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Research on the Cause (Etiology), Characteristics (including Neurology and Cognition) and Prevalence of Autism Spectrum Disorders
Cardinal, D. N., Griffiths, A. J., Maupin, Z. D., & Fraumeni‐McBride, J. (2020). An investigation of increased rates of autism in U.S. public schools. Psychology in the Schools, 58(1), 124-140. doi:10.1002/pits.22425
Abstract: "This study is intended to enhance our understanding of the dramatic increase in autism prevalence rates across the United States. A robust national and multistate sample of children and youth (5–22 years of age) was gathered and analyzed, using visual and statistical analysis of autism eligibility over a 15‐ to 17‐year period. Although the impact of environmental or genetic influences cannot be entirely ruled out, we identified significant shifts in eligibility trends that substantially contribute to the remarkable increase in autism prevalence. Assessment procedures and criteria for autism have sustained an indelible influence from this diagnostic migration, which has had a lasting impact on public schools. We use this information to provide meaningful implications for practicing psychology in the schools." (Cardinal, et al., 2020)
Duesenberg, M. K. D., & Burns, M. K. (2022). Autism spectrum disorder identification in schools: Impact of criteria, assessments, and student data for identification decisions. Psychology in the Schools, 59(4), 845–865. https://doi.org/10.1002/pits.22649
Abstract: " Autism spectrum disorder (ASD) is often diagnosed by clinical practitioners with criteria from the American Psychiatric Association, but an educational diagnosis is usually based on state special education law and is geared towards addressing concerns within schools. The current study aims to examine the extent to which the clinical diagnosis of ASD corresponds to the educational diagnosis of Autism, and what factors and assessments influenced the diagnosis. Data consisted of 32 randomly selected deidentified initial school evaluation reports (autism = 16; non‐autism = 16) from one midwestern state. The reports were coded based on identification methods and student data. Results indicate that the Autism Diagnostic Observation Schedule, Second Edition assessment was the strongest predictor of Autism eligibility within schools, but students with a cognitive ability score that was one standard deviation below the mean (i.e., standard score £84) were more frequently identified with educational eligibility of ASD (AU) by a factor of 14.67 as compared with individuals with a higher cognitive score. Implications for future research and practice are included.
Pan, P., Tammimies, K., and Bölte, S. (2019). The association between Somatic Health, autism spectrum disorder, and autistic traits. Behavior Genetics, 50(4), 233-246. doi:10.1007/s10519-019-09986-3
Abstract: "This study used a twin cohort to investigate the association of autism spectrum disorder (ASD) and autistic traits with somatic health. A total of 344 twins (172 pairs; mean age 15.56±5.62 years) enriched for ASD and other neurodevelopmental conditions were examined. Medical history and current physical problems were collected with a validated questionnaire to determine twin’s somatic health. The Social Responsiveness Scale (SRS-2) was used to measure the participant’s severity of autistic traits. Identified somatic health issues with significant within-twin pair differences were tested in relation to both ASD diagnosis and autistic traits in a co-twin control model. Twins with ASD exhibited more neurological and immunological health problems compared to those without ASD (p=0.005 and p=0.004, respectively). The intra-pair differences of neurological conditions and SRS-2 score were significantly correlated in monozygotic twins differing for autism traits (r=0.40, p=0.001), while the correlation was not found for immunological problems. In addition, a conditional model for analysis of within-twin pair effects revealed an association between neurological problems and clinical ASD diagnosis (Odds ratio per neurological problem 3.15, p=0.02), as well as autistic traits (β=10.44, p=0.006), after adjusting for possible effects of co-existing attention deficit hyperactivity disorder and general intellectual abilities. Our findings suggest that neurological problems are associated with autism, and that non-shared environmental factors contribute to the overlap for both clinical ASD and autistic traits. Further population-based twin studies are warranted to validate our results and examine in detailed the shared genetic and environmental contributions of neurological problems and ASD." (Pan, Tammimies, and Bölte, 2019)
Shephard, E., Tye, C., Ashwood, K. L., Azadi, B., Asherson, P., Bolton, P. F., and McLoughlin, G. (2018). Resting-state neurophysiological activity patterns in young people with ASD, ADHD, and ASD + ADHD. Journal of Autism and Developmental Disorders, 48(1), 110-122. doi:10.1007/s10803-017-3300-4
Abstract: "Altered power of resting-state neurophysiological activity has been associated with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which commonly co-occur. We compared resting-state neurophysiological power in children with ASD, ADHD, co-occurring ASD + ADHD, and typically developing controls. Children with ASD (ASD/ASD + ADHD) showed reduced theta and alpha power compared to children without ASD (controls/ADHD). Children with ADHD (ADHD/ASD + ADHD) displayed decreased delta power compared to children without ADHD (ASD/controls). Children with ASD+ADHD largely presented as an additive cooccurrence with deficits of both disorders, although reduced theta compared to ADHD-only and reduced delta compared to controls suggested some unique markers. Identifying specific neurophysiological profiles in ASD and ADHD may assist in characterising more homogeneous subgroups to inform treatment approaches and aetiological investigations." (Shephard, et al., 2018)
Sheldrick, R. C., & Carter, A. S. (2018). State-level trends in the prevalence of autism spectrum disorder (ASD) from 2000 to 2012: A reanalysis of findings from the autism and Developmental Disabilities Network. Journal of Autism and Developmental Disorders, 48(9), 3086–3092. https://doi.org/10.1007/s10803-018-3568-z
Abstract: “Since 2000, the Autism and Developmental Disabilities Network (ADDM) has published detailed prevalence estimates for autism spectrum disorder (ASD) among 8 year-olds, which are widely interpreted as the U.S. national prevalence of ASD. Although differences in state-level ASD prevalence has been reported, state-level heterogeneity has not been explored systematically. We analyzed state-level estimates and trends in ASD prevalence from 2000 to 2012 using secondary data from bi-annual ADDM reports. Heterogeneity among state-level ASD prevalence estimates were apparent in 2000 and grew between 2000 and 2012. Findings highlight the need for greater understanding of how children with ASD are identified by the medical and educational systems, which has significant implications for the state-level resources required to effectively manage ASD.
Abstract: "This study is intended to enhance our understanding of the dramatic increase in autism prevalence rates across the United States. A robust national and multistate sample of children and youth (5–22 years of age) was gathered and analyzed, using visual and statistical analysis of autism eligibility over a 15‐ to 17‐year period. Although the impact of environmental or genetic influences cannot be entirely ruled out, we identified significant shifts in eligibility trends that substantially contribute to the remarkable increase in autism prevalence. Assessment procedures and criteria for autism have sustained an indelible influence from this diagnostic migration, which has had a lasting impact on public schools. We use this information to provide meaningful implications for practicing psychology in the schools." (Cardinal, et al., 2020)
Duesenberg, M. K. D., & Burns, M. K. (2022). Autism spectrum disorder identification in schools: Impact of criteria, assessments, and student data for identification decisions. Psychology in the Schools, 59(4), 845–865. https://doi.org/10.1002/pits.22649
Abstract: " Autism spectrum disorder (ASD) is often diagnosed by clinical practitioners with criteria from the American Psychiatric Association, but an educational diagnosis is usually based on state special education law and is geared towards addressing concerns within schools. The current study aims to examine the extent to which the clinical diagnosis of ASD corresponds to the educational diagnosis of Autism, and what factors and assessments influenced the diagnosis. Data consisted of 32 randomly selected deidentified initial school evaluation reports (autism = 16; non‐autism = 16) from one midwestern state. The reports were coded based on identification methods and student data. Results indicate that the Autism Diagnostic Observation Schedule, Second Edition assessment was the strongest predictor of Autism eligibility within schools, but students with a cognitive ability score that was one standard deviation below the mean (i.e., standard score £84) were more frequently identified with educational eligibility of ASD (AU) by a factor of 14.67 as compared with individuals with a higher cognitive score. Implications for future research and practice are included.
Pan, P., Tammimies, K., and Bölte, S. (2019). The association between Somatic Health, autism spectrum disorder, and autistic traits. Behavior Genetics, 50(4), 233-246. doi:10.1007/s10519-019-09986-3
Abstract: "This study used a twin cohort to investigate the association of autism spectrum disorder (ASD) and autistic traits with somatic health. A total of 344 twins (172 pairs; mean age 15.56±5.62 years) enriched for ASD and other neurodevelopmental conditions were examined. Medical history and current physical problems were collected with a validated questionnaire to determine twin’s somatic health. The Social Responsiveness Scale (SRS-2) was used to measure the participant’s severity of autistic traits. Identified somatic health issues with significant within-twin pair differences were tested in relation to both ASD diagnosis and autistic traits in a co-twin control model. Twins with ASD exhibited more neurological and immunological health problems compared to those without ASD (p=0.005 and p=0.004, respectively). The intra-pair differences of neurological conditions and SRS-2 score were significantly correlated in monozygotic twins differing for autism traits (r=0.40, p=0.001), while the correlation was not found for immunological problems. In addition, a conditional model for analysis of within-twin pair effects revealed an association between neurological problems and clinical ASD diagnosis (Odds ratio per neurological problem 3.15, p=0.02), as well as autistic traits (β=10.44, p=0.006), after adjusting for possible effects of co-existing attention deficit hyperactivity disorder and general intellectual abilities. Our findings suggest that neurological problems are associated with autism, and that non-shared environmental factors contribute to the overlap for both clinical ASD and autistic traits. Further population-based twin studies are warranted to validate our results and examine in detailed the shared genetic and environmental contributions of neurological problems and ASD." (Pan, Tammimies, and Bölte, 2019)
Shephard, E., Tye, C., Ashwood, K. L., Azadi, B., Asherson, P., Bolton, P. F., and McLoughlin, G. (2018). Resting-state neurophysiological activity patterns in young people with ASD, ADHD, and ASD + ADHD. Journal of Autism and Developmental Disorders, 48(1), 110-122. doi:10.1007/s10803-017-3300-4
Abstract: "Altered power of resting-state neurophysiological activity has been associated with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which commonly co-occur. We compared resting-state neurophysiological power in children with ASD, ADHD, co-occurring ASD + ADHD, and typically developing controls. Children with ASD (ASD/ASD + ADHD) showed reduced theta and alpha power compared to children without ASD (controls/ADHD). Children with ADHD (ADHD/ASD + ADHD) displayed decreased delta power compared to children without ADHD (ASD/controls). Children with ASD+ADHD largely presented as an additive cooccurrence with deficits of both disorders, although reduced theta compared to ADHD-only and reduced delta compared to controls suggested some unique markers. Identifying specific neurophysiological profiles in ASD and ADHD may assist in characterising more homogeneous subgroups to inform treatment approaches and aetiological investigations." (Shephard, et al., 2018)
Sheldrick, R. C., & Carter, A. S. (2018). State-level trends in the prevalence of autism spectrum disorder (ASD) from 2000 to 2012: A reanalysis of findings from the autism and Developmental Disabilities Network. Journal of Autism and Developmental Disorders, 48(9), 3086–3092. https://doi.org/10.1007/s10803-018-3568-z
Abstract: “Since 2000, the Autism and Developmental Disabilities Network (ADDM) has published detailed prevalence estimates for autism spectrum disorder (ASD) among 8 year-olds, which are widely interpreted as the U.S. national prevalence of ASD. Although differences in state-level ASD prevalence has been reported, state-level heterogeneity has not been explored systematically. We analyzed state-level estimates and trends in ASD prevalence from 2000 to 2012 using secondary data from bi-annual ADDM reports. Heterogeneity among state-level ASD prevalence estimates were apparent in 2000 and grew between 2000 and 2012. Findings highlight the need for greater understanding of how children with ASD are identified by the medical and educational systems, which has significant implications for the state-level resources required to effectively manage ASD.
Research on Behavior
Leaf, J. B., Cihon, J. H., Ferguson, J. L., Milne, C. M., Leaf, R., & McEachin, J. (2020). Advances in our understanding of behavioral intervention: 1980 to 2020 for individuals diagnosed with autism spectrum disorder. Journal of Autism and Developmental Disorders, 51(12), 4395–4410. https://doi.org/10.1007/s10803-020-04481-9
Abstract: “There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.”
Raulston, T. J., Hansen, S. G., Machalicek, W., McIntyre, L. L., & Carnett, A. (2019). Interventions for repetitive behavior in young children with autism: A survey of behavioral practices. Journal of Autism and Developmental Disorders, 49(8), 3047–3059. https://doi.org/10.1007/s10803-019-04023-y
Abstract: “Children with autism spectrum disorder (ASD) display social-communication deficits and present with rigid and repetitive patterns of behavior and/or interests (RRBIs). Compared to interventions for social-communication skills, less attention has been given to RRBIs, especially with regard to interventions for young children. We surveyed 128 behavior analysts who implemented interventions for young children with ASD on their use of 16 practices and one assessment for the treatment of RRBIs. The majority of our sample perceived the practices to be effective in producing sustainable behavior change. Behavior analysts generally responded in the same way to items about reinforcement-based practices, punishment-based practices, and a group of commonly packaged antecedent and consequence-based package components. Implications and
future directions are discussed.
Zane, E., Neumeyer, K., Mertens, J., Chugg, A., & Grossman, R. B. (2017). I think we’re alone now: Solitary Social Behaviors in adolescents with autism spectrum disorder. Journal of Abnormal Child Psychology, 46(5), 1111–1120. https://doi.org/10.1007/s10802-017-0351-0
Abstract: “Research into emotional responsiveness in Autism Spectrum Disorder (ASD) has yielded mixed findings. Some studies report uniform, flat and emotionless expressions in ASD; others describe highly variable expressions that are as or even more intense than those of typically developing (TD) individuals. Variability in findings is likely due to differences in study design: some studies have examined posed (i.e., not spontaneous expressions) and others have examined spontaneous expressions in social contexts, during which individuals with ASD—by nature of the disorder—are likely to behave differently than their TD peers. To determine whether (and how) spontaneous facial expressions and other emotional responses are different from TD individuals, we video-recorded the spontaneous responses of children and adolescents with and without ASD (between the ages of 10 and 17 years) as they watched emotionally evocative videos in a non-social context. Researchers coded facial expressions for intensity, and noted the presence of laughter and other responsive vocalizations. Adolescents with ASD displayed more intense, frequent and varied spontaneous facial expressions than their TD peers. They also produced significantly more emotional vocalizations, including laughter. Individuals with ASD may display their emotions more frequently and more intensely than TD individuals when they are unencumbered by social pressure. Differences in the interpretation of the social setting and/or understanding of emotional display rules may also contribute to differences in emotional behaviors between groups.”
Abstract: “There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.”
Raulston, T. J., Hansen, S. G., Machalicek, W., McIntyre, L. L., & Carnett, A. (2019). Interventions for repetitive behavior in young children with autism: A survey of behavioral practices. Journal of Autism and Developmental Disorders, 49(8), 3047–3059. https://doi.org/10.1007/s10803-019-04023-y
Abstract: “Children with autism spectrum disorder (ASD) display social-communication deficits and present with rigid and repetitive patterns of behavior and/or interests (RRBIs). Compared to interventions for social-communication skills, less attention has been given to RRBIs, especially with regard to interventions for young children. We surveyed 128 behavior analysts who implemented interventions for young children with ASD on their use of 16 practices and one assessment for the treatment of RRBIs. The majority of our sample perceived the practices to be effective in producing sustainable behavior change. Behavior analysts generally responded in the same way to items about reinforcement-based practices, punishment-based practices, and a group of commonly packaged antecedent and consequence-based package components. Implications and
future directions are discussed.
Zane, E., Neumeyer, K., Mertens, J., Chugg, A., & Grossman, R. B. (2017). I think we’re alone now: Solitary Social Behaviors in adolescents with autism spectrum disorder. Journal of Abnormal Child Psychology, 46(5), 1111–1120. https://doi.org/10.1007/s10802-017-0351-0
Abstract: “Research into emotional responsiveness in Autism Spectrum Disorder (ASD) has yielded mixed findings. Some studies report uniform, flat and emotionless expressions in ASD; others describe highly variable expressions that are as or even more intense than those of typically developing (TD) individuals. Variability in findings is likely due to differences in study design: some studies have examined posed (i.e., not spontaneous expressions) and others have examined spontaneous expressions in social contexts, during which individuals with ASD—by nature of the disorder—are likely to behave differently than their TD peers. To determine whether (and how) spontaneous facial expressions and other emotional responses are different from TD individuals, we video-recorded the spontaneous responses of children and adolescents with and without ASD (between the ages of 10 and 17 years) as they watched emotionally evocative videos in a non-social context. Researchers coded facial expressions for intensity, and noted the presence of laughter and other responsive vocalizations. Adolescents with ASD displayed more intense, frequent and varied spontaneous facial expressions than their TD peers. They also produced significantly more emotional vocalizations, including laughter. Individuals with ASD may display their emotions more frequently and more intensely than TD individuals when they are unencumbered by social pressure. Differences in the interpretation of the social setting and/or understanding of emotional display rules may also contribute to differences in emotional behaviors between groups.”
Research on Language & Communication
Cheung, Y., Lai, C. O., Cihon, J. H., Leaf, J. B., & Mountjoy, T. (2020). Establishing requesting with children diagnosed with autism using embedded instruction in the context of academic activities. Journal of Behavioral Education, 31(2), 265–280. https://doi.org/10.1007/s10864-020-09397-z
Abstract: “Embedded instruction offers a potentially effective, non-disruptive, and socially acceptable intervention approach for individuals diagnosed with autism spectrum disorder (ASD) in general education settings. However, the literature using embedded instruction has not frequently provided data on embedded instruction targets and targets within the ongoing lessons or maintenance of the acquired skills. This study
evaluated the effectiveness of embedded instruction to teach three individuals diagnosed with ASD communication skills during the course of existing lessons. Data were collected on embedded instruction targets, academic targets (i.e., targets within existing lessons), and maintenance of mastered targets. The results of a non-concurrent multiple baseline design indicated embedded instruction was effective for all three participants and the acquired skills maintained. The results are discussed with respect to future research and clinical application of the methods evaluated.
Clarke, K. A., & Williams, D. L. (2020). Instruction using augmentative and alternative communication supports: Description of current practices by speech-language pathologists who work with children with autism spectrum disorder. American Journal of Speech-Language Pathology, 29(2), 586–596. https://doi.org/10.1044/2019_ajslp-19-00045
“Purpose: The aim of this research study was to examine common practices of speech-language pathologists (SLPs) who work with children with autism spectrum disorder (ASD) with respect to whether or not SLPs consider processing differences in ASD or the effects of input during their instruction.
Method: Following a qualitative research method, how SLPs instruct and present augmentative and alternative communication systems to individuals with ASD, their rationale for method selection, and their perception of the efficacy of selected interventions were probed. Semistructured interviews were conducted as part of an in-depth case report with content analysis.
Results: Based on completed interviews, 4 primary themes were identified: (a) instructional method, (b) input provided, (c) decision-making process, and (d) perceived efficacy of treatment. Additionally, one secondary theme, training and education received, was identified.
Conclusions: Clinicians reported making decisions based on the needs of the child; however, they also reported making decisions based on the diagnostic category that characterized the child (i.e., ASD). The use of modeling when teaching augmentative and alternative communication to individuals with ASD emerged as a theme, but variations in the method
of modeling were noted. SLPs did not report regularly considering processing differences in ASD, nor did they consider the effects of input during instruction.”
Hampton, L. H., & Kaiser, A. P. (2016). Intervention effects on spoken-language outcomes for children with autism: A systematic review and meta-analysis. Journal of Intellectual Disability Research, 60(5), 444–463. https://doi.org/10.1111/jir.12283
Abstract: Background Although spoken-language deficits are not core to an autism spectrum disorder (ASD) diagnosis, many children with ASD do present with delays in this area. Previous meta-analyses have assessed the effects of intervention on reducing autism symptomatology, but have not determined if intervention improves spoken language. This analysis examines the effects of early interventions on spoken language in children with ASD. Method A systematic review of 1756 studies of children with ASD who participated in early intervention resulted in the inclusion of 26 studies in the current review. These studies included 1738 participants with ASD who were, on average, 3.3 years old (SD=0.91). Results This random-effects meta-analysis of spoken-language outcomes for children with ASD who received early intervention as compared with usual treatments yielded a significant overall mean effect size of g =0.26 (CI= 0.11 to 0.42). On average, children with ASD significantly increased their use of spoken- language following experimental early interventions. Treatments delivered simultaneously by a clinician and a parent resulted in greater gains in spoken-language than treatments delivered by a clinician or parent only. No other participant or study characteristics predicted individual-study effect sizes. Conclusions Early intervention improves spoken language outcomes for children with ASD, and the largest effects are found when both parent and clinician implement the intervention. Recommendations for practice include adding systematic parent training to interventions for spoken language to potentially improve outcomes. Future research should report standard language measures as well as child (cognitive ability and socio-economic status) and intervention characteristics to improve evidence related to the effects of interventions on spoken communication in children with ASD.
Iarocci, G., Hutchison, S. M., & O’Toole, G. (2017). Second language exposure, functional communication, and executive function in children with and without autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 47(6), 1818–1829. https://doi.org/10.1007/s10803-017-3103-7
Abstract: “Parents and professionals are concerned that second language exposure may delay communication in children with ASD. In this study 174 youth (6–16 years) with and without ASD, exposed to a second language, were compared on executive function (EF) and functional communication (FC) with their peers without exposure. There were no significant differences between groups on age, IQ, and socioeconomic status. Parents reported on language exposure and rated EF and FC skills within everyday social contexts. The findings indicated that second language exposure in children with ASD is not associated with delay in cognitive and functional communication skills rather there was evidence of a reduced clinical impact as indexed by a lower percentage of children whose FC and EF ratings fell within the clinical range.”
Abstract: “Embedded instruction offers a potentially effective, non-disruptive, and socially acceptable intervention approach for individuals diagnosed with autism spectrum disorder (ASD) in general education settings. However, the literature using embedded instruction has not frequently provided data on embedded instruction targets and targets within the ongoing lessons or maintenance of the acquired skills. This study
evaluated the effectiveness of embedded instruction to teach three individuals diagnosed with ASD communication skills during the course of existing lessons. Data were collected on embedded instruction targets, academic targets (i.e., targets within existing lessons), and maintenance of mastered targets. The results of a non-concurrent multiple baseline design indicated embedded instruction was effective for all three participants and the acquired skills maintained. The results are discussed with respect to future research and clinical application of the methods evaluated.
Clarke, K. A., & Williams, D. L. (2020). Instruction using augmentative and alternative communication supports: Description of current practices by speech-language pathologists who work with children with autism spectrum disorder. American Journal of Speech-Language Pathology, 29(2), 586–596. https://doi.org/10.1044/2019_ajslp-19-00045
“Purpose: The aim of this research study was to examine common practices of speech-language pathologists (SLPs) who work with children with autism spectrum disorder (ASD) with respect to whether or not SLPs consider processing differences in ASD or the effects of input during their instruction.
Method: Following a qualitative research method, how SLPs instruct and present augmentative and alternative communication systems to individuals with ASD, their rationale for method selection, and their perception of the efficacy of selected interventions were probed. Semistructured interviews were conducted as part of an in-depth case report with content analysis.
Results: Based on completed interviews, 4 primary themes were identified: (a) instructional method, (b) input provided, (c) decision-making process, and (d) perceived efficacy of treatment. Additionally, one secondary theme, training and education received, was identified.
Conclusions: Clinicians reported making decisions based on the needs of the child; however, they also reported making decisions based on the diagnostic category that characterized the child (i.e., ASD). The use of modeling when teaching augmentative and alternative communication to individuals with ASD emerged as a theme, but variations in the method
of modeling were noted. SLPs did not report regularly considering processing differences in ASD, nor did they consider the effects of input during instruction.”
Hampton, L. H., & Kaiser, A. P. (2016). Intervention effects on spoken-language outcomes for children with autism: A systematic review and meta-analysis. Journal of Intellectual Disability Research, 60(5), 444–463. https://doi.org/10.1111/jir.12283
Abstract: Background Although spoken-language deficits are not core to an autism spectrum disorder (ASD) diagnosis, many children with ASD do present with delays in this area. Previous meta-analyses have assessed the effects of intervention on reducing autism symptomatology, but have not determined if intervention improves spoken language. This analysis examines the effects of early interventions on spoken language in children with ASD. Method A systematic review of 1756 studies of children with ASD who participated in early intervention resulted in the inclusion of 26 studies in the current review. These studies included 1738 participants with ASD who were, on average, 3.3 years old (SD=0.91). Results This random-effects meta-analysis of spoken-language outcomes for children with ASD who received early intervention as compared with usual treatments yielded a significant overall mean effect size of g =0.26 (CI= 0.11 to 0.42). On average, children with ASD significantly increased their use of spoken- language following experimental early interventions. Treatments delivered simultaneously by a clinician and a parent resulted in greater gains in spoken-language than treatments delivered by a clinician or parent only. No other participant or study characteristics predicted individual-study effect sizes. Conclusions Early intervention improves spoken language outcomes for children with ASD, and the largest effects are found when both parent and clinician implement the intervention. Recommendations for practice include adding systematic parent training to interventions for spoken language to potentially improve outcomes. Future research should report standard language measures as well as child (cognitive ability and socio-economic status) and intervention characteristics to improve evidence related to the effects of interventions on spoken communication in children with ASD.
Iarocci, G., Hutchison, S. M., & O’Toole, G. (2017). Second language exposure, functional communication, and executive function in children with and without autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 47(6), 1818–1829. https://doi.org/10.1007/s10803-017-3103-7
Abstract: “Parents and professionals are concerned that second language exposure may delay communication in children with ASD. In this study 174 youth (6–16 years) with and without ASD, exposed to a second language, were compared on executive function (EF) and functional communication (FC) with their peers without exposure. There were no significant differences between groups on age, IQ, and socioeconomic status. Parents reported on language exposure and rated EF and FC skills within everyday social contexts. The findings indicated that second language exposure in children with ASD is not associated with delay in cognitive and functional communication skills rather there was evidence of a reduced clinical impact as indexed by a lower percentage of children whose FC and EF ratings fell within the clinical range.”
Research on Social Skills
Crosland, K., & Dunlap, G. (2012). Effective strategies for the inclusion of children with autism in general education classrooms. Behavior Modification, 36(3), 251–269. https://doi.org/10.1177/0145445512442682
Abstract: “Successful inclusion of students with autism spectrum disorder (ASD) in general education classrooms can be challenging and may require additional supports. This article provides information on recent trends in autism intervention research and a review of research that has addressed individualized and systemic interventions for promoting inclusion. Response to intervention and schoolwide positive behavior support are reviewed as organizational/systems strategies relevant to preventing problems and improving social and academic outcomes for students with ASD. Additional individualized strategies that can be implemented within these models are described. A discussion of future research directions is provided.” (Crosland and Dunlap, 2012).
Leaf, J. B., Ferguson, J. L., Cihon, J. H., Milne, C. M., Leaf, R., & McEachin, J. (2019). A critical review of social narratives. Journal of Developmental and Physical Disabilities, 32(2), 241–256. https://doi.org/10.1007/s10882-019-09692-2
Abstract: “Social narratives, or story-based interventions, are defined as stories that describe social situations, appropriate social behaviors to display, and when to display the specified behaviors. Social narratives are a commonly implemented and empirically evaluated procedure used to improve social behavior and decrease the probability of aberrant behavior for individuals diagnosed with autism spectrum disorder. Although social narratives are a commonly implemented and evaluated procedure, recommendations about their use and effectiveness is conflicting. This paper reviews six interventions that fit the definition of social narratives (i.e., Social Stories™/social stories, social scripts, cartooning, comic strip conversations, power cards, and social autopsies). Fifteen articles were analyzed across multiple methodological dimensions to determine the level of evidence (i.e., convincing, partial, or not convincing). Results of the analysis indicated that the majority of social narrative studies did not demonstrate convincing evidence. Recommendations for clinicians and future research are discussed based on the results of the literature review.
Wang, L. A., Petrulla, V., Zampella, C. J., Waller, R., & Schultz, R. T. (2022). Gross Motor Impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses. Psychological Bulletin, 148(3-4), 273–300. https://doi.org/10.1037/bul0000358
Abstract: “Gross motor ability is associated with profound differences in how children experience and interact with their social world. A rapidly growing literature on motor development in autism spectrum disorder (ASD) indicates that autistic individuals exhibit impairment in gross motor skills. However, due to substantial heterogeneity across studies, it remains unclear which gross motor skills are impaired in ASD, when and for whom these differences emerge, and whether motor and social impairments are related. The present article addressed these questions by synthesizing research on gross motor skills in ASD in two separate meta-analyses. The first examined gross motor deficits in ASD compared to neurotypical (NT) controls, aggregating data from 114 studies representing 6,423 autistic and 2,941 NT individuals. Results demonstrated a significant overall deficit in gross motor skills in ASD (Hedges’ g = −1.04) that was robust to methodological and phenotypic variation and was significant at every level of the tested moderators. However, moderation analyses revealed that this deficit was most pronounced for object control skills (i.e., ball skills), clinical assessment measures, and movements of the upper extremities or the whole body. The second meta-analysis investigated whether gross motor and social skills are related in ASD, synthesizing data from 21 studies representing 654 autistic individuals. Findings revealed a modest but significant overall correlation between gross motor and social skills in ASD (r = 0.27). Collectively, results support the conclusion that motor deficits are tied to the core symptoms of ASD. Further research is needed to test the causality and directionality of this relationship.” (Wang, et al., 2022)
Abstract: “Successful inclusion of students with autism spectrum disorder (ASD) in general education classrooms can be challenging and may require additional supports. This article provides information on recent trends in autism intervention research and a review of research that has addressed individualized and systemic interventions for promoting inclusion. Response to intervention and schoolwide positive behavior support are reviewed as organizational/systems strategies relevant to preventing problems and improving social and academic outcomes for students with ASD. Additional individualized strategies that can be implemented within these models are described. A discussion of future research directions is provided.” (Crosland and Dunlap, 2012).
Leaf, J. B., Ferguson, J. L., Cihon, J. H., Milne, C. M., Leaf, R., & McEachin, J. (2019). A critical review of social narratives. Journal of Developmental and Physical Disabilities, 32(2), 241–256. https://doi.org/10.1007/s10882-019-09692-2
Abstract: “Social narratives, or story-based interventions, are defined as stories that describe social situations, appropriate social behaviors to display, and when to display the specified behaviors. Social narratives are a commonly implemented and empirically evaluated procedure used to improve social behavior and decrease the probability of aberrant behavior for individuals diagnosed with autism spectrum disorder. Although social narratives are a commonly implemented and evaluated procedure, recommendations about their use and effectiveness is conflicting. This paper reviews six interventions that fit the definition of social narratives (i.e., Social Stories™/social stories, social scripts, cartooning, comic strip conversations, power cards, and social autopsies). Fifteen articles were analyzed across multiple methodological dimensions to determine the level of evidence (i.e., convincing, partial, or not convincing). Results of the analysis indicated that the majority of social narrative studies did not demonstrate convincing evidence. Recommendations for clinicians and future research are discussed based on the results of the literature review.
Wang, L. A., Petrulla, V., Zampella, C. J., Waller, R., & Schultz, R. T. (2022). Gross Motor Impairment and its relation to social skills in autism spectrum disorder: A systematic review and two meta-analyses. Psychological Bulletin, 148(3-4), 273–300. https://doi.org/10.1037/bul0000358
Abstract: “Gross motor ability is associated with profound differences in how children experience and interact with their social world. A rapidly growing literature on motor development in autism spectrum disorder (ASD) indicates that autistic individuals exhibit impairment in gross motor skills. However, due to substantial heterogeneity across studies, it remains unclear which gross motor skills are impaired in ASD, when and for whom these differences emerge, and whether motor and social impairments are related. The present article addressed these questions by synthesizing research on gross motor skills in ASD in two separate meta-analyses. The first examined gross motor deficits in ASD compared to neurotypical (NT) controls, aggregating data from 114 studies representing 6,423 autistic and 2,941 NT individuals. Results demonstrated a significant overall deficit in gross motor skills in ASD (Hedges’ g = −1.04) that was robust to methodological and phenotypic variation and was significant at every level of the tested moderators. However, moderation analyses revealed that this deficit was most pronounced for object control skills (i.e., ball skills), clinical assessment measures, and movements of the upper extremities or the whole body. The second meta-analysis investigated whether gross motor and social skills are related in ASD, synthesizing data from 21 studies representing 654 autistic individuals. Findings revealed a modest but significant overall correlation between gross motor and social skills in ASD (r = 0.27). Collectively, results support the conclusion that motor deficits are tied to the core symptoms of ASD. Further research is needed to test the causality and directionality of this relationship.” (Wang, et al., 2022)
Research on Sensory Issues
Dellapiazza, F., Michelon, C., Picot, M.-C., & Baghdadli, A. (2021). A longitudinal exploratory study of changes in sensory processing in children with ASD from the elena cohort. European Child & Adolescent Psychiatry, 31(7), 1–10. https://doi.org/10.1007/s00787-021-01746-1
Abstract: “Atypical sensory processing (SP) is a diagnostic criterion of autism spectrum disorder (ASD). However, little is known about its course during development. In this exploratory longitudinal study, we aimed to investigate the course of SP among children with ASD and identify clinical variables associated with changes. We used a subsample of 51 children with confirmed ASD, aged from 3 to 10 years, recruited from the ELENA cohort. SP was assessed using the Sensory Profile questionnaire at baseline and three years later. Our preliminary results highlight the heterogeneity of the evolution of SP during the children’s development and the existence of three subgroups based on the course of SP (improvement, stable, and worsening). In addition, the children’s adaptive skills and maladaptive behaviors were related to the course of SP. These results could be confirmed in future studies with a larger sample size using a longitudinal approach to capture individual variability in SP. In addition, our results highlight the importance of accounting for temporal changes in the sensory needs of individuals with ASD in clinical practice.”
Durrani, H. (2020). Sensory-based relational art therapy approach (S-Brata): A framework for art therapy with children with ASD. Art Therapy, 38(2), 78–86. https://doi.org/10.1080/07421656.2020.1718054
Abstract: “This article presents a sensory-based relational art therapy approach (S-BRATA) framework for working with children with autism spectrum disorder (ASD) that explicitly addresses sensory integration dysfunction (SID) and impaired attachment. Developed based on three case studies and rooted in grounded theory methodology, the study resulted in seven themes: (1) sense of safety, (2) working with the child’s sensory profile, (3) art materials as entry point for engagement, (4) attachment formation through mirroring and attunement, (5) flexibility in approach, (6) structure and boundaries, (7) art product not the focus. As a preliminary framework, S-BRATA extends and develops established concepts into a unified model.
Leader, G., Flynn, C., O’Rourke, N., Coyne, R., Caher, A., & Mannion, A. (2021). Comorbid psychopathology, challenging behavior, sensory issues, adaptive behavior and quality of life in children and adolescents with autism spectrum disorder. Developmental Neurorehabilitation, 1–11. https://doi.org/10.1080/17518423.2021.1898058
Abstract: “Aim: Comorbid psychopathology refers to having a diagnosis of two or more co-occurring psychological disorders. The current study investigated the differences between children and adolescents with no-mild, moderate and severe comorbid psychopathology in children and adolescents with ASD. Method: Parents of 133 children completed the Autism Spectrum Disorder-Comorbid for Children, Behavior Problems Inventory-Short Form, Pediatric Quality of Life Inventory, Vineland Adaptive Behavior Scales, Social Communication Questionnaire, Short Sensory Profile, and Behavioral/Educational Interventions and Complementary/Alternative Medicine (CAM) Interventions of the Autism Treatment Network Registry Parent Baseline Assessment. Results: A significant difference was found between severity of comorbid psychopathology and all types of challenging behavior and all sensory issues except movement. A small effect size was also found between comorbid psychopathology and quality of life. Conclusion: The findings from this study show significant difficulties associated with those with comorbid psychopathology in ASD in challenging behavior, sensory issues and quality of life.
Abstract: “Atypical sensory processing (SP) is a diagnostic criterion of autism spectrum disorder (ASD). However, little is known about its course during development. In this exploratory longitudinal study, we aimed to investigate the course of SP among children with ASD and identify clinical variables associated with changes. We used a subsample of 51 children with confirmed ASD, aged from 3 to 10 years, recruited from the ELENA cohort. SP was assessed using the Sensory Profile questionnaire at baseline and three years later. Our preliminary results highlight the heterogeneity of the evolution of SP during the children’s development and the existence of three subgroups based on the course of SP (improvement, stable, and worsening). In addition, the children’s adaptive skills and maladaptive behaviors were related to the course of SP. These results could be confirmed in future studies with a larger sample size using a longitudinal approach to capture individual variability in SP. In addition, our results highlight the importance of accounting for temporal changes in the sensory needs of individuals with ASD in clinical practice.”
Durrani, H. (2020). Sensory-based relational art therapy approach (S-Brata): A framework for art therapy with children with ASD. Art Therapy, 38(2), 78–86. https://doi.org/10.1080/07421656.2020.1718054
Abstract: “This article presents a sensory-based relational art therapy approach (S-BRATA) framework for working with children with autism spectrum disorder (ASD) that explicitly addresses sensory integration dysfunction (SID) and impaired attachment. Developed based on three case studies and rooted in grounded theory methodology, the study resulted in seven themes: (1) sense of safety, (2) working with the child’s sensory profile, (3) art materials as entry point for engagement, (4) attachment formation through mirroring and attunement, (5) flexibility in approach, (6) structure and boundaries, (7) art product not the focus. As a preliminary framework, S-BRATA extends and develops established concepts into a unified model.
Leader, G., Flynn, C., O’Rourke, N., Coyne, R., Caher, A., & Mannion, A. (2021). Comorbid psychopathology, challenging behavior, sensory issues, adaptive behavior and quality of life in children and adolescents with autism spectrum disorder. Developmental Neurorehabilitation, 1–11. https://doi.org/10.1080/17518423.2021.1898058
Abstract: “Aim: Comorbid psychopathology refers to having a diagnosis of two or more co-occurring psychological disorders. The current study investigated the differences between children and adolescents with no-mild, moderate and severe comorbid psychopathology in children and adolescents with ASD. Method: Parents of 133 children completed the Autism Spectrum Disorder-Comorbid for Children, Behavior Problems Inventory-Short Form, Pediatric Quality of Life Inventory, Vineland Adaptive Behavior Scales, Social Communication Questionnaire, Short Sensory Profile, and Behavioral/Educational Interventions and Complementary/Alternative Medicine (CAM) Interventions of the Autism Treatment Network Registry Parent Baseline Assessment. Results: A significant difference was found between severity of comorbid psychopathology and all types of challenging behavior and all sensory issues except movement. A small effect size was also found between comorbid psychopathology and quality of life. Conclusion: The findings from this study show significant difficulties associated with those with comorbid psychopathology in ASD in challenging behavior, sensory issues and quality of life.
Research on Academic Intervention
Aljohani, W. A., Javed, A., Ferguson, J. L., Cihon, J. H., Milne, C. M., & Leaf, J. B. (2021). Comparison of simultaneous prompting to error correction for children with autism spectrum disorder. Focus on Autism and Other Developmental Disabilities, 37(2), 83–95. https://doi.org/10.1177/10883576211036429
Abstract: “This study compared simultaneous prompting with an error correction procedure for teaching three children diagnosed with autism spectrum disorder expressive labels. Using a parallel treatment design nested within a multiple probe design, the researchers taught each participant how to expressively label pictures of sports teams or cartoon characters using either simultaneous prompting or an error correction procedure. The goal was to evaluate the effectiveness, efficiency, and acquisition during teaching for each participant across the two conditions. Results indicated that both teaching procedures were effective, with high rates of maintenance, and all participants responded correctly during the majority of teaching trials.
Cleary, A. M., McNeely-White, K. L., Hausman, H., Dawson, J., Kuhn, S., Osborn, R. M., Huebert, A. M., & Rhodes, M. G. (2021). Wearable Technology for automatizing science-based study strategies: Reinforcing Learning through intermittent smartwatch prompting. Journal of Applied Research in Memory and Cognition, 10(3), 444–457. https://doi.org/10.1016/j.jarmac.2021.01.001
Abstract: “This study explored smartwatches’ potential for implementing and automatizing the use of retrieval as a study tool outside of classroom contexts. Across five experiments, review prompts delivered via a smartwatch after reading scientific passages enhanced retention of factual information from the passages and reduced forgetting after a two-day delay. The delivery format—delivery in the form of testing versus in the form of restudying—mattered to the level of learning benefit shown. Consistent with the testing effect, delivering the information as a test question followed a minute later by its answer was generally more beneficial than delivering it as a mere factual statement for restudy. Whether participants were reading magazines, watching Netflix episodes, or engaging with their own smartphones while receiving the smartwatch prompts made no difference to the beneficial effect of the smartwatch prompting on retention. Thus, smartwatch prompts can be applied strategically to automatize outside-of-the-classroom learning reinforcement.
Kim, S. Y., Rispoli, M., Mason, R. A., Lory, C., Gregori, E., Roberts, C. A., Whitford, D., & David, M. (2021). A systematic quality review of technology-aided reading interventions for students with autism spectrum disorder. Remedial and Special Education, 43(6), 404–420. https://doi.org/10.1177/07419325211063612
Abstract: “Technology has been widely used to teach reading skills to students with autism spectrum disorder (ASD), but the quality of research backing up this practice has not yet been fully investigated. The purpose of this review was to examine the quality of research on technology-aided reading interventions for students with ASD and summarize study characteristics of research studies with meeting the What Works Clearinghouse (WWC) design standards. A total of 31 studies using group design (n = 4) or single-case design (n = 27) were systematically aggregated, and 16 studies (52%) met the WWC design standards. Study features related to participants, intervention, technology usage, and outcome variables were synthesized for these 16 studies. Results indicated that two types of technology (i.e., computer, iPad) were used to deliver reading instruction through software programs or support interventionist-directed reading instruction. Finally, implications for research and practice are discussed.
Kouo, J., & Visco, C. (2021). Technology-aided instruction and intervention in teaching students with autism to make inferences. Focus on Autism and Other Developmental Disabilities, 108835762110125. https://doi.org/10.1177/10883576211012597
Abstract: “Inferential readings skills are necessary in ensuring that students with autism spectrum disorders (ASD) are successful in the general education curriculum. These skills provide a foundation for reading comprehension across content areas. Technology-aided instruction and intervention (TAII) has the potential to address these reading deficits, by presenting content in an interactive format. Using an adapted alternating treatment design (ATD), the present study compared the impact of the TinyTap app, videos, and traditional graphic organizers to improve the inferential reading skills of two middle school students with ASD. Replication of the most effective intervention occurred, and maintenance data were collected. The results suggested that the TinyTap treatment condition was the most functionally effective in increasing inferential reading skills. From the research, there are a number of implications moving forward for both practitioners and future researchers examining the impact of TAII on academic skills.”
Abstract: “This study compared simultaneous prompting with an error correction procedure for teaching three children diagnosed with autism spectrum disorder expressive labels. Using a parallel treatment design nested within a multiple probe design, the researchers taught each participant how to expressively label pictures of sports teams or cartoon characters using either simultaneous prompting or an error correction procedure. The goal was to evaluate the effectiveness, efficiency, and acquisition during teaching for each participant across the two conditions. Results indicated that both teaching procedures were effective, with high rates of maintenance, and all participants responded correctly during the majority of teaching trials.
Cleary, A. M., McNeely-White, K. L., Hausman, H., Dawson, J., Kuhn, S., Osborn, R. M., Huebert, A. M., & Rhodes, M. G. (2021). Wearable Technology for automatizing science-based study strategies: Reinforcing Learning through intermittent smartwatch prompting. Journal of Applied Research in Memory and Cognition, 10(3), 444–457. https://doi.org/10.1016/j.jarmac.2021.01.001
Abstract: “This study explored smartwatches’ potential for implementing and automatizing the use of retrieval as a study tool outside of classroom contexts. Across five experiments, review prompts delivered via a smartwatch after reading scientific passages enhanced retention of factual information from the passages and reduced forgetting after a two-day delay. The delivery format—delivery in the form of testing versus in the form of restudying—mattered to the level of learning benefit shown. Consistent with the testing effect, delivering the information as a test question followed a minute later by its answer was generally more beneficial than delivering it as a mere factual statement for restudy. Whether participants were reading magazines, watching Netflix episodes, or engaging with their own smartphones while receiving the smartwatch prompts made no difference to the beneficial effect of the smartwatch prompting on retention. Thus, smartwatch prompts can be applied strategically to automatize outside-of-the-classroom learning reinforcement.
Kim, S. Y., Rispoli, M., Mason, R. A., Lory, C., Gregori, E., Roberts, C. A., Whitford, D., & David, M. (2021). A systematic quality review of technology-aided reading interventions for students with autism spectrum disorder. Remedial and Special Education, 43(6), 404–420. https://doi.org/10.1177/07419325211063612
Abstract: “Technology has been widely used to teach reading skills to students with autism spectrum disorder (ASD), but the quality of research backing up this practice has not yet been fully investigated. The purpose of this review was to examine the quality of research on technology-aided reading interventions for students with ASD and summarize study characteristics of research studies with meeting the What Works Clearinghouse (WWC) design standards. A total of 31 studies using group design (n = 4) or single-case design (n = 27) were systematically aggregated, and 16 studies (52%) met the WWC design standards. Study features related to participants, intervention, technology usage, and outcome variables were synthesized for these 16 studies. Results indicated that two types of technology (i.e., computer, iPad) were used to deliver reading instruction through software programs or support interventionist-directed reading instruction. Finally, implications for research and practice are discussed.
Kouo, J., & Visco, C. (2021). Technology-aided instruction and intervention in teaching students with autism to make inferences. Focus on Autism and Other Developmental Disabilities, 108835762110125. https://doi.org/10.1177/10883576211012597
Abstract: “Inferential readings skills are necessary in ensuring that students with autism spectrum disorders (ASD) are successful in the general education curriculum. These skills provide a foundation for reading comprehension across content areas. Technology-aided instruction and intervention (TAII) has the potential to address these reading deficits, by presenting content in an interactive format. Using an adapted alternating treatment design (ATD), the present study compared the impact of the TinyTap app, videos, and traditional graphic organizers to improve the inferential reading skills of two middle school students with ASD. Replication of the most effective intervention occurred, and maintenance data were collected. The results suggested that the TinyTap treatment condition was the most functionally effective in increasing inferential reading skills. From the research, there are a number of implications moving forward for both practitioners and future researchers examining the impact of TAII on academic skills.”
Research on Collaboration
Azad, G. F., Marcus, S. C., & Mandell, D. S. (2020). Partners in school: Optimizing Communication between parents and teachers of children with autism spectrum disorder. Journal of Educational and Psychological Consultation, 31(4), 438–462. https://doi.org/10.1080/10474412.2020.1830100
Abstract: “Partners in School: is a consultation model with the goal of enhancing communication between two of the most important stakeholders in children’s lives – parents and teachers. Using a single–group pre–post design, this preliminary study examined the effect of Partners in School on parent–teacher communication outcomes and the factors associated with these outcomes. Participants were 26 teachers and 49 parents of children with autism spectrum disorder (ASD). Parents and teachers completed surveys before and after participating in Partners in School. Teachers reported an increase in their communication to parents. However, parents did not report an increase in their communication to teachers. Teachers’ self–efficacy, expectations, and intervention fidelity were associated with increased communication to parents. Parental self–efficacy and teacher experience were associated with parents’ reports of communication to teachers. Our findings suggest that family– school consultation services may be used to enhance teachers’ communication with parents.”
Emmons, C. L., & Zager, D. (2017). Increasing collaboration self-efficacy to improve educational programming for students with autism. Focus on Autism and Other Developmental Disabilities, 33(2), 120–128. https://doi.org/10.1177/1088357616686312
Abstract: “Collaborative teaming among specialists can enhance educational success by leveraging resources and building capacity to maximize effectiveness. Special educators’ change in perceptions of their efficacy as collaborators in the education of students with autism spectrum disorder (ASD) was studied before and after completing a year-long federally funded graduate certificate program in autism. Self-perceptions of collaborative expertise were examined in eight cohorts of educators over 7 years. Analysis of the results indicated a significant increase in perceptions of efficacy level in six of the cohorts at ≤ .006. The size of the effect of the program on participants’ self-perceptions of their efficacy in working collaboratively with other school personnel was large for seven of the cohorts and medium for one. Most importantly, results from Greenhouse–Geisser analysis showed that the posttest scores on collaboration efficacy level were significantly higher than the pretest scores across all cohorts, and that the pattern of change in pretest to posttest scores was similar across all eight cohorts.
Mueller, R., & Moskowitz, L. J. (2020). Positive family intervention for children with ASD: Impact on parents’ cognitions and stress. Journal of Child and Family Studies, 29(12), 3536–3551. https://doi.org/10.1007/s10826-020-01830-1
Abstract: “While parent training often focuses on teaching parents of children with Autism [Spectrum] Disorders (ASD) specific skills to address their child’s problem behavior, it has often overlooked factors related to parents’ own mental health and well-being, such as how they think and feel about their child’s behavior and their parenting. The purpose of this study was to examine the impact of positive family intervention (PFI), a parent training program which combines cognitive-behavioral therapy (CBT) with family based positive behavior support (PBS), on parents’ cognitions and children’s problem behavior for families of children with ASD. A nonconcurrent multiple baseline design across three mothers was used to examine the impact of PFI on parent-reported stress, self-efficacy, attributions, rational and irrational beliefs, pessimism, and ratings of child behavior problems. Each mother received eight weekly 90-minute PFI sessions without the child present. Findings demonstrated significant decreases in parent ratings of problem behavior as well as observed child problem behavior for all three families, though visual analysis showed only modest change in parent-reported problem behavior for one of those three mothers, and direct observation data was only collected pre- and post-intervention. Two of the three mothers reported significant decreases in dysfunctional child- and parent-causal attributions, irrational beliefs, and pessimistic thoughts. In addition, one of those two mothers reported improvements in parental stress and self-efficacy. This study suggests that there may be benefits to incorporating CBT with PBS in terms of affecting parents’ perceptions of their children and themselves. Factors potentially contributing to or limiting the effectiveness of PFI for each participant are discussed.
Stone, W. L., Ibanez, L. V., Carpentier, P., Posner, E., Bravo, A., Frederick, L., & Locke, J. (2019). Early intervention providers’ perspectives about working with families of toddlers with suspected ASD: A qualitative study. Journal of Autism and Developmental Disorders, 51(3), 814–826. https://doi.org/10.1007/s10803-019-04337-x
Abstract: “Part C early intervention (EI) providers are at the front line of service provision for children under 3 years old with developmental delays or disabilities. As such, they can play a key role in both the early detection of autism spectrum disorder (ASD) and the provision of ASD-specialized treatment. Focus groups were conducted with 25 EI providers from three agencies in a Northwestern U.S. county to understand their role in the identification of ASD and communication about ASD concerns to families. Results revealed the tension that providers experience between maintaining a positive and supportive relationship with families and raising the issue of possible ASD. Cultural influences affecting ASD care and suggestions for desired resources were also discussed.”
Abstract: “Partners in School: is a consultation model with the goal of enhancing communication between two of the most important stakeholders in children’s lives – parents and teachers. Using a single–group pre–post design, this preliminary study examined the effect of Partners in School on parent–teacher communication outcomes and the factors associated with these outcomes. Participants were 26 teachers and 49 parents of children with autism spectrum disorder (ASD). Parents and teachers completed surveys before and after participating in Partners in School. Teachers reported an increase in their communication to parents. However, parents did not report an increase in their communication to teachers. Teachers’ self–efficacy, expectations, and intervention fidelity were associated with increased communication to parents. Parental self–efficacy and teacher experience were associated with parents’ reports of communication to teachers. Our findings suggest that family– school consultation services may be used to enhance teachers’ communication with parents.”
Emmons, C. L., & Zager, D. (2017). Increasing collaboration self-efficacy to improve educational programming for students with autism. Focus on Autism and Other Developmental Disabilities, 33(2), 120–128. https://doi.org/10.1177/1088357616686312
Abstract: “Collaborative teaming among specialists can enhance educational success by leveraging resources and building capacity to maximize effectiveness. Special educators’ change in perceptions of their efficacy as collaborators in the education of students with autism spectrum disorder (ASD) was studied before and after completing a year-long federally funded graduate certificate program in autism. Self-perceptions of collaborative expertise were examined in eight cohorts of educators over 7 years. Analysis of the results indicated a significant increase in perceptions of efficacy level in six of the cohorts at ≤ .006. The size of the effect of the program on participants’ self-perceptions of their efficacy in working collaboratively with other school personnel was large for seven of the cohorts and medium for one. Most importantly, results from Greenhouse–Geisser analysis showed that the posttest scores on collaboration efficacy level were significantly higher than the pretest scores across all cohorts, and that the pattern of change in pretest to posttest scores was similar across all eight cohorts.
Mueller, R., & Moskowitz, L. J. (2020). Positive family intervention for children with ASD: Impact on parents’ cognitions and stress. Journal of Child and Family Studies, 29(12), 3536–3551. https://doi.org/10.1007/s10826-020-01830-1
Abstract: “While parent training often focuses on teaching parents of children with Autism [Spectrum] Disorders (ASD) specific skills to address their child’s problem behavior, it has often overlooked factors related to parents’ own mental health and well-being, such as how they think and feel about their child’s behavior and their parenting. The purpose of this study was to examine the impact of positive family intervention (PFI), a parent training program which combines cognitive-behavioral therapy (CBT) with family based positive behavior support (PBS), on parents’ cognitions and children’s problem behavior for families of children with ASD. A nonconcurrent multiple baseline design across three mothers was used to examine the impact of PFI on parent-reported stress, self-efficacy, attributions, rational and irrational beliefs, pessimism, and ratings of child behavior problems. Each mother received eight weekly 90-minute PFI sessions without the child present. Findings demonstrated significant decreases in parent ratings of problem behavior as well as observed child problem behavior for all three families, though visual analysis showed only modest change in parent-reported problem behavior for one of those three mothers, and direct observation data was only collected pre- and post-intervention. Two of the three mothers reported significant decreases in dysfunctional child- and parent-causal attributions, irrational beliefs, and pessimistic thoughts. In addition, one of those two mothers reported improvements in parental stress and self-efficacy. This study suggests that there may be benefits to incorporating CBT with PBS in terms of affecting parents’ perceptions of their children and themselves. Factors potentially contributing to or limiting the effectiveness of PFI for each participant are discussed.
Stone, W. L., Ibanez, L. V., Carpentier, P., Posner, E., Bravo, A., Frederick, L., & Locke, J. (2019). Early intervention providers’ perspectives about working with families of toddlers with suspected ASD: A qualitative study. Journal of Autism and Developmental Disorders, 51(3), 814–826. https://doi.org/10.1007/s10803-019-04337-x
Abstract: “Part C early intervention (EI) providers are at the front line of service provision for children under 3 years old with developmental delays or disabilities. As such, they can play a key role in both the early detection of autism spectrum disorder (ASD) and the provision of ASD-specialized treatment. Focus groups were conducted with 25 EI providers from three agencies in a Northwestern U.S. county to understand their role in the identification of ASD and communication about ASD concerns to families. Results revealed the tension that providers experience between maintaining a positive and supportive relationship with families and raising the issue of possible ASD. Cultural influences affecting ASD care and suggestions for desired resources were also discussed.”
Research on Transitions for Adults and Children with ASD
Roberts, K. D. (2010). Topic areas to consider when planning transition from high school to postsecondary education for students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 25(3), 158–162. https://doi.org/10.1177/1088357610371476
Abstract: “For many individuals with an autism spectrum disorder (ASD), attending and completing postsecondary education is a viable option. However, success in postsecondary education for these individuals may require more planning and ongoing support than students without an ASD. This article provides educators and transition support personnel with a range of topics to consider when working with students with ASD and their families to develop a comprehensive transition plan. These topic areas include career exploration, academic goal setting and preparation, assessing and knowing learning styles, self-advocacy skills, reasonable accommodations, academic supports, interagency collaboration, technology, and time management skills.
Solomon, C. (2020). Autism and employment: Implications for employers and adults with ASD. Journal of Autism and Developmental Disorders, 50(11), 4209–4217. https://doi.org/10.1007/s10803-020-04537-w
Abstract: “A small but growing body of research has been conducted on vocational outcomes for adults with Autism Spectrum Disorder (ASD); however, limited resources have been directed towards understanding outcomes for competitive employers. While ASD does present with a range of social communication and adaptive behavior deficits, adults on the spectrum may be extremely efficient, trustworthy, reliable, and cost-effective employees. Nevertheless, fewer than half of young adults with ASD maintain a job. Many businesses are unwilling to hire these capable candidates, concerned among other things about an increase in supervision costs and a decrease in productivity. This is a bias based on misperceptions; the financial and social benefits of hiring adults with ASD, for businesses and the individual, often outweigh the costs.
Starr, E. M., Martini, T. S., & Kuo, B. C. (2014). Transition to kindergarten for children with autism spectrum disorder: a focus group study with ethnically diverse parents, teachers, and early intervention service providers. Focus on Autism and Other Developmental Disabilities, 31(2), 115–128. https://doi.org/10.1177/1088357614532497
Abstract: “Despite the stated importance of a successful kindergarten transition (TTK) for future school success, no research has addressed this transition for culturally/ethnically diverse families having children with autism spectrum disorders (ASD). To address this gap, six focus groups (three with ethnically diverse parents, one with kindergarten teachers, and one each with early childhood resource teachers and early intervention providers) were conducted to elicit the experiences of these stakeholders regarding TTK for children with ASD generally, and the TTK experience for ethnically diverse families specifically. Four major themes relating to TTK emerged from the focus groups: Relationship Building, Communication, Knowledge, and Support. While these themes were relevant for all groups, parents who were relatively recent immigrants and for whom English was not a first language identified unique difficulties. Results are discussed within the context of Bronfenbrenner’s Ecological Systems Theory. Recommendations to improve the experience for ethnically diverse families are explored.
Abstract: “For many individuals with an autism spectrum disorder (ASD), attending and completing postsecondary education is a viable option. However, success in postsecondary education for these individuals may require more planning and ongoing support than students without an ASD. This article provides educators and transition support personnel with a range of topics to consider when working with students with ASD and their families to develop a comprehensive transition plan. These topic areas include career exploration, academic goal setting and preparation, assessing and knowing learning styles, self-advocacy skills, reasonable accommodations, academic supports, interagency collaboration, technology, and time management skills.
Solomon, C. (2020). Autism and employment: Implications for employers and adults with ASD. Journal of Autism and Developmental Disorders, 50(11), 4209–4217. https://doi.org/10.1007/s10803-020-04537-w
Abstract: “A small but growing body of research has been conducted on vocational outcomes for adults with Autism Spectrum Disorder (ASD); however, limited resources have been directed towards understanding outcomes for competitive employers. While ASD does present with a range of social communication and adaptive behavior deficits, adults on the spectrum may be extremely efficient, trustworthy, reliable, and cost-effective employees. Nevertheless, fewer than half of young adults with ASD maintain a job. Many businesses are unwilling to hire these capable candidates, concerned among other things about an increase in supervision costs and a decrease in productivity. This is a bias based on misperceptions; the financial and social benefits of hiring adults with ASD, for businesses and the individual, often outweigh the costs.
Starr, E. M., Martini, T. S., & Kuo, B. C. (2014). Transition to kindergarten for children with autism spectrum disorder: a focus group study with ethnically diverse parents, teachers, and early intervention service providers. Focus on Autism and Other Developmental Disabilities, 31(2), 115–128. https://doi.org/10.1177/1088357614532497
Abstract: “Despite the stated importance of a successful kindergarten transition (TTK) for future school success, no research has addressed this transition for culturally/ethnically diverse families having children with autism spectrum disorders (ASD). To address this gap, six focus groups (three with ethnically diverse parents, one with kindergarten teachers, and one each with early childhood resource teachers and early intervention providers) were conducted to elicit the experiences of these stakeholders regarding TTK for children with ASD generally, and the TTK experience for ethnically diverse families specifically. Four major themes relating to TTK emerged from the focus groups: Relationship Building, Communication, Knowledge, and Support. While these themes were relevant for all groups, parents who were relatively recent immigrants and for whom English was not a first language identified unique difficulties. Results are discussed within the context of Bronfenbrenner’s Ecological Systems Theory. Recommendations to improve the experience for ethnically diverse families are explored.