Parenting behaviour among parents of children with autism spectrum disorder

Contrary to the extensive amount of empirical findings about parental perceptions, parenting cognitions, and coping in families with a child with autism spectrum disorder (ASD), research about parenting itself is very scarce. A first goal of this study was to examine the factor structure and internal consistency of two scales to measure parenting behaviour: the Parental Behaviour Scale-short version (PBS, Van Leeuwen, 2002, Van Leeuwen and Vermulst, 2004, Van Leeuwen and Vermulst, 2010) and a new scale to measure parenting behaviours more specifically relevant to children with ASD. A second goal was to compare general and more specific parenting behaviour among parents of children with and without ASD. The participants were 305 parents of a child with ASD between 8 and 18 years old and 325 parents of a typically developing child between 8 and 18 years old. Parents completed both scales. Exploratory factor analysis of the new scale resulted in two factors: Stimulating the Development and Adapting the Environment. Multisample confirmatory factor analyses showed good fit indices for the noninvariant model of both the PBS and the new scale. Mean level analyses revealed significant main effects of group with higher mean scores for the control group in comparison with the experimental group for the subscale Harsh Punishment and the reversed effect for the subscale Stimulating the Development. We concluded that it is possible to use the parenting constructs of the PBS-short version to investigate parenting behaviour of parents with and without children with ASD. Furthermore, the new scale showed a relatively stable two factor structure for the control group as well as for the experimental group. The two factors ‘Stimulating the child's Development’ and ‘Adapting the child's Environment’ were also convincing as regards content. A first indication was found that parents of children with ASD indeed use more specifically relevant parenting behaviours. It is self-evident that more research is needed to gain further insight into the nature of these behaviours.     

Nutritional deficiencies and overweight prevalence among children with autism spectrum disorder

Children with autism spectrum disorder (ASD) are at risk of developing nutritional deviations. Three to six year old children with ASD were compared to their typically developing siblings and to a typically developing age and gender matched control group, in order to evaluate their intake and body mass index.Nutrient intake was compared to the Dietary Reference Intake using three-day diet diaries completed by the parents. The sum percentage of nutritional deficiencies in the ASD group compared to the typical development group was 342.5% (±122.9%) vs. 275.9% (±106.8%), respectively (P = 0.026). A trend toward higher deficiency in the ASD group was observed as compared to the sibling group 363% (±122.9%) vs. 283.2% (±94.7%) (P = 0.071). A higher body mass index was found in the ASD group compared to their counterparts, despite their nutritional deficiencies. In conclusion, children with ASD are more likely to suffer from nutritional deficiencies despite higher body mass index.     

Everyday expressions of pain in children with and without autism spectrum disorder

BackgroundAnecdotal reports from parents suggest that their children with autism spectrum disorder (ASD) may have diminished pain experiences and expressions. In contrast, objective measures of pain have been used to document typical and enhanced expressions of pain in response to noxious stimuli (e.g., blood draw) among children with autism. The purpose of this study was to compare non-biased parental ratings of pain among children with and without ASD.MethodAs an everyday measure of pain, parents completed The Non-Communicating Children’s Pain Checklist (NCCPC-R) across two time windows (i.e., 2 h and 1 week) for 31 children with ASD and 19 children without ASD.ResultsThere were no significant group differences in everyday expressions of pain between children with and without ASD. However, in general, increased autism symptomology severity was associated with decreased parental ratings of pain expressions.ConclusionThese results continue to support a framework where children with ASD may have typical pain sensitivity, however, their expressions of pain may differ based on where individuals lie on the autism spectrum.     

Characteristics of aggression among persons with autism spectrum disorders

Autism spectrum disorder (ASD) is a commonly occurring life long developmental disorder with core symptoms of communication and social skills deficits. Stereotyped and repetitive behaviors are also present. Along with these core symptoms, a number of co-occurring problems such as aggression are present. The present study reviewed papers that describe various characteristics of aggressive behaviors among persons with ASD. The preponderance of studies involved children who were male. Aggression was more severe in males. Where the maintaining variables were studied, tangible and escape, and some core aspects of ASD such as cognitive rigidity and poor social and communication skills, were associated with aggression. The implication of these data and other characteristics of this challenging behavior are discussed.     

Sleep in children with autism spectrum disorder

Children with autism spectrum disorder demonstrate an increased prevalence of difficulties with sleep initiation and maintenance. The consequences may include alterations in daytime behavior, memory, and learning in patients, and significant stress in caretakers. The dysregulation of melatonin synthesis, sensitization to environmental stimuli, behavioral insomnia syndromes, delayed sleep phase syndrome, rapid eye movement sleep behavior disorder, and comorbid anxiety, depression, and epilepsy comprise common etiologic factors. The clinical assessment of sleep problems in this population and a management algorithm are presented.     

Participation in extracurricular activities for children with and without siblings with autism spectrum disorder

Objective: To compare the number, frequency, enjoyment and performance in extracurricular activities of siblings of children with autism spectrum disorders (ASD) to their typically developing (TD) peers, and to identify differences between actual and desired participation. Methods: A case-control study with 30 siblings of children with ASD and 30 siblings of TD children was conducted using the Paediatric Interest Profiles and a questionnaire. Results: Siblings of children with ASD participated in fewer extracurricular activities than those with TD siblings. ASD symptoms were significantly associated with the sibling participating in fewer extracurricular activities. Children with TD siblings had higher enjoyment scores in relaxation activities than children with siblings with ASD. Conclusion: While results were mainly positive, some differences indicated that having a sibling with ASD may impact participation in extracurricular activities. Assessments of participation barriers, as well as support to minimise participation restrictions among siblings of children with ASD are required.     

Physical aggression in children and adolescents with autism spectrum disorders

Aggression is a clinically significant problem for many children and adolescents with autism spectrum disorders (ASD). However, there have been few large-scale studies addressing this issue. The current study examined the prevalence and correlates of physical aggression in a sample of 1584 children and adolescents with ASD enrolled in the Autism Treatment Network. The prevalence of aggression was 53%, with highest prevalence among young children. Aggression was significantly associated with a number of clinical features, including self-injury, sleep problems, sensory problems, GI problems, communication and social functioning. In multivariate models, self-injury, sleep problems, and sensory problems were most strongly associated with aggression. The results indicate that aggression is markedly prevalent, and clinical implications and directions for future research are discussed.     

Relationship of autistic traits between parents and children with and without autism spectrum disorder

BackgroundAlthough parents with a child with autism spectrum disorder (ASD) have usually been identified as having the “broader autism phenotype”, empirical research on the differences in autistic-like characteristics between parents with and without ASD children has yielded inconsistent results.MethodThis survey of the autistic traits of parents and children was conducted in 119 parents with ASD children and 108 parents with typically developing (TD) children. Parents’ autistic traits were quantified using the Autism-Spectrum Quotient and children’s autistic traits were quantified using the Autism Spectrum Quotient—Children’s Version.ResultsThe autistic traits of ASD children were significantly higher than those of the TD children; however, autistic traits were similar between parents in the two groups. Furthermore, the correlations of autistic traits between parents and children were only significant for the TD group and not for the ASD group.ConclusionsThe current findings indicate that the relationship of autistic traits between parents and children exists in the TD group, and that the Autism-Spectrum Quotient may be used for parents as a screening aid to identify children who should be further screened for autistic traits.     

孤独谱系障碍患儿的感觉特征

目的 使用中文版儿童感觉剖析量表探讨孤独谱系障碍(ASD)患儿的感觉特点.方法 采用中文版儿童感觉剖析量表对66例ASD患儿和66名健康发育儿童进行评定,由监护人完成.分析孤独症患儿与健康儿童在感觉方面的差异.结果 除感觉剖析量表的口腔感觉处理和影响活动水平的运动的调节部分外,ASD患儿在其他部分及全量表的得分均与健康儿童的差异有统计学意义(P<0.01).结论 除口腔感觉处理和影响活动水平的运动的调节外,ASD患儿的各项感觉特征与健康发育儿童均存在一定差异.中文版儿童感觉剖析量表对区别ASD患儿与健康发育儿童有一定的鉴别力.     

BOLD signal variability and complexity in children and adolescents with and without autism spectrum disorder

Variability of neural signaling is an important index of healthy brain functioning, as is signal complexity, which relates to information processing capacity. Alterations in variability and complexity may underlie certain brain dysfunctions. Here, resting-state fMRI was used to examine variability and complexity in children and adolescents with and without autism spectrum disorder (ASD). Variability was measured using the mean square successive difference (MSSD) of the time series, and complexity was assessed using sample entropy. A categorical approach was implemented to determine if the brain measures differed between diagnostic groups (ASD and controls). A dimensional approach was used to examine the continuum of relationships between each brain measure and behavioral severity, age, IQ, and the global efficiency (GE) of each participant’s structural connectome, which reflects the structural capacity for information processing. Using the categorical approach, no significant group differences were found for neither MSSD nor entropy. The dimensional approach revealed significant positive correlations between each brain measure, GE, and age. Negative correlations were observed between each brain measure and the severity of ASD behaviors across all participants. These results reveal the nature of variability and complexity of BOLD signals in children and adolescents with and without ASD.     

Speech intonation in children with autism spectrum disorder

Objective: The prosody of children with autism spectrum disorder (ASD) has several abnormal features. We assessed the speech tone of children with ASD and of children with typical development (TD) by using a new quantitative acoustic analysis. Methods: Our study participants consisted of 63 children (26 with ASD and 37 with TD). The participants were divided into 4 groups based on their developmental features and age. We assessed the variety of the fundamental frequency (F0) pattern quantitatively, using pitch coefficient of variation (CV), considering the different F0 mean for each word. Results: (1) No significant difference was observed between the ASD and TD group at pre-school age. However, the TD group exhibited significantly greater pitch CV than the ASD group at school age. (2) In pitch CV, range and standard deviation of the whole speech of each participant, no significant differences were observed between the type of participants and age. (3) No significant correlation was found between the pitch CV of each word and the Japanese Autism Screening Questionnaire total score, or between the pitch CV of each word and the intelligence quotient levels in the ASD group. A significant correlation was observed between the pitch CV of each word and social reciprocal interaction score. Conclusions: We assessed the speech tone of children with ASD by using a new quantitative method. Monotonous speech in school-aged children with ASD was detected. The extent of monotonous speech was related to the extent of social reciprocal interaction in children with ASD.     

Patterns of autism spectrum symptomatology in individuals with Down syndrome without comorbid autism spectrum disorder

Background

Prevalence estimates of autism spectrum disorder (ASD) in Down syndrome (DS) are highly varied. This variation is partly due to the difficulty of screening for and diagnosing comorbid ASD in individuals with a syndrome that carries its own set of social communicative and behavioral difficulties that are not well documented. The aim of this study was to identify the typical range of social communicative impairments observed in children, adolescents, and young adults with DS who do not have comorbid ASD.

Methods

We examined patterns of scores from the five subscales of the Social Responsiveness Scale (SRS) in 46 individuals with DS (ages 10–21 years) without comorbid ASD relative to the published normative sample. We also explored the correlations between SRS symptomatology and age, nonverbal cognition, and receptive language.

Results

SRS scores were elevated (i.e., more ASD symptoms endorsed), with mean scores falling into the clinically significant range. Analysis by subscale revealed a specific pattern, with Autistic Mannerisms and Social Cognition scores significantly more elevated than Social Communication scores, which were significantly more elevated than Social Awareness and Social Motivation scores. Correlations between SRS scores and the other measures varied by subscale.

Conclusions

General elevated ASD symptomatology on the SRS indicates the need for developing population-based norms specific to DS. The pattern of scores across subscales should inform clinicians of the typical range of behaviors observed in DS so that individuals with atypical patterns of behavior can be more easily identified and considered for a full ASD evaluation.     

Treatment of aggression in children and adolescents with autism and conduct disorder

The optimal clinical management of aggression in children and adolescents involves both behavioral and pharmacologic intervention strategies. This article reviews medication treatments for youngsters with autistic disorder and conduct disorder, conditions for which the pharmacologic management of aggression is often necessary. Efficacy results and associated adverse effects from selected clinical trials of most classes of psychotropic medications are discussed. While preliminary progress has been made in the development of medication treatments for these serious disorders of youth, additional controlled research and longitudinal studies are needed to better understand the efficacy and tolerability of currently available compounds within each diagnostic group.     

Anthropometric measures of Spanish children with autism spectrum disorder

We aimed to compare body mass index (BMI) and healthy eating index (HEI) in children with autism spectrum disorder (ASD, n = 105) and typically developing (TD, n = 495) children. They were aged 6–9 years, lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds. In this case–control study, the weight, height and BMI were measured for both groups. Three-day food records were used to assess dietary intake. Although the differences between children with ASD and TD children in raw BMI (p = 0.44), BMI z-score (p = 0.37), HEI (p = 0.43) and total energy intake (p = 0.86) were not significant, children with ASD and the boys subgroup were shorter (p = 0.01), but not the girls subgroup, compared to TD children of the same gender. Using the controls values as a reference, the BMI distribution in children with ASD became distorted, with values below the 5th percentile (11% vs. 4%, p = 0.03) and above the 95th percentile (8% vs. 5%, p = 0.04). The gender- and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39, respectively, vs. TD children. Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habits.     

Stimulus pairing training in children with autism spectrum disorder

In early training for children with autism spectrum disorders (ASDs), matching-to-sample (MTS) tasks are widely used to teach various language and cognitive skills. However, some problems in conducting MTS training for children with developmental disabilities are also recognized. In this study, we examined the effectiveness of stimulus pairing training as a training procedure for children with ASDs. Two boys with ASDs participated in this study. During the stimulus pairing training trial, the children observed only two corresponding stimuli were paired successively. Participant's learning as a result of stimulus pairing training was assessed by MTS tests, which were conducted immediately after the training. In this study, visual–visual and visual–auditory stimulus relations were trained in stimulus pairing training. As a result, both participants could learn the stimulus relations by stimulus pairing training. The effectiveness and efficiency of the pairing training procedure and some issues to be considered in applying this procedure for children with ASDs are discussed.     

Minor neurological dysfunction in children with autism spectrum disorder

Aim The aim of this study was to improve the understanding of brain function in children with autism spectrum disorder (ASD) in relation to minor neurological dysfunctions (MNDs). Method We studied MNDs in 122 children (93 males, 29 females; mean age 8y 1mo, SD 2y 6mo) who, among a total cohort of 705 children (513 males, 192 females; mean age 9y, SD 2y 0.5mo) referred to a regional outpatient non‐academic psychiatric centre in the Netherlands, were diagnosed with ASD after an extensive multidisciplinary psychiatric assessment. Children with clear neurological abnormalities (e.g. cerebral palsy or spina bifida) were excluded from the study. MNDs were assessed in all 705 children using the Touwen examination method. Special attention was paid to the severity and type of MND. Data of the children with ASD were compared with neurological morbidity data of children with other psychiatric disorders and with children in the general population, who were born at Groningen University Hospital between 1975 and 1978. Results Seventy‐four percent of the children with ASD showed complex MNDs compared with 52% of the children with other psychiatric disorders and 6% of the reference group (χ²=18.0, p<0.001; χ²=937.5, p<0.001 respectively). Specific dysfunctions frequently encountered in ASD were dysfunctional posture and muscle tone, fine manipulative disability, dyscoordination, and excessive associated movements. Conclusion These findings suggest a contribution of dysfunctional supraspinal networks involving multiple parts of the brain in the pathogenesis of ASD. This is consistent with findings from neuroimaging studies, and highlights the importance of neurological examinations in paediatric psychiatric assessments.