First Impressions Matter: Exploring Children's Negative Perceptions of Autistic Children.

Many autistic individuals face social challenges that may be due to the negative perceptions of their non-autistic peers. This study investigated school-aged children’s first impressions of autistic and non-autistic children. Thirty-seven children (ages 5-12 years) watched brief videos of autistic and non-autistic children discussing their interests and rated these children’s traits, and their behavioral intentions towards the children. Autistic children were rated as more awkward, aggressive, and less likeable, though the raters’ willingness to interact with the children in the videos was similar for both autistic and non-autistic children. The raters’ negative perceptions of the autistic children were not related to the raters' age, IQ, sex, autistic traits, or social competence. Future work should aim to further investigate what factors influence biases. These findings highlight the need for interventions in school settings to address early perceptions of autism. Educating children about autism can help challenge stereotypes and promote inclusion, ultimately fostering more positive interactions between autistic and non-autistic children.

Alexithymia is characterized by difficulties identifying and describing one's own emotions and the emotions of others. These challenges with understanding emotions in people with alexithymia may give rise to difficulties with social interactions. Given that alexithymia frequently co-occurs with autism spectrum disorder (ASD), and that both populations have difficulties with social interactions, it is of interest to determine whether alexithymia can help to parse some of the heterogeneity in social competence in autistic and nonautistic individuals. The caregivers of 241 children (6-14 years old), including 120 autistic, and 121 nonautistic, rated their child's social competence using the Multidimensional Social Competence Scale (MSCS), autism traits using the Autism Spectrum Quotient (AQ), and alexithymia traits using the Children's Alexithymia Measure (CAM). Regression analyses indicated that age, IQ, sex, AQ, and CAM scores accounted for 40.2% of the variance in autistic children's, and 68.2% of the variance in nonautistic children's, parent-reported social competence. Importantly, after controlling for age, IQ, sex, and AQ scores, CAM scores alone accounted for an additional 16.2% of the variance in autistic children's, and 17.4% of the variance in nonautistic children's social competence. These results indicate that higher alexithymia traits predict lower levels of social competence, suggesting that increased difficulty in identifying and describing one's own emotions and the emotions of others is associated with poorer social competence. Furthermore, CAM scores were found to partially mediate the relationship between autistic traits and social competence, suggesting that comorbid alexithymia traits may be partially responsible for poor social competence in individuals with high autistic traits. This research contributes to the understanding of the factors associated with the development of social competence and highlights alexithymia as a potential target for identification and intervention to improve social competence. LAY SUMMARY: Alexithymia is a condition where people find it hard to think and talk about their (and others') feelings. About 50% of autistic people have alexithymia. This might be why they have social and emotional difficulties. Parents answered questions about alexithymia and social difficulties their children have. Children with more alexithymia problems had poorer social skills. Thus, alexithymia may be related to social problems faced by autistic and nonautistic children.

The current study examined whether social competence and autistic traits are related to anxiety and depression in autistic and non-autistic children. Parents of 340 children aged 6 to 12years old, including 186 autistic and 154 non-autistic children completed the Autism Spectrum Quotient (AQ) to assess their child's autistic traits, the Multidimensional Social Competence Scale (MSCS) to assess their child's social competence, and the Behaviour Assessment Scale for Children 2 (BASC-2) to assess their child's internalizing symptoms of depression and anxiety, and children were administered the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) to assess their intellectual abilities. Hierarchical multiple regression analyses were conducted to investigate the relations between social competence, autistic traits, anxiety, and depression. Social competence was related to anxiety and depression symptoms in autistic children, but only depression symptoms in non-autistic children, above and beyond the effects of autistic traits, IQ and age. Autistic children were also reported to experience more severe anxiety and depression symptoms, and more autistic traits were related to higher levels of anxiety and depression in both groups. These findings suggest that social competence and internalizing symptoms are intricately connected in autistic children and need to be jointly considered in both assessment and intervention. The social implications are discussed with an emphasis on acceptance of diverse social styles as a viable avenue to reduce children's internalizing symptoms.

Autism spectrum disorder (ASD) is a developmental disorder characterized by persistent deficits in social communication and interaction. Speech is an important form of social communication. Prosody (e.g. vocal pitch, rhythm, etc.), one aspect of the speech signal, is crucial for ensuring information about the emotionality, excitability, and intent of the speaker, is accurately expressed. The objective of this study was to gain a better understanding of how auditory information is used to regulate speech prosody in autistic and non-autistic children, while exploring the relationship between the prosodic control of speech and social competence. Eighty autistic (M = 8.48 years, SD = 2.55) and non-autistic (M = 7.36 years, SD = 2.51) participants produced vocalizations while exposed to unaltered and frequency altered auditory feedback. The parent-report Multidimensional Social Competence Scale was used to assess social competence, while the Autism-Spectrum Quotient and the Autism Spectrum Rating Scales were used to assess autism characteristics. Results indicate that vocal response magnitudes and vocal variability were similar across autistic and non-autistic children. However, autistic children produced significantly faster responses to the auditory feedback manipulation. Hierarchical multiple regressions indicated that these faster responses were significantly associated with poorer parent-rated social competence and higher autism characteristics. These findings suggest that prosodic speech production differences are present in at least a subgroup of autistic children. These results represent a key step in understanding how atypicalities in the mechanisms supporting speech production may manifest in social-communication deficits, as well as broader social competence, and vice versa. Autism Res 2020, 13: 1880-1892. © 2020 International Society for Autism Research and Wiley Periodicals LLC LAY SUMMARY: In this study, autistic and non-autistic children produced vowel sounds while listening to themselves through headphones. When the children heard their vocal pitch shifted upward or downward, they compensated by shifting their vocal pitch in the opposite direction. Interestingly, autistic children were faster to correct for the perceived vowel sound changes than their typically developing peers. Faster responses in the children with ASD were linked to poorer ratings of their social abilities by their parent. These results suggest that autistic and non-autistic children show differences in how quickly they control their speech, and these differences may be related to the social challenges experienced by autistic children.

Although autism inclusion and acceptance has increased in recent years, autistic people continue to face stigmatization, exclusion, and victimization. Based on brief 10-second videos, non-autistic adults rate autistic adults less favourably than they rate non-autistic adults in terms of traits and behavioural intentions. In the current study, we extended this paradigm to investigate the first impressions of autistic and non-autistic children by non-autistic adult raters and examined the relationship between the rater's own characteristics and bias against autistic children. Segments of video recorded interviews from 15 autistic and 15 non-autistic children were shown to 346 undergraduate students in audio with video, audio only, video only, transcript, or still image conditions. Participants rated each child on a series of traits and behavioural intentions toward the child, and then completed a series of questionnaires measuring their own social competence, autistic traits, quantity and quality of past experiences with autistic people, and explicit autism stigma. Overall, autistic children were rated more negatively than non-autistic children, particularly in conditions containing audio. Raters with higher social competence and explicit autism stigma rated autistic children more negatively, whereas raters with more autistic traits and more positive past experiences with autistic people rated autistic children more positively. These rapid negative judgments may contribute to the social exclusion experienced by autistic children. The findings indicate that certain personal characteristics may be related to more stigmatised views of autism and decreased willingness to interact with the autistic person. The implications of the findings are discussed in relation to the social inclusion and well-being of autistic people.

BackgroundAutistic children report higher levels of bullying victimization than their non-autistic peers. However, autistic children with fewer social difficulties, as measured on the Autism Diagnostic Observation Schedule (ADOS), are more likely to report being bullied. Autistic children with stronger social skills may not only be more likely to identify and report incidents of bullying, but they may also be more likely to interact with their non-autistic peers, increasing their likelihood of being victimized. Autistic girls may be especially at-risk of experiencing bullying victimization, as a growing body of research suggests that autistic girls demonstrate fewer social difficulties and are more socially motivated than autistic boys. Here, we explored reported problems with peers and bullying victimization among a carefully matched sample of autistic and non-autistic boys and girls. Qualitative methods were further implemented to gain a more holistic understanding of the social experiences of autistic boys and girls.MethodsThis mixed-methods study analyzed the transcribed clinical evaluations of 58 autistic children (29 girls) matched to 42 non-autistic children (21 girls) on age and IQ. Within each diagnostic group, boys and girls were matched on ADOS severity score. We compared reported problems with peers and bullying victimization across sex and diagnosis. Among autistic children, we further examined whether ADOS social affect (SA), restricted repetitive behaviors, and severity scores predicted problems with peers and bullying victimization. We then identified themes related to personal experiences of victimization.ResultsAutistic children were more likely than non-autistic children to have experienced bullying victimization, and autistic children with lower ADOS severity and SA scores were more likely to report having been bullied. While autistic boys and girls reported similar levels of bullying victimization, qualitative analyses revealed sex differences in the underlying causes of peer conflict.LimitationsThis study was a secondary data analysis. The standardized set of questions on the ADOS limited the amount of information that children provided about their peer relationships, and variations in follow-up questions may have influenced children’s responses.ConclusionsAlthough autism symptomatology places autistic children at greater risk for bullying victimization compared to their non-autistic peers, greater social challenges among autistic children are associated with lower rates of victimization. This study further highlights the importance of using mixed-methods approaches to discover nuances in the social experiences of autistic girls and boys that may become opportunities for support.

Background: Vocabulary composition and word-learning biases are closely interrelated in typical development. Such word-learning biases are influenced by perceptually and conceptually salient word features, including imageability, concreteness, iconicity, and attention to shape. Autistic children often have delayed language acquisition, but there is currently little research examining the underlying mechanisms autistic children use to acquire words. The current study aimed to examine the noun composition of autistic children across a range of vocabulary sizes by examining associations between expressive noun vocabulary size and imageability, iconicity, concreteness and evidence for the shape bias, and to examine whether these patterns differ from their non-autistic peers. Methods: Participants for the word features analyses included 246 autistic children who were reported to produce between 5-312 nouns, and 940 expressive-vocabulary non-autistic children. Participants in the shape bias analyses included 272 autistic children who were reported to produce between 1-312 nouns, and 1,021 expressive-vocabulary and non-autistic children. Expressive vocabulary knowledge was measured using the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2007). Results: Each analysis indicated that imageability, iconicity, and concreteness were associated with noun vocabulary size for both groups. Both groups displayed nonlinear change across vocabulary size, and group differences were found for each perceptual feature except imageability The pattern of the associations differed slightly for concreteness and iconicity for the autistic group, primarily at the very earliest points in noun vocabulary learning. Across the three word features, both autistic and non-autistic children learn highly imageable, iconic, and concrete words during the earliest stages of noun learning. Both groups also demonstrated evidence for the shape bias system, but the trajectory of growth of evidence for the system differed between the two groups. Conclusions: Imageability, iconicity, and concreteness were identified as significant lexicosemantic features for describing expressive noun vocabulary size in autistic children. Although slight differences across word features were observed, autistic children seem to have broadly similar noun vocabularies to their non-autistic peers. Furthermore, autistic children with smaller vocabularies produced more words that are highly imageable, iconic, and concrete, whereas children with larger vocabularies produced words that are less perceptually salient, indicating a potential shift away from reliance on perceptual-based language processing. We report unique information about nonlinear growth patterns associated with each word feature, with evidence for the shape system, and distinctions in these growth patterns between groups. Future studies should explore word-learning and lexical growth patterns involving early verb acquisition in autistic children.

To compare the national prevalence of meeting physical activity, screen time, and sleep guidelines between autistic and nonautistic children and identify factors associated with meeting these guidelines. Prevalences for each health-determining behavior were estimated using the 2022 National Survey of Children's Health, using national guidelines. Complex survey-weighted logistic regression, adjusted for demographic covariates, was used to measure associations between autism and meeting each guideline, and to identify potential child, family, community, and policy-level determinants of each behavior among autistic children. The prevalence of meeting all three guidelines was low among autistic and nonautistic children across age groups. Physical activity guidelines were met at similarly low rates among autistic and nonautistic children; however, autistic children of all age groups were less likely to meet screen time guidelines, and those in the 3-5 and 6-11years age groups were less likely to meet sleep guidelines. Moderate/severe autism, irregular bedtime, low parental education, and lacking a medical home were associated with lower likelihood of meeting sleep guidelines. Irregular bedtime and high income were associated with lower likelihood of meeting physical activity guidelines. Autistic children meet guidelines for physical activity, screen time, and sleep at a low prevalence and less than their nonautistic peers. Clinicians should develop individualized plans to facilitate adherence to guidelines among autistic children. Interventions should address modifiable factors, including bedtime regularity and access to medical homes. Further research and policy efforts should be made to improve adherence to guidelines among autistic children and subsequently reduce health disparities.

Autistic individuals often face challenges perceiving and expressing emotions, potentially stemming from differences in speech prosody. Here we explore how autism diagnoses between groups, and measures of social competence within groups may be related to, first, children's speech characteristics (both prosodic features and amount of spontaneous speech), and second, to these two factors in mothers' speech to their children. Autistic (n = 21) and non-autistic (n = 18) children, aged 7-12 years, participated in a Lego-building task with their mothers, while conversational speech was recorded. Mean F0, pitch range, pitch variability, and amount of spontaneous speech were calculated for each child and their mother. The results indicated no differences in speech characteristics across autistic and non-autistic children, or across their mothers, suggesting that conversational context may have large effects on whether differences between autistic and non-autistic populations are found. However, variability in social competence within the group of non-autistic children (but not within autistic children) was predictive of children's mean F0, pitch range and pitch variability. The amount of spontaneous speech produced by mothers (but not their prosody) predicted their autistic children's social competence, which may suggest a heightened impact of scaffolding for mothers of autistic children. Together, results suggest complex interactions between context, social competence, and adaptive parenting strategies in driving prosodic differences in children's speech.

Autistic children are less likely to participate in sport than non-autistic children, but we know little about how patterns of participation in team and individual sport change across childhood. Drawing on a nationally representative cohort of Australian children, this study analysed trajectories of participation in team and individual sport between the ages of 8 and 15 using a group-based multiple trajectory modelling approach. A five-group solution was found to be the best fit to the data, identifying distinct patterns of sport participation over time. In comparison with non-autistic children, autistic children were more likely to belong to the 'sport avoider' group with low participation in both team and individual sport at all ages. Conversely, autistic children were less likely to be classified in the 'team sportsperson', 'ex-team sportsperson' or 'mixed sportsperson' groups. No difference in the likelihood of belonging to the 'individual sportsperson' group was found. Risk factors for trajectory group membership were similar for autistic and non-autistic children. Our findings indicate that autistic children are particularly likely to experience exclusion from team sport environments, and this exclusion persists over time. Similar rates of participation in individual sport for autistic and non-autistic children indicate that these environments may be more supportive for autistic children.Lay abstractAutistic children are less likely to participate in sport than non-autistic children, but we know little about how patterns of participation in team and individual sport change across childhood. Drawing on data for a group of Australian children whose families were reinterviewed between ages 8 and 15, the present study patterns of participation in team and individual sport over time. Findings from the analysis suggested that children could be grouped into five patterns of participation in team and individual sport between the ages of 8 and 15. In comparison with non-autistic children, autistic children were more likely to belong to the 'sport avoider' group with low participation in both team and individual sport at all ages. Conversely, autistic children were less likely to belong to the 'team sportsperson', 'ex-team sportsperson' or 'mixed sportsperson' groups. Similar numbers of autistic and non-autistic children belonged to the 'individual sportsperson' group. Factors linked to patterns of participation over time were similar for autistic and non-autistic children. Our findings indicate that autistic children are particularly likely to experience exclusion from team sport environments, and this exclusion persists over time. Similar rates of participation in individual sport for autistic and non-autistic children indicate that these environments may be more supportive for autistic children.

Autistic people are often portrayed as lacking empathy. Yet they are not indifferent to others’ feelings. To advance our understanding of the early development of empathy in autistic children, this longitudinal study followed the development of four empathy abilities: emotion contagion, attention to others, emotion acknowledgment, and prosocial actions, in 1- to 6-year-old autistic children (N = 61; Mage = 55.49 months), in comparison with non-autistic peers (N = 145; Mage = 52.16 months). Once a year, for 4 consecutive years, children’s empathic reactions were evaluated by experimenters who acted out emotional episodes to elicit empathy in children, and by parents who filled out empathy questionnaires. We confirmed autistic children’s difficulty attending to others, acknowledging others’ emotions, and initiating prosocial actions. However, according to parents, they did not differ from non-autistic children in emotion contagion with others’ negative emotions. Notably, autistic children showed a greater increase in prosocial actions over time than their non-autistic peers. We discussed how to interpret these findings in light of the “double empathy problem,” and stressed the importance of removing the stereotypical view of autism. Furthermore, this study was among the first to show that autistic children have the potential to learn and to improve empathy skills.Lay abstractEmpathy is a highly valued human capacity. Yet, autistic people are often portrayed as lacking in empathy. Recent research, which views empathy as a complex construct emerging from multiple interrelated emotional and cognitive processes, argues that, although many autistic people do have difficulty understanding others’ emotions, and this may hinder them from responding to others in a prosocial manner, they are not indifferent to other people’s feelings. Hoping to contribute to a better understanding of the unique challenges that autistic children face in their empathy development, we followed the development of four empathy abilities: emotion contagion, attention to others, emotion acknowledgment, and prosocial actions, in 1- to 6-year-old autistic children, in comparison with non-autistic children. Once a year, for 4 consecutive years, children’s empathy abilities were evaluated by experimenters who acted out emotional episodes to provoke empathy in children, and by parents who filled out empathy questionnaires. We found that autistic children experienced indeed more difficulty attending to others, acknowledging others’ emotions, and initiating prosocial actions toward others. However, according to parents, they did not differ from their non-autistic peers in feeling along with others’ negative emotions. This indicates that it might not be the case that autistic children did not want to act empathetically toward others. Rather, they might not know how to do so. Notably, despite these difficulties, when looking at children’s developmental trajectories, autistic children showed similar improvements over time as non-autistic children. This provides evidence that autistic children have the potential to learn and to improve their empathy skills.

Autistic children have been shown to have poorer bone health than their non-autistic peers, but previous evidence on this topic has been based on small clinical samples and is limited by how bone health has been measured. The association between autism and bone health may also reflect confounding by correlated genetic or environmental factors, but prior studies have not addressed this issue. We address these issues using data from a population-representative cohort of Australian children with bone health measured by peripheral quantitative computed tomography (pQCT) for both children and parents. Data for 1,274 children (66 autistic, 1,208 non-autistic) aged 11-12 years (50% male) were drawn from the Child Health CheckPoint within the Longitudinal Study of Australian Children. pQCT measures at the tibial diaphysis (ankle) and metaphysis (shin) were recorded using an identical protocol for children and one attending parent. Child autism was parent reported. Regression analyses were used to compare differences between autistic and non-autistic children, and between parents of autistic children and parents of non-autistic children. Our findings indicate poorer bone health as assessed by tibial pQCT among autistic children compared to non-autistic children at both the metaphysis and diaphysis. No differences in pQCT measures were found between parents of autistic and non-autistic children, suggesting no evidence of confounding by shared genetic or environmental factors. These findings reinforce the need to support improved bone development among autistic children and suggest that differences in bone health are likely driven by behavioural factors that are potentially amenable to intervention.

In the present study, we asked autistic and non-autistic children to recount personally experienced basic (fear, happiness, sadness) and self-conscious (guilt, pride, embarrassment) emotions. Using linguistic analyses, children's recounts were examined in order to gain new insights into their understanding of these emotions. Children were asked to recount personally experienced basic and self-conscious emotions. Discourse and content analyses were performed on their responses. For basic emotions, autistic and non-autistic children's recounts did not differ in terms of number of responses provided following two requests, length of responses (i.e., number of verb and argument clauses in recounts), and the number of prompts needed to elicit basic emotion recounts. Moreover, children did not differ in the appropriateness of their recounts of basic emotions, although autistic children made fewer causal inferences about sadness than their non-autistic peers. In contrast, autistic children offered significantly fewer recounts of guilt and embarrassment and provided briefer recounts of guilt compared to their non-autistic peers. Autistic children also made fewer references to others in their recounts for guilt and embarrassment and were less likely to include social context information (i.e. references to others). Finally, autism symptomatology predicted appropriateness of content for guilt and pride, whereas vocabulary level predicted appropriateness of content for sadness and embarrassment. Few linguistic differences were found in children's recounting of basic emotions, whereas autistic children showed less appropriate content for self-conscious emotions. Implications of our findings in terms of possible avenues for intervention and training are given.

For non-autistic children, it is well established that linguistic awareness skills support their success with reading and spelling. Few investigations have examined whether these same linguistic awareness skills play a role in literacy development for autistic elementary school-age children. This study serves as a first step in quantifying the phonological, prosodic, orthographic, and morphological awareness skills of autistic children; how these skills compare to those of non-autistic children; and their relation to literacy performance. We measured and compared the phonological, prosodic, orthographic, and morphological awareness skills of 18 autistic (with average nonverbal IQs) and 18 non-autistic elementary school-age children, matched in age, nonverbal IQ, and real-word reading. The relations between linguistic awareness and the children's word-level literacy and reading comprehension skills were examined, and we explored whether the magnitude of these relations was different for the two groups. Regression analyses indicated the relative contribution of linguistic awareness variables to performance on the literacy measures for the autistic children. The non-autistic children outperformed the autistic children on most linguistic awareness measures. There were moderate-to-strong relations between performances on the linguistic awareness and literacy measures for the non-autistic children, and most associations were not reliably different from those for the autistic children. Regression analyses indicate that the performance on specific linguistic awareness variables explains unique variance in autistic children's literacy performance. Although less developed than those of their non-autistic peers, the linguistic awareness skills of autistic elementary school-age children are important for successful reading and spelling.

When partners coordinate their movement in time and space to reach a goal, they perform joint action, an important part of every interaction. Joint action involves motor abilities and socio-cognitive skills like theory of mind. Autistic children’s lower joint motor coordination (joint action) abilities as well as their motor functioning and theory of mind difficulties may interfere with efficient peer interaction. However, the shared contribution of motor and theory of mind to partners’ joint action was not yet explored. This study investigated those contributors (motor and theory of mind) along with group and age differences in 84 autistic children ages 6–16 years and 64 non-autistic children matched by age, sex, and IQ across three age-groups: early-childhood, preadolescence, and adolescence. Basic and advanced theory of mind skills and most motor tasks were higher among adolescents versus early-childhood. However, the autistic group consistently underperformed the non-autistic group in basic and advanced theory of mind levels and in all gross- and fine-motor tasks across all age-groups, revealing unique motor development characteristics in autism. A significant joint full mediation effect emerged for motor and theory of mind skills on joint action performance in both study groups. Understanding that motor and theory of mind skills together underlie joint action opens up a new channel of intervention to facilitate peer interaction.Lay abstractWhen two or more people move together in a coordinated way at the same time and in the same place, they perform “joint action,” which is an important part of everyday social interaction. Joint action involves the activation of both motor skills and the social-cognitive understanding of others’ thoughts, feelings, and desires—their ability to hold “Theory of Mind.” Motor functioning and Theory of Mind may be challenging for autistic individuals. We wanted to investigate how motor skills and the ability to understand others’ minds develop in autistic and non-autistic children and adolescents and to explore how these skills contribute to joint action performance. We compared 84 autistic children with 64 non-autistic children matched by age, sex, and IQ. Among these 6- to 16-year-olds, we examined three age-groups: early-childhood, preadolescence, and adolescence. We found that older participants, both in the autistic and non-autistic groups, showed better abilities than younger participants in basic and advanced Theory of Mind skills and in most motor tasks. However, non-autistic children outperformed autistic children in Theory of Mind (at basic and advanced levels) and also in all gross-motor and fine-motor tasks, across all age-groups. The autistic group’s motor patterns were characterized by greater variability in tasks’ rated difficulty levels compared to their non-autistic peers, who showed more intact, uniform patterns. Both motor and Theory of Mind skills were found to significantly impact joint action performance in both study groups. These findings are important for understanding joint action’s underlying mechanisms and for refining social intervention programs for autistic individuals.