Amanda L. Richdale, Eric M. J. Morris, Lauren P. Lawson
{"title":"Suicidality in Autistic Adolescents and Adults: Sleep the Unexplored Connection?","authors":"Amanda L. Richdale, Eric M. J. Morris, Lauren P. Lawson","doi":"10.1002/aur.3306","DOIUrl":"10.1002/aur.3306","url":null,"abstract":"<div>\u0000 \u0000 <p>Despite substantial evidence linking insomnia with increased suicidality in non-autistic populations, its role in autism remains under-explored. Poor sleep, most commonly insomnia symptoms (hereafter insomnia), is a significant issue in autism, affecting up to 80% of autistic children and adults, compared with 30%–50% of children and about 45% of adults in the general population. Sleep, along with quality of life, anxiety, depression, and social well-being, is a top mental health research priority for autistic adults. These factors are all significantly associated with insomnia in both autistic and non-autistic individuals. Current findings highlight the association between depression, psychosocial factors, and suicidality in autistic individuals. Key factors in suicidality for autistic people include increased autistic traits, loneliness, lack of social support, and experiences such as camouflaging and burnout. What is under-explored is the role of sleep in suicidality and mental health in autism. Effective psychological interventions for insomnia in autistic individuals are lacking, and there is limited understanding of whether treating insomnia can reduce suicidality. Only two pilot studies have investigated insomnia treatments for autistic adults. In this commentary, we argue that, given the high rate of suicidality in autism and the potential role of insomnia, it is crucial to investigate whether insomnia contributes to suicidality in autistic people and if addressing sleep through prevention strategies, supports, and interventions improves outcomes. Collaboration with the autistic community is essential for addressing this knowledge gap and developing effective interventions.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 3","pages":"468-475"},"PeriodicalIF":5.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daneele Thorpe, Connor M. Kerns, Lauren J. Moskowitz, Amy Drahota, Matthew Lerner, the UCAS Consortium
{"title":"Understanding the Association Between Neighborhood Resources and Trauma-Informed Care Among Providers Who Serve Autistic Youth","authors":"Daneele Thorpe, Connor M. Kerns, Lauren J. Moskowitz, Amy Drahota, Matthew Lerner, the UCAS Consortium","doi":"10.1002/aur.3305","DOIUrl":"10.1002/aur.3305","url":null,"abstract":"<div>\u0000 \u0000 <p>A growing body of literature suggests that youth with autism spectrum disorders (ASD), herein, autistic youth, face an increased risk of being exposed to adverse childhood experiences (ACEs). However, trauma-informed approaches to care among autistic youth remain limited. In a large cross-sectional survey of ASD providers (<i>N</i> = 670) recruited from five U.S. locations, we examined the association between neighborhood resources using the Child Opportunity Index (i.e., educational, health/environmental, and social/economic opportunities) and the frequency at which providers engaged in trauma-informed care (i.e., inquire about, screen for, treat, and provide referrals for trauma diagnosis and treatment) and the types of adverse childhood experiences (ACEs) they screen for (i.e., maltreatment/neglect and household dysfunction). The latent model revealed that providers in neighborhoods with fewer resources engaged in more trauma-informed care and were more likely to screen for ACEs related to household dysfunction. Follow-up exploratory analyses indicated that providers in the lowest 20% of opportunity neighborhoods made the greatest efforts in trauma screening for maltreatment and household dysfunction, followed closely by those in the lowest 40%, compared to higher-opportunity areas. Sensitivity analyses, controlling for potential nesting effects, confirmed similar results. These findings may suggest a concerted effort to ensure that autistic youth in highly disadvantaged areas receive adequate trauma screening. However, lower screening rates in higher-resourced neighborhoods may mean trauma-exposed autistic youth in these areas are overlooked. Expanding provider training to emphasize trauma inquiry across all neighborhoods could help address this gap. Limitations, implications for policy and practice, and future directions are discussed.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 3","pages":"553-569"},"PeriodicalIF":5.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sayyed Ali Samadi, Ameneh Mahmoodizadeh, Mehdi Foladgar, Shahnaz Bakhshalizadeh Moradi, Baran Lotfi, Roy McConkey
{"title":"The Childhood Autism Rating Scale Second Edition (CARS2) and Its Applicability in an Iranian Sample","authors":"Sayyed Ali Samadi, Ameneh Mahmoodizadeh, Mehdi Foladgar, Shahnaz Bakhshalizadeh Moradi, Baran Lotfi, Roy McConkey","doi":"10.1002/aur.3309","DOIUrl":"10.1002/aur.3309","url":null,"abstract":"<p>The present study aimed to evaluate the reliability and validity of the Childhood Autism Rating Scale: Second Edition (CARS2) in diagnosing individuals with autism in Iran. A mixed-method approach was used and 313 participants were recruited, with an age range of 2–32 years, for CARS2-Standard Form (ST) and 218 individuals aged 6–25 years for CARS2-High Functioning (HF). The participants were recruited from daycare centers, schools, and clinics with different developmental trajectories: autism, intellectual disabilities, and neurotypical development. All participants with autism and intellectual disabilities had been clinically diagnosed previously. In addition, the CARS2-Questionnaire of Parent Concerns (QPC) was used to gather qualitative data on 30 randomly selected parents and the perspectives of the 20 test administrators were also collected. The CARS2 had high internal consistency, inter-rater reliability, and test–retest reliability. Factor analyses revealed a one-factor structure for CARS2-ST and a three-factor structure for CARS2-HF. When adjustments were made to the cut-off points, the discriminant analyses indicated that CARS2 effectively differentiated between those with autism and typical development but less so with persons who had intellectual disabilities. The qualitative data analysis and the extracted themes suggest that the CARS2-QPC is a valid tool for collecting autism-related information from parents. Our findings suggest that the CARS2 is broadly a reliable and valid instrument for diagnosing autism spectrum in Iran in the absence of more extensive assessments.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 3","pages":"541-552"},"PeriodicalIF":5.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aur.3309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Derek S. Andrews, Andrew J. Dakopolos, Joshua K. Lee, Brianna Heath, Devani Cordero, Marjorie Solomon, David G. Amaral, Christine Wu Nordahl
{"title":"Cortical Thickness Differences in Autistic Children With and Without Intellectual Disability","authors":"Derek S. Andrews, Andrew J. Dakopolos, Joshua K. Lee, Brianna Heath, Devani Cordero, Marjorie Solomon, David G. Amaral, Christine Wu Nordahl","doi":"10.1002/aur.3313","DOIUrl":"10.1002/aur.3313","url":null,"abstract":"<p>Of the 1 in 36 individuals in the United States who are diagnosed with autism spectrum disorder, nearly 40% also have intellectual disability (ID). The cortex has been widely implicated in neural processes underlying autistic behaviors as well as intellectual ability. Thus, neuroimaging features such as cortical thickness are of particular interest as a possible biomarkers of the condition. However, neuroimaging studies often fail to include autistic individuals with ID. As a result, there are few studies of cortical thickness in autistic individuals across the entire range of intellectual abilities. This study used MRI to evaluate cortical thickness in young autistic children (<i>n</i> = 88, mean age 5.37 years) with a large range of intellectual ability (IQ 19–133) as well as nonautistic, nondevelopmentally delayed (referred to here as typically developing [TD]) peers (<i>n</i> = 53, mean age 5.29 years). We first investigated associations between full scale IQ and cortical thickness in both autistic and TD children. Autistic children had significant negative associations (i.e., thinner cortex, higher IQ) in bilateral entorhinal cortex, right fusiform gyrus, superior, middle and inferior temporal gyri, and right temporal pole that were not present in TD children. Significantly thicker cortex was also observed in these regions for autistic children with ID (i.e., IQ ≤ 70) compared with those without. Last, given the reported correspondence between the severity of autism symptoms and intellectual ability, we compared cortical thickness associations with both IQ and ADOS Calibrated Severity Scores and found these patterns overlapped to a significant degree across the cortex.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 3","pages":"486-497"},"PeriodicalIF":5.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aur.3313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joshua Ryan Smith, Seri Lim, Snehal Bindra, Sarah Marler, Bavani Rajah, Zachary J. Williams, Isaac Baldwin, Nausheen Hossain, Jo Ellen Wilson, D. Catherine Fuchs, James Luccarelli
{"title":"Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism With Intellectual Disability: An Observational Study","authors":"Joshua Ryan Smith, Seri Lim, Snehal Bindra, Sarah Marler, Bavani Rajah, Zachary J. Williams, Isaac Baldwin, Nausheen Hossain, Jo Ellen Wilson, D. Catherine Fuchs, James Luccarelli","doi":"10.1002/aur.3315","DOIUrl":"10.1002/aur.3315","url":null,"abstract":"<p>Catatonia is a highly morbid psychomotor and affective disorder, which can affect autistic individuals with and without intellectual disability. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments in autistic individuals has not been described. We conducted a prospective observational cohort study of patients with autism and co-morbid catatonia who received outpatient care in a specialized outpatient clinic from July 1, 2021 to May 31, 2024. Data investigating pharmacologic interventions, and clinical measures including the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), Kanner Catatonia Examination (KCE), and Clinical Global Impression—Improvement (CGI-I) were collected. Forty-five autistic patients with co-morbid catatonia were treated during the study period. The mean age was 15.6 (SD = 7.9) years [Mdn = 16.0, range 6.0–31.0]. Forty-one patients (91.1%) met criteria for autism with co-occurring intellectual disability. All patients received pharmacotherapy. Forty-four (97.8%) were treated with benzodiazepines with a mean maximal daily dose of 17.4 mg (SD = 15.8) lorazepam equivalents. Thirty-five patients (77.8%) required more than one medication class for treatment. Sixteen (35.6%) patients received electroconvulsive therapy. Fourteen patients (31.1%) attempted to taper off benzodiazepines after achieving clinical improvement during the study period; of these, 5 patients (11.1%) were successfully tapered off, and the remaining 9 (17.8%) discontinued the taper due to a return of catatonic symptoms. Statistically significant improvement was observed across all clinical domains except the KCS. However, the majority remained at least partially symptomatic over the study period. Three patients (6.7%) died over the study period. Despite clinical improvements while receiving the gold standard for psychopharmacologic management of catatonia, chronic symptoms remained for the majority of catatonia patients over the study period, and few were able to taper and discontinue benzodiazepine treatment. Notably, the open label design of this study is a limiting factor when interpreting the results.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 2","pages":"449-462"},"PeriodicalIF":5.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aur.3315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What We Publish and What We Do Not","authors":"David G. Amaral, the Associate Editors","doi":"10.1002/aur.3307","DOIUrl":"10.1002/aur.3307","url":null,"abstract":"<p>The editors of <b>\u0000 <i>Autism Research</i>\u0000 </b> would like to wish you a healthy, happy, and productive 2025. <i>If you consider publishing a paper in the journal in the future, please read the following</i>:</p><p>During 2024, we received an unprecedented number of submissions to <i>Autism Research</i>. We thank the authors and the reviewers for their support of the journal. We also received an unusually large number of submissions that were not consistent with the aims and scope of the journal and, therefore, were not suitable for publication in the journal. For many of these, it appears that the authors had not fully reviewed the Author Guidelines, which can be found by clicking the “Contribute” button on the blue banner on the journal home page. This takes authors to the following link (https://onlinelibrary.wiley.com/page/journal/19393806/homepage/forauthors.html).</p><p>To be fully informed about the types of submission most likely to be published in <i>Autism Research</i>, we would encourage potential authors to review the instructions in full and to pay special attention to the second section “2. Aims & Scope” of the Author Guidelines. <b>This section is there to help you determine whether your article is appropriate for the journal</b>. In the text below, we summarize some of the important inclusion and exclusion criteria for submitted papers.</p><p>The journal focuses on reports of novel findings related to genetic, neurobiological, immunological, medical, epidemiological, and psychological mechanisms and how these influence developmental processes in autism spectrum disorder. The journal encourages the submission of original research papers (Research Articles and Short Reports) that take a developmental approach to the biology and psychology of autism, with a particular emphasis on identifying underlying mechanisms and integrating across different levels of analysis. Contributions are typically empirical, but the journal also publishes theoretical papers if they significantly advance thinking. The journal encourages papers reporting work on animal, cell, or other model systems that are directly relevant to a better understanding of autism or related conditions. The journal also publishes reports of carefully conducted clinical trials of treatments for the core symptoms or one of the common co-occurring conditions of autism.</p><p>For papers submitted to <i>Autism Research</i>, a <b>clinical trial</b> is defined as any research study that prospectively assigns human participants or groups to one or more interventions to evaluate the effects of those interventions on <b>health-related biomedical or behavioral outcomes</b>. Health-related interventions include drugs, surgical procedures, devices, behavioral treatments, dietary interventions, or educational programs. By this definition, an equine or animal-assisted intervention would be considered a clinical trial. Health outcomes include any biomedical ","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 1","pages":"7-8"},"PeriodicalIF":5.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aur.3307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula Araya, Katrina Phillips, Karen Waldie, Lisa Underwood
{"title":"Gross Motor Development in Children With Autism: Longitudinal Trajectories From the Growing Up in New Zealand Study","authors":"Paula Araya, Katrina Phillips, Karen Waldie, Lisa Underwood","doi":"10.1002/aur.3304","DOIUrl":"10.1002/aur.3304","url":null,"abstract":"<p>This study explored gross motor development (GMD) trajectories among 6359 children, with and without autism, from the <i>Growing Up in New Zealand</i> longitudinal cohort study. By the age of 8, 173 children had either an autism diagnosis (<i>n</i> = 108) or parent-reported autism concerns (<i>n</i> = 65). Gross motor milestones were reported by mothers when children were 9, 24, and 54 months of age. We found that irrespective of autism diagnosis, GMD delays at 24 months of age were more likely among girls, children born preterm, and those whose mothers identified as European. A mixed-effect logistic regression model, controlling for antenatal maternal and child covariates, revealed that the proportion of children with GMD delay (relative to their peers) increased significantly from 9 to 54 months for all three groups, but the increase was greater for those with autism concerns (OR = 1.28, 95% CI = 1.08–1.52) or an autism diagnosis (OR = 1.26, 95% CI = 1.10–1.43) compared to the no autism group (OR = 1.06, 95% CI = 1.02–1.10). Differences in the changes in GMD performance among children with an autism diagnosis compared to those without autism occurred between 9 and 24 months (OR = 2.16, 95% CI = 1.13–4.13). No significant GMD delay differences were found at any time between children with an autism diagnosis versus those with autism concerns. Children with a GMD delay should be screened for autism at 24 m. Early identification is the first step toward knowledge-based, effective intervention of developmental difficulties.</p>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 2","pages":"437-448"},"PeriodicalIF":5.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aur.3304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristen Lyall, Aisha S. Dickerson, Annette M. Green, Seth Frndak, Lisa A. Croen, Jennifer L. Ames, Lyndsay A. Avalos, Judy L. Aschner, Nicole R. Bush, Carlos A. Camargo Jr, Viren D'Sa, Stephen R. Dager, Anne L. Dunlop, Assiamira Ferrara, Jody M. Ganiban, James E. Gern, Tre D. Gissandaner, J. Carolyn Graff, Irva Hertz-Picciotto, Alison E. Hipwell, Tengfei Ma, Meghan Miller, Laura Murphy, Margaret R. Karagas, Rachel S. Kelly, Amy Margolis, Daphne Koinis-Mitchell, Cindy T. McEvoy, Daniel Messinger, Ruby Nguyen, Emily Oken, Sally Ozonoff, Grier P. Page, Susan L. Schantz, Rebecca J. Schmidt, Coral L. Shuster, Julie B. Schweitzer, Stephen J. Sheinkopf, Joseph B. Stanford, Cindy O. Trevino, Scott T. Weiss, Heather E. Volk, Robert M. Joseph, program collaborators for Environmental influences on Child Health Outcomes
{"title":"Demographic Correlates of Autism: How Do Associations Compare Between Diagnosis and a Quantitative Trait Measure?","authors":"Kristen Lyall, Aisha S. Dickerson, Annette M. Green, Seth Frndak, Lisa A. Croen, Jennifer L. Ames, Lyndsay A. Avalos, Judy L. Aschner, Nicole R. Bush, Carlos A. Camargo Jr, Viren D'Sa, Stephen R. Dager, Anne L. Dunlop, Assiamira Ferrara, Jody M. Ganiban, James E. Gern, Tre D. Gissandaner, J. Carolyn Graff, Irva Hertz-Picciotto, Alison E. Hipwell, Tengfei Ma, Meghan Miller, Laura Murphy, Margaret R. Karagas, Rachel S. Kelly, Amy Margolis, Daphne Koinis-Mitchell, Cindy T. McEvoy, Daniel Messinger, Ruby Nguyen, Emily Oken, Sally Ozonoff, Grier P. Page, Susan L. Schantz, Rebecca J. Schmidt, Coral L. Shuster, Julie B. Schweitzer, Stephen J. Sheinkopf, Joseph B. Stanford, Cindy O. Trevino, Scott T. Weiss, Heather E. Volk, Robert M. Joseph, program collaborators for Environmental influences on Child Health Outcomes","doi":"10.1002/aur.3296","DOIUrl":"10.1002/aur.3296","url":null,"abstract":"<div>\u0000 \u0000 <p>Prevalence of autism diagnosis has historically differed by demographic factors. Using data from 8224 participants drawn from the Environmental influences on Child Health Outcomes (ECHO) Program, we examined relationships between demographic factors and parent-reported autism-related traits as captured by the Social Responsiveness Scale (SRS; <i>T</i> score > 65) and compared these to relations with parent-reported clinician diagnosis of ASD, in generalized linear mixed effects regression analyses. Results suggested lower odds of autism diagnosis, but not of SRS <i>T</i> > 65, for non-Hispanic Black children (adjusted odds ratio [OR] = 0.76, 95% CI 0.55, 1.06) relative to non-Hispanic White children. Higher maternal education was associated with reduced odds of both outcomes (OR = 0.73, 95% CI 0.51, 1.05 for ASD autism diagnosis and 0.4, 95% CI 0.29, 0.55 for SRS score). In addition, results suggested a lower likelihood of autism diagnosis but a higher likelihood of an SRS score > 65 in Black girls. Findings suggest lower diagnostic recognition of autism in non-Hispanic Black children, despite a similar degree of SRS-assessed autism-related traits falling in the clinically elevated range. Further work is needed to address this disparity.</p>\u0000 </div>","PeriodicalId":131,"journal":{"name":"Autism Research","volume":"18 3","pages":"648-659"},"PeriodicalIF":5.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}