Parental Occupational Exposures and Autism Spectrum Disorder

Both self-report and industrial hygienist (IH) assessed parental occupational information were used in this pilot study in which 174 families (93 children with ASD and 81 unaffected children) enrolled in the Childhood Autism Risks from Genetics and Environment study participated. IH results indicated exposures to lacquer, varnish, and xylene occurred more often in the parents of children with ASD compared to the parents of unaffected children. Parents of children with ASD were more likely to report exposures to asphalt and solvents compared to parents of unaffected children. This study was limited by the small sample size, but results suggest that workplace exposures to some chemicals may be important in the etiology of ASD and deserve further investigation.     

Parental Experiences with Early Identification and Initial Care for their Child with Autism: Tailored Improvement Strategies

Journal of Autism and Developmental Disorders - Whereas it is well documented how parents experience the diagnostic process of their child with autism spectrum disorder (ASD), less is known about...     

Predicting Parent Reactions at Diagnostic Disclosure Sessions for Autism

Journal of Autism and Developmental Disorders - Receiving a diagnosis of autism for their child can be a pivotal moment for parents, yet there is little research about how providers can predict...     

Parental Broad Autism Phenotype and the Language Skills of Children with Autism Spectrum Disorder

Father–child and mother–child interactions were examined in order to investigate concurrent associations between three characteristics of parental broad autism phenotype (i.e., aloofness, rigidity, pragmatic language deficits), parental verbal responsiveness, and language skills of children with ASD. Results for mothers indicated that aloofness and rigidity were negatively associated with both child-initiated engagement and child language skills. Maternal aloofness was also negatively correlated with verbal responsiveness to their children, but rigidity was not. Results suggest that the association between aloofness and child language are potentially mediated by maternal use of responsive verbal behaviors. Maternal pragmatic language deficits were not concurrently related to child-initiated engagement or language skills. In contrast, for fathers, aloofness and rigidity were unrelated to child-initiated engagement and language skills. Paternal pragmatic deficits were also not associated with child language, however significant positive associations were found between paternal pragmatic language deficits and frequency of child-initiated engagement. Results are discussed in reference to potential clinical implications and directions for future research.     

Parental Report of Sleep Problems in Children with Autism

This research evaluated parent reports of sleep behaviors of four groups of children: those with Autism or Pervasive Developmental Disorders, those with General Mental Retardation alone, those attending Special Education classes (with no MR diagnosis), and a control group of similar aged children without a developmental diagnosis. Diagnostic classification and demographic information were determined through parent report, report of classroom registration, and the Gilliam Autism Rating Scale (Gilliam, 1995). To evaluate sleeping behavior the study used a 28-item, five-factor scale (Behavioral Evaluation of Disorders of Sleep/BEDS; Schreck, 1997/1998) constructed from the diagnostic criteria for childhood sleep disorders found in the International Classification of Sleep Disorders: Diagnostic and Coding Manual (ICSD, American Sleep Disorders Association, 1990). Findings suggest that reports of parents with children with autistic characteristics exhibit expected quantities of sleep, but parent perception of their sleep difficulties and sleep quality is different for children with autism than for children in all other study groups.     

Linking Parental Perceptions to Interactions in Young Children with Autism

This study examines the relation of parental perceptions and observed parent–child interactive behaviors. Samples observed included normally developing children, children with autism, and children with mental retardation who were equivalent on mental age. Parental perceptions of children's temperament and parental feelings of parenting stress were examined. Results indicated that parental perceptions of autistic children's behavior were more often linked to actual child and parental behaviors than in the comparison samples. Parents who reported their autistic children as more difficult in temperamental style had children who were less engaged during a social game with the parent and less responsive in interaction with an experimenter. Parents who reported greater stress had autistic children who were less responsive in social interactions with others.     

Treatments for Autism: Parental Choices and Perceptions of Change

Empirically conducted studies of the efficacy of various treatments for autism are limited, which leaves parents with little evidence on which to base their treatment decisions (Kasari, Journal of Autism and Developmental Disorders, 32: 447-461, 2002). The purpose of this study was to examine the types of treatments in current use by families of children with ASD. In addition, parents' perceptions of improvement in their child's functioning were explored. Through an online survey, a sample of 970 parents of ASD children reported on the treatments currently in use, those discontinued, and reasons for discontinuation. Results indicate that most families adopt multiple treatment approaches. Parents were most likely to discontinue non-evidence based treatments when they did not see improvement in their child's functioning.     

Children with Autism: Quality of Life and Parental Concerns

Past research has shown that children with autism and their families have compromised quality of life (QOL) in several domains. This study examined QOL and parental concerns in children with autism during early childhood, childhood, and adolescence compared to children with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) and to typical controls from a US national sample. Families with children diagnosed with autism reported more profound QOL effects than families of children with ADD/ADHD or unaffected controls. Children with autism were significantly less likely to attend religious services, more likely to miss school, and less likely to participate in organized activities. Parental concerns over learning difficulty, being bullied, stress-coping, and achievement were overwhelming in the autism group relative to the comparison groups.     

Parental Perceptions and Child Emotional and Behavioral Problems in Autism

Emotional and behavioral difficulties in children with autism often present problems for families seeking appropriate treatment interventions. Using data from the 2011 Survey of Pathways to Diagnosis and Services, ordinal logistic regression models were used to examine the association between parental perceptions about autism and their reports of child emotional and behavioral problems. Results showed that parents who attributed their child’s autism to environmental factors, experienced emotional upset or confusion about autism, or perceived the condition to be pervasive or burdensome, were more likely to reported clinically significant emotional and behavioral difficulties. Findings suggest that support services must consider parent perceptions when developing interventions to assist with children’s emotional and behavioral challenges. Implications for practice and research are discussed.     

Parental Recognition of Developmental Problems in Toddlers with Autism Spectrum Disorders

Symptoms of Autism Spectrum Disorders (ASD) begin to manifest during the first 2 years; there is limited evidence regarding type and timing of symptom onset. We examined factors related to parental age of recognition (AOR) of early abnormalities and the association between AOR and diagnosis and levels of functioning at 2 and 4 years in 75 toddlers with ASD. Results suggest significant differences between autism and PDD-NOS in the AOR and type of first concerns. Early social and motor delays as well as maternal age was associated with AOR. Later AOR was associated with poorer social-communicative and nonverbal cognitive functioning at 2 and 4. The findings are discussed in a context of identifying distinct developmental trajectories within the autism spectrum.     

Brief Report: Parental Age and the Sex Ratio in Autism

The male-to-female (M:F) ratio for autism spectrum disorders (ASD), typically about 4:1, appears to decrease with increasing paternal age, but this relationship has not been systematically tested. With 393 ASD cases from families with two or more ASD cases, we categorized paternal age into five age groups (<30, 30–34, 35–39, 40–44, 45+) and found that the M:F ratio was significantly decreased with increasing paternal age groups and remained so after also adjusting for maternal age. No significant relationship between maternal age group and the M:F ratio was observed. This study suggests that the M:F ratio is reduced with increasing paternal age consistent with de novo genetic or genomic anomalies arising more frequently as men age and then conceive children.     

Obstetric and Parental Psychiatric Variables as Potential Predictors of Autism Severity

Associations between obstetric and parental psychiatric variables and subjects' Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) domain scores were examined using linear mixed effects models. Data for the 228 families studied were provided by the Autism Genetic Resource Exchange. Hypertension (P = 0.002), preeclampsia (P = 0.021) and generalized edema (P = 0.011) were associated with higher ADI-R communication scores. Hypertension (P = 0.011), albuminuria (P = 0.039) and generalized edema (P = 0.009) were associated with higher ADI-R repetitive behaviors scores. Parent depression was associated with higher ADI-R repetitive behaviors scores (P = 0.005), and parent anxiety with lower ADOS social/communication composite scores (P = 0.025). The associations between hypertension-related obstetric conditions and autistic severity warrant further investigation and raise intriguing questions regarding potential causal and modifying factors in autism.     

Parental Perspectives on Inclusion: Effects of Autism and Down Syndrome

This study examined the effects of the child's diagnosis (autism vs. Down syndrome), age, and current educational placement on parental perceptions toward inclusion for their child with disabilities. Parents of children with autism and with Down syndrome completed surveys regarding their opinions on their child's current educational placement, their desire for changing the current placement, and their views on inclusive education. Results indicated that diagnosis, age, and current placement influenced parental opinion on the ideal educational placement for their child. Parents of children with Down syndrome were significantly more likely to endorse inclusion (full-time placement in general education) as the ideal educational program for their child whereas parents of children with autism were more likely to endorse mainstreaming (consistent part-time placement with general education students). Parents of younger children and parents whose children were already placed in general education programs were more positive towards inclusion than parents of older children or students currently in special education. Findings are discussed in terms of child characteristics and prevailing educational practices.     

Guidelines for Evaluating Intervention Programs for Children with Autism

It is now well recognized that early diagnosis and intervention improves the prognosis for children with autism. It is crucial that professionals be aware and sensitive to the needs of autistic persons and their families. We must never lose sight of the long-term goal of treatment and must not become so infatuated with any one treatment that we fail to provide the education parents need. It is incumbent upon us, as professionals, to educate parents and help them evaluate the myriad of information with which they are bombarded. In this article a framework for thinking about autism and principles of evaluation are reviewed. Components of appropriate early intervention programs are then described and guidelines for evaluating alternative treatments are provided.     

Evaluating an engagement-based preference assessment for children with Autism

One method of conducting preference assessments with individuals who have autism involves measuring the time spent by the child engaging with various stimuli. Engagement is generally defined as showing interest in the stimulus but few studies have investigated the potential effects of the quality of engagement with the stimulus on reinforcer effectiveness. In this study, both the duration and quality of engagement were measured for four children with autism aged between 4 and 5 years who participated in a duration-based multiple stimulus with replacement preference assessment. Stimuli were classified into one of the following three categories based on duration and quality of engagement with each stimulus presented: no interest; interest and; active engagement. The relative reinforcing value of stimuli from each category was then investigated. Results showed that the quality of engagement with the stimulus did not predict the relative reinforcer effectiveness of the selected stimuli for any of the participants. For two children, the procedure was effective in differentiating stimuli classified as no interest and those with which the child had engaged, regardless of the quality of that engagement. The utility of an engagement-based preference assessment that also measures quality of engagement with stimuli as a means to guide selection of reinforcers for children with autism is discussed.     

Strategies for Conducting Research on Language in Autism

Several different methodological approaches that have been used in studying language in children with autism are outlined. In classic studies, children with autism are compared to comparison groups typically matched on age, IQ, or mental age in order to identify which aspects of language are uniquely impaired in autism. Several methodological problems are noted with this approach including (a) heterogeneity of the autism population, (b) mental retardation, (c) developmental change with age, and (d) sample size and ascertainment. An alternative strategy is suggested which focuses on identifying the complex expression of the language phenotype in autism across the full range of the syndrome. This approach explores within-group individual differences in language functioning, and recently identified distinct language phenotypic subgroups within the autism population that are relevant to understanding the underlying genetic and neurobiological etiology of autism.     

Use of Home Videotapes to Confirm Parental Reports of Regression in Autism

The current study examined consistency between parental reports on early language development and behaviors in non-language domains and observer-coded videotapes of young children with and without autism spectrum disorder (ASD) and autistic regression. Data are reported on 56 children (84% male) with ASD (early onset or autistic regression) and 14 typically developing children (57% male) who had home videotapes. Unique to the current study is the independent identification of loss/no loss for each child by both parental report and observer-coded home videotapes and the examination of agreement between these two methods. Results indicate substantial concordance between parental report and observer codes for onset and loss of expressive language, but minimal concordance for loss in non-language domains, suggesting a need for supplementation of parental reports in these areas.     

Explaining and Selecting Treatments for Autism: Parental Explanatory Models in Taiwan

Parental explanatory models about autism influence the type of therapy a child receives, the child’s well-being, and the parents’ own psychological adaptation. This qualitative study explored explanatory models used by parents of children with autism. In-depth interviews were conducted with 13 parents of children with autism from a medical center in Taiwan. Despite high educational background, most of these parents attributed their child’s autism to both biomedical and supernatural etiologies without apparent conflicts. These parents chose a wide variety of treatment strategies, including biomedical and alternative treatments, which often created time/energy pressures and financial burden, and were influenced by parents’ cause attribution. Parents’ illness explanations influence their treatment selections and need to be understood and accepted by health care providers.