A lack of social competence is one of the primary characteristics of children diagnosed with autism spectrum disorder (ASD). This pervasive lack of social competence can cause individuals with ASD to struggle to develop meaningful social relationships with peers and adults across their lifetime. Thus, learning appropriate socialization skills is an essential component in the education of this population. The purpose of the current study was to provide an initial investigation into the effectiveness of a comprehensive social skills training intervention on the social competence of young children with ASD using direct recording methods. Eight students with ASD between the ages of 5 and 7 years, with current placements in self-contained kindergarten or first grade classrooms in the public school setting participated in a 12 week intervention. The intervention implemented was “The Incredible Flexible You: A Social Thinking Curriculum for Preschool and Early Elementary Years” (Hendrix, Palmer, Tarshis, & Winner, 2013), a packaged, multi-sensory social skills training program developed to promote the social competence of young children with ASD. The intervention was presented daily for approximately 20 minutes in a small group school setting. Using a concurrent multiple baseline across participants single-case research design, the research study aimed to evaluate the effectiveness of the program upon the participant’s positive social initiations, positive social responses, and active engagement during recess. Observational data were collected utilizing both a frequency behavior count system and a timed interval behavioral observation system. Additionally, data were collected via the Autism Social Skills Profile (ASSP; Bellini & Hopf, 2007) through pre- and post-intervention parent forms to determine the effects of the program on the overall social functioning of the participants. Procedural fidelity was collected throughout the research, and social validity was also assessed utilizing the Behavior Intervention Rating Profile (BIRP, Von Brock & Elliott, 1987). Overall, participants made slight gains in social competency, yet the data did not support a functional relation between the intervention and dependent variables. Individual participant progress was discussed in detail. Limitations of the study and implications for practice and future research in social competency for young children with ASD were further discussed.

Divided attention, or the ability to respond to more than one task simultaneously, is an important skill for navigating complex social, communicative, academic, and professional settings. The purpose of the current study was to understand the association between the volume of the posterior cerebellum and divided attention in individuals with autism spectrum disorders (ASDs) and control participants. It was hypothesized that the ASD group would have worse divided attention abilities and smaller posterior cerebellar volumes compared to the control group. Furthermore, reduced posterior cerebellar volume was expected to be associated with weaker divided attention abilities. Participants were young adult males with high-functioning autism spectrum disorders (n=15) and controls matched for age, handedness, and nonverbal IQ (n=19). Results showed partial support for worse divided attention performance in ASDs and for a positive association between posterior cerebellar volume and divided attention performance. There were no group differences in posterior cerebellar volume, and accounting for intracranial volume did not affect findings. Limitations of the current study and future directions are discussed. / text

The purpose of this project is to critically analyze and review parent training interventions published between the years 2000 to 2013 focused on enhancing social and communicative behaviors in young children between 3 to 10 years old with autism spectrum disorder. All studies involved a form of parent training in combination with an intervention type such as pivotal response training, milieu approach and naturalistic approaches. Overall, each study yielded positive outcomes for children with ASD, but data collection strategies, target goals, and outcome measures were variable. This review included an in-depth analysis of 16 studies of parent intervention programs evaluated based on their goals, methodology, and effectiveness of parent training on the children with ASD’s language skills. The review will present a set of guidelines for parents and professionals to use when deciding on the most effective and efficient parent training therapy for families who have children with ASD. Critically evaluating the available empirical research can help parents, therapists, and researchers more effectively consider viable options for parent training programs tailored to support the needs of children with ASD. Tables will summarize the findings to make the information more accessible. Implications for future research will follow the literature review. / text

Objectives: There has been a significant increase in the incidence rates and public awareness of autism spectrum disorder (ASD) in recent years. The DSM-5’s latest modification of diagnostic criteria for ASD has also stimulated considerable debate. Despite the rising concerns, few studies have been conducted in the Chinese population of Hong Kong, especially among youth and adolescents. This study investigates the clinical profile of ASD in adolescents in Hong Kong. In addition to using screening instruments commonly used to assess specific ASD characteristics, other psychometric measures for internalizing and externalizing problems are employed to examine their associations with the ASD symptoms. It also assesses the extent to which different ASD symptoms and their associated features predict parenting stress. Methods: A total of 143 adolescents aged between 11 and 17 (M = 14.17; SD = 1.76) completed this study with their parents, including 71 adolescents with ASD and 72 typically developing adolescents. Adolescents completed two self-report measures of emotional symptoms: the Spence Children’s Anxiety Scale (SCAS) and Children’s Depression Inventory (CDI). Their parents completed the Autism Spectrum Screening Questionnaire (ASSQ), Child Behaviour Checklist (CBCL), and Spence Children’s Anxiety Scale – Parent version (SCAS-P) for evaluating their child’s characteristics. Parents also completed the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Parenting Stress Index-Short Form (PSI-SF) for measuring their own parenting stress. Results: All measures showed good to excellent internal consistency. They were as reliable and internally consistent as the original English versions. Parent reports in the ASD group were significantly higher than in the control group on all measures. Mean ASSQ scores in the ASD group fell within the clinical range. Optimal ASSQ cutoff scores were estimated using receiver operating characteristics analysis. ASD symptoms, as well as internalizing and externalizing problems, were found to be significant discriminators between the ASD group and the controls. In addition, parents reported that their child’s emotional and behaviour problems were more distressing than the ASD symptoms. Discussion: This study highlights the importance of evaluating specific ASD characteristics and their associated symptoms of emotional and behavioural disturbances. This study suggests an optimal cutoff score of 9 for the ASSQ in Hong Kong. However, there is a need to assess its generalizability using large-scale community samples and other childhood clinical conditions. Although the findings appear to support the revised DSM-5 taxonomy of ASD, they must be interpreted with caution. Future treatments should provide parents with adequate professional support for reducing parenting stress and helping them cope with their child’s social, emotional, and behavioural impairments. Conclusions: This study documents preliminary norms for a broad range of measures for adolescents with ASD in Hong Kong. It also provides a useful empirical basis for future investigations of the interplay between specific ASD characteristics and their associated features. Regarding treatment planning, this study postulates a comprehensive treatment model for adolescents with ASD to guide treatment research. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Pragmatic language impairments have been found in children with high-functioning Autism (HFA). Limited studies have investigated the contributing factors. This study compared 23 children with HFA with 28 typically-developing children on pragmatic language measures, with their age, cognitive ability and language ability matched or controlled. Deficit of children with HFA was found in making inferences in comprehension but not in narrative ability, and abilities to make inferences in narrative and about psychological state. Theory of mind was an impairment for children with HFA and correlated with inferences about psychological state. In the measure of executive functioning at visual-perceptual level, better performance was found in children with HFA. This cognitive factor did not correlate with any pragmatic language measure. / published_or_final_version / Educational Psychology / Master / Master of Social Sciences

Background: Autism Spectrum Disorder (ASD) is a neuro-developmental disorder characterized by a triad of impairments in social interaction, communication, and restricted and repetitive behaviors. For children with autism especially those with high functioning (HFA), it is common to discover from clinical observation and from care-givers’ report that there are uneven performance in their cognitive profile and also executive difficulties. In recent years, there were enormous amount of researches attempting to delineate the cognitive deficits and the executive impairments in autism. Executive Functions (EF) was a widely studied construct in autism. The vast pool of researches establishes various focuses of investigation, including: (1) the biological level; (2) the cognitive level; (3) the task performance level; and (4) the everyday functioning level. Each of them has its own significance, and contributes distinctly in delineating the executive impairments in ASD. Taking into account the complexity of the EF construct and the far-reaching impacts it imposing on our everyday functioning, a comprehensive approach encompassing different levels of investigation in one research design is suggested to investigate the performance and specific areas of impairment of children with HFA in respective levels; and to explore the possible relationships between the levels of investigations. Methods: Forty aged 12-15 children participated in the research, twenty with HFA and twenty typically developing controls (TD), matched by gender, age and IQ. In the first part of the study, the participants were administered four traditional EF tasks including: inhibition, working memory, flexibility and planning to examine EF in the cognitive level. In the second part, they completed a novel multitasking test, the Battersea Multitask Paradigm (BMP) to examine executive difficulties in the task performance level. Parent ratings of the Behavior Rating Inventory of Executive Function (BRIEF) were collected for further investigation of their executive difficulties in the daily functioning level. Results: The 3-levels of investigation demonstrated converged results in examining the executive ability of ASD. From the integrated analyses, more evidence was gained to speculate that the planning inefficiency of children with HFA was due to their inability to cognitively construct the plan rather than their ability to execute or implement the plan. In real-life situations, they have particular difficulties in time management, to prioritize multiple and interleaved tasks, and to coordinate intended actions for future goal attainment. Moreover, their cognitive inflexibility had a pattern of “get stuck” or perseverates on the same task till completion before moving onto the next task. Their inflexibility to switch seemed to be explained by the preference to follow a more structured kind of sequence or action, i.e. to persist and finish one task before moving to another one. They were actually excellent “rule follower”, might not be as rigid of not willing to change. Significant positive relationships were only observed between the EF measures and Multitask variables. / published_or_final_version / Educational Psychology / Doctoral / Doctor of Psychology

Objectives: The purpose of this thesis was to identify risk factors for the development of mental health concerns in pre-teens and adolescents with Autism Spectrum Disorder (ASD), and in particular the role of early childhood ASD symptomatology in their development. Additionally, this thesis generated prevalence estimates for mental health concerns in Canadian adolescents with ASD. Methods: The parents of 390 individuals with ASD were invited to participate in a survey, either online or by mail. Sixty-seven parents completed and returned surveys. Kendall tau b correlation coefficients were calculated for the association between age at assessment with ADI-R and score in each domain. Prevalence estimates with 95% confidence intervals were generated, and the Kappa statistic was used to determine the strength of agreement between parent-reported diagnoses and clinical CBCL scores. Finally, bivariate analysis was used to determine if childhood ASD symptomatology was associated with mental health in adolescence, followed by logistic regression modeling to evaluate the effect of other possible risk factors. Results: Scores on two domains of the ADI-R were significantly associated with age at assessment, therefore, it was necessary to control for age at assessment with the ADI-R on these domains in the analysis conducted in Chapter Four. Forty-five percent of the study sample met case criteria for a comorbid psychiatric disorder. Anxiety, mood and attention-deficit disorders were the most common disorders in this sample. Early childhood ASD symptoms were not associated with the development of mental health concerns in adolescence. Family history and female gender were associated with the development of mental health concerns in adolescence. Conclusions: Nearly half of the individuals in our sample have been diagnosed with a psychiatric disorder, or are experiencing clinically significant symptoms that may be indicative of such a disorder. Our findings of discrepancies between parent-reported diagnoses and CBCL scores, indicates that many individuals in our sample are experiencing clinically significant mental health concerns, but do not have an official diagnosis. Finally, as has been reported previously, family history of mental illness and female gender were found to be associated with the development of a mental health concern in adolescence. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-10-14 11:06:50.53

Introduction: Autism Spectrum Disorder (ASD) is a behaviourally defined disorder characterised by impairments in three domains of social interaction, communication, and repetitive/restricted interests and behaviours (DSM-IV-TR; APA, 2000; ICD-10; WHO, 1992). Recent research suggests that this diagnostic triad may no longer fit as the best way to conceptualise ASD. Although not due for publication until 2013, a proposed revision of autistic disorder for DSM-V has merged three domains into two; i) Social/communication deficits and ii) Fixated interests and repetitive behaviours (APA, 2010). The aim of this study was to examine the structure of ASD symptom domains within the Adult Asperger Assessment (AAA; Baron-Cohen et al., 2005). Method: Confirmatory factor analysis was used to examine data from a clinical population of adults diagnosed with Asperger Syndrome (AS) and High Functioning Autism (HFA). Results: Analysis suggested that none of the theoretically-driven models were supported by the AAA data. However, it did highlight high correlations between social and communication factors (r > 0.9) within unmodified models. Discussion: The results of the analysis did not provide support for the move towards considering ASD as a dyad of ‘social-communication’ impairments and repetitive/restricted interests and behaviours, as none of the models were supported by the AAA data. The validity of the AAA as a diagnostic tool is discussed, as well as limitations and suggestions for future research. Conclusion: This study did not provide the evidence required to endorse a move towards the proposed DSM-V dyad. Further research to understanding the structure of autism symptoms could improve diagnostic and classification systems, and further studies of the genetic and neurobiological bases of ASD.

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disability diagnosed in an increasing number of children. ASD has few effective treatment options. This study describes ASD prevalence and use of psychotropic medications among children and youth in Manitoba. Methodology: Administrative data from the Repository at the Manitoba Centre for Health Policy (MCHP) were used to create a cohort of children born in Manitoba. Diagnoses of ASD were based on medical claim records, hospital abstracts, or special education funding data. Results: Between 2010 and 2014, 3079 Manitoba children aged 0-14 had an ASD diagnosis (1.2% prevalence). Child demographic, health and education, and family environmental characteristics were compared between children with ASD and children in the general population; children with ASD with and without psychotropic medications; and among all children with psychotropic medications. Children with ASD were more likely to have a psychotropic medication than children in the general population. Children with ASD were more likely to receive a psychotropic medication if they were older than age 4, were diagnosed with ASD later than age 4, received special education funding, had participated in behavioural programming, had a co-occurring psychiatric condition, had a sibling diagnosed with ASD or had ever been in the care of child welfare. This study demonstrated that children with ASD received a greater number and intensity of psychotropic medications than children in the general population with similar demographic and psychiatric conditions. Conclusions: In Manitoba, the prevalence of ASD is increasing and differences exist between children with ASD and children in the general population. Future research and treatment planning for children with mental disorders and developmental disabilities should consider the appropriateness of the patterns of medication use and equity of treatment interventions found in this study. / October 2016

Autism spectrum disorder (ASD) has been attributed to genetic and non-genetic risk factors. Of the non-genetic factors, prenatal and perinatal complications have been extensively investigated, though few associations have been replicated consistently. We selected 2,562 families with at least one individual with ASD and one unaffected sibling. We investigated the relationships between 29 prenatal and perinatal complications and ASD, while considering the influences of confounding factors, comorbid conditions, and different ASD definitions. Although many complications were associated with ASD in the pairwise comparisons, only haematological disorders of the newborn and lower Apgar scores remained significant after adjusting for the effects of the confounders. After removing individuals with congenital anomalies, only 5-minute Apgar scores were associated with ASD. In conclusion, after considering confounding effects and four ASD definitions, several perinatal complications were associated with ASD with moderate effect sizes. Furthermore, comorbid conditions with ASD appear to be intertwined in these relationships. / October 2016