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Engaging in meaningful activities (e.g., leisure, spiritual, fitness) significantly affects caregivers' quality of life (QoL), yet the determinants of participation in caregivers of Autistic children remain largely unknown. The current study examined child and caregiver correlates of primary caregiver participation in meaningful activities. One hundred and six primary caregivers of Autistic children (7–12 years) were recruited from three unique cohorts of Autistic children in this cross‐sectional study. Primary caregivers completed online questionnaires measuring occupational gaps (i.e., desired activities caregivers are not participating in), QoL, parenting stress, perceived family outcomes, and social support. In addition to undertaking direct assessments of children's cognition and language, primary caregivers also reported on their child's adaptive behavior, social–emotional skills, and participation. Caregivers reporting fewer occupational gaps (i.e., ≤2 desired activities) were more likely to have Autistic children with no co‐occurring conditions, who were older, and with better adaptive behaviors, social–emotional skills, and more frequent home and school participation, compared to caregivers reporting many gaps (i.e., ≥3 desired activities). Caregivers with fewer occupational gaps also reported improved QoL, parenting stress, social support, perceived community inclusiveness, and family outcomes. Logistic regression analysis identified child age, child adaptive behavior, social–emotional skills, home participation, and the caregivers' perceived family outcomes and QoL as important predictors of their occupational gaps. The findings demonstrate that caregiver participation in desired activities was associated with increased functional ability and independence of the child, as well as their perceived capacity to meet their child's needs. Supporting parents' sense of efficacy in meeting their children's needs and building their skills and knowledge will serve to improve both caregiver and child outcomes. Lay Summary: This research explored factors that might affect how much parents of Autistic children engage in activities they want to do. The results revealed that children's everyday life and social skills, as well as how often they participate in activities at home, were linked to their parents' involvement in meaningful activities. Additionally, parents' confidence in meeting their child's needs and their overall quality of life were found to be significant factors influencing their level of participation. [ABSTRACT FROM AUTHOR]

Researchers have begun to explore the characteristics and risk factors for autistic burnout, but assessment tools are lacking. Our study comprehensively examined and compared the psychometric properties of the unpublished 27‐item AASPIRE Autistic Burnout Measure (ABM), and personal and work scales of the Copenhagen Burnout Inventory (CBI) to evaluate their efficacy as screening measures for autistic burnout, with a group of 238 autistic adults. Exploratory factor analyses (EFA) revealed a 4‐factor structure for the ABM and a 2‐factor structure for the CBI personal scale (CBI‐P). Factorial validity and dimensionality were examined with four exploratory models which indicated a unidimensional structure for the ABM with an overarching 'Autistic Burnout' construct, and multidimensional CBI‐P structure comprising two subscales and overarching 'Personal Burnout' construct. Other reliability and validity indicators included Spearman correlations, analysis of variance, receiver operating characteristics, sensitivity, specificity, and intra‐class correlations (ICC). The ABM and CBI‐P were strongly correlated with depression, anxiety, stress, and fatigue. Unexpectedly, correlations between the burnout measures and camouflaging, and wellbeing measures were moderate. Potential overlap between burnout and depression and fatigue was examined through EFA, which supported convergent validity of the ABM and depression measure, while correlations and ICC analyses revealed mixed results. We concluded that the ABM and the CBI‐P Emotional Exhaustion subscale were valid preliminary screening tools for autistic burnout. Testing with larger and more diverse autistic samples is required to further examine the psychometric properties of the ABM, and to understand the relationships between autistic burnout and depression, and masking. Lay Summary: Early research shows that autistic burnout could be very harmful and can have negative consequences for the mental health and wellbeing of autistic people. Outside the autistic community, most people do not know about autistic burnout, so we need to find ways for healthcare providers and researchers to identify and measure the condition. This study tested two burnout questionnaires, the new AASPIRE Autistic Burnout Measure (ABM) and the Copenhagen Burnout Inventory (CBI) to compare how well they were able to detect and measure autistic burnout among a group of 238 autistic adults. We also examined whether the ABM was measuring a unique condition called 'Autistic Burnout' or if the symptoms were better described by measures of depression and fatigue. Our research found that both the ABM and 'Emotional Exhaustion' subscale of the CBI‐P accurately detected self‐reported autistic burnout among the study participants, but more testing is needed with more diverse groups of autistic people, and those with higher support needs. We also need to explore the relationship between autistic burnout and depression further. [ABSTRACT FROM AUTHOR]

Parents of Autistic children often modify their participation in leisure, social, and employment activities to meet the caregiving needs of their child. However, few studies have examined the impact this has on caregiver quality of life (QoL). The aim in the current study was to examine the role of participation in a range of activities on QoL amongst primary and secondary caregivers of school‐aged Autistic children. Eighty‐eight primary (93% mothers) and 63 secondary (91% fathers) caregivers of Autistic children (aged 7‐ to 12‐years) participated in this cross‐sectional study, with time pressure, participation, social support, parenting stress, and QoL measured via an online questionnaire. Compared to secondary caregivers, primary caregivers reported fewer employment hours, increased time pressure, less participation in desired activities, and higher perceived responsibility of domestic and child‐rearing tasks. Similar levels of leisure frequency, parenting stress, and QoL were identified by both caregivers. Hierarchical regression revealed caregiver participation as important for QoL in both primary and secondary caregivers. However, when measures of caregiver well‐being were added to the model, the unique contribution of participation to QoL was reduced, particularly for secondary caregivers. Overall, the findings demonstrate that despite differences in caregiver roles and responsibilities, participation in meaningful activities was important for QoL in all caregivers. Lay Summary: The present study examined participation and well‐being outcomes in primary and secondary caregivers, providing evidence for the different caregiver roles and responsibilities within families of Autistic children. While primary and secondary caregiver responsibilities were different, the findings showed that access to meaningful activities was important for quality of life amongst both primary and secondary caregivers. [ABSTRACT FROM AUTHOR]

Our previous cross‐sectional investigation (Chetcuti et al., 2020) showed that infants with autism traits could be divided into distinct subgroups based on temperament. This longitudinal study builds on this existing work by exploring the continuity of temperament subgroup classifications and their associations with behavioral/clinical phenotypic features from infancy to toddlerhood. 103 infants (68% male) showing early signs of autism were referred to the study by community healthcare professionals and seen for assessments when aged around 12‐months (Time 1), 18‐months (Time 2), and 24‐months (Time 3). Latent profile analysis revealed inhibited/low positive, active/negative reactive, and sociable/well‐regulated subgroups at each timepoint, and a unique reactive/regulated subgroup at Time 3. Cross‐tabulations indicated a significant likelihood of children having a recurrent subgroup classification from one timepoint to the next, and no apparent patterns to the movement of children who did change from one subgroup to another over time. Temperament subgroups were associated with concurrent child social–emotional functioning and autism traits, but unrelated to child age, sex, or developmental level. These findings suggest that temperament subgroup classifications might represent a reliable and very early indicator of autism characteristics and social–emotional functioning among infants/toddlers with autism traits. Lay Summary: Features of temperament make individuals on the autism spectrum different from one another and predict many important outcomes, but just how stable are these? To address this question, we (a) characterized the temperament features of children with autism traits at three timepoints across infancy and toddlerhood and (b) explored how temperament features were associated with social–emotional outcomes at each timepoint. We observed significant continuity in each respect, concluding that temperament may be a reliable early sign of social–emotional outcomes in children with autism traits. [ABSTRACT FROM AUTHOR]

This study examined the factors associated with social‐communicative outcomes for children on the autism spectrum receiving early intervention in inclusive versus specialised early childhood education programmes. Fifty‐eight preschool‐aged children randomly assigned to receive the Group‐Early Start Denver Model (G‐ESDM) in either inclusive or specialised (i.e., autism‐specific) classrooms across one calendar year showed similar outcomes at group mean‐level across measures of communication and social behaviour. We examined factors moderating outcomes across settings. Novel moderation analyses revealed that higher baseline social interest and nonverbal cognitive skills were associated with increased social communication gains for children in the inclusive classrooms, but not for those in specialised settings. Children who spend more time paying attention to people and have higher cognitive skills might benefit from receiving early intervention in inclusive settings, whilst these factors might be less relevant for children educated in specialised settings. Lay Summary: This study examined the characteristics of children on the autism spectrum who benefit the most from receiving intervention in inclusive versus specialised early childhood education settings. Fifty‐eight preschool‐aged children were randomly assigned to receive an evidence‐supported intervention called the G‐ESDM in either inclusive or autism‐specific classrooms across one calendar year. Children who spent more time paying attention to people and had higher cognitive skills prior to receiving the intervention experienced more gains in inclusive settings. Conversely, these factors were unrelated to gains for children educated in specialised settings. [ABSTRACT FROM AUTHOR]

Early qualitative research indicates that autistic burnout is commonly experienced by autistic people and is associated with significant, negative consequences for their mental health, wellbeing, and quality of life, including suicidality. Findings to date suggest that factors associated with being autistic and the widespread lack of autism awareness and acceptance within society contribute to the onset and recurrence of autistic burnout. Based on autistic adults' descriptions of their lived experiences, a Conceptual Model of Autistic Burnout (CMAB) is proposed, which describes a series of hypothesized relationships between identified risk and protective factors that may contribute to, or buffer against, autistic burnout. The theoretical framework for the CMAB is based on the Social‐Relational model of disability and neurodiversity paradigm, and the Job Demands‐Resources model of burnout, and Conservation of Resources theory. The CMAB offers a holistic perspective for understanding individual, social, and environmental factors that can influence autistic burnout via various direct and indirect pathways. Autistic burnout research is in its infancy and the CMAB provides a foundation for future investigations about this condition. Lay Summary: Although many autistic people describe experiencing autistic burnout, there has been little research on this topic. Based on descriptions of autistic peoples' lived experiences, we developed a conceptual model to explore how various risk and protective factors may interact to contribute to, or prevent, autistic burnout. [ABSTRACT FROM AUTHOR]

Background: There is growing understanding of the potential benefits of a multi‐method approach to accurately capture language skills of children on the autism spectrum. Tools such as Language ENvironment Analysis (LENA) provide an efficient means of capturing and analysing early child vocalizations (CVs) and the language learning environment. While developed to capture whole‐day recordings of child language in naturalistic settings, there is potential utility in capturing, but little knowledge about, primary LENA metrics—including CVs and conversational turns (CTs)—and novel metrics, such as vocalization ratios (VRs), sampled in clinical practice settings where children are often seen. Moreover, recent research indicates that the novel VR may offer a broad indicator of children's developmental level, beyond just their language abilities, a hypothesis yet to be investigated in a large sample of children for whom the LENA was designed (i.e., pre‐schoolers). Aims: To explore the extent to which primary and novel LENA metrics collected during brief one‐to‐one clinical interaction was a useful indicator of developmental outcomes for children on the autism spectrum. Methods & Procedures: Participants were recruited as part of an on‐going research programme evaluating early intervention outcomes (n = 99; age 14–47 months). Language samples were collected at intake (T1) using the wearable LENA Digital Language Processors during a one‐to‐one, play‐based assessment with a clinician. Direct (Mullen Scales of Early Learning—MSEL) and parent‐report (Vineland Adaptive Behavior Scales—VABS) measures of verbal and non‐verbal skills were also collected at intake (T1) and again at exit (T2), approximately 12 months later. Outcomes & Results: Few correlations were observed between child measures and CVs, a primary LENA metric. The novel VR metric was associated with concurrent direct assessment (MSEL) (and to a lesser extent parent report; VABS) measures of verbal and non‐verbal skills, with moderate positive correlations found between VRs and all directly assessed subscale scores. However, VRs did not uniquely contribute to the prediction of child outcomes when baseline skills were also considered. Conclusions & Implications: The novel VR may provide an insight into autistic children's overall development in addition to their language ability, suggesting that even when collected in a short recording format, LENA might be a useful component of a multi‐method assessment approach. What this paper adds: What is already known on the subject: To accurately capture language skills of children on the autism spectrum, multi‐method approaches, including natural language sampling, are recommended. Tools such as LENA provide an efficient means of capturing and analysing naturalistic child language and the language learning environment. What this paper adds to existing knowledge: This study demonstrates the potential benefits, and limitations, of using LENA to augment assessment of young children on the autism spectrum. Specifically, LENA provides a complementary, and low burden, method for capturing child language samples. What are the potential or actual clinical implications of this work?: Novel metrics, such as the VR, collected during brief clinical interactions might be a useful component of a multi‐method assessment approach for children on the autism spectrum. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has had a significant impact on the mental health and wellbeing of the world's population, with particularly negative effects on vulnerable populations, including autistic people. Although some consensus regarding specific impact on aspects of wellbeing and mental health in autism is starting to emerge, it is unclear whether the pandemic has increased suicide risk. The goals of this study were to examine (a) potential associations between COVID‐19 impact and depression, personal wellbeing, and suicide risk factors in Australian autistic adults and (b) age and gender effects. The COVID‐19 Impact Scale (CIS), Personal Wellbeing Index, Patient Health Questionnaire, and the Suicide Behavior Questionnaire, Revised (SBQ‐R), were administered to 111 autistic adults aged 20 to 71 years during the second wave of the COVID‐19 pandemic in Australia. COVID‐19 impact showed small associations with poorer personal wellbeing (r = −0.224, p = 0.023, [−0.409, −0.016]) and higher depressive symptoms (r = 0.268, p = 0.006, [0.056, 0.445]) and was not associated with the SBQ‐R suicide risk score (r = 0.081, p = 0.418, [−0.118, 0.264). No significant effects were identified for age. Although model results were similar for women and men, the strength of the associations between personal wellbeing and depression (z = −2.16, p = 0.015), and depression and SBQ‐R suicide risk (z = 1.961, p = 0.025), were stronger in women than in men. Qualitative analysis of an open response question from the CIS suggested that the pandemic had both positive and negative impacts on participants. The COVID‐19 pandemic has had a large impact on the mental health and wellbeing of the world's population, particularly vulnerable populations such as autistic people. It is not known if these impacts on mental health and wellbeing have increased suicide risk. Our findings suggest that the impact of the COVID‐19 pandemic may be associated with poorer wellbeing and higher depression, but is not associated with suicide risk. Overall, autistic people reported both positive and negative impacts of the pandemic on their lives. [ABSTRACT FROM AUTHOR]

Links between temperament and social–emotional difficulties are well‐established in normative child development but remain poorly characterized in autism. We sought to characterize distinct temperament subgroups and their associations with concurrent internalizing and externalizing symptoms in a sample of 103 infants (Mage = 12.39 months, SD = 1.97; 68% male) showing early signs of autism. Latent profile analysis was used to identify subgroups of infants with distinct temperament trait configurations on the Infant Behavior Questionnaire‐Revised. Derived subgroups were then compared in terms of internalizing and externalizing symptoms on the Infant–Toddler Social and Emotional Assessment. Three distinct temperament subgroups were identified: (a) inhibited/low positive (n = 22), characterized by low Smiling and Laughter, low High‐Intensity Pleasure, low Vocal Reactivity, and low Approach; (b) active/negative reactive (n = 23), characterized by high Activity Level, high Distress to Limitations, high Sadness, high Fear, and low Falling Reactivity; and (c) well‐regulated (n = 51), characterized by high Cuddliness, high Soothability, and high Low‐Intensity Pleasure. There were no differences in infant sex ratio, mean age or developmental/cognitive ability. Inhibited/low‐positive infants had significantly more behavioral autism signs than active/negative reactive and well‐regulated infants, who did not differ. Inhibited/low‐positive and active/negative reactive infants had higher internalizing symptoms, relative to well‐regulated infants, and active/negative reactive infants also had higher externalizing symptoms. These findings align closely with those garnered in the context of normative child development, and point to child temperament as a putative target for internalizing and externalizing interventions. Lay Summary This study explored whether infants with early signs of autism could be grouped according to temperament characteristics (i.e., emotional, behavioral, and attentional traits). Three subgroups were identified that differed with respect to emotional and behavioral difficulties. Specifically, "inhibited/low‐positive" infants had high emotional difficulties, "active/negative reactive" infants had high emotional and behavioral difficulties, while "well‐regulated" infants had the lowest difficulties. [ABSTRACT FROM AUTHOR]

Recent evidence suggests the link between caregiver psychological distress and offspring social‐emotional difficulties may be accounted for by offspring temperament characteristics. However, existing studies have only focused on neurotypical children; thus, the current study sought to provide an initial examination of this process among children with varying levels of early autism features. Participants included 103 infants aged 9–16 months (M = 12.39, SD = 1.97; 68% male) and their primary caregiver (96% mothers) referred to a larger study by community healthcare professionals. We utilized caregiver‐reported measures of psychological distress (Depression Anxiety Stress Scales), infant temperament (Infant Behavior Questionnaire‐Revised) and internalizing and externalizing symptoms (Infant‐Toddler Social and Emotional Assessment) and administered the Autism Observation Schedule for Infants (AOSI) at an assessment visit to quantify autism features. Infant negative affectivity was found to mediate positive concurrent relations between caregiver psychological distress and infant internalizing and externalizing symptoms, irrespective of the infants' AOSI score. While preliminary and cross‐sectional, these results replicate and extend previous findings suggesting that the pathway from caregiver psychological distress to negative affectivity to social‐emotional difficulties might also be apparent among infants with varying levels of autism features. More rigorous tests of causal effects await future longitudinal investigation. Lay Summary Offspring of caregivers experiencing psychological distress (i.e., symptoms of depression, anxiety, and/or stress) may themselves be at increased risk of poor mental health outcomes. Several previous studies conducted with neurotypical children suggest that this link from caregiver‐to‐child may be facilitated by children's temperament qualities. This study was a preliminary cross‐sectional exploration of these relationships in infants with features of autism. We found that infants' elevated negative emotions were involved in the relation between caregiver heightened psychological distress and children's mental health difficulties, consistent with neurotypical development. Autism Res 2020, 13: 1349–1357. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Prospective, longitudinal designs utilizing "high‐risk" infant siblings of children diagnosed with Autism Spectrum Disorder (ASD‐sibs) have provided unique and valuable insights regarding the early ASD phenotype. However, it remains unclear whether these cases are representative of all children with ASD. The objective in the present study was to investigate whether the early development of toddlers with ASD from multiplex (MPX) families, who have an affected older sibling, is similar or different to toddlers with ASD from simplex (SPX) families, where there is no affected sibling. A further aim was to examine patterns of association between autism symptom severity and cognitive functioning within each group to inform possible mechanisms for group similarities/differences. Behavioral and cognitive assessment data from a sample of toddlers with ASD was utilized, comprising 45 MPX, 127 first‐born SPX, and 72 later‐born SPX toddlers. Participants in the MPX group had significantly higher developmental quotients on the Mullen Scales of Early Learning compared to those in the SPX groups, who did not differ from each other. However, all three groups were similar on their autism severity scores (measured using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview), and the pattern of relationships between cognitive ability and autism symptom severity. The results suggest that caution be exercised in generalizing findings from ASD‐sib samples to other samples of children with ASD. The higher cognitive abilities in the MPX group, in addition to biological differences, may also be an outcome of family environmental factors, which deserves further investigation. Autism Research 2019, 12: 682–693. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: We sought to establish whether toddlers with autism from families where there is more than one affected child, called multiplex families, are different to children from simplex families, where there is only one affected child, and no other members within the immediate family with an autism diagnosis. We found that while toddlers from multiplex families were similar to those from simplex families in their autism symptoms, they were more developmentally advanced than children in the latter group. [ABSTRACT FROM AUTHOR]

People with Autism Spectrum Disorder (ASD) commonly experience poor outcomes in adulthood. Previous research on adult outcomes has focused on negative aspects of health and well‐being, while positive well‐being remains understudied. The current study charted 12‐month change in daily living skills, job satisfaction, depression, anxiety, and positive well‐being in 36 (32 male) newly employed adults with ASD aged 18 to 57 years who were participating in a supported employment program. There was a small increase in daily living skills, and a slight decrease in job satisfaction, with all other measures remaining stable over time. Regression analyses revealed that, controlling for baseline depression, positive well‐being negatively predicted depression at follow‐up. No significant predictors of anxiety were identified. Social support and depression at baseline were associated with positive well‐being at follow‐up; however, they were no longer significant predictors after the effects of baseline positive well‐being were taken into account. The findings provide evidence that positive well‐being may buffer against depression in people with ASD. Our finding of stability of mental health and well‐being measures over time indicates more research is required to uncover the mechanisms underpinning mental health and well‐being outcomes in employed adults with ASD. Autism Res 2019, 12: 482–494 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: People with autism commonly experience poor outcomes in adulthood. We studied mental health and well‐being in newly employed adults with autism who were participating in a supported employment program. Apart from a slight increase in daily living skills and a slight decrease in job satisfaction, other measures of mental health and well‐being remained stable over time. Our findings suggest that positive well‐being may protect against symptoms of depression in people with autism. [ABSTRACT FROM AUTHOR]

Emotion dysregulation is a common issue experienced by individuals with autism spectrum disorder (ASD) and has been associated with a wide range of negative mental and physical health outcomes. This commentary highlights the role emotion dysregulation plays in ASD by first considering the literature on emotion regulation (ER) in the general population and then summarizing the ER research in ASD. Based on the evaluation of previous research findings, we conclude that individuals with ASD have more ER difficulties and consistently self‐report or demonstrate a less adaptive pattern of ER strategy use. In addition, the higher prevalence of internalizing and externalizing issues seen in ASD are associated with the greater habitual use of some ER strategies and less habitual use of others. Conceptual and methodological limitations are discussed, including the use of coping measures and single‐method approaches, and ASD gender distribution. We propose a set of new directions for investigating ER in ASD, incorporating knowledge from other literatures on the role of flexibility in healthy adaptation, overlaps between flexibility and executive function deficits, the adaptive value of up‐regulation of positive emotions, and the importance of emotional self‐awareness. Increasing our capacity for identifying the mechanisms underlying co‐morbid affective disorders can ultimately inform the design of effective interventions to maximize the wellbeing of individuals with ASD. Autism Res 2018, 11: 962–978. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Research has shown that people diagnosed with autism tend to have difficulties with regulating their own emotions. This commentary article summarizes the main information from emotion regulation research conducted both in autism and in other populations. We make suggestions on how we can improve emotion regulation research in autism, with the ultimate goal being to use the learning gained from research to design effective interventions that can improve the wellbeing of people with autism. [ABSTRACT FROM AUTHOR]

Recent findings suggest that children with Autism Spectrum Disorder (ASD) are larger in size for head circumference (HC), height, and weight compared to typically developing (TD) children; however, little is known about their rate of growth, especially in height and weight. The current study aimed to: (a) confirm and extend upon previous findings of early generalized overgrowth in ASD; and (b) determine if there were any differences in the rate of growth between infants and toddlers with ASD compared to their TD peers. Measurements of HC, height, and weight were available for 135 boys with ASD and 74 TD boys, from birth through 3 years of age. Size and growth rate in HC, height, and weight were analyzed using a linear mixed‐effects model. Infants with ASD were significantly smaller in size at birth for HC, body length, and weight compared to TD infants (all P < 0.05); however, they grew at a significantly faster rate in HC and height in comparison to the TD children (P < 0.001); there was no significant difference between the groups in growth rate for weight (P > 0.05). The results confirmed that male infants and toddlers with ASD exhibit skeletal growth dysregulation early in life. Autism Res 2018, 11: 846–856. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Recent findings suggest that infants with Autism Spectrum Disorder (ASD) are smaller in size at birth compared to typically developing infants but grow larger than their peers during the first year. Little is known about their rate of growth, especially for height and weight. Our findings confirmed that infants with ASD are smaller in size at birth for head circumference (HC), height, and weight, but grow at a faster rate in HC and height than their peers from birth to 3 years. [ABSTRACT FROM AUTHOR]

Altered trajectories of brain growth are often reported in Autism Spectrum Disorder (ASD), particularly during the first year of life. However, less is known about prenatal head growth trajectories, and no study has examined the relation with postnatal autistic symptom severity. The current study prospectively examined the association between fetal head growth and the spectrum of autistic symptom severity in two large population‐based cohorts, including a sample of individuals with clinically diagnosed ASD. This study included 3,820 children from two longitudinal prenatal cohorts in The Netherlands and Australia, comprising 60 individuals with a confirmed diagnosis of ASD. Latent growth curve models were used to examine the relationship between fetal head circumference measured at three different time points and autistic traits measured in postnatal life using either the Social Responsiveness Scale or the Autism‐Spectrum Quotient. While lower initial prenatal HC was weakly associated with increasing autistic traits in the Dutch cohort, this relationship was not observed in the Australian cohort, nor when the two cohorts were analysed together. No differences in prenatal head growth were found between individuals with ASD and controls. This large population‐based study identified no consistent association across two cohorts between prenatal head growth and postnatal autistic traits. Our mixed findings suggest that further research in this area is needed. Autism Res2018, 11: 602–612. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary: It is not known whether different patterns of postnatal brain growth in Autism Spectrum Disorder (ASD) also occurs prenatally. We examined fetal head growth and autistic symptoms in two large groups from The Netherlands and Australia. Lower initial prenatal head circumference was associated with autistic traits in the Dutch, but not the Australian, group. No differences in head growth were found in individuals with ASD and controls when the data was combined. Our mixed findings suggest that more research in this area is needed. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) commonly present with difficulty regulating negative emotions, which has been found to impact their behavioral and mental health. Little research has documented the strategies that children with ASD use to regulate their emotion to understand whether they use qualitatively different strategies to children without ASD, whether these are developmentally delayed, or both. Forty-four children with ASD and 29 typically-developing children (2-4 years) were given tasks designed to mimic everyday life experiences requiring children to manage low-level stress (e.g., waiting for a snack) and children's emotion regulation strategies were coded. Parents reported on their child's mental health, wellbeing, and self-development. The results suggest differences in using emotion regulation strategies in children with ASD, reflecting a delay, rather than a deviance when compared to those used by children without ASD. Only children with ASD relied on their family members for physical and communicative soothing; the typically developing children relied on people outside of their family for help regulating their emotion. More frequent approach/less frequent avoidance was related to a higher self-evaluation in both groups, but was only additionally related to higher self-recognition and autonomy in the ASD group. These findings help to identify important emotion regulation intervention targets for this population, including supporting communication with people outside of the family and independence. Autism Res 2017, 10: 1808-1822. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Results suggest that children with autism had more difficulty using communication strategies to manage stress only with people outside the family; they used these strategies with family members as often as children without autism. For all children, more task approach/less avoidance was related to children's higher self-evaluation. These findings suggest targeting communication with people outside of the family and personality development as appropriate intervention goals. [ABSTRACT FROM AUTHOR]

Aim: To examine socio-demographic factors associated with maternal help-seeking for child developmental concerns in a longitudinal birth cohort study. An understanding of these factors is critical to improving uptake of services to maximise early identification and intervention for developmental concerns.Methods: A birth cohort was recruited from the post-natal wards of two teaching hospitals and through community nurses in South Western Sydney, Australia, between November 2011 and April 2013. Of the 4047 mothers approached, 2025 consented to participate (response rate = 50%). Socio-demographic and service use information was collected after the child's birth and when the child was 18 months of age. Sources of help were divided into three categories (formal health services, other formal services and informal supports) and compound variables were created by summing the number of different sources identified by mothers.Results: Significantly more sources of help were intended to be used and/or actually accessed by mothers born in Australia, whose primary language was English, with higher levels of education and annual household income, and among mothers of first-born children.Conclusions: Developmental concerns are known to increase with increased psychosocial adversity. Our findings of reduced intent to access and use of services by socio-economically disadvantaged families and those from culturally and linguistically diverse backgrounds suggests that an inverse care effect is in operation whereby those children with the greatest health needs may have the least access to services. Possible explanations for this, and recommendations for improving service accessibility for these populations through targeted and culturally appropriate services, are discussed. [ABSTRACT FROM AUTHOR]

Background: There is variability in the language of children with autism, even those who are high functioning. However, little is known about how they process language structures in real time, including how they handle potential ambiguity, and whether they follow referential constraints. Previous research with older autism spectrum disorder (ASD) participants has shown that these individuals can use context to access rapidly the meaning of ambiguous words. The severity of autism has also been shown to influence the speed in which children with ASD access lexical information. Aims: To understand more about how children with ASD process language in real time (i.e., as it unfolds). The focus was the integration of information and use of referential constraints to identify a referent named in a sentence. Methods & Procedures: We used an eye-tracking task to compare performance between young, high-functioning children with autism (HFA) and children with typical development (TD). A large sample of 5-9-year-old children (mean age = 6;8 years), 48 with HFA and 56 with TD participated; all were attending mainstream schools. For each item participants were shown a display of four images that differed in two dimensions. Each sentence contained an adjective and noun that restricted the choice from four to two (the target and competitor), followed by a prepositional phrase (e.g., the blue square with dots); this added modifying information to provide a unique description of the target. We calculated looking time at the target, the competitor and the two distractors for each 200 ms time interval as children processed the sentence and looked at the display. Generalized estimating equations were used to carry out repeated-measures analyses on the proportion of looking time to target and competitor and time to fixate to target. Outcomes & Results: Children in both groups (HFA and TD) looked at the target and competitor more than at the distractors following the adjective and noun and following the modifying information in the prepositional phrase more at the target. However, the HFA group was significantly slower in both phases and looked proportionally less at the target. Across the sample, IQ and language did not affect the results; however, age and attention had an impact. The older children showed an advantage in processing the information as did the children with higher attention scores. Conclusions & Implications: The HFA group took longer than the TD group to integrate the disambiguating information provided in the course of processing a sentence and integrate it with the visual information, indicating that for the ASD group incremental processing was not as advanced as for children with ASD, and they were less sensitive to referential conventions. Training for young children with ASD on the use of referential conventions and available contextual clues may be of benefit to them in understanding the language they hear. [ABSTRACT FROM AUTHOR]

Numerous studies have observed that a proportion of infants later diagnosed with autism spectrum disorder (ASD) experience accelerated head growth during the first years of life. An emerging methodology for examining the developmental trajectory prior to a diagnosis of ASD is to investigate siblings of affected individuals. The current study is the first prospective investigation of fetal growth in siblings of children with ASD. Two groups of pregnant women were recruited as part of the PRegnancy Investigation of Siblings and Mothers of children with autism cohort in Perth, Western Australia. The 'high risk' group ( n = 23) comprised pregnant women who have an existing child with a diagnosis of ASD and the 'low risk' group ( n = 36) comprised pregnant mothers who have an existing child who has developed typically. Prenatal ultrasounds were procured at multiple time-points throughout the second- and third-trimesters, enabling an examination of growth trajectories. Growth measurements were then compared for the high- and low-risk fetuses. Mixed linear regression models identified no significant differences between the high- and low-risk fetuses in the rate of prenatal head and body growth throughout the second- and third-trimester (all P-values >0.05). Similarly, there were no significant differences observed when comparing high and low risk groups on a ratio of head circumference relative to body size ( β = −0.019, P = 0.75). Future studies may consider looking beyond the macro architecture of the prenatal brain and examine the growth of brain subregions that have been implicated in the presentation of ASD symptoms. Autism Res 2016, 9: 210-216. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to investigate the frequency and age of children diagnosed with autism spectrum disorder (ASD) in Australia. Information regarding the age and diagnostic differences among ASD children registered in the Helping Children with Autism Package (HCWAP), a program that provides funding for early diagnosis and support services in Australia, are provided. It concludes that an accurate and reliable ASD diagnosis has a substantial gap on the age of children.

Individuals with Autism Spectrum Disorder ( ASD) show a diminished propensity to imitate others' actions, as well as a diminished sensitivity and responsivity to others' communicative cues, such as a direct gaze. However, it is not known whether failure to appreciate the communicative value of a direct gaze is associated with imitation abnormalities in this population. In this eye-tracking study, we investigated how 25 preschoolers with ASD, compared with 25 developmental and chronological age-matched children, imitate actions that are associated with a model's direct gaze versus averted gaze. We found that the model's direct gaze immediately prior to the demonstration increased the attention to the model and the propensity to imitate the demonstrated action in children without ASD. In contrast, preschoolers with ASD showed a similar propensity to look at the model's face and to imitate the demonstrated actions across the direct gaze and the averted gaze conditions. These data indicate that atypical imitation in ASD might be linked to abnormal processing of the model's communicative signals (such as a direct gaze) that modulate imitative behaviours in individuals without ASD. Autism Res 2014, 7: 392-399. © 2014 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The commentaries in this section refer to the review, Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009774. DOI: 10.1002/14651858.CD009774.pub2. Editor's note: Parents of children with autism often have a complicated life. In some cases, because of their child's behavior, they cannot take them to a restaurant or to a movie, let alone on a vacation. Finding child-care may be impossible. Some children with autism appear to be unhappy much of the time. Most parents would fly to the moon if that would make their child better, but it is our responsibility as clinicians to only assign parents tasks that are likely to benefit their child. In their commentaries, Professors Jacqueline Roberts and Cheryl Dissanayake provide their opinions on the fine art of balancing what we ask parents of autistic children to do. [ABSTRACT FROM AUTHOR]

Children with autism show clear deficits in copying others' bodily oriented actions whereas their capacity for replicating others' object-directed actions appears relatively spared. One explanation is that unlike bodily oriented actions, object-directed actions have tangible, functional outcomes and hence rely far less on social motivations for their production. To investigate this, we compared the performance of a group of children with high-functioning autism ( HFA) and a group of typically developing ( TD) children on two distinct object-directed tasks that are considered highly social: overimitation and synchronic imitation. Our findings were surprising. The HFA children copied all of a modeling adult's actions, including those that had no function or purpose (i.e. they overimitated), and they entered into extended bouts repeating an arbitrary action along with the adult who had a similar object to play with (i.e. they engaged in synchronic imitation). Moreover, they did so at rates indistinguishable from the TD children. This work demonstrates that the capacity and propensity for overimitation and synchronic imitation are intact in children with HFA, and questions whether socially based imitation should be considered an autism-specific deficit. Autism Res 2012, ●●:●●-●●. © 2012 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: In order to better understand the underlying biological mechanism/s involved in autism, it is important to investigate the cognitive and behavioural phenotypes associated with idiopathic autism (autism without a known cause) and comorbid autism (autism associated with known genetic/biological disorders such as fragile X syndrome). Parental effects associated with each type of autism also serve to cast light on the biological underpinnings of autism. Method: Forty-nine participants with idiopathic autism (AD; Mean age: 11.16; SD: 6.08) and their parents (45 mothers; 34 fathers), and 48 participants with fragile X syndrome and co-morbid autism (FXS/AD; Mean age: 17.30; SD: 10.22) and their parents (32 mothers; 30 fathers) were administered the ADOS-G and the age-appropriate Wechsler test to ascertain autism and cognitive profiles respectively. Results: The AD and FXS/AD groups showed a similar profile on the ADOS domains, with slightly higher scores on the Communication domain in the FXS/AD group, after adjusting for full-scale IQ. Marked differences between the groups in their cognitive abilities were apparent, with the FXS/AD group showing significantly lower scores on all subtests except Comprehension. While no parental effects were found for the FXS/AD group, a paternal effect was apparent on the combined ADOS score for the AD group. Moreover, midparental effects were found in this group for full-scale IQ (FSIQ) and verbal IQ (VIQ). Analyses also revealed parental effects for the subtests of Similarities, Vocabulary, and Information with predominantly maternal effect, and Digit Span with predominantly paternal effect. Both parents contributed to the midparental effect for Processing Speed. Conclusions: The results, together with our previous findings, suggest that the postulated combination of susceptibility genes for autism may primarily involve cognitive rather than behavioural processes. [ABSTRACT FROM AUTHOR]

The ongoing controversy over the distinction between autistic disorder and Asperger's disorder is important to resolve because of the implications regarding an understanding of the aetiology and prognosis, and the diagnostic and clinical practices relating to these conditions. This paper provides a critical evaluation of current published research evidence. Databases, such as PsychINFO and Medline, as well as book chapters, reference lists from relevant articles, and recent editions of key journals were searched for all relevant studies (until 2002) which incorporated participants diagnosed with high-functioning autism and Asperger's disorder using either cluster analysis or comparative approaches to examine similarities and differences between these groups. Keywords used in the searches included autistic disorder, Asperger's disorder, autism, high-functioning autism, and pervasive developmental disorder. On the basis of the available evidence, there seem to be few qualitative differences between autistic disorder and Asperger's disorder. There is currently insufficient evidence to establish the validity of Asperger's disorder as a syndrome distinct from high-functioning autism. The findings are consistent with the view that these disorders belong on an autism spectrum. [ABSTRACT FROM AUTHOR]

Presents information on a study which investigated the behavioral and cardiac responses of young children with autism to an adult showing either distress or a more neutral emotion. Methodology of the study; Behavioral measures of young children with autism; Cardiac measures; Data analysis; Results and discussion.

The results of two studies designed to investigate the short- and long-term stability of autistic children's responsiveness to displays of negative emotions in others are reported here. In the first study we measured the attention and behavioural responses of 22 autistic children to another's distress about a year and a half after initial assessments in a similar situation. In the second study, the children were re-assessed in two affective contexts over 5 years after initial testing. Individual differences in early responses to affect predicted affective responsiveness at each follow-up. Emotional responsiveness was positively associated with concurrent cognitive skills al each point of assessment. Furthermore, autistic children discriminated between affective and non-affective contexts when this discrimination was tested at the second follow-up. [ABSTRACT FROM AUTHOR]

Sixteen autistic, 16 normal and 16 Down syndrome children (aged 3-6 years) were observed with their mother and a female stranger in a laboratory playroom. Proximity and sociable behaviours were recorded continuously during three observation sessions. The autistic children showed behaviours indicating that they were clearly attached to their mothers: like the normal and Down syndrome children, they showed all behaviours preferentially to the mother and directed proximity behaviours almost exclusively to her. These attachments were functionally similar to those the comparison children. The deficits identified in the autistic group were restricted to a set of behaviours which have to do with social interaction such as Show, Give and Mutual Play. Descriptions of the aloof, unattached autistic child were not confirmed. [ABSTRACT FROM AUTHOR]