Non-autistic Children Research Articles

The complex relationship between greenspace and well-being in children with and without autism.

Greenspace (defined here as canopy coverage) positively correlates with improved well-being in typically developing individuals, but this relationship has not been established in children with autism spectrum disorder (ASD). To investigate this relationship, the current study merged data from the National Survey of Children's Health (2012) with the National Land Cover Database. Across typically developing children, children with ASD, and non-autistic children with special healthcare needs (CSHCN), greenspace unexpectedly negatively correlated with well-being. Further, compared with typically developing children, children with ASD or CSHCN status had lower well-being. Interestingly, typically developing children with conduct problems displayed an unexpected negative relationship (i.e. as greenspace increased whereas well-being decreased), though those without conduct problems showed no relationship. Children with ASD displayed no relationship between greenspace independent of conduct problems. CSHCN displayed non-significant trends suggesting mild positive relationships between greenspace and well-being. These data indicate the relationship between greenspace and well-being is more complex than expected and may depend on the diagnostic traits of the population studied.

Oral Care Knowledge, Attitudes, and Practices of Black/African American Caregivers of Autistic Children and Non-Autistic Children.

Oral health is a vital component of overall health. Children from underserved, minoritized populations (i.e., Black/African Americans, autistic children) are at even greater risk for experiencing oral health disparities. This study aims to illuminate the oral health knowledge, attitudes, and practices of Black/African American caregivers of autistic and non-autistic children. Black/African American caregivers of children (4-to-14 years) on the autism spectrum (n = 65) or not on the autism spectrum (n = 60), participated in a survey, with input from literature reviews, interviews, previous research, and reviews by experts. Caregivers demonstrated basic knowledge of oral health with significantly lower scores for caregivers of autistic children. Caregivers care about oral health and would like to increase their knowledge. Significant differences in oral care practices were found between the autistic and non-autistic groups. Caregivers reported they can access dental services with relative ease, including finding their child a dentist, scheduling a dental appointment, and accessing transportation (personal or public) to attend the visit. Black/African American caregivers of autistic children and children without autism seem to have foundational knowledge about oral health and basic practices; however, they are interested in learning more. Therefore, tailored oral health education programs may help mitigate oral health disparities for Black/African American families.

Dietary intake in children on the autism spectrum is altered and linked to differences in autistic traits and sensory processing styles.

Diets of children and adolescents on the autism spectrum often differ when compared to their non-autistic peers. Most dietary studies have been limited by small sample sizes and rarely assess the heterogeneity of autism. Addressing this gap, this study compared the anthropometrics, dietary composition, dietary quality, and food variety of 154 Australian children and adolescents on the spectrum and 213 non-autistic children (71 siblings and 142 unrelated controls). Beyond the case-control approach, within-group comparisons assessed the influence of autism clinical presentations and sensory processing styles on body mass index (BMI) and measures of dietary intake among those on the spectrum. In this word first study of diet that included between-group comparisons with non-autistic peers (siblings and an unrelated comparison group) and within-autism group comparisons, we found that children on the spectrum consumed limited variety and lower quality of food and non-autistic siblings also ate comparably higher levels of energy-dense, nutrient poor food, and less diary. This may be due to autistic traits influencing family's diets or shared sensory sensitivities driving dietary intake. Within the autism group, higher autistic traits were associated with lower BMIs and a specific dietary pattern higher in simple carbohydrates and lower in unprocessed protein. Contrastingly, greater sensitivity to sensory stimuli was associated with a healthier diet. Increased age was linked to more varied diets but also diets higher in saturated fats and energy-dense, nutrient poor foods. Overall, this research highlights that potential mediators of dietary intake, such as familial influences, autistic traits, sensory processing styles, age and sex, need to be considered when assessing diet in the autistic population. LAY SUMMARY: In this study of dietary differences linked to autism, children, and teenagers on the spectrum ate fewer different foods and were less likely to eat recommended amounts of fruits and vegetables when compared to non-autistic siblings and unrelated children and teenagers. There were also family differences, in that those on the spectrum and their siblings ate more unhealthy foods and less dairy. Among those on the spectrum, dietary differences were linked to age, sex, autistic traits and sensory processing styles.

Toward feeling, understanding, and caring: The development of empathy in young autistic children.

Empathy 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.

Revisiting the simplification of adult language input in the context of naturalistic developmental behavioral interventions: A commentary.

Naturalistic developmental behavioral interventions (NDBI) are an evidence-based class of early interventions for improving language and social communication skills in autistic children. However, relatively little is known about how individual elements of NDBI support child development. This commentary focuses on one common element across NDBI models: the simplification of adult language input. Advances in developmental science focusing on the length and complexity of adult spoken utterances suggests that natural, grammatical utterances facilitate comprehension and expressive language development in autistic and nonautistic children. Yet, NDBI tend to recommend shorter and simpler adult utterances. We close by describing directions for future research which would inform recommendations around adult language input in NDBI to optimally support child language and communication development.

Parental Imitations and Expansions of Child Language Predict Later Language Outcomes of Autistic Preschoolers.

Both the amount and responsiveness of adult language input contribute to the language development of autistic and non-autistic children. From parent–child interaction footage, we measured the amount of adult language input, overall parent responsiveness, and six discrete parent responsive behaviours (imitations, expansions, open-ended questions, yes/no questions, comments and acknowledgements) to explore which types of responsiveness predicted autistic preschoolers’ language five months later, after controlling for adult language input. We found expansions and particularly imitations to be more important for later language than overall responsiveness. This study emphasises the need to capture what exactly about parent language input influences child language acquisition, and adds to the evidence that imitating and expanding early language might be particularly beneficial for autistic preschoolers.

Assessment of Parental Perceptions of Socio-Psychological Factors, Unmet Dental Needs, and Barriers to Utilise Oral Health Care in Autistic Children.

Introduction: Parents' participation is crucial in the dental health intervention of children with autism spectrum disorder (ASD). Parenting children with ASD is extremely stressful and challenging. Parents and other caregivers have a responsibility to care for and raise children with ASD. Parental perception of the condition, situational adaptation, and attitude towards the issue are significant indicators of how they will respond and eventually adapt to it.Methodology: A comparative, descriptive study was done on parents of 154 autistic children and 235 normal children. An 11-variable questionnaire eliciting various details of socio-psychological factors affecting the utilisation of oral health care was designed and validated. The questionnaire also included parameters regarding barriers to accessing dental services. The dental caries and oral hygiene status of all children were examined using the Basic Oral Health Survey 2013 proforma. Chi-square and independent t-tests were applied to find significant differences between the groups.Results: A greater number of male children (61.0%) were observed among autistic children. Parental perception regarding socio-psychological concerns with raising an autistic child showed significant differences for all variables between the groups except for assistance in the child’s task with 90.2% as against 55% of the parents with non-autistic children. Parents of autistic children were more receptive to the idea of focus group discussion. Decayed teeth were significantly found to be higher in autistic cohorts (2.554 ± 1.616 versus 1.779 ± 1.841). Oral hygiene status was also statistically significant amongst autism-affected children than those who were not at p =0.000.Conclusion: The present study explored various socio-psychological factors of parental perception of autistic children. A better outcome can be suggested when parents gained awareness regarding various strategies and treatment options available for their child's oral health. Furthermore, dental health can be improved by bringing in certain environmental modifications in which the autistic child is groomed.

Silver linings of the Covid-19 pandemic… for some! Comparing Experiences and Social demographic characteristics of autistic and non-autistic children with SEND in England

Several studies on the impact of Covid-19 on children’s wellbeing have been published, including for those with Special Educational Needs and Disabilities. However, limited evidence is available on who these children may be, their socioeconomic background, age, gender or type of school attended. This study examines the role of socio-demographic characteristics on the experiences of Autistic Children, compared to non-Autistic children, to assess the detrimental impact of the pandemic, but also potential silver linings. Primary-school aged Autistic children were more likely to mention a silver lining (for mental health), as well as younger non-Autistic children from more affluent backgrounds. Similar effects were observed for older non-Autistic boys with special needs attending mainstream settings (regarding physical health).

Multimodal interaction analysis of non-lexical vocalisations in low-verbal autistic children

ABSTRACT This article analyses non-lexical vocalisations produced by low-verbal autistic children. Seven dyads of naturalistic interactions between non-autistic adults and low-verbal autistic children over five years old were analysed from a multimodal conversation analysis perspective. Data were extracted from an audio-visual corpus of interactions in institutional (school) and non-institutional settings (home). The data are in Brazilian Portuguese. The videos are visualised using the ELAN tool and transcribed. The analyses showed that in some cases participants did not reach a mutual understanding of the semantic meaning of non-lexical vocalisations, while in other cases, the meanings of vocalisations emerged between the participants in the multimodal process of sense-making in their embodied context. A microanalysis of where these vocalisations occurred and their multimodal aspects (linguistics, bodily, material, and spatial) suggests that: a) such occurrences are both initiated by the autistic child and responsive to the non-autistic interlocutor’s turn; b) some vocalisations play an important role in the sequential organisation of the interaction, promoting the maintenance of intersubjective of low verbal children; and c) non-autistic adult interlocutors perform a varied set of actions, recycling, incorporating, retaking, assigning meaning, and repairing the non-lexical vocalisations produced by autistic children. The indexical analysis shows how communicative ecologies create meaning. This study thus contributes to our understanding of the interactional behaviour of these children and their interlocutors.

Genetic Pathways Associated With Sleep Problems in Children With Autism Spectrum Disorder.

AimsChildren on the autism spectrum are more likely to have sleep problems than non-autistic children. Sleep disturbance may exacerbate emotional and behavioral problems of children on the autism spectrum. A better understanding of the biological mechanisms underlying sleep disturbance provide clues to better management for this co-morbid condition in autism. The goal of the current study is to identify genetic variants associated with sleep disturbance and melatonin levels in autistic children.MethodsA total of 969 children on the autism spectrum were genotyped using the Global Screening Array v1 or Global Screening Array v2. Sleep problems were assessed using the Children's Sleep Habits Questionnaire (CSHQ). Melatonin levels were measured using the urine samples of 219 probands. The relationship between the melatonin level and CSHQ score was examined using the general linear model. The genetic variants associated with the CSHQ score and melatonin level as two separate quantitative traits were determined using genomewide association studies.ResultsThe data indicates that urine melatonin levels were positively associated with CSHQ scores, suggesting that autistic children with a poorer sleep qualiy could has higher melatonin level. Furthermore, genetic assocication studies suggest that genetic pathways involved in pro-inflammatory responses might be involved in sleep disturbance, while genetic pathways involved in catecholamine-secreting PC12 cells and Schwann cells could be associated with melatonin levels.ConclusionsTaken together, our findings indicate that sleep disturbance and melatonin metabolism could be attributable to distinct biological mechanisms in autistic children since they might not share genetic contributors.

Altruism, hypocrisy and theory of mind in autistic and nonautistic children.

Children make choices between generosity and greed every day. Often they must also choose between confession or denial of antisocial acts like greed, thereby displaying either honesty or hypocrisy. Such choices pose cognitive challenges that, in theory, might reflect children's developing social-cognitions and affect their daily social lives and developmental opportunities. Individual differences in altruism and hypocrisy were examined in relation to theory of mind (ToM) in 102 school-age children (44 autistic; 58 typically developing) using ecologically valid altruism and hypocrisy tests where generosity had lasting real-life costs and hypocrisy was self-serving. Selfless altruism was abundant for autistic and nonautistic children alike and was significantly predicted by ToM over and above other predictors like age, gender, and language. More nonautistic (74%) than autistic children (41%) displayed hypocrisy, although individual ToM differences among ASD children were not significantly correlated with it. Findings extend to new instances (altruism and hypocrisy) evidence of ToM's importance for everyday social behaviors that impact upon peer relations while also extending past evidence that: (a) unexpected sociomoral strengths can coexist with ToM delays, (b) attention to individual differences is crucial, and (c) autistic children's capacity to develop sociomoral reasoning should not be underestimated. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Online safety experiences of autistic young people: An Interpretative Phenomenological Analysis

BackgroundMany autistic young people use online devices for social connection and to share interests. However, there is limited research regarding autistic online safety behaviours. Compared with non-autistic children, parental surveys have indicated that autistic young people are less likely to block people and/or online sites. To date, no research has explored autistic young people’s perceptions of their online safety experiences. This qualitative research explored autistic young people’s experiences of communicating with others online, as well as their online safety experiences. MethodSemi-structured interviews were conducted with 14 autistic young people aged 11–17 years (M = 14.0, SD = 2.2), including 8 males (M = 13.9, SD = 2.1) and 6 females (M = 14.5, SD = 2.5). These were conducted face to face (n = 1), phone call (n = 2), or via Skype (n = 8) or live web chat (n = 3). Questions explored factors relating to autistic young people’s online safety experiences. ResultsInterpretative Phenomenological Analysis was used to analyse the data. In line with previous studies, autistic young people reported being victims of cyberbullying. Young autistic females reported being subject to online sexual harassment. While participants’ online experiences varied, there were commonalities, including a desire for more support to block online comments and/or individuals. ConclusionsOur results support previous findings that autistic young people are subject to online harassment and are not confident blocking unwanted contact from others online. Future interventions will be more readily accepted and ecologically valid if they address the unique needs of autistic young people.

The role of robotic toys in shaping play and joint engagement in autistic children: Implications for future design

Autistic children are thought to develop social attention skills differently from non-autistic children. Previous work has shown that technology, and specifically tangible toys, could have the potential to support social attention in autistic children. A key challenge is knowing how to design and use interactive and intelligent technologies to support interaction in autistic children, given the heterogeneity in levels of social motivation, social development, and interest in digital technologies. To address this challenge, we examined in detail the interaction between digital features and autistic children’s joint engagement in a real-world setting, exploring the impact of tangible constraints in fostering social interaction. The current study observed autistic children (aged between 12 and 15 years) playing with a digital robotic toy and a non-digital counterpart, and measured social attention and engagement during free play. The results showed that increased and higher levels of joint attention when children had to share a toy between them, on both digital and non-digital interfaces. We found that autistic children individually vary in their propensity to engage in social interactions, as well as their responses to digital features. This work contributes to a growing area of evidence that tangible and smart technologies can create social opportunities for autistic children.

Brief report: replication of the psychometric characteristics of the behavioral inflexibility scale in an independent sample.

The Behavioral Inflexibility Scale (BIS) is a recently developed measure of behavioral inflexibility, defined as rigid patterns of behavior that contrast with the need to be flexible when the situation calls for it. In this study, we sought to replicate previous findings on the psychometric properties of the BIS in a community sample. Data for this study were collected using in-person assessments of 163 autistic and 95 non-autistic children ages 3-17 and included the BIS, measures of social-communication ability and repetitive behaviors, and an assessment of cognitive ability. Our findings replicate the psychometric properties of the BIS, indicating that the measure is a valid measure of behavioral inflexibility in ASD.

Toothbrushing and Oral Care Activities of Autistic and Non-Autistic Latino Children

Background: Oral care activities, e.g., toothbrushing, are habitual occupations often considered routine. However, for autistic children, performing these routine dental practices can be challenging due to the child’s sensory sensitivities, unique executive function, and the complicated way in which autistic children conceptualize structure and habits. Limited research exists exploring the nuances of oral care routines in the autistic population, and more knowledge is needed to support targeted education interventions to improve oral care and address health inequities. The purpose of this study was to examine videos of oral care routines in the home to understand how oral care activities, such as toothbrushing, were performed by autistic and non-autistic Latino/a children. Methods: Parents/caregivers from eighteen Latino/a families with children between 6 and 12 years old (n = 10 autistic children and n = 8 non-autistic children) video recorded their child’s oral care routines for three days. The research team blindly coded and analyzed these videos using an oral care observation template to understand how these activities were uniquely performed by the children. Results: Eighty-five oral care videos were analyzed for this study. In addition to noting areas of oral care that can be improved, which included length of brushing and using the correct brushing technique, we identified two themes related to the differences between oral care practices in the autistic and non-autistic children: parent involvement and modifications. Conclusions: Qualitative findings show that parental involvement was documented especially in the case of autistic children, and that two types of modifications, habitual and sensory, were observed that demonstrated parents being aware of the needs of their autistic child and modifying the oral care activity to meet those needs. By synthesizing observations from the oral care videos into suggestions for practitioners working with families, we hope to supplement knowledge about effective oral care practices for autistic and non-autistic Latino/a children, thereby improving overall oral health and reducing oral health inequities in this population.

Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions.

Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions.

Facial Features Detection System To Identify Children With Autism Spectrum Disorder: Deep Learning Models.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with brain development that subsequently affects the physical appearance of the face. Autistic children have different patterns of facial features, which set them distinctively apart from typically developed (TD) children. This study is aimed at helping families and psychiatrists diagnose autism using an easy technique, viz., a deep learning-based web application for detecting autism based on experimentally tested facial features using a convolutional neural network with transfer learning and a flask framework. MobileNet, Xception, and InceptionV3 were the pretrained models used for classification. The facial images were taken from a publicly available dataset on Kaggle, which consists of 3,014 facial images of a heterogeneous group of children, i.e., 1,507 autistic children and 1,507 nonautistic children. Given the accuracy of the classification results for the validation data, MobileNet reached 95% accuracy, Xception achieved 94%, and InceptionV3 attained 0.89%.

Brief Report: Family Accommodation is Associated with the Impact of Childhood Anxiety in Autism.

Anxiety is commonly experienced by children on the autism spectrum, and can negatively impact their lives. Family accommodation has been linked to the impact of anxiety on the child's life in non-autistic children. This study tested whether the same relationship holds for children on the autism spectrum. A community sample (n = 118) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and severity and impact of their child's anxiety, their own anxiety and family accommodation behaviours. Family accommodation was associated with the impact of child anxiety, over and above anxiety severity of the child and parent. Findings support the involvement of parents in psychosocial support for children on the autism spectrum experiencing anxiety.

An investigation of a novel broad autism phenotype: increased facial masculinity among parents of children on the autism spectrum.

The broad autism phenotype commonly refers to sub-clinical levels of autistic-like behaviour and cognition presented in biological relatives of autistic people. In a recent study, we reported findings suggesting that the broad autism phenotype may also be expressed in facial morphology, specifically increased facial masculinity. Increased facial masculinity has been reported among autistic children, as well as their non-autistic siblings. The present study builds on our previous findings by investigating the presence of increased facial masculinity among non-autistic parents of autistic children. Using a previously established method, a ‘facial masculinity score’ and several facial distances were calculated for each three-dimensional facial image of 192 parents of autistic children (58 males, 134 females) and 163 age-matched parents of non-autistic children (50 males, 113 females). While controlling for facial area and age, significantly higher masculinity scores and larger (more masculine) facial distances were observed in parents of autistic children relative to the comparison group, with effect sizes ranging from small to medium (0.16 ≤ d ≤ .41), regardless of sex. These findings add to an accumulating evidence base that the broad autism phenotype is expressed in physical characteristics and suggest that both maternal and paternal pathways are implicated in masculinized facial morphology.

Parenting an Autistic Child Is Not Associated With the Amount of Facial Emotion Information Needed to Perceive Happiness or Sadness From Faces

One common feature of autism is “flat affect:” Many autistic people do not facially express emotion as intensely as non-autistic people. Although it can be difficult for a casual acquaintance or stranger to infer what someone with flat affect is feeling, some mothers of autistic children report learning to identify their children’s emotions from limited facial emotion information. We investigated whether this parenting experience is associated with the point at which mothers perceive happiness and sadness on faces of individuals other than their children. We used two tasks where faces of strangers morphed from a neutral expression to peak happiness and peak sadness; we measured the point at which mothers first perceived happiness and sadness in these morphs. In samples that were overwhelmingly North American, White, and highly educated, mothers of autistic children (n = 24), mothers of non-autistic children (n = 24) and age-matched non-mothers (n = 24) did not differ in the point at which they perceived happiness and sadness. The heightened sensitivity some mothers of autistic children report in perceiving emotion on their children’s faces may not play a role in how they perceive emotion on other people’s faces, at least in the case of happiness and sadness. Interestingly, however, the three groups of middle-aged women perceived happiness (but not sadness) at an earlier point than a group of young adult women attending a U.S. university (n = 151), a finding that is consistent with socio-emotional selectivity theory.