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It has been reported that there is a rise in the number of individuals being diagnosed with autism spectrum disorder (ASD) in Singapore along with evolving changes in public awareness, attitudes, and levels of financial support occurring in the field in recent years. As such, this column presents the current status and issues related to the identification of individuals with ASD and the provision of early intervention services, education, and transition services for these people in Singapore. Additional needs and future recommendations are also included.

Research focusing on the intervention and support of children with autism spectrum disorders (ASD) has grown exponentially but this increase research has not been mirrored for adults with ASD. With the aims of informing intervention planning, improving quality of life, and areas for future research, 18 peer-reviewed research articles reporting the outcomes of adults with ASD were systematically reviewed. Despite methodological limitations, the literature review revealed a surprisingly high level of concordance in findings. Adults with ASD continue to experience significant degrees of impairment in the core deficits and correspondingly poor outcomes in social role attainment. Based on these findings, suggestions for the development of intervention and educational programs were proposed. Whilst no studies have targeted the quality of life of adults with ASD, the findings suggest a poor quality of life based on objective indicators. Directions for future research were also proposed. (Contains 3 tables.)

Aims: This study sought to investigate the predictors of spontaneous Picture Exchange Communication System (PECS) use in a naturalistic school setting. Method: The study recruited 44 students (36 boys and eight girls), aged between 6 to 18 years and their teachers (26 teachers and two teaching assistants). Teaching staff completed measures of student's communicative ability, autism symptomology and PECS abilities. Teachers also provided information of their PECS training history and PECS teaching experience. Findings: Stepwise Multiple Regression Analysis revealed that: (1) teacher's intentional pre-planning of PECS; (2) context in which PECS is used; (3) PECS phase level; and (4) the number of months of PECS teaching experience teachers had significantly predicted spontaneous PECS use. Child-dependent variables such as the severity of student's autism symptomology and level of student's mastery and age did not significantly predict spontaneous PECS use. Limitations: The limitations of this study are the small sample size, teachers' self-reported bias, and the lack of exploring other potential factors. Conclusions: The findings of the study highlight the importance for professionals, such as Educational Psychologists (EPs), to consider implementation factors that will impact the efficacy of intervention. In this study, it was the orchestration of how PECS is taught that had significantly predicted better PECS spontaneous use, rather than within-child factors. This suggests that PECS is suitable for a wide range of ASD learners. Additionally, it provides new insights for EPs to emphasise certain components over others during PECS teachers' trainings.

Anxiety-related problems are among the most frequently reported mental health difficulties in autism spectrum disorder. As most research has focused on clinical samples or high-functioning children with autism spectrum disorder, less is known about the factors associated with anxiety in community samples across the ability range. This cross-sectional study examined the association of gender, age, adaptive functioning and autism symptom severity with different caregiver-reported anxiety symptoms. Participants were caregivers of 241 children (6-18 years old) with autism spectrum disorder attending special schools in Singapore. Measures included the Spence Children's Anxiety Scale and assessments of overall emotional, behavioural and adaptive functioning. Caregivers reported more anxiety symptoms in total, but fewer social anxiety symptoms, than Spence Children's Anxiety Scale Australian/Dutch norms. There were no gender differences. Variance in total anxiety scores was best explained by severity of repetitive speech/stereotyped behaviour symptoms, followed by adaptive functioning. Severity of repetitive speech/behaviour symptoms was a significant predictor of separation anxiety, generalized anxiety, panic/agoraphobia and obsessive-compulsive subscale symptoms, but not of social phobia and physical injury fears. Adaptive functioning and chronological age predicted social phobia and generalized anxiety symptoms only. Severity of social/communication autism symptoms did not explain any anxiety symptoms, when the other variables were controlled for. Findings are discussed in relation to the existing literature. Limitations and possible implications for prevention, assessment and intervention are also discussed.

The student profile, model of service delivery, and support practices for young children with disabilities receiving early childhood intervention (ECI) in Singapore is reported and contrasted in this study. The supervisors/managers/principals of eight Early Intervention Programme for Infants and Children (EIPIC) centres, eight Integrated Child Care Programmes (ICCP), six privately run ECI centres, and 65 preschools participated in this study. Overall, autism spectrum disorder was the most commonly reported diagnosis in this study. EIPIC and privately run ECI centres supported mostly children with disabilities (frequently those with more severe disabilities) and provided more specialized education and therapy support, whereas ICCPs and preschools educated them alongside typically developing peers. EIPIC centres provided the most resource and teacher support for young children with disabilities. Issues pertaining to the reported rates of disabilities among the young children and support models/practices are discussed.

This study sought to understand the perspectives of four youth with high-functioning autism spectrum disorders (HFA) regarding their experiences in Singapore secondary schools. Qualitative analyses of in-depth interviews revealed that youth with HFA actively construct their experience of being a person with HFA. The extent to which the youth were engaged or disengaged in school appears to be related to the support provided by the environment. Implications of the findings for practice are discussed. The role of the phenomenological approach to providing insights into the lives of persons with HFA is also discussed.

This study sought to understand the parental expectations of social attainments in the postschool years. The parents of 20 adolescents with autism spectrum disorders (ASD) attending special schools were interviewed. Most expected their children would be working in sheltered workshops or unemployed. All parents indicated that their children would live with them until they were unable to provide appropriate care, and nearly half expressed wishes for relatives to care for them thereafter. None expected any independent access to the community. Analysis of the interviews suggested that the adolescents' learning and behavior, parental concerns, availability of formal resources, and societal factors influenced parents' expectations. Implications for working with Asian populations and for service delivery in Singapore are discussed.

Aims: This study examined parental perspectives on the importance and likelihood of future adult outcomes for children with Autism Spectrum Disorders (ASD), Intellectual Disabilities (ID), or Multiple Disabilities (MD) and some of the factors that may affect parental aspirations. Methods: Parents of 105 children with ASD, ID, or MD were presented with 21 possible future outcomes and were asked to indicate how important and how likely they considered these outcomes for their children with disabilities when they become adults. Results: Parents rated the overall likelihood of their child attaining various future outcomes significantly lower than the importance they placed on these same outcomes. They mostly valued future outcomes relating to their children's personal satisfaction, safety and security over and above those relating to social participation. Parental ratings of the importance or likelihood of outcomes did not differ across the diagnostic groups. Ratings of importance were independent of the child's age, gender, diagnosis, or severity of functioning, but likelihood ratings were significantly predicted by the children's symptom severity. Conclusions: The implications of this study's findings for service development, intervention and transitioning planning, and treatment outcome research are discussed in relation to existing literature and the study's strengths and limitations. (Contains 3 tables and 1 footnote.)

The extent to which early social communication behaviors predict later communication and intellectual outcomes was investigated via retrospective video analysis. Joint attention, imitation, and complex object play behaviors were coded from edited home videos featuring scenes of 29 children with ASD at 9-12 and/or 15-18 months. A quantitative interval recording of behavior and a qualitative rating of the developmental level were applied. Social communication behaviors increased between 9-12 and 15-18 months. Their mean level during infancy, but not the rate of change, predicted both Vineland Communication scores and intellectual functioning at 3-7 years. The two methods of measurement yielded similar results. Thus, early social communicative behaviors may play pivotal roles in the development of subsequent communication and intellectual functioning.

This study sought to understand the profile of and the factors which impact upon challenging behaviors among children with autism spectrum disorders (ASD) and multiple disabilities (MD). Teachers of 322 and 132 children with ASD and MD, respectively, attending special schools in Singapore, completed the Developmental Behavior Checklist, Teacher Version (DBC-T; Einfeld & Tonge, 1995). The findings suggest that children with ASD exhibit elevated levels of challenging behavior in all areas, relative to children with MD. Multiple regression analyses also indicate that diagnostic category was associated with all aspects of challenging behavior measured by the DBC-T. In addition, age was associated with only disruptive/antisocial behaviors in this study. Theoretical and practical implications were discussed. (Contains 2 tables.)

This study investigated how children with autism spectrum disorders (ASD) make social judgments of social situations and provide justifications for their responses. Fifteen children with ASD and 15 typically developing children (ages from 9 to 13 years old) were presented with eight vignettes, based on the Dewey Story Test (Dewey, 1991) and developed for the purposes of this study. The participants rated the appropriateness (on a 4-point Likert scale) of the socially inappropriate event (test item) and non-social appropriate event (control item) in each vignette. Justifications for each rating were also elicited at the end of each vignette. The children with ASD rated socially inappropriate behaviors in vignettes no differently from their typically developing peers but rated control items as stranger. They also had a higher tendency to provide inappropriate/bizarre and don't know/no response justifications instead of appropriate/social justifications (that reflect social awareness). The impact of the method of eliciting social judgments of social situations and its impact on findings are discussed. (Contains 4 tables and 2 figures.)

This study describes the profile of and relationships between adaptive skills and the maladaptive behaviors exhibited by adolescents with autism spectrum disorders (ASD) attending special schools in Singapore. Parents of 20 adolescents with ASD attending special schools completed the Development Behavior Checklist (DBC; Einfeld & Tonge, 1995; Einfeld & Tonge, 2002) and were interviewed on Vineland Adaptive Behavior Scales, second edition (VABS-II; Sparrow, Cicchetti, & Balla, 2005). Consistent with studies conducted in other contexts, this study reported low levels of adaptive skills and the presence of challenging behavior, albeit at levels reflecting lower levels of severity when compared with previous research. The only statistically significant relationship between the instruments was the correlation between the social and communication subscales of the VABS-II with the social relatedness subscale of the DBC. Implications for further research and for practice are discussed. (Contains 2 tables.)

Highlights: [•] Parent–child agreement in reporting anxiety in ASD was examined in a non-clinical sample. [•] Thirty-eight dyads completed the Spence Children's Anxiety Scale (SCAS). [•] Agreement was strongest in Physical Injury, Separation and GAD subscales. [•] 14/38 SCAS items largely describing overt anxiety symptoms showed moderate/strong agreement. [•] More autistic symptoms were associated with poorer agreement in GAD, Panic and OCD subscales. [Copyright &y& Elsevier]

The extent to which early social communication behaviors predict later communication and intellectual outcomes was investigated via retrospective video analysis. Joint attention, imitation, and complex object play behaviors were coded from edited home videos featuring scenes of 29 children with ASD at 9-12 and/or 15-18 months. A quantitative interval recording of behavior and a qualitative rating of the developmental level were applied. Social communication behaviors increased between 9-12 and 15-18 months. Their mean level during infancy, but not the rate of change, predicted both Vineland Communication scores and intellectual functioning at 3-7 years. The two methods of measurement yielded similar results. Thus, early social communicative behaviors may play pivotal roles in the development of subsequent communication and intellectual functioning. [ABSTRACT FROM AUTHOR]

This study investigated how children with autism spectrum disorders (ASD) make social judgments of social situations and provide justifications for their responses. Fifteen children with ASD and 15 typically developing children (ages from 9 to 13 years old) were presented with eight vignettes, based on the Dewey Story Test (Dewey, 1991) and developed for the purposes of this study. The participants rated the appropriateness (on a 4-point Likert scale) of the socially inappropriate event (test item) and non-social appropriate event (control item) in each vignette. Justifications for each rating were also elicited at the end of each vignette. The children with ASD rated socially inappropriate behaviors in vignettes no differently from their typically developing peers but rated control items as stranger. They also had a higher tendency to provide inappropriate/bizarre and don’t know/no response justifications instead of appropriate/social justifications (that reflect social awareness). The impact of the method of eliciting social judgments of social situations and its impact on findings are discussed. [ABSTRACT FROM AUTHOR]