Concerns of parents and teachers of children with autism in elementary school

Many consensus guidelines encourage parents and teachers to openly communicate about their concerns regarding their children. These guidelines attest to the importance of achieving consensus about what issues are most critical and how to address them. The purpose of this study was to examine whether parents and teachers (1) agree about their concerns for their children with autism and (2) when given the opportunity, whether they discussed these concerns. Participants were 39 parent-teacher dyads of children with autism in kindergarten-through-fifth grade autism support classrooms. Each parent and teacher was interviewed separately about their concerns and then observed together in a discussion about the child. Parents and teachers generally agreed about their primary and secondary concerns. When given an opportunity to communicate their concerns, 49% of the parent-teacher dyads discussed problems that neither reported as their primary concern, and 31% discussed problems that neither reported as their primary or secondary concern. These findings suggest that interventions should target parent-teacher communication, rather than agreement, to facilitate home-school collaboration.

Keywords: autism; autism spectrum disorders; family–school partnerships; parent–teacher communication.

Effective parent-teacher communication involves problem-solving concerns about students. Few studies have examined problem solving interactions between parents and teachers of children with autism spectrum disorder (ASD), with a particular focus on identifying communication barriers and strategies for improving them. This study examined the problem-solving behaviors of parents and teachers of children with ASD. Participants included 18 teachers and 39 parents of children with ASD. Parent-teacher dyads were prompted to discuss and provide a solution for a problem that a student experienced at home and at school. Parents and teachers also reported on their problem-solving behaviors. Results showed that parents and teachers displayed limited use of the core elements of problem-solving. Teachers displayed more problem-solving behaviors than parents. Both groups reported engaging in more problem-solving behaviors than they were observed to display during their discussions. Our findings suggest that teacher and parent training programs should include collaborative approaches to problem-solving.

Keywords: autism; autism spectrum disorder; parent-teacher communication; problem-solving.

Background: Peer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.

Method: The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.

Results: Four of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.

Conclusion: PMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.

Keywords: Autism spectrum disorder; Peer-mediated interventions; Systematic review.

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that would benefit from low-cost and reliable improvements to screening and diagnosis. Human language technologies (HLTs) provide one possible route to automating a series of subjective decisions that currently inform “Gold Standard” diagnosis based on clinical judgment. In this paper, we describe a new resource to support this goal, comprised of 100 20-minute semi-structured English language samples labeled with child age, sex, IQ, autism symptom severity, and diagnostic classification. We assess the feasibility of digitizing and processing sensitive clinical samples for data sharing, and identify areas of difficulty. Using the methods described here, we propose to join forces with researchers and clinicians throughout the world to establish an international repository of annotated language samples from individuals with ASD and related disorders. This project has the potential to improve the lives of individuals with ASD and their families by identifying linguistic features that could improve remote screening, inform personalized intervention, and promote advancements in clinically-oriented HLTs.

Keywords: annotation; autism spectrum disorder; collection; data distribution; language resources; quality control.

Objective: This study compared use of and associated expenditures for Medicaid-reimbursed school-based and out-of-school services for children with autism spectrum disorder (ASD) and those with other psychiatric disorders.

Methods: Philadelphia County Medicaid claims were used to identify children ages five to 17 who received behavioral health services through Medicaid any time between October 2008 and September 2009 (N=24,271). Children were categorized into four diagnostic groups: autism spectrum disorder (ASD), conduct disorder or oppositional defiant disorder (conduct-ODD), attention-deficit hyperactivity disorder (ADHD), and other psychiatric disorders. Logistic regression analysis compared use of in-school and out-of-school behavioral health services between children with ASD and children with other psychiatric disorders. Generalized linear models with gamma distribution were used to estimate differences in Medicaid expenditures for in-school and out-of-school services and total Medicaid expenditures for both service types by disorder, with adjustments for age, sex, and race-ethnicity.

Results: The most common diagnosis was ADHD (40%); 35% had other psychiatric disorders, 21% had conduct-ODD, and 4% had ASD. A significantly greater proportion of children with ASD (52%) received in-school behavioral health services (conduct-ODD, 5%; ADHD, 8%; and other psychiatric disorders, 1.7%) Per-child expenditures for both school-based and out-of-school behavioral health services were significantly higher for children with ASD than for children in the other groups.

Conclusions: Medicaid represents an important source of in-school and out-of-school care for children with ASD and their families. States that expand Medicaid under the Affordable Care Act should give careful consideration to covering school-based mental health services for children with ASD.

Phelan-McDermid syndrome (PMS), a monogenic form of autism spectrum disorder (ASD), results from deletion or mutation of the SHANK3 gene. Atypical sensory reactivity is now included in the diagnostic criteria for ASD. Examining the sensory phenotype in monogenic forms of ASD, such as PMS, may help identify underlying mechanisms of sensory reactivity. Using the Short Sensory Profile, the current study compared sensory reactivity in 24 children with PMS to 61 children with idiopathic ASD (iASD). Results suggest that children with PMS show more low energy/weak symptoms and less sensory sensitivity as compared to children with iASD. This study is the first to demonstrate differences in sensory reactivity between children with PMS and iASD, helping to refine the PMS phenotype.

Keywords: 22q13 deletion syndrome; Autism; Autism spectrum disorder; Phelan–McDermid syndrome; Sensory profile; Sensory reactivity.

Sensory reactivity is a new DSM-5 criterion for autism spectrum disorder (ASD). The current study aims to validate a clinician-administered sensory observation in ASD, the Sensory Processing Scale Assessment (SPS). The SPS and the Short Sensory Profile (SSP) parent-report were used to measure sensory reactivity in children with ASD (n = 35) and typically developing children (n = 27). Sixty-five percent of children with ASD displayed sensory reactivity symptoms on the SPS and 81.1 % on the SSP. SPS scores significantly predicted SSP scores. We next identified the five SPS tasks that best differentiated groups. Our results indicate that a combination of parent-report and at least the five most differentiating observational tasks may be most sensitive in identifying the presence of sensory reactivity issues.

Keywords: Autism spectrum disorder; New DSM-5 criterion; Sensory Processing Scale Assessment; Sensory reactivity.

There are inconsistent findings regarding parent and teacher agreement on behavioral ratings of their children with autism. One possible reason for this inconsistency is that studies have not taken autism severity into account. This study examined parent and teacher concordance of social behavior based on symptom severity for children with autism. Participants were 123 parent-teacher dyads who completed the Social Responsiveness Scale. Symptom severity was assessed using the Autism Diagnostic Observation Schedule (ADOS). Results indicated that parent and teacher ratings were statistically significantly correlated at the beginning and end of the academic year, but only for severely affected children. Teacher report of social deficits was correlated with symptom severity as measured by the ADOS; parent report was not. These findings have implications for improving assessment procedures and parent-teacher collaboration.

Keywords: Social Responsiveness Scale; autism; autism spectrum disorder; parent-teacher relationships; social behavior.

Introduction of the National Institute of Mental Health’s Research Domain Criteria and revision of diagnostic classification for Autism Spectrum Disorder in the latest diagnostic manual call for a new way of conceptualizing heterogeneous ASD features. We propose a novel conceptualization of ASD, borrowing from the schizophrenia literature in clustering ASD features along positive, negative, and cognitive dimensions. We argue that this dimensional conceptualization can offer improved ability to classify, diagnose, and treat, to apply and predict response to treatment, and to explore underlying neural and genetic alterations that may contribute to particular feature clusters. We suggest the proposed conceptualization can advance the field in a manner that may prove clinically and biologically useful for understanding and addressing heterogeneity within ASD.

Keywords: Autism spectrum disorder; Classification; Diagnosis; Heterogeneity; RDoC; Symptoms.

Autism spectrum disorder, Anxiety, Differential diagnosis, Assessment, Measurement

Human neuroimaging studies suggest that aberrant neural connectivity underlies behavioural deficits in autism spectrum disorders (ASDs), but the molecular and neural circuit mechanisms underlying ASDs remain elusive. Here, we describe a complete knockout mouse model of the autism-associated Shank3 gene, with a deletion of exons 4-22 (Δe4-22). Both mGluR5-Homer scaffolds and mGluR5-mediated signalling are selectively altered in striatal neurons. These changes are associated with perturbed function at striatal synapses, abnormal brain morphology, aberrant structural connectivity and ASD-like behaviour. In vivo recording reveals that the cortico-striatal-thalamic circuit is tonically hyperactive in mutants, but becomes hypoactive during social behaviour. Manipulation of mGluR5 activity attenuates excessive grooming and instrumental learning differentially, and rescues impaired striatal synaptic plasticity in Δe4-22(-/-) mice. These findings show that deficiency of Shank3 can impair mGluR5-Homer scaffolding, resulting in cortico-striatal circuit abnormalities that underlie deficits in learning and ASD-like behaviours. These data suggest causal links between genetic, molecular, and circuit mechanisms underlying the pathophysiology of ASDs.