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Early elementary students on the autism spectrum are at risk for poor quality student-teacher relationships (STRs), a key contributor to student outcomes. However, these students' own appraisals of their STRs are nearly absent from the literature. This study examined children's perspectives of STRs and agreement with teacher-reported STRs for a sample of young autistic students (N = 136; 5-9 years). Although a majority of students responded affirmatively to items reflecting positive perceptions of STRs (e.g., 80.7% reported liking their teacher, 75.0% reported being liked by their teacher), results also revealed that some students perceived negative STR experiences (e.g., 14.7% reported that they get angry with their teacher, 17.6% reported that they get in trouble a lot). Student and teachers' scores were not significantly correlated, suggesting that students and teachers may have unique perspectives on specific aspects of their relationship.

To identify target areas for professional development, this mixed-methods study examined general education teachers' perceptions of autism and pedagogical practices in early elementary classrooms in the United States. In focus groups, teachers (N = 18) identified terms they associated with autism and strategies they used for inclusion and relationship building. Participants systematically free-listed and ranked their responses to three prompts. Using ranked responses, saliency scores were calculated to assess the perceived importance and frequency of responses. Teachers' most salient perceptions of autism (e.g., social difficulties, focused/fixed interests) revealed an awareness of core symptoms. Salient inclusion practices included assigning special classroom responsibilities and showcasing student talents; salient relationship-building strategies included embracing students' special interests and engaging in one-on-one time. Implications for teacher trainings are discussed. [This article was published in "Journal of Autism and Developmental Disorders" v52 p3977-3990 2022 (EJ1343886).]

To identify target areas for professional development, this mixed-methods study examined general education teachers' perceptions of autism and pedagogical practices in early elementary classrooms in the United States. In focus groups, teachers (N = 18) identified terms they associated with autism and strategies they used for inclusion and relationship building. Participants systematically free-listed and ranked their responses to three prompts. Using ranked responses, saliency scores were calculated to assess the perceived importance and frequency of responses. Teachers' most salient perceptions of autism (e.g., social difficulties, focused/fixed interests) revealed an awareness of core symptoms. Salient inclusion practices included assigning special classroom responsibilities and showcasing student talents; salient relationship-building strategies included embracing students' special interests and engaging in one-on-one time. Implications for teacher trainings are discussed.

Due to the coronavirus disease 2019 (COVID-19) pandemic, the importance of telehealth has rapidly increased, in particular as many in-person clinics have closed. Early intervention is crucial for improving outcomes in children with autism spectrum disorder (ASD). As such, the need for timely assessments and diagnoses remains despite COVID-19-related closures. This study offers preliminary data collected from 23 children assessed through a no-cost autism clinic in Southern California using a novel telehealth model. This includes an overview of an adapted, telehealth version of in-person observational assessment techniques for diagnosing autism. In addition, preliminary data on social validity assessed at two points are presented. Findings suggest that caregivers found the telehealth assessment procedures acceptable and convenient, and overall were satisfied with both the assessment and the written report/verbal feedback. Implications for future uses of telehealth are discussed, including how telehealth can assist with decision-making around school-based services and/or placement.

Objective: Transition from school to early adulthood incurs many changes and may be associated with deterioration in general health in youth with autism. We aimed to investigate this. Method: The National Longitudinal Transitions Study-2 is a USA nationally representative sample of youth receiving special education services, aged 13–17 at wave 1, followed-up over 10 years in five data collection waves. We conducted random-effects ordered logistic regressions to determine the odds ratios (OR) with 95% confidence intervals of wave, age, sex, ethnicity/race, additional intellectual disabilities, parental/guardian relationship status, and household income being associated with general health status in youth with autism. Results: Across waves, only between 74.3%–69.6% had excellent/very good health (71.7%–58.8% in those with co-occurring intellectual disabilities), but wave was not associated with health status. Associations were with age OR = 1.18 (1.04, 1.33), co-occurring intellectual disabilities OR = 1.56 (1.00, 2.44), and household income OR = 0.61 (0.40, 0.94) at $30,001–$50,000, OR = 0.44 (0.27, 0.72) at $50,001–$70,000, and OR = 0.34 (0.20, 0.56) at $70,001+. Sex, ethnicity/race, and parental/guardian relationship status were not associated with health status. Conclusion: There was little change in general health status longitudinally across the transitional period, but the proportion with excellent/very good health was low at each wave. Transitional planning should consider co-occurring intellectual disabilities, and the wider socioeconomic context in which children/youth with autism are raised. Lack of other longitudinal studies indicates a need for replication. [ABSTRACT FROM AUTHOR]

Autistic students often experience peer relationship difficulties. As peer acceptance and rejection may be malleable over time, we examined predictors of change in peer acceptance and peer rejection among early elementary‐age autistic students. We followed 166 autistic children (mean age: 6.1 years [range: 4–8], 82.5% boys, grades preK‐2nd) longitudinally across 2 school years. Social skills, internalizing problems, and externalizing behaviors were considered as predictors of change in teacher‐rated peer acceptance and rejection, covarying IQ and autism characteristics. Autistic children experienced high rejection and low acceptance; 51.9% of children were rejected by peers in one or both school years. Results revealed distinct predictors for peer acceptance versus rejection: social skills predicted change in peer acceptance across school years, whereas externalizing problems predicted change in peer rejection. Internalizing problems did not predict change in either construct. Findings can assist school professionals in supporting social acceptance and acceptance for young autistic students. Practitioner points: The quality of autistic student's relationships with their peers fluctuates across time. With an understanding of the factors that uniquely influence peer acceptance and peer rejection, practitioners can identify targets for intervention to support autistic students development of positive peer relationships.An autistic student's externalizing problems play an important role in the rejection they experience from peers over time, such that autistic students with increasing externalizing behaviors are more likely to experience teasing and difficulty getting along with their peers.On the other hand, autistic students' social skills were the primary factor related to peer acceptance, suggesting that autistic students with improved social skills are better positioned to engage as an integrated, included member of the peer group. [ABSTRACT FROM AUTHOR]

Emotional and behavioral problems (EBPs), such as anxiety, overactivity, and aggression, can influence the diagnosis of autism spectrum disorder (ASD). The gold standard diagnostic tool for ASD, the Autism Diagnostic Observation Schedule—Second Edition, includes three items ("E-codes") for EBPs that are frequently associated with ASD. Few empirical investigations have explored the use of E-codes. This study examined the relationship between E-codes and child characteristics (e.g., cognitive abilities, ASD symptom severity) in a sample of young children with ASD (N = 233). Findings indicated that E-codes positively correlated with ASD symptom severity and negatively associated with IQ. Symptom severity also significantly accounted for the variance in EBPs. Implications for ASD assessment as well as future research are discussed. [ABSTRACT FROM AUTHOR]

To identify target areas for professional development, this mixed-methods study examined general education teachers' perceptions of autism and pedagogical practices in early elementary classrooms in the United States. In focus groups, teachers (N = 18) identified terms they associated with autism and strategies they used for inclusion and relationship building. Participants systematically free-listed and ranked their responses to three prompts. Using ranked responses, saliency scores were calculated to assess the perceived importance and frequency of responses. Teachers' most salient perceptions of autism (e.g., social difficulties, focused/fixed interests) revealed an awareness of core symptoms. Salient inclusion practices included assigning special classroom responsibilities and showcasing student talents; salient relationship-building strategies included embracing students' special interests and engaging in one-on-one time. Implications for teacher trainings are discussed. [ABSTRACT FROM AUTHOR]

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Due to the coronavirus disease 2019 (COVID‐19) pandemic, the importance of telehealth has rapidly increased, in particular as many in‐person clinics have closed. Early intervention is crucial for improving outcomes in children with autism spectrum disorder (ASD). As such, the need for timely assessments and diagnoses remains despite COVID‐19‐related closures. This study offers preliminary data collected from 23 children assessed through a no‐cost autism clinic in Southern California using a novel telehealth model. This includes an overview of an adapted, telehealth version of in‐person observational assessment techniques for diagnosing autism. In addition, preliminary data on social validity assessed at two points are presented. Findings suggest that caregivers found the telehealth assessment procedures acceptable and convenient, and overall were satisfied with both the assessment and the written report/verbal feedback. Implications for future uses of telehealth are discussed, including how telehealth can assist with decision‐making around school‐based services and/or placement. KEY POINTS: Validation of telehealth assessments for autism spectrum disorders (ASD) is important to increase accessibility and timely diagnosis for families.Preliminary data on social validity suggests that caregivers found telehealth procedures to be helpful, convenient, and useful.A majority of caregivers planned to share the clinical report with their teacher or school. [ABSTRACT FROM AUTHOR]

Autistic children experience more externalizing and internalizing symptoms relative to non-autistic peers. Higher quality parent-teacher relationships (PTR) may support children's adjustment. At the same time, higher levels of these mental health difficulties may create a strained relationship between parents and teachers. Therefore, the relation between PTR quality and externalizing or internalizing symptoms may be bidirectional. This study examined the longitudinal associations between PTR quality and externalizing or internalizing symptoms among 192 autistic children (91% boys, ages 4–8 years) across three assessments spanning two academic years. Eight cross-lagged panel analyses were conducted to examine how parent-rated PTR quality and teacher-rated PTR quality relate to parent-rated or teacher-rated externalizing and internalizing symptoms. Results showed that (1) parent-rated symptoms appeared to drive changes in PTR quality; this pattern was more consistently shown with parent-rated externalizing symptoms than with internalizing symptoms. (2) Teacher-rated symptoms did not drive changes in PTR quality. Finally, (3) there was no support for a relationship-driven or a reciprocal model; in other words, PTR quality did not contribute to changes in children's externalizing or internalizing symptoms over time. Higher parent-reported child symptoms appeared to predict reduced PTR quality across multiple teachers, school years, and classroom contexts. Addressing children's elevated mental health problems may take a toll on parents' and teacher's ability to collaborate effectively over time. The results demonstrate the importance of interventions targeting child internalizing and externalizing symptoms at home, which may indirectly improve PTR quality. • First study to examine the transactional effects of parent teacher relationships and mental health symptoms in autistic children. • Parent perceptions of elevated internalizing and externalizing symptoms impacted relationships between parents and teachers. • Children's elevated mental health symptoms may take a toll on parents' and teacher's ability to collaborate effectively. • Parent-teacher relationship quality did not impact changes in children's externalizing or internalizing symptoms over time. [ABSTRACT FROM AUTHOR]

Background: The Social Motivation Hypothesis proposes that individuals with autism spectrum disorder (ASD) experience social interactions as less rewarding than their neurotypical (TD) peers, which may lead to reduced social initiation. Existing studies of the brain's reward system in individuals with ASD report varied findings for anticipation of and response to social rewards. Given discrepant findings, the anticipation of and response to social rewards should be further evaluated, particularly in the context of intervention outcome. We hypothesized that individual characteristics may help predict neural changes from pre- to post-intervention. Methods: Thirteen adolescents with ASD received the Program for the Education and Enrichment of Relational Skills (PEERS) intervention for 16 weeks; reward-related EEG was collected before and after intervention. Fourteen TD adolescents were tested at two timepoints but did not receive intervention. Event-related potentials were calculated to measure anticipation of (stimulus-preceding negativity; SPN) and response to (reward-related positivity; RewP) social and non-social rewards. Additionally, measures of social responsiveness, social skills, and intervention-engagement were collected. Group differences were analyzed as well as individual differences using prediction models. Result: Parent-reported social responsiveness and social skills improved in adolescents with ASD after participation in PEERS. ASD adolescents displayed marginally decreased anticipation of social rewards at post-intervention compared to pre-intervention. Regression models demonstrated that older adolescents and those with lower parent-reported social motivation prior to participation in PEERS displayed marginally increased social reward anticipation (more robust SPN) from pre- to post-intervention. Participants who displayed more parent-reported social motivation before intervention and were more actively engaged in the PEERS intervention evidenced increased social reward processing (more robust RewP) from pre- to post-intervention. Conclusion: Findings suggest that there may be differences in saliency between wanting/anticipating social rewards vs. liking/responding to social rewards in individuals with ASD. Our findings support the hypothesis that identification of individual differences may predict which adolescents are poised to benefit the most from particular interventions. As such, reported findings set the stage for the advancement of "precision medicine." This investigation is a critical step forward in our ability to understand and predict individual response to interventions in individuals with ASD. [ABSTRACT FROM AUTHOR]

Classrooms can create barriers to young autistic students' social and behavioral success at school. Better quality student-teacher relationships (STRs) have been associated with improved student social and behavioral outcomes. When teachers use more positive response strategies (e.g., praise), they create more opportunities for positive interactions with students, likely developing closer STRs. The present study uses SEM to investigate a path by which teachers' use of positive response strategies is associated with closer STRs, which lead to improved social functioning and classroom engagement for N = 145 young autistic students (age 4–7 years). Factors contributing to teachers' reported frequency of using positive response strategies were also explored using multiple linear regression. The model was a close fit to the data (χ2 (18, N = 145) = 18.4, p =.43, TLI = 1.0, CFI = 1.0, RMSEA =.01). Teachers who reported using positive response strategies more frequently had significantly closer STRs, which were associated with lasting improvements in students' social functioning and engagement in the classroom. Positive response strategies that teachers reported using most frequently were praise, positive comments, and incentives. Teachers' perceived usefulness of positive response strategies and regular trainings in autism were significantly associated with frequency of positive response strategy use. Positive, supportive classrooms in which teachers utilized more positive response strategies and developed closer STRs were associated with young autistic students' academic engagement and social functioning. Regular autism trainings and perceived usefulness of positive response strategies emerged as significant factors for teachers' use of strategies. • Teachers' use of positive response strategies was associated with closer STRs. • Closer STRs promoted better academic engagement and social functioning. • Perceived usefulness and autism training were associated with positive support use. • Positive classroom supports and STRs help autistic students engage and integrate. [ABSTRACT FROM AUTHOR]

Student academic behavioral engagement (BE) contributes to learning and school success. Student-teacher relationships (STRs) may promote BE, although previous findings regarding how these constructs are associated over time are mixed. For young autistic students who face barriers to early school success, a high-quality STR may serve as a key protective factor to promote classroom engagement. The present study investigated connections between teacher-rated STR quality and student BE over two school years for 146 young autistic children (grade PK-2) using cross-lagged structural equation modeling. A full model with cross-lagged paths from BE to STR quality and from STR quality to BE was first examined. Potential confounding variables (i.e., externalizing behaviors, cognitive skills, and language skills) were included. The model was then trimmed by removing all non-significant paths. It was hypothesized that the final model would highlight the unidirectional influence of STR quality on BE. Results supported the unidirectional influence of STR quality on BE across one school year. STR quality at the beginning of the first school year predicted behavioral engagement at the end of the year (β =.26, p <.01) BE outcomes persisted into the following school year (β =.45, p <.001). Findings suggest that STR quality significantly contributes to engagement for young autistic students, potentially serving as a critical protective factor for classroom success. This highlights the importance of developing quality STRs with high levels of closeness and low levels of conflict for students on the spectrum in early schooling. • Student-teacher relationships (STRs) drive engagement for young autistic students. • Better STRs led to greater levels of behavioral engagement across one school year. • High-quality STRs may buffer autistic students' risk for lower levels of engagement. • Teachers should prioritize developing quality STRs with young autistic students. [ABSTRACT FROM AUTHOR]

Emotion Regulation is a key factor in the psychological well‐being of children on the autism spectrum. Therapeutic co‐regulation is posited here as fundamental to addressing Emotion Regulation needs. A therapeutic combination of Child‐Centred Play Therapy and Rhythmic Relating is assessed in its potential to improve Emotion Regulation outcomes (over 10 months; 25 weekly sessions), via co‐regulatory experience, in a case study of a 5‐year‐old autistic boy. The parent‐rated Emotion Regulation Checklist (Shields & Cicchetti, Developmental Psychology, 33, 1997, 906) was completed every week. Mean Start and Finish scores were taken for checklist total and all subscales. Emotion Regulation percentage‐change‐over‐time values are calculated for the participant and, using percentiles, are compared and statistically ranked in relation to our comparison group: Autistic boys without concurrent cognitive impairment, not receiving psychological or behavioural therapies (over 10 months; N = 66). A graphical representation of Emotion Regulation demonstrates weekly change. As compared to our comparison group, our participant's overall Emotion Regulation improvements (over 10 months) are statistically likely to be due to his participation in therapy (p < 0.04). Graphical representation of Emotion Regulation over time demonstrates a compelling blind correlation between the period of significant positive change in our participant's Emotion Regulation and the therapist's clinical notes on positive change observed in the clinic. [ABSTRACT FROM AUTHOR]

Early elementary students on the autism spectrum are at risk for poor quality student-teacher relationships (STRs), a key contributor to student outcomes. However, these students' own appraisals of their STRs are nearly absent from the literature. This study examined children's perspectives of STRs and agreement with teacher-reported STRs for a sample of young autistic students (N = 136; 5–9 years). Although a majority of students responded affirmatively to items reflecting positive perceptions of STRs (e.g., 80.7% reported liking their teacher, 75.0% reported being liked by their teacher), results also revealed that some students perceived negative STR experiences (e.g., 14.7% reported that they get angry with their teacher, 17.6% reported that they get in trouble a lot). Student and teachers' scores were not significantly correlated, suggesting that students and teachers may have unique perspectives on specific aspects of their relationship. [ABSTRACT FROM AUTHOR]