and gay (N?=?201) adolescents (aged 14-22 years). We found gender differences in cross-sex and cross-orientation patterns of best friendship. Gay men (52%) reported more cross-sex friendships than lesbians (20%). The 52% of participants had cross-orientation friendships, and no differences were found between lesbians and gay men. Lesbian and gay men with a cross-orientation best friend showed a lower level of internalized sexual stigma. Gay men with cross-orientation friendship showed a low level of internalized sexual stigma and less conflict with a best friend. For gay men and lesbian participants, self-disclosure to the best friend was better predicted by internalized sexual stigma and self-disclosure. Future studies may provide direct comparisons between heterosexual and sexual minority individuals.     

It’s not really lying. Autism spectrum disorder relates to lower recognition of other-oriented lies through a decrease in perceived intentionality of the liar

BackgroundThere is mixed evidence regarding how persons with ASD deal with deception. Some studies show that autism is related to difficulties in lying, others show no differences between individuals with ASD and typically developing persons in use of deception. It may be that individuals with ASD have difficulties in understanding what lying is.MethodIn Study 1 (N = 66) we matched a sample of individuals clinically diagnosed with autism spectrum disorder with typically developing individuals. Study 2 (N = 256) was conducted with participants from the general population. We asked participants to evaluate deceitfulness of protagonists’ behavior in stories presenting other-oriented and self-oriented lying.ResultsThe results suggest that the higher the autistic traits, the less individuals perceive the liar as behaving intentionally. In the case of more complex, other-oriented lies, autistic traits indirectly relate to recognition of lies through attribution of intentionality.ConclusionThese findings show how autistic traits relate to understanding of lying and suggest that it might be interesting to test training among individuals with ASD aimed at learning how to recognize deception.     

Understanding Behavioural Rigidity in Autism Spectrum Conditions: The Role of Intentional Control

Although behavioural rigidity belongs to the core symptoms of autism spectrum conditions, little is known about its underlying cognitive mechanisms. The current study investigated the role of intentional control mechanisms in behavioural rigidity in autism. Autistic individuals and their matched controls were instructed to repeatedly choose between two simple cognitive tasks and to respond accordingly to the subsequently presented stimulus. Results showed that autistic participants chose to repeat tasks more often than their controls and when choosing to switch, they demonstrated larger performance costs. These findings illustrate that when required to make their own choices, autistic people demonstrate rigidity at different performance levels, suggesting that intentional control mechanisms might be important for a better understanding of behavioural rigidity in autism.     

Decontextualised Minds: Adolescents with Autism are Less Susceptible to the Conjunction Fallacy than Typically Developing Adolescents

The conjunction fallacy has been cited as a classic example of the automatic contextualisation of problems. In two experiments we compared the performance of autistic and typically developing adolescents on a set of conjunction fallacy tasks. Participants with autism were less susceptible to the conjunction fallacy. Experiment 2 also demonstrated that the difference between the groups did not result from increased sensitivity to the conjunction rule, or from impaired processing of social materials amongst the autistic participants. Although adolescents with autism showed less bias in their reasoning they were not more logical than the control group in a normative sense. The findings are discussed in the light of accounts which emphasise differences in contextual processing between typical and autistic populations.     

Gender Identity in Autism: Sex Differences in Social Affiliation with Gender Groups

High rates of gender variance have been reported in autistic people, with higher variance in autistic females than males. The social component of gender identity may be affected, with autistic females experiencing lower identification with and feeling less positively about their gender groups than controls. We measured gender identification, gender self-esteem, and aspects of gender expression (masculinity and femininity) in autistic natal males and females, and controls (N?=?486). We found that autistic people had lower gender identification and gender self-esteem than controls, and autistic natal females had lower gender identification than autistic natal males and natal female controls. In conclusion, autistic people, particularly natal females, had lower social identification with and more negative feelings about a gender group.     

Autistic Children's Use of Semantic Common Sense and Theory of Mind: A Comparison with Typical and Mentally Retarded Children

To compare Japanese autistic children's use of semantic knowledge and theory of mind with mentally retarded and typically developing children's, they were tested on their comprehension of active and passive sentences and false belief understanding. Autistic children were sensitive to plausibility levels of semantic bias as were 4-year-olds with typical development when comprehending sentences, although impaired in belief understanding as compared with mentally retarded children and typically developing 5-year-olds. Children's sentence comprehension had no association with belief understanding. Results suggest that autistic children with certain verbal intelligence can utilize semantic common sense to comprehend sentences as can typically developing children and that the ability to comprehend sentences is relatively independent of theory of mind.     

‘I am who I am’: Reputation concerns in adolescents on the autism spectrum

BackgroundAdolescence is often characterised by an increased concern for one’s reputation in typical development. The extent to which autistic adolescents are concerned for their reputation, however, is unclear.MethodSemi-structured interviews were conducted with 12 autistic adolescents and five members of school staff to examine reputation concerns in autism. Topics discussed included being ‘cool’, friendships, worries and self-concepts.ResultsThematic analysis revealed that autistic adolescents were sometimes concerned about their reputation, although many reported that they did not want to be cool. Instead, they preferred to be true to themselves and struggled to understand the rules of being cool. Adolescents’ difficulties in coping with unpredictability also contributed to their understanding of social rules. Findings were supported by the responses of school staff.ConclusionsThis study suggests that autistic adolescents can be concerned about their reputation, with some wishing to be accepted for having a reputation for being different.     

“Always a glass ceiling.” Gender or autism; the barrier to occupational inclusion

BackgroundUnder- and unemployment adversely affect the economic, health, and social circumstances of people with autism; notably those with a diagnosis of autism spectrum disorder or high autistic traits (HATs). However, little research has been published comparing the experiences of women to men with HATs, and women without autism (i.e., those typically developing; TD) to ascertain if employment issues are a function of gender or autistic traits (ATs).MethodAn anonymous online survey was conducted attracting 28 women and 18 men with HATs aged 18–68 years (M = 38.63, SD = 13.12), with a further 21 TD women and 16 TD men aged 23–62 years (M = 38.38, SD = 10.32). Quantitative data were analysed via logistic regression to ascertain the extent to which employment issues were a function of gender or ATs while controlling for confounding variables such as education, and age. Qualitative data were analysed using inductive thematic analysis, then quantitatively using chi-square or Fisher’s Exact Test.ResultsIt was found that ATs, not gender, was significant to most vocational experiences.ConclusionsIt is proposed that employers place greater importance on technical ability than social-communication skills when hiring and supervising women with HATs to reduce barriers and increase workplace diversity.     

“They Thought It Was an Obsession”: Trajectories and Perspectives of Autistic Transgender and Gender-Diverse Adolescents

Despite research exploring autism in gender-diverse adolescents, no studies have elicited these individuals’ perspectives. In-depth interviews with 22 well-characterized autistic gender-diverse adolescents revealed critical themes, including: recollections of pre-pubertal gender nonconformity; vivid experiences of gender dysphoria; a fear of social gender expression due to perceived animosity toward transgender people; and specific challenges that result from the interplay of gender diversity and neurodiversity. During the ~?22 month study social gender affirmation increased in six participants and gender dysphoria attenuated in four participants. Given the ethical imperative to understand and prioritize the voiced perspectives and needs of autistic gender minority adolescents as well as the discovery of shared themes and experiences in this population, results should inform clinical research approaches and priorities.     

Friendship in High-functioning Children with Autism Spectrum Disorder: Mixed and Non-mixed Dyads

Friendships containing a child with autism and a friend with typical development ("mixed" friendships, n = 26) and those of children with autism and a friend with a disability ("non-mixed," n = 16) were contrasted with friendships of typically developing subjects and their friends (n = 31). Measures included dyadic interaction samples, and interview and questionnaire data from subjects, friends, and parents. Mixed friendship interactions resembled typical friendships. Participants in mixed friendships were more responsive to one another, had stronger receptive language skills, exhibited greater positive social orientation and cohesion, and demonstrated more complex coordinated play than in the non-mixed dyads. Exposure to typical peers appears to have significant effects on friendship behaviors.     

Judging intentionality in the context of ambiguous actions among autistic adults

BackgroundDiscerning intentional from unintentional actions is a key aspect of social cognition. Mental state attribution tasks show that autistic people are less accurate than neurotypicals in attributing an agent’s intention when there is clearly a right answer. Little is known about how autistic people judge the intentionality of ambiguous actions (i.e., actions that are neither clearly intentional nor clearly unintentional).AimsThis study sought to find out whether autistic individuals differ in their interpretation of ambiguous action compared to neurotypical controls.Methods and procedures20 autistic and 20 neurotypical adults completed an ambiguous action and theory of mind task. Autistic traits, verbal reasoning and non-verbal perceptual reasoning ability were measured.Outcomes and resultsResults show that intentionality endorsement scores for ambiguous but prototypically accidental actions were higher in autistic participants than controls. Theory of Mind (ToM) scores did not correlate with intentionality endorsement scores in either group therefore group differences could not be explained by ToM ability.Conclusion and implicationsAutistic participants had a tendency to over-attribute intention compared to neurotypicals, which could not be explained by ToM ability. Studying ambiguous action is important with respect to ecological validity, given that we often face ambiguous actions during social encounters.     

The link between emotion regulation,social functioning,and depression in boys with ASD

PurposeSymptoms of depression are common in children and adolescents with an autism spectrum disorder (ASD), but information about underlying developmental factors is limited. Depression is often linked to aspects of emotional functioning such as coping strategies, but in children with ASD difficulties with social interactions are also a likely contributor to depressive symptoms.MethodologyWe examined several aspects of emotional coping (approach, avoidant, maladaptive) and social functioning (victimization, negative friendship interactions) and their relation to depression symptoms in children with ASD (N = 63) and typically developing (TD) peers (N = 57). Children completed a battery of self-report questionnaires.ResultsLess approach and avoidant, but more maladaptive coping strategies, and poor social functioning were uniquely associated with more symptoms of depression in children with ASD. Only less approach and more maladaptive coping were uniquely associated with depression severity in TD boys.ConclusionsUnlike TD boys, boys with ASD who report using avoidant strategies to deal with stressful situations report fewer symptoms of depression, suggesting that this may be an adaptive emotion regulation strategy. However, understanding the role of over-arousal in this process, inferences about long-term effects of this strategy, its causality and direction of effects will require additional research.     

Parental adjustment, marital relationship, and family function in families of children with autism

This study aimed to investigate the psychopathology, marital relationship, and family function in parents of children with autistic disorder (autism) as compared to parents of typically developing children. We also compared these measures between the mothers and the fathers. We assessed 151 families with at least one child with autistic disorder and 113 families of typically developing children in Taiwan. Both parents completed the self-administered questionnaires measuring psychopathology, marital dyadic adjustment, and family function. Both parents of children with autism suffered from more psychopathology and less dyadic consensus than parents of typically developing children; mothers of children with autism, perceived less marital satisfaction, affection expression, family adaptability and cohesion than mothers of typically developing children. We also found that mothers of children with autism displayed more psychopathology and marital maladjustment than did the fathers. These findings highlight that parents of children with autism encounter more psychological problems, marital difficulties and family dysfunction, particularly their mothers.     

Nonverbal Communication in Two- and Three-Year-Old Children with Autism

The forms, functions, and complexity of nonverbal communication used by very young children with autism were investigated. Fourteen children with autism were matched to 14 children with developmental delays and/or language impairments on the basis of CA, MA, and expressive vocabulary. Subjects participated in a structured communication assessment consisting of 16 situations designed to elicit requesting or commenting behavior. Children with autism requested more often and commented less often than controls. Autistic children were less likely to point, show objects, or use eye gaze to communicate, but were more likely to directly manipulate the examiner's hand. The autistic group also used less complex combinations of behaviors to communicate. Implications for early identification and intervention are discussed.     

Autism disclosure – The decisions autistic adults make

BackgroundAutistic people face dilemmas regarding whether to disclose their autism due to the potential negative consequences. While there have been studies examining the issue of disclosure, a small but growing number have specifically investigated how autistic adults make decisions to disclose. The aim of the study was to understand the perspective of autistic adults about the decisions behind disclosure.MethodsThis cross-sectional mixed methods study recruited 30 autistic adults who completed an online survey. The online survey included free response text spaces to answer questions about disclosure. An inductive approach using thematic analysis was used for the analyses of the survey responses. Participants also completed two self report measures about how strongly they identify with an autism identity and how positively they view this identity.ResultsThemes of informed judgement and raising awareness appeared central to how decisions were made to disclose Autism. Participants did not strongly identify with the diagnostic label, nor did they feel particularly negative towards the label.ConclusionMisconceptions and stigma about autism can inhibit individuals from disclosing and can contribute to poorer mental health. Thus, educating the public is vital to reduce negative misconceptions of autism to not only better understand Autism but to help raise awareness so that autism can be discussed without fear of stigmatisation.     

Reasoning on the Basis of Fantasy Content: Two Studies with High-Functioning Autistic Adolescents

Reasoning about problems with empirically false content can be hard, as the inferences that people draw are heavily influenced by their background knowledge. However, presenting empirically false premises in a fantasy context helps children and adolescents to disregard their beliefs, and to reason on the basis of the premises. The aim of the present experiments was to see if high-functioning adolescents with autism are able to utilize fantasy context to the same extent as typically developing adolescents when they reason about empirically false premises. The results indicate that problems with engaging in pretence in autism persist into adolescence, and this hinders the ability of autistic individuals to disregard their beliefs when empirical knowledge is irrelevant.     

Le devenir autiste au féminin : difficultés diagnostiques et ressources subjectives. Une revue de littérature

ObjectivesThe scientific literature shows that Autism Spectrum Disorder (ASD) in women may be differentiated by a number of factors, thus impacting how many women are diagnosed with ASD, particularly in adulthood. According to recent data, the prevalence of ASD diagnosis is 3 males to 1 female. Several authors have attempted to explain this ratio by pointing to possible subjective resources that allow women to avoid the autistic manifestations measured by standard tools. In particular, certain “camouflage strategies” would not be detected during the usual assessments. However, these strategies have certain disadvantages, particularly in terms of identity construction.MethodWe conducted a literature review on the characteristics and expressions of the female autism phenotype and on so-called “camouflage” strategies. In this context, we translated into French the Camouflaging Autistic Traits Questionnaire (CAT-Q), developed and validated by Hull and colleagues (2019), in order to encourage its scientific evaluation in the context of research on the diagnosis of ASD for women.ResultsWe have identified several reasons for the diagnostic issues encountered by women with autism: the androcentric nature of autism research; gender bias; diagnostic complexity because of the many co-morbidities; and inadequate diagnostic instruments and settings. The evolution of autism in women also implies that personality construction modulates the expression of these disorders.DiscussionThis work opens up both a reflection on the need for improvement of diagnostic procedures and tools for all autistic subjects, as well as a clinical interest in their psychic resources. We also suggest that the use of a projective test could help to circumvent some of the biases present in the habitual tools.ConclusionThese discussions should be pursued to raise awareness of the relationship between autism and gender. Advancing the modelling of camouflage strategies would make it possible to propose adaptations in clinical and diagnostic practices and to respond to the important issues surrounding the population of women with autism, perhaps more globally to participate in rethinking the heterogeneity and definitions of autism.     

Friendship and personal adjustment during adolescence.

A questionnaire evaluating the friendship network, the expectations towards friends, the level of intimacy and attachment with friends, as well as the presence of conflicts with friends, was administered to 349 adolescents. The sample consisted of both males and females, age ranging from 12 to 18 years. Subjects were also given various personal adjustment indices that were obtained from the Offer Self Image Questionnaire. The results demonstrate that there are small differences in the friendship network across age and gender. Analysis of the qualitative aspects of friendship are generally constant with respect to age, but demonstrate marked differences with respect to gender: girls expect more from their friends than boys and their level of attachment and intimacy with friends is greater. The results also indicate that the number of friends in the network is not significantly correlated with the personal adjustment variables. Multiple regression analyses revealed that the quality of attachment maintained with friends and the absence of conflict experiences in friendship account for a low but significant proportion of the score variance obtained from the personal adjustment scale. The possibility to confer personal problems and the preoccupations to friends seems beneficial for the acquisition of adaptive behavior. Deficiencies in communication with friends or confrontation experiences and feelings of alienation are related to some forms of maladaptive behavior.