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Understanding the needs of adolescents and emerging adults with Autism Spectrum Disorder (ASD) with respect to transition to postsecondary education is critical to development of user-informed transition programming. Parents of adolescents and emerging adults with ASD (n = 52) and ADHD (n = 47) completed an online survey. Social interaction training and independent living training were services frequently requested by parents in the ASD group. Additionally, parents of postsecondary students with ASD endorsed distinct challenges with self-advocacy, managing emotions, and managing personal/adaptive skills relative to postsecondary students with ADHD. The profile of parent-reported difficulties and needed services compared to transition to postsecondary education for students with ASD is distinguishable from that for ADHD, suggesting individualized transition planning and in-college supports.

There is growing evidence of a camouflaging effect among females with autism spectrum disorder (ASD), particularly among those without intellectual disability, which may affect performance on gold-standard diagnostic measures. This study utilized an age- and IQ-matched sample of school-aged youth (n = 228) diagnosed with ASD to assess sex differences on the ADOS and ADI-R, parent-reported autistic traits, and adaptive skills. Although females and males were rated similarly on gold-standard diagnostic measures overall, females with higher IQs were less likely to meet criteria on the ADI-R. Females were also found to be significantly more impaired on parent reported autistic traits and adaptive skills. Overall, the findings suggest that some autistic females may be missed by current diagnostic procedures.

The lack of sensitive measures suitable for use across the range of functioning in autism spectrum disorder (ASD) is a barrier to treatment development and monitoring. The Emotion Dysregulation Inventory (EDI) is a caregiver-report questionnaire designed to capture emotional distress and problems with emotion regulation in both minimally verbal and verbal individuals. The first two phases of the EDI’s development are described, including: (1) utilizing methods from the Patient-Reported Outcomes Measurement Information System (PROMIS®) project to develop the item pool and response options; and (2) assessment of the EDI in psychiatric inpatients with ASD. The results suggest that the EDI captures a wide range of emotion dysregulation, is sensitive to change, and is not biased by verbal or intellectual ability.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is often accompanied by impaired emotion regulation (ER). There has been increasing emphasis on developing evidence-based approaches to improve ER in ASD. Electroencephalography (EEG) has shown success in reducing ASD symptoms when used in neurofeedback-based interventions. Also, certain EEG components are associated with ER. Our overarching goal is to develop a technology that will use EEG to monitor real-time changes in ER and perform intervention based on these changes. As a first step, an EEG-based brain computer interface that is based on an Affective Posner task was developed to identify patterns associated with ER on a single trial basis, and EEG data collected from 21 individuals with ASD. Accordingly, our aim in this study is to investigate EEG features that could differentiate between distress and non-distress conditions. Specifically, we investigate if the EEG time-locked to the visual feedback presentation could be used to classify between WIN (non-distress) and LOSE (distress) conditions in a game with deception. Results showed that the extracted EEG features could differentiate between WIN and LOSE conditions (average accuracy of 81%), LOSE and rest-EEG conditions (average accuracy 94.8%), and WIN and rest-EEG conditions (average accuracy 94.9%).

Programming to optimize successful transition into adulthood and build skills for independence is consistent with the goal of improving autonomous living among adults with autism, which is a top stakeholder-identified priority. There has been surprisingly little research; however, on structured curricula targeting transition into adulthood. This formative community pilot trial of Stepped Transition to Employment and Postsecondary Education Success (STEPS) was designed to test feasibility and effectiveness as implemented by community-based providers and, secondarily, to identify factors that affect implementation. This was a 2-phase study. Phase 1 involved engagement with a group of community stakeholders to identify factors likely to influence implementation of STEPS. Phase 2 involved an open pilot trial of STEPS. In the Hybrid Type 1 trial, 24 adolescents and young adults with autism received STEPS in their communities at a local agency unaffiliated with the research study. Based on stakeholder input (Phase 1), several adjustments were made to the program before implementation (eg, increased attention to building client motivation and clarification of the role of caregivers). Stakeholders and providers indicated that STEPS could be successfully delivered and adopted in the community. From the pilot (Phase 2), results indicate feasibility of study procedures and intervention implementation, supporting future larger-scale implementation. Satisfaction (eg, how helpful and beneficial) with the program was reported as moderate or higher by the participants, and the only 2 drops occurred before the program start. Caregiver-rated transition readiness significantly increased from baseline to end point (P<.001), as well as some domains of functional independence (finance management, self-care, and engagement in the community; all P<.05). Employment and education status at the end point did not yield a clear pattern indicating a positive or negative impact of the program. This pilot study supports the feasibility, acceptability, and effectiveness of STEPS as delivered by community providers.

Social Anxiety Disorder (SAD) and Autism Spectrum Disorders (ASD) are fairly common psychiatric conditions that impair the functioning of otherwise healthy young adults. Given that the two conditions frequently co-occur, measurement of the characteristics unique to each condition is critical. This study evaluated the structure and construct overlap of two screening measures of SAD and ASD. Results from 623 young adults indicated that separable, though highly correlated, factors can be derived from the two measures related to social anxiety and social difficulties. The ASD screening measure also taps unique factors related to restricted interests and attention to details, theory of mind deficits, and a preference for routine. Recommendations are provided for accurate screening of symptoms of both SAD and ASD.

Social anxiety symptoms are common among cognitively unimpaired youth with autism spectrum disorder (ASD). Few studies have investigated the co-occurrence of social anxiety disorder (SAD) in adults with ASD, although identification may aid access to effective treatments and inform our scientific efforts to parse heterogeneity. In this preliminary study, we examined the clinical presentation of SAD in adults with ASD ( n  = 28), relative to SAD uncomplicated by ASD ( n  = 26). A large subset (50 %) of the adults with ASD met diagnostic criteria for SAD. The adults with ASD plus SAD differed from those with ASD without SAD on several characteristics. Findings demonstrate that many adults with ASD are aware of their social difficulties and experience impairing social anxiety.

Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verbal IQ below 85 or above 115, and ages 16 and older. Best practice diagnostic procedures should include the Module 4 in conjunction with other assessment tools. Balancing needs for sensitivity and specificity depending on the purpose of assessment (e.g., clinical vs. research) and demographic characteristics mentioned above will enhance its utility.

The purpose of this study was to explore relationships among anxiety, loneliness, and degree of social skill deficit in a sample of youth with autism spectrum disorders (ASD). Participants ( N  = 20) were between 7 and 14 years of age, verbal, and had low average or higher assessed intelligence (average IQ = 92 ± 14.41). Youth who self-reported elevated levels of anxiety reported greater feelings of social loneliness. Those participants earning above average total anxiety scores reported significantly more loneliness than those with less anxiety ( F  = 6.60, p  < .05). A significant relationship between parent-reported child withdrawal and depression and social disability also was found. Recommendations for assessment of co-occurring psychiatric problems in youth with ASD are offered.

Autism spectrum disorder (ASD) is predominantly diagnosed in males. In explaining the differential rate of occurrence in males and females, biogenetic models have been proposed and studied, often to the exclusion of potential social or cultural factors that may influence different rates of diagnosis across the genders. In this theoretical paper, we consider sociocultural influences that may contribute to the differential expression of ASD in females and partially explain potential underidentification of ASD in females. Based on our synthesis of the extant literature, we propose that ASD may be underidentified in affected females without co-occurring intellectual impairment, owing to a pattern of subtle yet potentially meaningful gender differences in symptom manifestation (e.g., less unusual stereotyped and repetitive behaviors in females, increased prevalence of internalizing problems in females) and gender inequities in research on the ASD phenotype that potentially contributes to biases in assessment tools and diagnostic practices. We offer recommendations for future research directions on gender differences in ASD, and we suggest implications to inform best practice and policy for the assessment of females with ASD.