The broad autism phenotype predicts child functioning in autism spectrum disorders

Background

Broad autism phenotype (BAP) is a milder expression of the social and communication impairments seen in autism spectrum disorders (ASD). While prior studies characterized the BAP in unaffected family members of probands with ASD, the relationship between parental BAP traits and proband symptomatology remains poorly understood. This study utilizes the Broad Autism Phenotype Questionnaire (BAPQ) in parents and the Social Responsiveness Scale (SRS) in children to examine this connection. We hypothesized that in families affected by ASD, elevated maternal and paternal BAPQ scores would correlate with greater autism symptomatology in diagnosed children. In an extension of prior research, we also explored this relationship in families with typically developing children (TDC).

Methods

Two hundred and forty-five children with ASD, 129 TDC and all parents were recruited as part of a larger study investigating relationships between genes, brain and behavior. The Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS) and expert clinical judgment confirmed ASD diagnoses in children. SRS was collected for all children. Parents completed a self-report BAPQ and an informant report BAPQ for their spouse; an average of self-report and informant report for each parent was used in all analyses.

Results

Mothers and fathers of children with ASD had significantly higher rates of BAP traits as compared to parents of TDC. Maternal and paternal BAPQ total scores were not correlated with child IQ in either group. In the ASD group, 10% of mothers and 21% of fathers scored above the established BAP threshold compared to 4% of TDC parents. Crude regression analyses showed that maternal and paternal BAPQ total scores accounted for significant variance in child SRS scores in both ASD (17.1%) and TDC (19.8%) families.

Conclusions

Our results suggest that broad autism symptomatology in parents is moderately associated with their child’s autism symptomatology. This result extended to TDC families, suggesting that the BAPQ and SRS capture subtle, subclinical social variation in both children and adults. These findings could help define multi-generational social impairments in future phenotypic and genetic studies.     

The relationship between family functioning and behavior problems in children with autism spectrum disorders

Although it is well known that families of children with an autism spectrum disorder (ASD) are at risk for increased stress and other problems, little is known about what child characteristics may mediate that risk. To address the impact of child behavior problems on family health, we examined data collected from 136 families raising children with ASD. Children were divided into groups based on parent responses to the Child Behavior Checklist (CBCL): low versus high internalizing and low versus high externalizing behavior problems. Family functioning was measured using the Family Impact Questionnaire, Revised (FIQ-R). Results of ANCOVA analyses indicated significant group differences in FIQ-R domains of Negative Attitudes About Parenting, Social Relationships, Sibling Impact, and Impact to Marriage when comparing externalizing behaviors. None of the FIQ-R domains demonstrated group differences when comparing internalizing behaviors. Correlation coefficients indicated moderately strong associations between higher externalizing behaviors and poorer family functioning, with the most significant associations among child behavior and increased negativity in parenting perceptions and poorer social functioning. This study provides information regarding co-occurring behaviors that have the strongest negative association with family functioning and the domains of family functioning most vulnerable to the severity of such behaviors.     

The intervention priorities of parents of children with autism spectrum disorders in Iran

When designing and implementing evidence-based programs for children with an autism spectrum disorder, the intervention priorities of parents are important criteria. Although studies in developed countries have explored parents’ intervention priorities, there is a paucity of this kind of research in developing countries. This research explores the intervention priorities of 207 Iranian parents for their children with autism in Tehran, the capital of Iran. Participants with children between 2 to 21 years of age were asked to rate their intervention priorities from among 10 main categories. In addition, correlations between children’s difficulties and parental intervention priorities were examined.The results indicate that building social communication skills was the highest intervention priority for parents of Iranian children with autism, a contrast to typical current service provision in Iran. The results also substantiated that presence of social communication difficulties and challenging behaviors in children are typically correlated with parents' intervention priorities.     

Quality of life for parents of children with autism spectrum disorders

This project describes health-related quality of life (HRQoL) of parents of children with autism spectrum disorders (ASDs) using mixed methods. Parents of children with ASDs (N = 224) reported on their HRQoL, depression, and caregiving burden using quantitative tools. HRQoL scores were slightly worse than from those in normative populations especially related to stress and mental health. For example, parents reported average HRQoL scores from SF-6D of 0.74, which was clinically significant lower than an average normative U.S. population. 40% of parents reported having clinical depression symptoms. Married parents reported lower depression symptoms than parents who were not. In addition, families with three or more children with special health care needs (CSHCN) reported lower HRQL and higher caregiving burden than families with less CSHCN. In the qualitative study, we conducted five focus groups to gain insight as to the reasons a child's ASD might influence a parent's HRQoL. Qualitative data further supports the notion that parental HRQoL was negatively influenced by their child's ASDs. Studies that seek to quantify the influence of ASDs and to assess the effect of interventions for children with ASDs may consider measuring the effects on family members as well.     

Vaccine-related beliefs and practices of parents of children with autism spectrum disorders

Although the assertion of a link between vaccines and autism has been scientifically rejected, the theory continues to be popular and may influence the attitudes of parents of children with autism spectrum disorders. The authors sought to assess how often parents change or discontinue their child's vaccine schedule after autism spectrum disorder diagnosis and whether beliefs about the etiology of autism affect their decision to do so. The authors surveyed 197 (43%) of 460 eligible parents of children under 18 years of age with autism spectrum disorders who were enrolled in a state-funded agency that provides services to those with developmental disabilities in western Los Angeles County. Half of the parents discontinued or changed vaccination practices, and this was associated with a belief that vaccines contributed to autism spectrum disorders, indicating a potential subset of undervaccinated children. Educational tools should be designed to assist physicians when talking to parents of children with autism spectrum disorders about vaccination.     

Features of the broader autism phenotype in people with epilepsy support shared mechanisms between epilepsy and autism spectrum disorder

Richard, A.E., I.E. Scheffer and S.J. Wilson. Features of the broader autism phenotype in people with epilepsy support shared mechanisms between epilepsy and autism spectrum disorder. NEUROSCI BIOBEHAV REV 21(1) XXX–XXX, 2016. To inform on mechanisms underlying the comorbidity of epilepsy and autism spectrum disorder (ASD), we conducted meta-analyses to test whether impaired facial emotion recognition (FER) and theory of mind (ToM), key phenotypic traits of ASD, are more common in people with epilepsy (PWE) than controls. We contrasted these findings with those of relatives of individuals with ASD (ASD-relatives) compared to controls. Furthermore, we examined the relationship of demographic (age, IQ, sex) and epilepsy-related factors (epilepsy onset age, duration, seizure laterality and origin) to FER and ToM. Thirty-one eligible studies of PWE (including 1449 individuals: 77% with temporal lobe epilepsy), and 22 of ASD-relatives (N = 1295) were identified by a systematic database search. Analyses revealed reduced FER and ToM in PWE compared to controls (p < 0.001), but only reduced ToM in ASD-relatives (p < 0.001). ToM was poorer in PWE than ASD-relatives. Only weak associations were found between FER and ToM and epilepsy-related factors. These findings suggest shared mechanisms between epilepsy and ASD, independent of intellectual disability.     

The relationship between parental stress and mastery,forgiveness, and social support among parents of children with autism

BackgroundParents of children with autism have significantly more parenting-stress symptoms than parents of typically developing children. Therefore, the main goal of the present study was to examine the relationship between personal and social resources among families of different cultures, in which parents are coping with the stress of raising children with autism.MethodTwo hundred and nine (N = 209) participants, including Jewish (n = 105) and Arab (n = 104) participants, completed demographic, mastery, forgiveness, social support, and parental stress questionnaires.ResultsThe study findings demonstrated no significant differences between the groups regarding mastery, forgiveness, or social support. However, a marginally significant difference was found with regard to the age at the time of diagnosis and parental stress. Arab children were diagnosed earlier and Arab parents reported higher levels of parental stress. Hierarchical multiple regressions showed that among the Jewish sample age, education, financial situation, mastery, and social support contributed significantly to the explained variance in parental stress. Among the Arab sample, severity of autism, forgiveness, mastery, and social support contributed significantly to the explained variance in parental stress.ConclusionsThese findings make an important contribution to our understanding of mastery, forgiveness, and social support while helping parents cope with the stress of raising a child with autism. In addition, in multicultural countries, it is important to be aware of differences and similarities in the factors predicting parental stress.     

Factors associated with depressive symptoms in parents of children with autism spectrum disorders

Parents of children with autism spectrum disorders (ASDs) have higher rates of depressive symptoms than parents of typically developing (TD) children or parents of children with other developmental disorders. The purpose of this study was to examine child and parent sleep as factors associated with depressive symptoms in parents of children with ASDs. Participants included 34 families (17 ASD, 17 TD, 17 mothers and 11 fathers per group). Both objective sleep quantity (actigraphy) and subjective sleep quality were obtained, along with measures of parent depressive symptoms and child daytime behavior. Child sleep quantity was a significant predictor of maternal depressive symptoms, controlling for group and child behavior. Fathers sleep quality was a significant predictor of paternal depressive symptoms, controlling for child behavior and child sleep disturbances. This study suggests that along with child behavior, parent and child sleep variables are associated with parental depressive symptoms. Future studies should continue to use a multi-method measurement approach for sleep, and interventions that target child sleep should include parent sleep and parent daytime functioning as outcome variables.     

Contributors to well-being and stress in parents of children with autism spectrum disorder

BackgroundParents of children with autism spectrum disorder (ASD) present more well-being and stress problems than parents of typically developing (TD) children. However not all parents present these problems. These problems can be due to a dynamic interaction between environmental antecedents, person antecedents, and mediating processes. Understanding how these factors separately contribute to explain parents’ well-being and stress can have implications for intervention programs. The aim of this study was to explain parents’ subjective well-being and physiological stress by considering whether they had a child with ASD or not and their child’s negativity (environmental antecedents), their perception of their child’s problems (person antecedents), and their use of reappraisal (mediating processes).MethodThirty-seven parents of children with ASD and 41 parents of TD children reported their subjective well-being and their physiological stress was assessed. Additionally, children’s negativity was observed, parents rated their perception of their child’s problems (autistic traits, emotion regulation ability, and lability/negativity), and parents reported their use of reappraisal.ResultsCompared to parents of TD children, parents of children with ASD reported having lower subjective well-being and had increased physiological stress. Parents’ perceptions of children’s lability/negativity and parents’ use of reappraisal were better predictors of parents’ subjective well-being than ASD and parents’ perceptions of children’s lability/negativity contributed to parents’ physiological stress as much as ASD.ConclusionsPrevention and intervention programs targeting parental well-being and stress will benefit from working with parents at the level of perceptual constructs and reappraisal ability.     

Parenting stress in Chinese mothers of children with autism spectrum disorders

Objective

Elevated parenting stress has been observed among mothers of children with autism spectrum disorders (ASDs) in western countries, but little is known about mothers of Han Chinese children. The aim of the current study was to further the knowledge about stress experienced by Chinese mothers of children with ASD by examining maternal parenting stress in Heilongjiang province of China.

Methods

In this cross-sectional study, data about participants’ demographic characteristics, parenting stress, anxiety, depression, child’s behavioral problems, coping strategies, and social support were collected though a questionnaire survey. The participants included 150 families with ASD children, who were consecutively admitted to the clinics of the Children Development and Behavior Research Center in Harbin Medical University, Heilongjiang Disabled Persons Federation, and Mudanjiang Child Welfare Home.

Results

The participants reported elevated parenting stress. Mothers’ parenting stress was associated with levels of depression and anxiety, and child’s behavioral symptoms. Child’s behavioral symptoms, maternal anxiety, maternal depressive symptoms, and lack of governmental financial support were associated with overall parenting stress.

Conclusions

Government support may play an important role in reducing parenting stress in this population.     

Macrocephaly in children with autism spectrum disorders

Research indicates the presence of macrocephaly or abnormally large head circumferences in children with autism and spectrum-related disorders, compared with their typically developing peers. Previous research, however, centered on non-nationally representative, clinic-based samples of children and adults with autism spectrum disorders. Moreover, these samples were typically small. The present study represents results of a nationally representative, community-based sample of children with and without autism spectrum disorders, derived from the Early Childhood Longitudinal Study Birth Cohort. Results reveal statistically nonsignificant differences in the head circumferences of children with autism spectrum disorders across three time points, compared with children without autism spectrum disorders. These results may be considered highly generalizable, because they are derived from a nationally representative, community-based sample of children with and without autism spectrum disorders from the Early Childhood Longitudinal Study Birth Cohort.     

Sleep in children with autism spectrum disorders

The amount of research conducted on sleep in children and adolescents has increased dramatically over the past decade due to the recognition that many children have significant sleep problems leading to daytime dysfunction. Approximately one third of typically developing children have sleep difficulties at some point, and a similar percentage of adolescents have impaired or insufficient sleep leading to daytime impairments. Sleep problems are known to occur at even greater rates in children with special needs, such as those with developmental disabilities, psychiatric conditions, and medical illnesses. The recognition that interventions can improve sleep and may result in better daytime functioning has fueled a growing interest in more fully characterizing the sleep problems in children with special needs. This article presents a discussion of the sleep problems experienced by children with one particular group of developmental disorders—the autism spectrum disorders.     

An evaluation of school involvement and satisfaction of parents of children with autism spectrum disorders

Parental school involvement and satisfaction are unstudied in families raising a child with an autism spectrum disorder (ASD). To fill this gap, the current study utilized a national sample of families (N = 8,978) from the 2007 Parent and Family Involvement in Education survey ( U.S. Department of Education, National Center for Education Statistics, 2006-2007 ). Parents of children with ASDs were found to be more likely than parents of children without the disorder to attend parent-teacher conferences, meet with school guidance counselors, and help with homework. Parents of children with ASD were also more dissatisfied with the level of communication provided by the school. There was a significant positive correlation between parental school involvement and parental school satisfaction. These findings have important implications for how schools interact with families with children with ASD.     

微小RNA与孤独症谱系障碍研究进展

孤独症谱系障碍（ASD）是一组严重的高异质性神经发育障碍,是遗传因素和复杂环境因 素共同作用的结果,病理学机制还不清楚。大量的研究提示表观遗传学机制尤其是特殊脑区的miRNA 表达异常可能参与了ASD 的发生发展,循环miRNA 有望成为早期诊断的生物学标志物。     

Autism severity and motor abilities correlates of imitation situations in children with autism spectrum disorders

Impaired performance in a range of imitation tasks has been described in children with autism spectrum disorders (ASD) and several underlying mechanism have been suggested. This study examined whether imitation abilities are related to autism severity and to motor skills. Furthermore, the performance of children with ASD in four imitation situations (body movements and ‘action on objects’, using meaningful and non-meaningful tasks) was compared. Twenty-five children aged 32–51 months diagnosed with autism (23) and ASD (2) were evaluated for autism severity using the Autism Diagnosis Observation Schedule and for gross and fine motor skills using the Peabody Developmental Motor Scales. Controlling for cognitive level, imitation abilities in all four situations correlated significantly only with autism severity measures and mostly with socio-communication deficits. Motor abilities were below average and did not correlate with imitation abilities nor with autism severity. Comparison of the four imitation situations revealed that performances of meaningful actions were better than non-meaningful actions and imitation of ‘action on objects’ was better than imitation of body movements. The current research supports the fact that socio-communication deficits and not motor abilities are linked to imitation abilities in young children with autism.     

孤独症谱系障碍患儿家长病耻感与应对方式和社会支持的相关性分析

背景 孤独症谱系障碍（ASD）发病率呈上升趋势,ASD患儿的治疗和训练过程漫长,给患儿家庭带来沉重的负担,导致家长容易产生病耻感,目前缺少ASD患儿家长病耻感相关的调查研究。目的 探讨ASD患儿家长病耻感与应对方式和社会支持的相关性,为降低该群体的病耻感水平并采取针对性的干预措施提供参考。方法 以2021年1月-2022年5月乌鲁木齐市某三甲医院儿童保健门诊收治的ASD患儿的家长为研究对象。采用一般资料问卷、连带病耻感量表（ASS）、简易应对方式问卷（SCSQ）和社会支持评定量表（SSRS）进行调查,采用Pearson相关分析考查病耻感与应对方式和社会支持的相关性。结果 ASD患儿家长ASS总评分为（52.40±11.22）分。相关分析结果显示,ASD患儿家长ASS总评分与SCSQ消极应对维度评分呈正相关（r=0.787,P<0.01）,与SCSQ积极应对维度评分和SSRS总评分均呈负相关（r=-0.565、-0.795,P均<0.01）。回归分析结果显示,ASD患儿家长病耻感受应对方式和社会支持的影响（?R²=0.768,F=114.931,P<0.01）,可解释总变异的76.80%。结论 ASD患儿家长病耻感处于中等偏高水平,家长的应对方式和社会支持是影响病耻感的重要因素。     

The relationship between gender and age of first concern in toddlers with autism spectrum disorders

The age at which parents first developed concerns over their child's development was examined in 965 toddlers with autism spectrum disorders (ASD) and atypical development to examine the potential role of gender. A two-way analysis of covariance was conducted with gender and diagnosis entered as independent variables, age at assessment entered as a covariate, and age of parents’ first concerns entered as the dependent variable. The average age of parents’ first concerns was significantly younger for females when compared to males. Additionally, the age of parents’ first concerns was significantly younger for toddlers with ASD when compared to toddlers with atypical development. No significant interaction was found. Possible explanations for the results and their implications are discussed.     

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

ObjectiveTo determine the relationship of motor skills and adaptive behavior skills in young children with autism.DesignA multiple regression analysis tested the relationship of motor skills on the adaptive behavior composite, daily living, adaptive social and adaptive communicative skills holding constant age, non-verbal problem solving, and calibrated autism severity.SettingMajority of the data collected took place in an autism clinic.ParticipantsA cohort of 233 young children with ASD (n = 172), PDD-NOS (n = 22) and non-ASD (developmental delay, n = 39) between the ages of 14–49 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity.InterventionsNot applicable.Main outcome measuresThe primary outcome measures in this study were adaptive behavior skills.ResultsFine motor skills significantly predicted all adaptive behavior skills (p < 0.01). Gross motor skills were predictive of daily living skills (p < 0.05). Children with weaker motor skills displayed greater deficits in adaptive behavior skills.ConclusionsThe fine and gross motor skills are significantly related to adaptive behavior skills in young children with autism spectrum disorder. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion.