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Students with Autism Spectrum Disorder (ASD) tend to struggle with reading comprehension, often resulting in difficulties with inference generation. While most of the previous research has focused on the product of comprehension, we report a preliminary validation of an experimental reading task in English to measure, by means of eye-movements, the time course of generating consistent and inconsistent inferences during reading. The task was tested with a group of 12 students with ASD (age range: 10-15) who showed accuracy differences between inference and control conditions. Participants spent longer reading in the inconsistent than control condition regarding go past times and second pass times and made more regressions into the target and post-target regions, but these differences were not significant.

Fragile X syndrome (FXS) is characterized by variable neurobehavioral abnormalities, which leads to difficulties in developing and evaluating treatments and in determining accurate prognosis. We employed a pediatric cross-sectional sample (1,072 males, 338 females) from FORWARD, a clinic-based natural history study, to identify behavioral subtypes by latent class analysis. Input included co-occurring behavioral conditions, sleep and sensory problems, autistic behavior scales (SCQ, SRS-2), and the Aberrant Behavior Checklist revised for FXS (ABC[subscript FX]). A 5-class solution yielded the most clinically meaningful, pharmacotherapy independent behavioral groups with distinctive SCQ, SRS-2, and ABC[subscript FX] profiles, and adequate non-overlap ([greater than or equal to] 71%): "Mild" (31%), "Moderate without Social Impairment" (32%), "Moderate with Social Impairment" (7%), "Moderate with Disruptive Behavior" (20%), and "Severe" (9%). Our findings support FXS subtyping, for improving clinical management and therapeutic development. [Written with the FORWARD Consortium.]

Compare developmental profiles and core ASD symptom manifestation between male and female toddlers with DSM-5 ASD. Retrospective record review of 500 toddlers (79% male) at time of ASD diagnosis. There were no differences in developmental functioning between males and females. When adjusting for multiple comparisons, sex differences were only noted for sensory seeking behavior occurring at a higher frequency in females. Overall, there were no significant differences in demographic characteristics, developmental functioning, or manifestation of core ASD symptoms between males versus female toddlers at the time of DSM-5 ASD diagnosis.

There is uncertainty among researchers and clinicians about how to best measure autism spectrum dimensional traits in adults. In a sample of adults with high levels of autism spectrum traits and without intellectual disability (probands, n = 103) and their family members (n = 96), we sought to compare self vs. informant reports of autism spectrum-related traits and possible effects of sex on discrepancies. Using correlational analysis, we found poor agreement between self- and informant-report measures for probands, yet moderate agreement for family members. We found reporting discrepancy was greatest for female probands, often self-reporting more autism-related behaviors. Our findings suggest that autism spectrum traits are often underrecognized by informants, making self-report data important to collect in clinical and research settings.

Discrete Trial Training (DTT) is a method of intervention for individuals with Autism Spectrum Disorder (ASD). Applications of DTT require prescribed repetitions of instruction. DTT is typically implemented via trained instructors or teachers. However, prior analysis has demonstrated the potential of parent-implemented DTT. Prior research demonstrated that DTT training can be implemented with a high degree of fidelity using a student teacher population. However, to date, no studies have evaluated the use of a DTT telehealth training with parents of children with ASD. The purpose of this study was to evaluate the feasibility of a remote parent training method to allow parents to implement DTT in home settings. To this end, three parent participants of children diagnosed with ASD were trained to implement DTT through a telehealth modality in a nonconcurrent multiple baseline design. Results suggested efficacy of this method at DTT skills acquisition.

This waitlist-controlled cluster randomized clinical trial presents the results of PS + ASD for military dependent and connected youth with ASD. Following earlier findings regarding PS + ASD, this study expands upon that previous work by including a new population, military dependent and connected transition aged youth with ASD. Findings indicate that military dependent and connected youth who participated in PS + ASD gained competitive integrated employment at 60% despite the impact of the COVID-19 pandemic and economic downturn. In addition, these youth worked a mean of 24.42 h weekly and earned an average hourly wage of $9.38 at one year post baseline while the waitlist control group participants did not gain CIE. In addition, by 18 months, 58.3% of participants gained positions in federal employment. Implications of the study are discussed.

In dialogue, speakers tend to imitate, or align with, a partner's language choices. Higher levels of alignment facilitate communication and can be elicited by affiliation goals. Since autistic children have interaction and communication impairments, we investigated whether a failure to display affiliative language imitation contributes to their conversational difficulties. We measured autistic children's lexical alignment with a partner, following an ostracism manipulation which induces affiliative motivation in typical adults and children. While autistic children demonstrated lexical alignment, we observed no affiliative influence on ostracised children's tendency to align, relative to controls. Our results suggest that increased language imitation--a potentially valuable form of social adaptation--is unavailable to autistic children, which may reflect their impaired affective understanding.

In conversation, the listener plays an active role in conversation success, specifically by providing "listener feedback" which signals comprehension and interest. Previous work has shown that frequency of feedback positively correlates with conversation success. Because individuals with ASD are known to struggle with various conversational skills, e.g., turn-taking and commenting, this study examines their use of listener feedback by comparing the frequency of feedback produced by 20 adolescents with ASD and 23 neurotypical (NT) adolescents. We coded verbal and nonverbal listener feedback during the time when participants were listening in a semi-structured interview with a research assistant. Results show that ASD participants produced significantly fewer instances of listener feedback than NT adolescents, which likely contributes to difficulties with social interactions.

The objective of this study was to identify subgroups of toddlers with DSM-5 ASD based on core ASD symptoms using a person-based analytical framework. This is a retrospective study of 500 toddlers (mean age 26 months, 79% male) with DSM-5 ASD. Data were analyzed using latent class analyses in which profiles were formed based on ASD symptomatology. Social communication (SC) symptoms favored a three-class solution, while restricted/repetitive behaviors (RRBs) favored a two-class solution. Classes with higher consistency of SC deficits were younger, with lower developmental functioning. The class with more RRBs was older, with higher functioning. If confirmed in other populations, these classes may more precisely characterize subgroups within the heterogeneous group of toddlers at time of ASD diagnosis.

This study reports the results of a multi-site, parallel block randomized clinical trial to expand the previous findings regarding the implementation of Project SEARCH plus ASD Supports (PS + ASD) on employment outcomes upon graduation from high school. Participants were 156 individuals with significant impact from ASD between the ages of 18-21. There was a significant difference between treatment and control groups with 73.4% of the treatment group acquiring competitive employment at or above minimum wage by 1-year after graduation compared to 17% of the control group for whom data was provided. At 1-year, employed treatment group participants worked an average of 21.2 h per week (SD = 9) for a mean hourly wage of $9.61 per hour (SD = $1.55).

Cognitive and adaptive behaviour abilities early in life provide important clinical prognostic information. We examined stability of such skills in children at high familial risk for ASD who either met diagnostic criteria for ASD at age 7 years (HR-ASD, n = 15) or did not (HR-non-ASD, n = 24) and low-risk control children (LR, n = 37), prospectively studied from infancy. For both HR groups, cognitive skills were consistently lower across time than those of LR children. HR-ASD children showed increasing difficulties in adaptive behaviour over time compared to LR children, while the HR-non-ASD children showed no such difficulties. This pattern of change may inform our understanding of developmental profiles of HR siblings beyond core ASD symptoms.

This paper investigates the role of caregiver mental health and parenting practices as predictors of attachment in children with intellectual disability/developmental delay, comparing between children with ASD (n = 29) and children with other developmental disabilities (n = 20). Parents reported that children with ASD had high levels of anxiety and stress, and attachment insecurity in children (less closeness and more conflict in attachment relationships, and more inhibited attachment behaviours) compared with children with other developmental disabilities. Children's attachment quality was associated with parenting practices and the presence of an ASD diagnosis. These results highlight the bidirectional nature of the quality of caregiving environments and attachment in children with ASD, and also provide a strong rationale for targeting children's attachment quality in early interventions. [This article represents a collaborative effort on behalf of the Mental Health of Young People with Developmental Disabilities (MHYPeDD) team.]

To determine the rate and predictors of autism spectrum disorder (ASD) in congenital diaphragmatic hernia (CDH). Between 06/2004 and 09/2015 a total of 110 CDH survivors underwent neurodevelopmental (ND) testing and screening for ASD, followed by a full autism diagnostic evaluation if indicated at our institution. We found a 9 time higher rate of ASD in CDH children compared to the general population (P = 0.0002). Multiple patient-related and clinical variables risk factors of ASD were identified by univariate analysis. However, only short-term and long-term neurodevelopmental delays were strongly associated with ASD in CDH by multivariate comparisons. There is a striking prevalence of ASD in CDH survivors and our findings suggest that all CDH children should be regularly screened for ASD.

Impairments in social interaction and communication are critical features of ASD but the underlying processes are poorly understood. An under-explored area is the social motor synchronization that happens when we coordinate our bodies with others. Here, we explored the relationships between dynamical measures of social motor synchronization and assessments of ASD traits. We found (a) spontaneous social motor synchronization was associated with responding to joint attention, cooperation, and theory of mind while intentional social motor synchronization was associated with initiating joint attention and theory of mind; and (b) social motor synchronization was associated with ASD severity but not fully explained by motor problems. Findings suggest that objective measures of social motor synchronization may provide insights into understanding ASD traits.

Having a consistent source of medical care may facilitate diagnosis of autism spectrum disorders (ASD). This study examined predictors of age of ASD diagnosis using data from the 2011-2012 National Survey of Children's Health. Using multiple linear regression analysis, age of diagnosis was predicted by race, ASD severity, having a consistent source of care (CSC), and the interaction between these variables after controlling for birth cohort, birth order, poverty level, parental education, and health insurance. While African American children were diagnosed earlier than Caucasians, this effect was moderated by ASD severity and CSC. Having a CSC predicted earlier diagnosis for Caucasian but not African American children. Both physician and parent behaviors may contribute to diagnostic delays in minority children.

Individuals with Asperger's Syndrome (AS) often have difficulties with social interactions and conversations. We investigated if these difficulties could be attributable to a deficit in the ability to linguistically converge with an interlocutor, which is posited to be important for successful communication. To that end, participants completed two cooperative tasks with a confederate, which allowed us to measure linguistic alignment with the confederate in terms of lexical choice, syntactic structure and spatial frame of reference. There was no difference in the performance of individuals with AS and matched controls and both groups showed significant alignment with the confederate at all three levels. We conclude that linguistic alignment is intact in adults with AS engaged in structured, goal-directed social interactions.

While it is well-known that individuals with autism spectrum disorder (ASD) have difficulties processing faces, very little is known about the origins of these deficits. The current study focused on 6- and 11-month-old infants who were at either high-risk (n = 43) or low-risk (n = 31) for developing ASD based on having a sibling already diagnosed with the disorder. Eye-tracking data were collected while the infants viewed color photographs of faces. Similar to previous studies with both typically developing adults and infants, low-risk infants demonstrated a preference for looking at the left side of the face (known as a left visual field bias) that emerged by 11 months of age. In contrast, high-risk infants did not demonstrate a left visual field bias at either age. Comparisons of the amount of attention given to the eye versus mouth regions indicated no differences between the two risk groups. (Contains 1 table and 6 figures.)

There is a growing amount of evidence suggesting that individuals with autism have difficulty with categorization. One basic cognitive ability that may underlie this difficulty is the ability to abstract a prototype. The current study examined prototype and category formation with dot patterns in high-functioning adults with autism and matched controls. Individuals with autism were found to have difficulty forming prototypes and categories of dot patterns. The eye-tracking data did not reveal any between group differences in attention to the dot patterns. However, relationships between performance and intelligence in the autism group suggest possible processing differences between the groups. Results are consistent with previous studies that have found deficits in prototype formation and extend these deficits to dot patterns.

Are there consistent markers of atypical prosody in speakers with high functioning autism (HFA) compared to typically-developing speakers? We examined: (1) acoustic measurements of pitch range, mean pitch and speech rate in conversation, (2) perceptual ratings of conversation for these features and overall prosody, and (3) acoustic measurements of speech from a structured task. Increased pitch range was found in speakers with HFA during both conversation and structured communication. In global ratings listeners rated speakers with HFA as having atypical prosody. Although the HFA group demonstrated increased acoustic pitch range, listeners did not rate speakers with HFA as having increased pitch variation. We suggest that the quality of pitch variation used by speakers with HFA was non-conventional and thus not registered as such by listeners.

There is a growing amount of evidence suggesting that individuals with autism have difficulty with face processing. One basic cognitive ability that may underlie face processing difficulties is the ability to abstract a prototype. The current study examined prototype formation with natural faces using eye-tracking in high-functioning adults with autism and matched controls. Individuals with autism were found to have significant difficulty forming prototypes of natural faces. The eye-tracking data did not reveal any between group differences in the general pattern of attention to the faces, indicating that these difficulties were not due to attentional factors. Results are consistent with previous studies that have found a deficit in prototype formation and extend these deficits to natural faces.

Three groups of 18 children were selected for this study, one group with autism spectrum disorders (ASD), one group with developmental delays in which ASD was ruled out (DD), and one group with typical development (TD), from a pool of 3026 children who were screened with the Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP, Wetherby & Prizant, 2002) Infant-Toddler Checklist under 24 months of age. The CSBS DP Behavior Sample was videotaped on selected children as a second-level evaluation during the second year of life. The Infant-Toddler Checklist had a sensitivity and specificity of 88.9% for this sample of children. Significant group differences were found on the Infant-Toddler Checklist and the Behavior Sample, however, these differences did not distinguish children with ASD and DD with high accuracy. The videotapes of the Behavior Sample were reanalyzed to identify red flags of ASD. Nine red flags differentiated children in the ASD group from both the DD and TD groups and four red flags differentiated children in the ASD Group from the TD group but not the DD group. These 13 red flags were found to discriminate the three groups with a correct classification rate of 94.4%.