Parental Autism Spectrum Disorder Research Articles

Narrative Ability in Autism and First-Degree Relatives.

Narrative is an important communication skill for sharing personal experiences and connecting with others. Narrative skills are often impacted in autism spectrum disorder (ASD) and have important consequences for social interactions and relationships. Subtle differences in narrative have also been reported among first-degree relatives of autistic individuals, suggesting that narrative may also be an etiologically important language-related skill that is influenced by genes associated with ASD. This study examined narrative ability and related visual attention during narration in ASD and first-degree relatives of individuals with ASD (siblings and parents) to understand how narrative and related attentional styles may be variably impacted across the spectrum of ASD genetic influence. Participants included 56 autistic individuals, 42 siblings of autistic individuals, 49 controls, 161 parents of autistic individuals, and 61 parent controls. Narratives were elicited using a wordless picture book presented on an eye tracker to record concurrent gaze. Findings revealed parallel patterns of narrative differences among ASD and sibling groups in the use of causal language to connect story elements and the use of cognitive and affective language. More subtle differences within the domain of causal language were evident in ASD parents. Parallel patterns in the ASD and sibling groups were also found for gaze during narration. Findings implicate causal language as a critical narrative skill that is impacted in ASD and may be reflective of ASD genetic influence in relatives. Gaze patterns during narration suggest similar attentional mechanisms associated with narrative among ASD families.

Bioenergetic signatures of neurodevelopmental regression.

Background: Studies have linked autism spectrum disorder (ASD) to physiological abnormalities including mitochondrial dysfunction. Mitochondrial dysfunction may be linked to a subset of children with ASD who have neurodevelopmental regression (NDR). We have developed a cell model of ASD which demonstrates a unique mitochondrial profile with mitochondrial respiration higher than normal and sensitive to physiological stress. We have previously shown similar mitochondrial profiles in individuals with ASD and NDR. Methods: Twenty-six ASD individuals without a history of NDR (ASD-NoNDR) and 15 ASD individuals with a history of NDR (ASD-NDR) were recruited from 34 families. From these families, 30 mothers, 17 fathers and 5 typically developing (TD) siblings participated. Mitochondrial respiration was measured in peripheral blood mononuclear cells (PBMCs) with the Seahorse 96 XF Analyzer. PBMCs were exposed to various levels of physiological stress for 1h prior to the assay using 2,3-dimethoxy-1,4-napthoquinone. Results: ASD-NDR children were found to have higher respiratory rates with mitochondria that were more sensitive to physiological stress as compared to ASD-NoNDR children, similar to our cellular model of NDR. Differences in mitochondrial respiration between ASD-NDR and TD siblings were similar to the differences between ASD-NDR and ASD-NoNDR children. Interesting, parents of children with ASD and NDR demonstrated patterns of mitochondrial respiration similar to their children such that parents of children with ASD and NDR demonstrated elevated respiratory rates with mitochondria that were more sensitive to physiological stress. In addition, sex differences were seen in ASD children and parents. Age effects in parents suggested that mitochondria of older parents were more sensitive to physiological stress. Conclusion: This study provides further evidence that children with ASD and NDR may have a unique type of mitochondrial physiology that may make them susceptible to physiological stressors. Identifying these children early in life before NDR occurs and providing treatment to protect mitochondrial physiology may protect children from experiencing NDR. The fact that parents also demonstrate mitochondrial respiration patterns similar to their children implies that this unique change in mitochondrial physiology may be a heritable factor (genetic or epigenetic), a result of shared environment, or both.

Effects of service dogs on children with ASD's symptoms and parents' well-being: On the importance of considering those effects with a more systemic perspective.

The integration of a service dog can have numerous benefits for children with Autism Spectrum Disorder (ASD). However, although integration takes place within a family, little is known about the dynamics of these benefits on the family microsystem. Thus, the aim of our study was to propose a more systemic perspective, not only by investigating the benefits of SD integration, but also by exploring the relationships between improvements in children with ASD, parents' well-being, parenting strategies and the quality of the child-dog relationship. Twenty parent-child with ASD dyads were followed before, as well as 3 and 6 months after service dog integration. At each stage, parents completed an online survey which included: the Autism Behavior Inventory (ABI-S), the State-Trait Anxiety Inventory (STAI-Y), the Parenting Stress Index Short Version (PSI-SF), the Monash Dog Owner Relationship Scale (MDORS) and the Parenting Styles and Dimensions Questionnaire (PSDQ). First, repeated measure one-way ANOVAs revealed that both children's ASD symptoms and parents' anxiety decreased significantly after service dog integration. Additionally, Spearman correlations revealed that the more ASD symptoms decreased, the more parent's anxiety and parenting stress also decreased. Second, the quality of the child-dog relationship appeared to contribute to those benefits on both children's ASD symptoms and parents' well-being. Interestingly, parenting strategies seemed to adapt according to these benefits and to the quality of the child-dog relationship. Through a more systemic perspective, this study highlighted that the integration of a service dog involved reciprocal and dynamic effects for children with ASD and their parents, and shed new light on the processes that may underlie the effects of a service dog for children with ASD.

22 Families’ Experiences with Autism Service Navigation and Mobile Application-based Support

Abstract Background Navigating services following an autism spectrum disorder (ASD) diagnosis is a challenging and lengthy process. Families of children with ASD increasingly experience difficulty locating and accessing services, leading to the inaccessibility of care. These difficulties were further exacerbated by COVID-19 and little is known about families' experience navigating services during the pandemic. Given the complexities of accessing publicly funded developmental services and the lack of a comprehensive platform to navigate available services, prior to the pandemic our research team developed a mobile application, My Autism Passport (MAP), to assist families in identifying publicly available ASD services. Our goal was to determine whether a mobile application would provide families with greater self-efficacy during these challenging times. Objectives The primary objective of our study was to determine the impact of MAP on caregiver self-efficacy. Design/Methods A randomized controlled trial of 34 caregivers of children under 6 years of age who were given a new diagnosis of ASD in the last year were recruited into the study. 17 were randomized to receive MAP. Access to ASD services and parent self-efficacy scores were collected via questionnaires at baseline and then at 6 months from recruitment in both groups. Self-efficacy was measured using the Parent Empowerment and Self-Efficacy Measurement (PEEM). Results Our study consisted of an ethnically diverse group of participants with varying socioeconomic levels. At baseline, participants indicated an overall mean PEEM score of 131.8 (±28.2) in the control arm, and 138.5 (±23.3) in the App arm at the time of diagnosis (p-value 0.6149). At 6 months following ASD diagnosis, the overall score was 123.2 (±35.7) in the control arm, and 137.3 (±33.3) in the App arm (p-value 0.4413). There was a trend towards decreasing feelings of self-efficacy in the control group compared to those with the App who had a stable self-efficacy score. Conclusion Our study indicates that the use of a mobile app to assist service navigation may be helpful for families in self-navigation for autism services. Data collection and analysis are ongoing for one-year post-diagnosis.

Consistency between parent report and direct assessment of development in toddlers with autism spectrum disorder and other delays: Does sex assigned at birth matter?

The current study examined differences between parent report and diagnostician direct assessment of receptive language, expressive language, and fine motor abilities in toddlers with autism spectrum disorder (ASD) and other delays. Additionally, this study examined whether parent-diagnostician consistency varied by child diagnosis and sex assigned at birth (SAB). Initial mixed analysis of variances (ANOVAs) were conducted using data from a sample of 646 toddlers to examine whether parent-diagnostician consistency differed by child diagnosis. Matched samples (using child age, SAB, and nonverbal IQ) were then created within each diagnostic group and mixed ANOVAs were conducted to examine if consistency was similar in matched diagnostic subsamples and whether it differed by SAB. Findings from the full sample mostly replicated previous research that has documented consistency between parent report and direct observation regardless of child diagnosis. However, when examined in matched diagnostic subgroups, more nuanced patterns were observed. Parent report of receptive language was lower in ASD and ASD features subgroups and parent report of fine motor skills was lower than direct observation in the ASD, ASD features, and developmental delay groups. When examining the moderating effect of SAB, only expressive language was impacted for children in the ASD group. Results indicate the importance of considering child demographic characteristics and that child SAB may impact parent report and/or diagnostician perception of expressive language.

A profile of prosodic speech differences in individuals with autism spectrum disorder and first-degree relatives.

Impairments in prosody (e.g., intonation, stress) are among the most notable communication characteristics of individuals with autism spectrum disorder (ASD) and can significantly impact communicative interactions. Evidence suggests that differences in prosody may be evident among first-degree relatives of autistic individuals, indicating that genetic liability to ASD is expressed through prosodic variation, along with subclinical traits referred to as the broad autism phenotype (BAP). This study aimed to further characterize prosodic profiles associated with ASD and the BAP to better understand the clinical and etiologic significance of prosodic differences. Autistic individuals, their parents, and respective control groups completed the Profiling Elements of Prosody in Speech-Communication (PEPS-C), an assessment of receptive and expressive prosody. Responses to expressive subtests were further examined using acoustic analyses. Relationships between PEPS-C performance, acoustic measurements, and pragmatic language ability in conversation were assessed to understand how differences in prosody might contribute to broader ASD-related pragmatic profiles. In ASD, receptive prosody deficits were observed in contrastive stress. With regard to expressive prosody, both the ASD and ASD Parent groups exhibited reduced accuracy in imitation, lexical stress, and contrastive stress expression compared to respective control groups, though no acoustic differences were noted. In ASD and Control groups, lower accuracy across several PEPS-C subtests and acoustic measurements related to increased pragmatic language violations. In parents, acoustic measurements were tied to broader pragmatic language and personality traits of the BAP. Overlapping areas of expressive prosody differences were identified in ASD and parents, providing evidence that prosody is an important language-related ability that may be impacted by genetic risk of ASD.

Targeted sequencing and clinical strategies in children with autism spectrum disorder: A cohort study.

Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with genetic and clinical heterogeneity. Owing to the advancement of sequencing technologies, an increasing number of ASD-related genes have been reported. We designed a targeted sequencing panel (TSP) for ASD based on next-generation sequencing (NGS) to provide clinical strategies for genetic testing of ASD and its subgroups. Methods: TSP comprised 568 ASD-related genes and analyzed both single nucleotide variations (SNVs) and copy number variations (CNVs). The Autism Diagnostic Observation Schedule (ADOS) and the Griffiths Mental Development Scales (GMDS) were performed with the consent of ASD parents. Additional medical information of the selected cases was recorded. Results: A total of 160 ASD children were enrolled in the cohort (male to female ratio 3.6:1). The total detection yield was 51.3% for TSP (82/160), among which SNVs and CNVs accounted for 45.6% (73/160) and 8.1% (13/160), respectively, with 4 children having both SNVs and CNV variants (2.5%). The detection rate of disease-associated variants in females (71.4%) was significantly higher than that in males (45.6%, p = 0.007). Pathogenic and likely pathogenic variants were detected in 16.9% (27/160) of the cases. SHANK3, KMT2A, and DLGAP2 were the most frequent variants among these patients. Eleven children had de novo SNVs, 2 of whom had de novo ASXL3 variants with mild global developmental delay (DD) and minor dysmorphic facial features besides autistic symptoms. Seventy-one children completed both ADOS and GMDS, of whom 51 had DD/intellectual disability (ID). In this subgroup of ASD children with DD/ID, we found that children with genetic abnormalities had lower language competence than those without positive genetic findings (p = 0.028). There was no correlation between the severity of ASD and positive genetic findings. Conclusion: Our study revealed the potential of TSP, with lower cost and more efficient genetic diagnosis. We recommended that ASD children with DD or ID, especially those with lower language competence, undergo genetic testing. More precise clinical phenotypes may help in the decision-making of patients with genetic testing.

Cognitive reappraisal training for parents of children with autism spectrum disorder.

Parents of children with autism spectrum disorder (ASD) experience higher stress levels than those of typically developing children. The goal of the current study was to examine whether a mentalization-based intervention would enhance parental cognitive reappraisal, an adaptive form of emotion regulation associated with lower levels of stress. Findings from 27 parents who completed a short training indicated an improvement in cognitive reappraisal. In exploratory analyses, two different types of reappraisal were examined. The intervention-related improvement was found mainly with one type of reappraisal, namely reflective reappraisal that consist of cognitive reappraisal with mentalization characteristics. In light of the evidence indicating that high cognitive reappraisal and high reflective functioning are associated with quality caregiving, findings from the current study suggesting that a brief mentalization-based intervention supports ASD parents' cognitive reappraisal with mentalization characteristics are promising and warrant further investigation.

Slower Peak Pupillary Response to Emotional Faces in Parents of Autistic Individuals.

BackgroundAtypical autonomic arousal has been consistently documented in autism spectrum disorder (ASD) and is thought to contribute to the social-communication phenotype of ASD. Some evidence suggests that clinically unaffected first-degree relatives of autistic individuals may also show subtle differences in indices of autonomic arousal, potentially implicating heritable pathophysiological mechanisms in ASD. This study examined pupillary responses in parents of autistic individuals to investigate evidence that atypical autonomic arousal might constitute a subclinical physiological marker of ASD heritability within families of autistic individuals.MethodsPupillary responses to emotional faces were measured in 47 ASD parents and 20 age-matched parent controls. Macro-level pupillary responses (e.g., mean, peak, latency to peak) and dynamic pupillary responses over the course of the stimulus presentation were compared between groups, and in relationship to subclinical ASD-related features in ASD parents. A small ASD group (n = 20) and controls (n = 17) were also included for exploratory analyses of parent–child correlations in pupillary response.ResultsParents of autistic individuals differed in the time course of pupillary response, exhibiting a later primary peak response than controls. In ASD parents, slower peak response was associated with poorer pragmatic language and larger peak response was associated with poorer social cognition. Exploratory analyses revealed correlations between peak pupillary responses in ASD parents and mean and peak pupillary responses in their autistic children.ConclusionDifferences in pupillary responses in clinically unaffected parents, together with significant correlations with ASD-related features and significant parent–child associations, suggest that pupillary responses to emotional faces may constitute an objective physiological marker of ASD genetic liability, with potential to inform the mechanistic underpinnings of ASD symptomatology.

Family Communication in Autism Spectrum Disorder: Applying the Family Caregiver Communication Typology to Parent Caregivers

ABSTRACT Parents of children with Autism Spectrum Disorder (ASD) experience greater stress and caregiver burden than parents of children with other disabilities. To cope with the stress of long-term caregiving, they rely on professionals for support and guidance. However, parents continue to report unmet communication and support needs. To inform tailored communication for parents of a child with ASD, this study used the existing Family Caregiver Communication Typology framework which identifies four caregiver communication types (manager, carrier, partner, and lone) and their unique communication and support needs. In-depth, structured interviews were conducted with parents (n = 22) and ASD professionals (n = 28) to explore communication characteristics of ASD parent caregivers. A thematic analysis revealed communication behaviors among four ASD parent caregiver types, further validating the typology. Future research is needed to develop targeted interventions for improving family-centered care based on ASD parent caregiver types.

Parental Stress of Pakistani Families with Children who Have Developmental Disabilities

Background: The goal of this research was to find out what factors were associated with these parenting effects in Pakistani mothers and dads who had children with intellectual disability (ID) or autism spectrum disorders (ASD) A total of 191 parents agreed to take part in the study, 100 of whom had a child with ADS and 91 of whom had a child with ID. Each participant filled out standardized parenting stress scale rating scales and provided demographic data during the interview. Families who have children with Autism and ID have higher emotional state, according to structural equation modelling. Objective: To find out parental stress of Pakistani families with children who have developmental disabilities. Methodology: The cross-sectional study was conducted through five different organizations in Lahore, Pakistan (Bases, Rising sun, Dimensions, Autism resource center, Oasis) and from two hospitals (Mayo Hospital Lahore and Sheikh Zaid Hospital). Standardized questionnaire (Parental stress scale) was used. Data was collected through standardized questionnaire after taking inform consent and distributed among the parents with children that have special needs (ASD and ID) Parents were asked to complete a questionnaire. Result scores were recorded for every respondent. The data was analyzed by “Statistical Package for Social Sciences” SPSS (version 22.0). Results: Using a standardized questionnaire, it was shown that the emotional well-being of families with children with ASD and ID was much worse, with both mothers and fathers reporting emotional exhaustion. Stress was exacerbated by a lack of emotional well-being. ASD parents show high percentage of 72.2% and ID parents show highest percentage of 61.1% so according to the given standardized questionnaire points the higher the percentage the higher the stress level. While raising a kid with neurological disabilities has a roughly comparable effect on Pakistani families as it does on parents in other countries, there are evidence that children with ASD and ID provide particular challenges to these families. Conclusion: Parents of both children face higher stress level. High level of parent stress needs timely counselling of the parents about the circumstances that they need to be encountered with having an abnormal child. They shall be aware with the techniques to deviate their mind from the most recurring point of stress. Keywords: Autism spectrum disorder, Intellectual disability, Parental stress, Pakistan, Health, developmental disability

A constellation of eye-tracking measures reveals social attention differences in ASD and the broad autism phenotype

BackgroundSocial attention differences, expressed through gaze patterns, have been documented in autism spectrum disorder (ASD), with subtle differences also reported among first-degree relatives, suggesting a shared genetic link. Findings have mostly been derived from standard eye-tracking methods (total fixation count or total fixation duration). Given the dynamics of visual attention, these standard methods may obscure subtle, yet core, differences in visual attention mechanisms, particularly those presenting sub-clinically. This study applied a constellation of eye-tracking analyses to gaze data from individuals with ASD and their parents.MethodsThis study included n = 156 participants across groups, including ASD (n = 24) and control (n = 32) groups, and parents of individuals with ASD (n = 61) and control parents (n = 39). A complex scene with social/non-social elements was displayed and gaze tracked via an eye tracker. Eleven analytic methods from the following categories were analyzed: (1) standard variables, (2) temporal dynamics (e.g., gaze over time), (3) fixation patterns (e.g., perseverative or regressive fixations), (4) first fixations, and (5) distribution patterns. MANOVAs, growth curve analyses, and Chi-squared tests were applied to examine group differences. Finally, group differences were examined on component scores derived from a principal component analysis (PCA) that reduced variables to distinct dimensions.ResultsNo group differences emerged among standard, first fixation, and distribution pattern variables. Both the ASD and ASD parent groups demonstrated on average reduced social attention over time and atypical perseverative fixations. Lower social attention factor scores derived from PCA strongly differentiated the ASD and ASD parent groups from controls, with parent findings driven by the subset of parents demonstrating the broad autism phenotype.LimitationsTo generalize these findings, larger sample sizes, extended viewing contexts (e.g., dynamic stimuli), and even more eye-tracking analytical methods are needed.ConclusionsFixations over time and perseverative fixations differentiated ASD and the ASD parent groups from controls, with the PCA most robustly capturing social attention differences. Findings highlight their methodological utility in studies of the (broad) autism spectrum to capture nuanced visual attention differences that may relate to clinical symptoms in ASD, and reflect genetic liability in clinically unaffected relatives. This proof-of-concept study may inform future studies using eye tracking across populations where social attention is impacted.

Birthpangs of Thivra: surmounting the hurdles to launch “Dwani”

Study level/applicability The case focuses on Thivra Info Solutions Pvt Ltd, an entrepreneurial organization incubated by Prasannan (she/her) in 2017. The organization started with a mission to provide technology-based learning solutions for children diagnosed with autism spectrum disorder (ASD). Thivra Info Solutions Pvt Ltd had developed multiple offerings, including gamified learning, targeted to ASD and general ed-tech users. The firm also launched “Dwani,” the communicative-based learning app for ASD children. The initial feedback by users, parents and teachers had been encouraging. Prasannan was exploring avenues to scale the business when the Covid-19 pandemic affected all the operations.The case presents the multiple dilemmas entrepreneurial firms face in managing resources, finances, growth and product and customer focus. Students are encouraged to debate the organization strategy, product and consumer target segments and solutions to scale the business while managing frugal resources. Subject area This case study can be used in entrepreneurship, leadership, crisis management, business development, organizational behavior and technology. Case overview The case study describes the navigation of Thivra from a Generic Gamified App to its niche of catering for ASD students. The case presents the challenges presented to leadership to manage the crisis and try to grow their entrepreneurial venture. This case has been designed for use in business-to-consumer marketing or entrepreneurship, gender entrepreneurship, ed-tech-based startups, in MBA, executive MBA or executive education programs in the field. The case is suitable for those doing business in Asia, for post-graduate and under-graduate students studying business innovation, entrepreneurship, strategy and marketing. It is also appropriate for courses on gender entrepreneurship; women and crisis management; and product management. The case aims at facilitating classroom discussion on the extension of Indian-based ed-tech startups to ASD children. Expected learning outcomes Students will also be able to explore the following issues: to study the role played by a business model that withstands the competition over a long period and adopting sustainability; to describe the concept and implications of paradoxical leadership, thereby drawing its impact on business decisions; to analyze how a leader acts in terms of crisis from a startup point of view; to draw the phases and constraints of the enterprise development and compare and contrast it based on gender; to demonstrate the value to different constituents (ASD students, parents, teachers and ASD counselors) by understanding their differentiated needs and developing powerful value propositions for each. Articulating and demonstrating this value is key to gaining the buy-in of the various decision-making units; to understand how, having gained traction in one market segment (in this case, tractions with parents of ASD children), a company can develop new market segments; to study the issues and problems faced by startups in developing economies, especially the tech-based ones; and to understand the application of gamification on education and communication for ASD children. Supplementary materials Teaching notes are available for educators only. Subject code CSS 3: Entrepreneurship

English language teaching for Autism Spectrum Disorders (ASD) learners during pandemic era

An Autistic child is a child who has special needs and developmental disorders. Therefore, in the teaching learning process, teachers who teach ASD learners need to have some knowledge of students’ needs. The objections of this study are to explain the implementation of English language teaching for ASD learners during the pandemic era and parents’ role in helping ASD learners understand English. This research employed qualitative research. The researchers applied observation, depth interview and documentation in data collection. The results showed that 1) the English language teaching process for ASD at RBA during the pandemic era applied offline and online learning mode. The material of English language teaching for ASD learners was based on the level of ASD diagnosis. The teachers used direct method, TPR, and Lexical method in offline learning, but for online learning, they used Direct and lexical methods. The teachers also utilised pictures or flashcards in offline learning whereas for online learning they gave the students worksheets and did a video call. In giving assessment, the teachers carried out anecdotal notes, checklists, interviews, and retelling stories 2) During the pandemic era, the role of ASD parents was to accompany their child at home pronouncing English vocabularies that had been given by the therapist at RBA. On the other hand, in on-line learning, the role of parents was as a teacher/therapist who gave treatment to their children at home based on therapists’ instructions.

A Longitudinal Study of Parent-Child Interactions and Language Outcomes in Fragile X Syndrome and Other Neurodevelopmental Disorders.

Difficulties with pragmatic language (i.e., language in social contexts, such as conversational ability) are a noted characteristic of the language profiles of both fragile X syndrome (FXS) and autism spectrum disorder (ASD), conditions which show significant phenotypic overlap. Understanding the origins and developmental course of pragmatic language problems in FXS and other developmental conditions associated with language impairment is a critical step for the development of targeted interventions to promote communicative competence across the lifespan. This study examined pragmatic language in the context of parent-child interactions in school-age children with FXS (who did and did not meet ASD criteria on the ADOS; n = 85), idiopathic ASD (n = 32), Down syndrome (DS; n = 38), and typical development (TD; n = 39), and their parents. Parent-child communicative interactions were examined across multiple contexts, across groups, and in relationship to pragmatic language outcomes assessed 2 years later. Results showed both overlapping and divergent patterns across the FXS-ASD and idiopathic ASD child and parent groups, and also highlighted key differences in pragmatic profiles based on situational context, with more pragmatic language difficulties occurring for both ASD groups in less structured interactions. Differences in parental language styles during parent-child interactions were associated with child language outcomes, likely reflecting the complex interplay of discourse style inherent to a parent, with the inevitable influence of child characteristics on parent language as well. Together, findings help delineate the dynamic and multifactorial nature of impaired pragmatic skills among children with FXS and other neurodevelopmental disorders associated with language impairment, with potential implications for the development of targeted interventions for pragmatic communication skills.

Family and Developmental History of Individuals With Autism Spectrum Disorder: Importance of the Clinical Diagnostic Interview for Diagnosis in Adolescents. An Explorative Study.

Background: Diagnosis of autism spectrum disorder (ASD) can be made early in childhood, but also later in adolescence or adulthood. In the latter cases, concerns about an individual's behavior typically lead to consultation of a mental health professional (MHP). As part of the initial clinical examination by the MHP, a clinical diagnostic interview is performed, in order to obtain the patient's history, and may lead to the hypothesis of ASD. We were here interested to study family and developmental history as key parts of the patient's history. The aim of the study was to investigate empirical differences between adolescents with ASD and adolescent control persons in family and developmental history.Method: Clinical diagnostic interview items addressing family and developmental history were adopted from their regular use at several university hospitals and in leading textbooks. Parents of male adolescents with normal intelligence and an ASD diagnosis (n = 67) and parents of male adolescents without psychiatric diagnosis (n = 51) between the age of 12 and 17 years were investigated. Data were operationalized into three categories: 0 = normal behavior, 1 = minor pathological behavior, and 2 = major pathological behavior. Differences were analyzed by multiple t-test of two-way ANOVA.Results: Adolescents with ASD expressed a profile of items significantly differing from control persons. Comparison of significant items with the empirical ASD literature indicated robust accordance.Conclusions: Our findings support the importance and feasibility of the clinical diagnostic interview of family and developmental history for initiation of the diagnostic process of ASD in adolescents.

Opinions of Turkish parents of children with autism spectrum disorder on use of complementary and alternative medicine methods

BackgroundThe use of CAMs is increasing in the pediatric population with chronic diseases. Culture may affect parents' choice of CAM. This study was conducted to determine the prevalence of using complementary and alternative medicines (CAMs) in children with Autism Spectrum Disorder (ASD) in Turkey and to evaluate their parents’ these practices and opinions on them. MethodThis exploratory and descriptive study was conducted between January and May 2019 with parents of 109 ASD children living in a province in Turkey. The data were collected using a “Socio-demographic information form” and a “Self-report form about CAM usage.” Numbers, percentages, and chi-square analysis were used to analyze the data. ResultsIt was found that 67.0 % of 109 children with autism used CAMs. It was determined that a total of 12 CAMs were used, and the most popular CAM therapy was spiritual relaxation techniques (prayers) (69.8 %), followed by probiotic supplements (49.3 %), vitamin supplements (38.4 %), equine-assisted therapy (34.2 %), music therapy (31.5 %), gluten-free diets(27.4 %). It was reported that CAM therapies had positive effects on children’s communication, behavior, learning, and health. ConclusionsThe study found that more than half of the Turkish parents with children with autism used CAM therapies. Healthcare providers should be aware of the high prevalence of using CAMs in children with ASD and inform parents about CAMs through regular and continuous training programs based on evidence-based practices.

Using a Hybrid Telehealth and Adaptive Aquatics Father Coaching Intervention for Children with Autism Spectrum Disorder: A Pilot Study

ABSTRACT Parent coaching interventions have been shown to be effective for increasing parent responsiveness and improving communication skills for children with autism spectrum disorder (ASD). However, few interventions have involved fathers. Challenges to father involvement include scheduling limitations, as well as evidence that strategies and activities shown to be effective with mothers may not generalise to fathers. Fathers may benefit from interventions that target strategies, which align with father-child communication and interaction styles. To mitigate barriers to father involvement, this study investigated the effects of a 12-week hybrid intervention program that combined telehealth coaching and in-person father–child aquatics sessions, on a father’s use of responsive communication and play strategies and child communication skills. A single subject, multiple baselines across behaviours experiment was conducted with one dyad (i.e. father, 5-year, 6-monthold child with ASD). Results showed that the participating father was able to quickly learn to use two of the three, targeted responsive strategies (i.e. follow-in comments, followin directives) within the context of parent–child aquatic play. The participating child showed small increases in use of spontaneous single words. Findings of this single subject study have important potential clinical implications for adapting ASD parent coaching programs to more effectively involve fathers.

Perceptions of Autism Spectrum Disorder (ASD) Etiology among Parents of Children with ASD.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and restricted or repetitive behaviors. Parental perceptions of the etiology of their child’s ASD can affect provider–client relationships, bonding between parents and their children, and the prognosis, treatment, and management of children with ASD. Thus, this study sought to examine the perceptions of ASD etiology of parents of children with ASD. Methods: Forty-two parents of children diagnosed with ASD were recruited across Texas. Semi-structured interviews were conducted individually. All interviews were recorded and later transcribed verbatim for content analysis utilizing NVivo 12.0 (QSR International, Doncaster, Australia). Results: The content analysis identified the following themes regarding parental perceptions of ASD etiology: Genetic factors (40.5%), environmental factors (31.0%), problems that occurred during pregnancy or delivery (23.8%), vaccinations (16.7%), other health problems (7.1%), parental age at the time of pregnancy (4.8%), and spiritual or religious factors (2.4%). Conclusions: The parental perceptions of ASD etiology were diverse, but several views, such as vaccinations and spiritual or religious factors, were not based on scientific evidence. Health professionals and researchers can use these findings to develop and provide targeted education to parents who have children with ASD. Our findings also support policymakers in developing campaigns designed to increase parental ASD awareness and knowledge.

Urine Nitric Oxide Is Lower in Parents of Autistic Children.

Parents raising children with autism spectrum disorder (ASD) usually carry on their daily life under tremendous stress, but limited empirical research has been devoted to this population. It is known that parents' health status directly impacts therapeutic outcome of ASD children. As an important regulator in cardiovascular, nervous and immune systems, nitric oxide (NO) levels haven't been reported in parents of ASD children yet. In this study, we measured urine nitrite and nitrate from 43 ASD parents (ASD-P), and 43 healthy adults in the same range of age (Control) who didn't have any ASD descendants. Comparison between the ASD-P and Control groups showed that , , and / were all significantly lower in the ASD-P group. Analysis on the interaction effect of sex and group indicated that urine of mothers in ASD-P was lower than that in females of the Control group, but no significant difference was observed between males in both groups. It is for the first time that urine nitric oxide metabolites (nitrite, nitrate) levels were precisely reported to differentiate parents of autistic children from other adults without ASD descendants. This phenomenon suggests that parents (especially mothers) of autistic children might have experienced more mental and physical stressors, which led to decreased NO levels during metabolism. Further investigations are necessary to uncover the etiology of low urine NO among parents of autistic children.