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This study provided preliminary validation of the Autism Detection in Early Childhood-Virtual (ADEC-V) for telehealth assessment of possible autism. Participants were 121 children (24.79% female) aged 18-47 months who completed telehealth evaluations at a large pediatric hospital in the Midwestern United States between October 2020 and February 2021. The ADEC-V showed good sensitivity (0.82) and specificity (0.78) and was significantly correlated with other ASD symptom measures (i.e., CARS-2, ADI-R). Internal consistency was acceptable ([alpha] = 0.77). These results need replication in a larger and broader sample including more children without ASD. This preliminary validation study identifies the ADEC-V as a promising measure for telehealth ASD assessments in young children.

This study investigated language profiles in a community-based sample of 104 children aged 1-3 years who had been diagnosed with autism spectrum disorder using "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.) diagnostic criteria. Language was assessed with the Mullen scales, Preschool Language Scale, fifth edition, and Vineland-II parent-report. The study aimed to determine whether the receptive-to-expressive language profile is independent from the assessment instrument used, and whether nonverbal cognition, early communicative behaviors, and autism spectrum disorder symptoms predict language scores. Receptive-to-expressive language profiles differed between assessment instruments and reporters, and Preschool Language Scale, fifth edition profiles were also dependent on developmental level. Nonverbal cognition and joint attention significantly predicted receptive language scores, and nonverbal cognition and frequency of vocalizations predicted expressive language scores. These findings support the administration of multiple direct assessment and parent-report instruments when evaluating language in young children with autism spectrum disorder, for both research and in clinical settings. Results also support that joint attention is a useful intervention target for improving receptive language skills in young children with autism spectrum disorder. Future research comparing language profiles of young children with autism spectrum disorder to children with non-autism spectrum disorder developmental delays and typical development will add to our knowledge of early language development in children with autism spectrum disorder.

A review of hospital records was conducted for children evaluated for autism spectrum disorders who completed both the Leiter International Performance Scale-Revised (Leiter-R) and Stanford-Binet Intelligence Scales, 5th Edition (SB5). Participants were between 3 and 12 years of age. Diagnoses were autistic disorder (n = 26, 55%) and pervasive developmental disorder--not otherwise specified (n = 21, 45%). Analysis showed that the full sample received significantly higher scores on the Leiter-R than SB5 (mean discrepancy of 20.91 points), specific diagnosis was not a significant factor, and younger children had a larger discrepancy between tests. These analyses strongly suggest that the Leiter-R and the SB5 may not be equivalent measures of intellectual functioning in children with autism spectrum disorders, and that use of one or the other exclusively could lead to misclassification of intellectual capacity.

Objective: Children with Pervasive Developmental Disorders (PDDs) have social interaction deficits, delayed communication, and repetitive behaviors as well as impairments in adaptive functioning. Many children actually show a decline in adaptive skills compared with age mates over time. Method: This 24-week, three-site, controlled clinical trial randomized 124 children (4 through 13 years of age) with PDDs and serious behavioral problems to medication alone (MED; n = 49; risperidone 0.5 to 3.5 mg/day; if ineffective, switch to aripiprazole was permitted) or a combination of medication plus parent training (PT) (COMB; n = 75). Parents of children in COMB received an average of 11.4 PT sessions. Standard scores and Age-Equivalent scores on Vineland Adaptive Behavior Scales were the outcome measures of primary interest. Results: Seventeen subjects did not have a post-randomization Vineland assessment. Thus, we used a mixed model with outcome conditioned on the baseline Vineland scores. Both groups showed improvement over the 24-week trial on all Vineland domains. Compared with MED, Vineland Socialization and Adaptive Composite Standard scores showed greater improvement in the COMB group (p = 0.01 and 0.05, and effect sizes = 0.35 and 0.22, respectively). On Age Equivalent scores, Socialization and Communication domains showed greater improvement in COMB versus MED (p = 0.03 and 0.05, and effect sizes = 0.33 and 0.14, respectively). Using logistic regression, children in the COMB group were twice as likely to make at least 6 months' gain (equal to the passage of time) in the Vineland Communication Age Equivalent score compared with MED (p = 0.02). After controlling for IQ, this difference was no longer significant. Conclusion: Reduction of serious maladaptive behavior promotes improvement in adaptive behavior. Medication plus PT shows modest additional benefit over medication alone. Clinical trial registration information--RUPP PI PDD: Drug and Behavioral Therapy for Children With Pervasive Developmental Disorders; http://www.clinicaltrials.gov; NCT00080145. (Contains 4 tables.)

Sleep problems associated with autism spectrum disorders (ASD) have been well documented, but less is known about the effects of sleep problems on day-time cognitive and adaptive performance in this population. Children diagnosed with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 335) from 1 to 10 years of age (M = 5.5 years) were evaluated for the relationships of Behavioral Evaluation of Disorders of Sleep (BEDS; Schreck, 1998) scores to measures of intelligence and adaptive behavior. Results suggested that children who slept fewer hours per night had "lower" overall intelligence, verbal skills, overall adaptive functioning, daily living skills, socialization skills, and motor development. Children who slept fewer hours at night with waking during the night had more communication problems. Breathing related sleep problems and fewer hours of sleep related most often to problems with perceptual tasks. The results indicate that quality of sleep--especially sleep duration--may be related to problems with day-time cognitive and adaptive functioning in children with autism and PDD-NOS. However, future research must be conducted to further understand these relationships. (Contains 5 tables.)

The history of autism treatment has been plagued with fad therapies which waste parents' and children's time, energy, and money. To determine if referral sources, such as professionals' recommendations, media, or scholarly sources, have influenced parents' treatment decisions, parents of at least one child with an autism spectrum disorder (N = 400) were surveyed to determine the sources they used to obtain treatment. Recommendations from professionals in non-medical fields and autism books were the most popular sources of information. Due to the diverse range of influences on parents' treatment decisions, a multifaceted dissemination strategy for the most effective therapies is warranted. (Contains 4 tables.)

Background: Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent-child behaviour before and after a structured parent training program for children with pervasive developmental disorders (PDD). We report on the use of this procedure in a pilot study of 12 participants with PDD. Results: Inter-rater reliability across behaviours coded ranged from 75-100% agreement. Blindly scored observations of behaviour showed medium effect sizes for changes in inappropriate child behaviour. Analyses of baseline scores revealed a moderate positive correlation between inappropriate child behaviours as measured in all four SOAP conditions and parent ratings of child noncompliance (r[subscript s] = 0.66, p less than 0.05). By contrast, the correlations of SOAP scores with parent ratings of irritability was lower (r[subscript s] = 0.40, p greater than 0.05). Conclusions: As our treatment targeted compliance, these preliminary results suggest that the SOAP provides a valid measure of noncompliant behaviour in children with PDD and is sensitive to treatment effects on inappropriate child behaviours. (Contains 3 tables.)

Peer-mediated approaches represent the largest and most empirically supported type of social intervention for children with autism. In this article, we discuss peer-initiation strategies, the peer-mediated intervention that has been most used to teach typically developing peers or siblings to improve the social play skills of children with autism. Also discussed are additional intervention strategies that have preliminary research support including: integrated play groups, peer buddy systems, and group oriented contingencies. Practical information regarding how to apply peer-initiation strategies and peer buddy systems in the school setting is also provided. (Contains 3 tables and 6 resources.)

The Autism Detection in Early Childhood (ADEC) is a brief, play-based screening tool for the assessment of autism spectrum disorder (ASD) in children aged 12-36 months. We examined the psychometric properties of the ADEC in a clinical sample of toddlers (n = 114) referred to a US pediatric hospital for assessment due to concerns of developmental delay or ASD. The ADEC (cutoff = 11) returned good sensitivity (.93-.94) but poorer specificity (.62-.64) for best estimate clinical diagnosis of ASD, and compared favorably with the ADOS-2. Internal consistency was acceptable, [alpha] = .80, and inter-rater reliability was high, ICC = .95. Results support the use of the ADEC as a clinical screen for ASD., Author(s): Darren Hedley [sup.1] [sup.2] [sup.3] , Rose E. Nevill [sup.3] , Yessica Monroy-Moreno [sup.2] [sup.4] , Natalie Fields [sup.3] , Jonathan Wilkins [sup.2] [sup.3] , Eric Butter [sup.2] [sup.3] [...]

Researchers have been placing an increased importance on discovering what variables contribute to better prognosis during behavioral interventions for children with autism. This article preliminarily identifies sleep problems that may exacerbate symptoms of autism; thus, possibly influencing effectiveness of daytime interventions. A data-base of parent report of sleep problems of children with autism (N=55), ranging from 5 to 12 years of age (M=8.2 years) was evaluated. Results suggested that fewer hours of sleep per night predicted overall autism scores and social skills deficits. Similarly, stereotypic behavior was predicted by fewer hours of sleep per night and screaming during the night. Increased sensitivity to environmental stimuli in the bedroom and screaming at night predicted communication problems. Finally, sensitivity to environmental stimuli in the bedroom also predicted fewer developmental sequence disturbances. The results indicate that sleep problems and the diagnostic characteristics of autism may be related. However, future research must be completed to determine the specific relationship.

We describe the development, preliminary psychometric properties, and cross-validation of the Behavioral Evaluation of Disorders of Sleep (BEDS: Schreck 1997/1998). Parental reports of problem sleep behavior in elementary school aged children 5 years to 12 years were collected for two samples. With the first sample, an exploratory factor analysis of parental responses (N = 307) resulted in reports of five distinct types of sleep problems: Expressive Sleep Disturbances; Sensitivity to the Environment; Disoriented Awakening; Sleep Facilitators; and Apnea/Bruxism. Four of these factors (Expressive Sleep Disturbances; Sensitivity to the Environment; Disoriented Awakening; and Apnea) were confirmed with the new participant sample (N = 1054). These factors of problem sleep behavior were similar to findings in other studies, with the exception of the exclusion of bedtime behavior problems.

This article reviews key applied research issues relevant to people with autism, including: systems delivery models and issues, how best to integrate treatments, providing treatments to those with limited monetary resources, cost and cost/benefit analyses, how to educate adult psychiatrists regarding autism, and gaps between research and practice. (Contains references.) (Author/CR)

This study compared parent reports of sleep behaviors of 38 children with autism or pervasive developmental disabilities with those of children with mental retardation alone, in special education but not retarded, or typically developing children. Findings indicated that parent perception of children's sleep difficulties and sleep quality was different for the autistic group. (Contains references.) (Author/DB)

Examined variables influencing teacher referrals regarding children suspected of having developmental or behavioral problems. Results indicate that younger children were not referred at a disproportionate rate, as compared to their older classmates. African American children were referred at a disproportionate rate for developmental handicap services when compared to Caucasian children. (RJM)

This article notes that regulations governing service provision in residential programs for persons with mental retardation may become decontextualized and fail to address individual needs or specific situations. Ecobehavioral analysis of rule-governed behavior in residential settings is suggested for measuring the effects of regulatory rules. (Author/DB)

This response to a paper by Guess and Carr (EC 602 212) on stereotypy and self-injury in the disabled evaluates their interpretation of the literature, use of conceptual terms, and treatment of behavior analysis principles. They are critiqued for using descriptive analogies and intervening variables to support their theory. (DB)

Author responds to comments (EC 232 033-037) on his paper (EC 232 032) concerning use of aversive therapy or punishment with mentally retarded persons. Paper notes ideological connotations often implied in the term "punishment" and the lack of response to the distinction made in his paper between this and the functional relations described by the concept of aversive conditioning. (DB)

The conflict between viewing aversive therapeutic interventions with mentally retarded persons from either an ideological or scientific perspective is examined. It is concluded that some of those who reject aversive therapeutic interventions do so out of a poor understanding of behavioral science and a primarily ideological frame of reference. (Author/DB)

This article uses preliminary data from 51 direct-care staff members and approximately 190 residents of a facility for nonambulatory individuals with profound mental retardation, to illustrate the roles of social, ecological, and regulatory contingencies of reinforcement and their potential counterhabilitative effects on residents. Results indicate a need for further research to better serve residents of such facilities. (Author/PB)