Teachers’ perspectives of the sexuality of children with autism spectrum disorders

Individuals with autism spectrum disorders (ASD) experience sexuality issues, but there are very few studies looking at sexuality and autism. The present study aims to examine teachers’ perceptions of sexual behaviors of 56 children with low functioning autism (LFA) and 20 children with high functioning autism (HFA) or Asperger Syndrome (AS). Teachers perceived children with LFA as exhibiting less socially acceptable behaviors, as possessing lessened awareness of privacy related rules, and as having more limited knowledge of typical sexual responses and behaviors in comparison to children with HFA or AS. However, teachers expressed more concerns for children with HFA or AS. These findings should be taken into consideration when designing intervention programs targeting sexuality of individuals with ASD.     

Parents of children with psychopathology: psychiatric problems and the association with their child’s problems

Knowledge is lacking regarding current psychopathology in parents whose children are evaluated in a psychiatric outpatient clinic. This especially accounts for fathers. We provide insight into the prevalence rates of parental psychopathology and the association with their offspring psychopathology by analyzing data on psychiatric problems collected in 701 mothers and 530 fathers of 757 referred children. Prevalence rates of parental psychopathology were based on (sub)clinical scores on the adult self report. Parent–offspring associations were investigated in multivariate analyses taking into account co-morbidity. Around 20 % of the parents had a (sub)clinical score on internalizing problems and around 10 % on attention deficit hyperactivity (ADH) problems. Prevalence rates did not differ between mothers and fathers. Parent–offspring associations did not differ between girls and boys. Maternal anxiety was associated with all offspring problem scores. In addition, maternal ADH problems were associated with offspring ADH problems. Paternal anxiety and ADH problems scores were specifically associated with offspring internalizing and externalizing problem scores, respectively. Associations with offspring psychopathology were of similar magnitude for mothers and fathers and were not influenced by spousal resemblance. Our study shows that both fathers and mothers are at increased risk for psychiatric problems at the time of a child’s evaluation and that their problems are equally associated with their offspring problems. The results emphasize the need to screen mothers as well as fathers for psychiatric problems. Specific treatment programs should be developed for these families in especially high need.     

Characteristics of communication among Japanese children with autism spectrum disorder: A cluster analysis using the Children’s Communication Checklist-2

Some overlap has been suggested among the subtypes of autism spectrum disorder (ASD) in children. The Japanese version of the Children’s Communication Checklist-2 (CCC-2) is a useful measure for identifying profiles in relation to communication impairments in children with ASD. The aim of this study was to investigate whether the CCC-2 could identify subtypes in relation to communication impairments in Japanese children with ASD. The study participants were 113 children with ASD but without intellectual disabilities aged 3–12 years. Parents were given the Japanese version of the CCC-2 and asked to rate their children, who were then classified into two groups based on statistical analysis. Significant differences were found between clusters in mean CCC-2 subscales. These results suggest that one subtype was associated with low language competence and strong characteristics of autism, while the other was associated with relatively high language competence and milder characteristics of autism.     

Chronic trauma impairs the neural basis of empathy in mothers: Relations to parenting and children’s empathic abilities

Early life stress carries long-term negative consequences for children's well-being and maturation of the social brain. Here, we utilize a unique cohort to test its effects on mothers' social brain, targeting mothers' neural empathic response in relation to caregiving and child empathic abilities. Mother-child dyads living in a zone of repeated war-related trauma were followed from early childhood and mother-child behavioral synchrony was repeatedly observed. At pre-adolescence(11–13 years) children's empathic abilities were assessed and mothers(N = 88, N = 44 war-exposed) underwent magnetoencephalography(MEG) while exposed to vicarious pain. All mothers showed alpha suppression in sensorimotor regions, indicating automatic response to others' pain. However, trauma-exposed mothers did not exhibit gamma oscillations in viceromotor cortex, a neural marker of mature empathy which utilizes interoceptive mechanisms for higher-order understanding and does not emerge before adulthood. Mother-child synchrony across the first decade predicted mothers' viceromotor gamma, and both synchrony and maternal viceromotor gamma mediated the relations between war-exposure and child empathic abilities, possibly charting a cross-generational pathway from mothers' mature neural empathy to children's empathic capacities. Our findings are first to probe the maternal social brain in adolescence in relation to parenting and underscore the need for targeted interventions to mothers raising children in contexts of chronic stress.     

School refusal behaviour: Are children and adolescents with autism spectrum disorder at a higher risk?

School refusal behaviour in students with autism spectrum disorder (ASD) is poorly studied despite being considered a serious problem. This study assessed the frequency, duration, and expression of school refusal behaviour in students with ASD, aged 9–16 years, without intellectual disability. Further, the associations between school refusal behaviour and sociodemographic factors were explored. Teachers and parents assessed this behaviour over 20 days in a cross-sectional study of 216 students, including 78 students with ASD and 138 typically developing (TD) students. School refusal behaviour was significantly higher in students with ASD as compared to TD students. Significant associations were found between school refusal behaviour and illness of other family members. The study concludes that school refusal behaviour is pervasive in students with ASD.     

Pathways to mental health-related quality of life for parents of children with autism spectrum disorder: roles of parental stress,children’s performance,medical support,and neighbor support

Parental mental health-related quality of life affects the ability of a family to cope with and adapt to the presence of a disability in a family member, such as their child. Therefore, understanding variables that influence parental mental health-related quality of life in families of children with autism spectrum disorder is important. The purpose of this study was to examine the pathways to parental mental health-related quality of life, focusing on the variables of parental stress, children’s performance, medical support, and neighbor support. These variables were hypothesized to be interrelated with one another and directly or indirectly associated with parental mental health-related quality of life. Samples of this study were 429 parents of children with autism spectrum disorder aged 6–17 years in the United States. These parents were selected from the respondents interviewed over the telephone by the 2007 National Survey of Children’s Health. The item indicators selected from the survey were used to construct latent variables for the investigated variables. Structural equation modeling was used to analyze the data. Results showed that parental stress, children’s performance, medical support, and neighbor support played important roles in the pathways. Implications and limitations are discussed.     

Associations between paternal depression and behaviour problems in children of 4–6 years

Maternal depression is associated with adverse child development, however little is known about paternal depression and child outcome. The aim of this study was to estimate the prevalence of paternal depression and assess its association with abnormal child behaviours among 4-6 year olds. Parents of 4-6 years olds were recruited via general practices and completed measures on child behaviour (Strengths and Difficulties Questionnaire), depression (Patient Health Questionnaire), and other covariates. The association of major and other paternal depressive syndrome with mother reported child behaviour was analysed. Eight percent (29/365) of fathers had depression (3.3 and 4.77% a major and other depressive syndrome, respectively). Major but not other paternal depressive syndrome was associated with an 8 and 36 times greater likelihood of child prosocial behaviour problems and peer problems respectively.     

Gene–environment interaction between the oxytocin receptor (OXTR) gene and parenting behaviour on children’s theory of mind

Theory of mind (ToM) is the ability to interpret and understand human behaviour by representing the mental states of others. Like many human capacities, ToM is thought to develop through both complex biological and socialization mechanisms. However, no study has examined the joint effect of genetic and environmental influences on ToM. This study examined how variability in the oxytocin receptor gene (OXTR) and parenting behaviour—two widely studied factors in ToM development—interacted to predict ToM in pre-school-aged children. Participants were 301 children who were part of an ongoing longitudinal birth cohort study. ToM was assessed at age 4.5 using a previously validated scale. Parenting was assessed through observations of mothers’ cognitively sensitive behaviours. Using a family-based association design, it was suggestive that a particular variant (rs11131149) interacted with maternal cognitive sensitivity on children’s ToM (P = 0.019). More copies of the major allele were associated with higher ToM as a function of increasing cognitive sensitivity. A sizeable 26% of the variability in ToM was accounted for by this interaction. This study provides the first empirical evidence of gene–environment interactions on ToM, supporting the notion that genetic factors may be modulated by potent environmental influences early in development.     

Parenting in families with a child with autism spectrum disorder and a typically developing child: Mothers’ experiences and cognitions

The parenting experiences of mothers in a family with a child with autism spectrum disorder (ASD) and a typically developing (TD) child were studied using a qualitative analysis of mothers’ perceptions of the impact of autism on family and personal life. An additional quantitative comparison was performed to evaluate the effect of ASD on mothers’ parenting cognitions about their other, TD child. Mothers differentiated clearly in parenting cognitions about their child with ASD and about their TD child. Strong associations were found between mothers’ symptoms of stress and depression, and their parenting cognitions about both their children. To maximize intervention outcome, family interventionists should consider parenting experiences and should become aware of interfering maternal feelings and cognitions, such as guilt or low parental self-efficacy beliefs.     

Exploring a method for evaluation of preschool and school children with autism spectrum disorder through checking their understanding of the speaker’s emotions with the help of prosody of the voice

Purpose

We attempted to evaluate the ability of 125 preschool and school children with autism spectrum disorder (ASD children) to understand the intentions of those speaking to them using prosody of the voice, by comparing it with that of 119 typically developing children (TDC) and 51 development-age-matched children with attention deficit hyperactivity disorder (ADHD children), and to explore, based on the results, a method for objective evaluation of children with ASD in the early and later periods of childhood.

Prosocial skills in young children with autism,and their mothers’ psychological well-being: Longitudinal relationships

The study aimed to explore the longitudinal association between prosocial skills in young children with an ASD and maternal psychological well-being. Participants were 132 children with autism drawn from the British Millennium Cohort Study (aged 9 months, 3 and 5 years). Three-wave cross-lagged structural equation models tested whether children's prosocial skills were reciprocally related to maternal psychological distress and life satisfaction. Findings indicated that relationships were not bidirectional, as both maternal outcomes were not associated with children's prosocial skills two years later. However, prosocial skills at 3 years were associated with improved maternal well-being (less distress and more life satisfaction) when children were 5-years-old. The study adds to the limited evidence base on bidirectional relationships between prosocial skills in ASD and proximal environmental variables. Findings highlight the importance of testing for reciprocal relationships rather than assuming unidirectional effects. In addition, they indicate that other-directed behaviors in children with autism have the potential to boost maternal well-being.     

Cognitive and affective empathy in children with conduct problems: Additive and interactive effects of callous–unemotional traits and autism spectrum disorders symptoms

Callous–unemotional (CU) traits and autism spectrum disorders (ASD) symptoms are characterized by problems in empathy; however, these behavioral features are rarely examined together in children with conduct problems. This study investigated additive and interactive effects of CU traits and ASD symptoms in relation to cognitive and affective empathy in a non-ASD clinic-referred sample. Participants were 134 children aged 3 to 9 years (M=5.60; 79% boys) with oppositional defiant/conduct disorder, and their parents. Clinicians, teachers, and parents reported on dimensions of child behavior, and parental reports of family dysfunction and direct observations of parental warmth/responsiveness assessed quality of family relationships. Results from multiple regression analysis showed that, over and above the effects of child conduct problem severity and quality of family relationships, both ASD symptoms and CU traits were uniquely associated with deficits in cognitive empathy. Moreover, CU traits demonstrated an independent association with affective empathy, and this relationship was moderated by ASD symptoms. That is, there was a stronger negative association between CU traits and affective empathy at higher versus lower levels of ASD symptoms. These findings suggest including both CU traits and ASD-related social impairments in models delineating the atypical development of empathy in children with conduct problems.     

For fathers raising children with autism,do coping strategies mediate or moderate the relationship between parenting stress and quality of life?

In response to the dramatic change in the perception of fatherhood and the significant expansion in fatherhood research, this study came to fill the gap in literature and examine the possible mediation and moderation effects of coping in the relationship between fathers’ of children with autism parenting stress and quality of life (QoL). Mediation and moderation effects were examined using multiple programs and software which included hierarchical regression, structural equation modeling and special Macros added to the analysis programs to confirm the findings. None of the investigated coping strategies could mediate or moderate the stress–QoL relationship among the 101 participating fathers. This study provides interesting information on how the stress-coping-QoL relationship among fathers of children with autism can be affected by the nature of their stress provoking situation, their individual characteristics, the environment and its demands and resources, and the way fathers perceive and apply their coping responses.     

Healthcare use and costs associated with children’s behavior problems

The objective of the study was to investigate associations between severity of behavior problems, specific symptom domains with healthcare use and costs in school-aged children. A cross-sectional study using data from the 10-year follow-up of two population-based birth cohorts was conducted on four rural and urban communities in Germany. There were 3,579 participants [1,834 boys (51%), 1,745 girls (49%)] on average aged 10.4 years. The severity levels (normal, at risk, abnormal) and symptom domains of behavioral problems were assessed by parent-reported strengths and difficulties questionnaire (SDQ).The outcomes were medical use categories (physicians, therapists, hospital, and rehabilitation), medical costs categories and total direct medical use and costs (calculated from parent-reported utilization of healthcare services during the last 12 months). Total direct medical costs showed a graded relationship with severity level (adjusted p < 0.0001). Average annual cost difference in total direct medical costs between at risk and normal total difficulties was Euro (€) 271 (SD 858), and € 1,237 (SD 2,528) between abnormal and normal total difficulties. A significant increase in physician costs showed between children with normal and at risk total difficulties (1.30), and between normal and abnormal total difficulties (1.29; p < 0.0001). Between specific symptom domains, children with emotional symptoms showed highest costs for physicians, psychotherapist, and hospitalization as well as total direct medical costs. Children with hyperactivity/inattention showed highest costs for therapists and emergency room costs. Healthcare use and costs are related to the severity of child behavior problems. In general, children’s costs for psychotherapy treatments have been low relative to general medical treatments which may indicate that some children with behavioral problems did not get appropriate care. To some degree, medical conditions may be attributable to some of the high hospitalization costs found in children with emotional symptom.     

A transdiagnostic data-driven study of children’s behaviour and the functional connectome

Behavioural difficulties are seen as hallmarks of many neurodevelopmental conditions. Differences in functional brain organisation have been observed in these conditions, but little is known about how they are related to a child’s profile of behavioural difficulties. We investigated whether behavioural difficulties are associated with how the brain is functionally organised in an intentionally heterogeneous and transdiagnostic sample of 957 children aged 5–15. We used consensus community detection to derive data-driven profiles of behavioural difficulties and constructed functional connectomes from a subset of 238 children with resting-state functional Magnetic Resonance Imaging (fMRI) data. We identified three distinct profiles of behaviour that were characterised by principal difficulties with hot executive function, cool executive function, and learning. Global organisation of the functional connectome did not differ between the groups, but multivariate patterns of connectivity at the level of Intrinsic Connectivity Networks (ICNs), nodes, and hubs significantly predicted group membership in held-out data. Fronto-parietal connector hubs were under-connected in all groups relative to a comparison sample and children with hot vs cool executive function difficulties were distinguished by connectivity in ICNs associated with cognitive control, emotion processing, and social cognition. This demonstrates both general and specific neurodevelopmental risk factors in the functional connectome.     

Atypical Sensory behaviours in children with Tourette’s Syndrome and in children with Autism Spectrum Disorders

Certain visual disturbances make it difficult to read text and have been attributed to visual stress, also called “pattern-related visual stress”. 12 Children with ASD, 12 children with Tourette's syndrome and without ASD and 12 controls, all matched on age and non verbal ability, participated in an experiment exploring sensory behaviours and visual stress. Reading rate and accuracy were assessed with the Wilkins Rate of Reading test with and without the Intuitive Overlays. Both the children with Tourette's and the children with ASD showed a higher prevalence of atypical sensory behaviours and symptoms of visual stress than the typically developing control children. Six out of twelve children with Tourette's syndrome (50%) read more accurately and over 15% more quickly with a coloured overlay. Four of the 12 children with ASD and none of the control children read over 15% more quickly with an overlay. The findings are discussed in relation to problems in sensory modulation.     

Teachers’ attitudes toward the inclusion of students with autism spectrum disorder: Impact of students’ difficulties

BackgroundStudents with autism spectrum disorder (ASD) are less included within mainstream educational systems. We argued that teachers’ attitudes toward their inclusion represent a key factor to understand this issue. Based on previous research showing that teachers are frequently reluctant to include them in mainstream education, we hypothesized that teachers’ attitudes could be predicted by the specific difficulties faced by these students.MethodOne thousand and sixty-four teachers were asked to express their attitudes toward the inclusion of students with ASD in an online questionnaire. The co-occurring difficulties that students with ASD could face were experimentally manipulated through brief information depicting specific set of difficulties.ResultsTeachers expressed more positive attitudes toward the inclusion of students with ASD with no difficulties, in comparison with those with behavioral difficulties, behavioral and cognitive difficulties, or those for whom difficulties were not specified – the control condition. Unexpectedly, teachers were not more positive regarding the inclusion of students with ASD with no difficulties in comparison with those with cognitive difficulties.ConclusionsWithout specific information, it seems that teachers spontaneously associated ASD with behavioral difficulties and that teachers’ attitudes were the most negative for students facing such difficulties (regardless of the presence or absence of cognitive difficulties). Nonetheless, by also suggesting that attitudes toward the inclusion of these students can be positive, these results seem to corroborate that the use of broader categories like “students with ASD” could be discussed.