Emerging adults who have Autism Spectrum Disorder (ASD) often encounter difficulties within the university setting. Despite an increase in the number of students with ASD enrolled in postsecondary educational institutions, there are few reports on the social, academic, and/or other needs of college students with ASD. The purpose of this study was to assess the perspectives of parents of emerging adults with ASD and ADHD, in order to inform efforts to address the poor postsecondary outcomes of students with ASD. Survey data were collected from parents who had a son or daughter in one of three educational placement groups (parents of high school students, parents of postsecondary students, and parents of individuals aged 18-25 not enrolled in education) among two disorders; ASD and ADHD. Participants were recruited nationally to participate in an online survey. Parents of emerging adults with ASD identified social interactions and daily living as primary difficulties for their son or daughter with ASD. Significant differences emerged with respect to difficulties among emerging adults with ADHD, who identified difficulties related to executive functioning and attention. Social interaction training was an identified needed service by parents of emerging adults with ASD. Additionally, independent living training was a common core service requested by parents of individuals with ASD and parents of individuals with ADHD. Results suggest that the postsecondary profile of parent-reported difficulties and needed services remains distinct for the diagnostic groups ASD and ADHD. These difficulties should be considered within the context of intervention for postsecondary students with ASD and ADHD. / Master of Science

Anxiety is an area of documented challenge for people with Autism Spectrum Disorder (ASD). Despite this, some studies state that those with ASD and language deficits have lower reported anxiety than those without language deficits. This effect may be due to the complicated task of appropriately evaluating anxiety in those with compromised language. Using biomarkers of anxiety, such as reduced Heart Rate Variability (HRV) and increased Heart Rate (HR), may improve anxiety assessment but more research is necessary. Specifically, it would be helpful to understand if the relationship between HRV/HR and anxiety is moderated by language abilities in children with ASD, and whether HRV/HR can discriminate between anxiety and other emotions, like anger, in children with ASD. This study examined the relationship between baseline HRV/HR, language ability, and different emotional states (i.e., anxiety and anger) in a sample of 23 children with ASD. It was hypothesized that receptive language would moderate the relationship between decreased HRV/increased HR and increased anxiety but not the relationship between decreased HRV/increased HR and increased anger. Multiple regression analyses indicated that HRV and HR were not significant predictors of anxiety or anger, and language was not a significant moderator. Future studies may wish to take new approaches to determining the role of language in the relationship between HRV/HR and anxiety. / Master of Science / Anxiety is an area of documented challenge for people with Autism Spectrum Disorder (ASD). Despite this, some studies state that those with ASD and language deficits have lower reported anxiety than those without language deficits. This effect may be due to the complicated task of appropriately evaluating anxiety in those with compromised language. Using biomarkers of anxiety, such as reduced Heart Rate Variability (HRV) and increased Heart Rate (HR), may improve anxiety assessment but more research is necessary. Specifically, it would be helpful to understand if the relationship between HRV/HR and anxiety is moderated by language abilities in children with ASD, and whether HRV/HR can discriminate between anxiety and other emotions, like anger, in children with ASD. This study examined the relationship between baseline HRV/HR, language ability, and different emotional states (i.e., anxiety and anger) in a sample of 23 children with ASD. It was hypothesized that receptive language would moderate the relationship between decreased HRV/increased HR and increased anxiety but not the relationship between decreased HRV/increased HR and increased anger. Multiple regression analyses indicated that HRV and HR were not significant predictors of anxiety or anger, and language was not a significant moderator. Future studies may wish to take new approaches to determining the role of language in the relationship between HRV/HR and anxiety.

Emerging research suggests that many adults with Autism Spectrum Disorder (ASD) experience impairing Social Anxiety Disorder (SAD) or social anxiety symptoms (e.g., Joshi et al., 2013; Kleinhans et al., 2010), yet there is little guidance or agreement about how to best assess social anxiety in this population. Direct examination of overt eye gaze patterns may help determine if the attentional biases often reported in people with SAD also operate in those with ASD and co-occurring social anxiety. This study sought to assess the influence of social anxiety on gaze patterns in adults with ASD. An exploratory aim was to better understand the phenomenology of SAD within ASD. Three groups of participants were included: adults with ASD (n = 25), adults with SAD (n = 25), and adults without ASD or SAD (n = 25). As hypothesized, a large subset (n = 11; 44%) of the participants with ASD met diagnostic criteria for SAD. Contrary to study hypotheses related to gaze patterns, however, there was no evidence for gaze vigilance followed by avoidance for socially threatening stimuli in either the ASD or SAD groups, and there was no relationship between fear of negative evaluation and gaze duration toward socially threatening stimuli within the ASD group. Possible reasons for these null findings are considered. Clinical implications and suggestions for future research are also discussed. / Ph. D.

Although clinically significant symptoms of anxiety or depression are present in nearly one in two people with autism spectrum disorder (ASD), little is known about how these symptoms may relate to social motivation, a key construct in the etiology of ASD. The aim of the current study was to examine patterns of anxiety, depression, ASD symptomatology, and social motivation in youth with ASD. Using a large public dataset of well-characterized youth with ASD (N = 195), we examined varying patterns of these symptoms via latent profile analysis (LPA). Three distinct classes emerged: one with moderate ASD severity and low levels of comorbid psychopathology, a second with more severe ASD symptoms and similarly low anxiety and depression, and a third with significantly elevated anxiety and depression. Neither sex nor age differed significantly among these classes, and indices of social interest early in development did not predict class membership. Implications of these symptom patterns for assessment and treatment of comorbidity in ASD are discussed. / Doctor of Philosophy / A large proportion of individuals with autism spectrum disorder (ASD) experience symptoms of anxiety and depression. Anxiety and depression might be related to social motivation, which is a key concept associated with the development of ASD. The current study examined variation in anxiety, depression, social motivation, and ASD symptom severity in a large sample of youth with ASD. Individuals in the sample were classified in groups by a statistical model. Models produced three separate groups: one group with moderate symptoms of ASD and relatively low levels of anxiety and depression, a second with more severe ASD symptoms and similarly low anxiety and depression, and a final group with moderate ASD symptoms and high anxiety and depression. Social motivation was strongest in the first and second groups, and low social motivation was strongly associated with anxiety and depression symptoms. Age and sex did not predict group membership, nor did items measuring social motivation early in development. Implications of these symptom patterns for the assessment and treatment of anxiety and depression in ASD are discussed.

Prior studies have identified diminished attending to faces, and in particular the eye region, in individuals with Autism Spectrum Disorder (ASD), which may contribute to the impairments they experience with emotion recognition and expression. The current study evaluated the acceptability, feasibility, and preliminary effectiveness of an attention modification intervention designed to attenuate deficits in facial emotion recognition and expression in children with ASD. During the 10-session experimental treatment, children watched videos of people expressing different emotions with the facial features highlighted to guide children's attention. Eight children with ASD completed the treatment, of nine who began. On average, the children and their parents rated the treatment to be acceptable and helpful. Although treatment efficacy, in terms of improved facial emotion recognition (FER), was not apparent on task-based measures, children and their parents reported slight improvements and most parents indicated decreased socioemotional problems following treatment. Results of this preliminary trial suggest that further clinical research on visual attention retraining for ASD, within an experimental therapeutic program, may be promising. / PHD / Previous studies have shown that individuals with Autism Spectrum Disorder (ASD) show lower looking at faces, especially the eyes, which may lead to the difficulties they show with ability to recognize other’s emotions and express their own emotions. This study looked at a new treatment designed to decrease the difficulties in emotion recognition and expression in children with ASD. The study looked at whether the treatment is possible, acceptable to children and their parents, and successful in decreasing the difficulty with emotion recognition. During the 10-session treatment, children watched videos of people making different expressions. The faces of the actors in the videos were highlighted to show the children the important area to look at. Eight children with ASD completed the treatment, of nine who started the treatment. On average, the children and their parents said that the treatment is acceptable and helpful. While the treatment was not successful in improving ability to recognize emotions on other’s faces on several tasks, children and their parents reported slight improvements. In addition, most parents reported less problems with social skills and emotion recognition and expression after the treatment. These results suggest that more clinical research may be needed to evaluate usefulness of such attention retraining for children with ASD.

Learning to drive represents a rite of passage for many adolescents and young adults, which increases their access to vocational, education, and social opportunities (Almberg et al., 2015; Cox et al., 2012; Lindsay, 2016). When examining licensure rates for individuals with developmental disabilities and/or Autism Spectrum Disorder, research demonstrates lower licensure rates and more difficulties obtaining licensure (Almberg et al., 2015; Cox et al., 2012). Most research focusses on teaching on the road or simulation based driving skills to increase licensure rates, however little research addresses the barriers these individuals face obtaining their drivers permit (Huang et al., 2012; Pandolfe, 2015; Smigiel, 2020; Vindin et al., 2021); . The current research study sought to fill in gaps in the literature by investigating the effects of a traditional academic intervention, Incremental Rehearsal’s, effects on increasing participants knowledge of the drivers manual used for the driver’s permit exam. Results demonstrated positive increases in correct responding for one participant, however inconsistent results for the other two participants. Varying results may be partially due to differing participant characteristics, which could be important for future research considerations.

Since the start of the COVID-19 pandemic, tele-based methods of autism assessment have been relied upon to a previously unparalleled degree; however, the need for such advancements is not new. Observation-based measures are a crucial component of face-to-face autism diagnostic evaluations, but few validated observation tools exist for remotely assessing autism across childhood, particularly for older children and adolescents, providing minimal guidance in this arena. Sanchez and Constantino (2020) previously validated a brief, face-to-face, clinician-facilitated observation coded according to the Childhood Autism Rating Scale, Second Edition (CARS-2). During the pandemic, this measure was adapted as a remote observation (rCARS2 Observation), but has yet to be validated in this format. The current study validated the rCARS2 Observation against the "gold-standard," in-person Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). In this sample of 30 children ages 1.97 to 16.66 years (M = 7.35, SD = 4.00), ADOS-2 and rCARS2 Observation total scores were highly correlated (ρ = .644, p < .001). Receiver operating characteristic (ROC) curves optimized rCARS2 Observation cutoff scores to maximize sensitivity and specificity in predicting possible diagnostic classification (88.9% sensitivity, 80% specificity) and ADOS-2 classification (83.3% sensitivity, 70.6%, specificity). At optimal cutoffs, the rCARS2 Observation predicted the correct diagnosis in 82.8% of cases and the same classification as the ADOS-2 in 75.9% of cases. Validation of this instrument provides support for an accessible and efficient remote autism observation. This is crucial in ensuring uniform training and clinical procedures for tele-assessment of autism, to help mitigate long-standing barriers to service access (e.g., geography, cost, availability). / Doctor of Philosophy / During the COVID-19 pandemic, many in-person services, including assessments for an autism diagnosis, were forced to shift to telehealth. When an autism assessment is completed in-person, it requires an "observation-based" measure, meaning that a clinician directly observes a child's behavior, in addition to an interview with a parent or caregiver. Families have faced barriers to accessing in-person autism assessments even prior to the pandemic, including geography, transportation difficulties, shortage of autism-specific providers, and high cost of services. As such, tele-assessment of autism is an important tool to consider in helping families to access these services. However, observation-based autism assessment measures that can be completed through telehealth from families' homes are few and not well-understood. The current study explores a brief telehealth observation tool (the rCARS2 Observation) and compares it to the "gold-standard" autism observation-based tool (the ADOS-2) that is typically used during in-person assessments of autism. This study found that scores on this remote measure and the in-person measure were strongly related and the remote observation measure showed great promise for predicting a diagnosis of autism in this study. This is the first study to explore the rCARS2 Observation to understand how well it can evaluate children's autism characteristics from home as compared with an in-person assessment tool. The success of this remote observation measure in the current study is promising and suggests that this may be one remote tool that clinicians can use in combination with a parent- or caregiver-interview to evaluate a child for an autism diagnosis as a shorter and more accessible tool to overcome many barriers to accessing services.

The number of autistic college students has risen over the decades and many of them are choosing to attend a community college to begin their higher education experience. However, once in college, autistic students face a set of challenges that influence their academic experience. Despite similar and elevated IQ’s many of autistic college students are not graduating at the same rate as their peers. Research of autism and higher education is typically comprised of information provided by professionals. However, there has been a growing number of scholars who have included the perspective of autistic individuals. A narrative inquiry research method was used to record and examine the experiences of 5 autistic community college students. In-person interviews recorded experiences regarding the transition to community college, experience with support services, and input about their community college experience. The transition to community college for autistic students was influenced by multiple factors that included a student’s high school experience, family dynamics, and current life circumstances. Participants accessed a variety of academic and non-academic supports. Academic supports included tutoring, counseling, and accommodations. Non-academic support included the support from family, friends, teachers, staff, and campus organizations. Participant’s knowledge of available supports was influenced mostly by their family’s knowledge. Input from participants indicated that teachers and coaches play significant roles in the lives of participants. Participants felt that more knowledge of autism was needed among faculty and staff that could be created through personal one-on-one relationships. Findings from this study suggest that institutions consider the was that social exchange influenced pivotal transitions that college students undergo according to Tinto’s model of student departure. This research could be used by community college administrators, faculty, and staff to in their efforts to support autistic student. This could include dedicating resources for transition planning, proactively promoting support services throughout all phases of recruitment and enrollment, and the development of campus-wide training resources.

Compared to non-immigrant families of children with autism spectrum disorders (ASD), immigrant families tend to experience more challenges securing an evaluation, obtaining a diagnosis, and accessing services for their child/children diagnosed with ASD. Several studies investigated the experiences of various groups of immigrant families. They found that the delays can be attributed to cultural differences in the way families interpret the meaning of ASD and their perceptions of the causes and treatment for ASD. Additionally, a lack of knowledge about ASD and fear of the stigma associated with ASD impacted immigrant parents' willingness to seek a diagnosis. However, few studies examined how Caribbean immigrants living in the United States experience a diagnosis of ASD for their child/children. This qualitative study explored Caribbean immigrant families' perceptions and experiences with ASD. A semi-structured, in-depth interview was used to collect data on families' experiences about symptoms, causes, and treatments of ASD, as well as their sources of support. The data were coded and analyzed using interpretative phenomenological analysis (IPA. Four themes were identified and discussed: A new world, emotional and physical burden caring for a child with ASD, attitudes about ASD in native cultures, and adapting to the new situation.

With one in every 59 individuals now diagnosed with autism spectrum disorder (ASD), there is a significant increase in college enrollment for these students, yet, alarmingly, this population has the highest college dropout rate. Using Rawl's social justice theory as the frame, this qualitative study identified the perceptions of students with ASD, their college professors, and the director of the Office of Disability Accommodation (ODA). Perceptions were examined through open-ended surveys regarding awareness of autism, knowledge of student civil rights, and the availability and adequacy of resources provided through the ODA. In addition, the students with autism participated in semi-structured face-to-face interviews. The findings of this study are consistent with other studies in reflecting barriers experienced by students with ASD, such as poor transition planning, communication, and self-advocacy limitations. The variance among reported perceptions revealed a lack of awareness and continuity of resources and support for students with autism, hindering their successful transition from high school to and through post-secondary education. Both students and professors expressed a lack of knowledge of students' rights at the college level and of how to access needed accommodations. These findings reveal the need for a greater awareness of supports needed by students with ASD as they enter college. The findings provide implications for professionals who provide transition services for individuals with ASD.