- Pilot Study Examining Caregiver-Child and Family Functioning in PEERS® for PreschoolersFactor, Reina S.; Rea, Hannah M.; Dahiya, Angela, V; Laugeson, Elizabeth A.; Scarpa, Angela (Springer, 2022-09)Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and often worsen. Research indicates including caregivers in social skills groups may increase generalization for child outcomes, while also benefiting caregivers by increasing their self-confidence in ability to coach their child. Further, there may be an impact on the entire family. This pilot study examined benefits to the caregiver-child relationship, caregiver self-efficacy, parenting style, and family functioning in an exploratory study of the PEERS® for Preschoolers (P4P) social skills program. The present pilot study aimed to examine the above variables with 15 children with ASD (11 boys; 66.7% white) without intellectual impairment in four groups, applying this novel intervention, informed by other PEERS® programs. Children ranged from 4 to 7 years (M = 4.87, SD = 1.25). Children and caregivers participated in groups twice weekly (i.e., 8 weeks, 16 sessions). Measures that captured specified variables were completed by caregivers as well as through an observational task. Results showed increases in parenting self-efficacy and positive caregiver-child interaction strategies, specifically in caregiver affect/animation and achievement orientation over intervention and at follow-up. Caregivers also noted improvements in overall parenting styles. Changes in family functioning were not indicated. This pilot intervention may positively impact both the child and caregiver, though more research is needed with larger samples that include a control group and apply conclusions to the larger population. Future research should address why changes to family functioning did not emerge and specific mechanisms that lead to positive caregiver-specific outcomes.
- Social attention during object engagement: toward a cross-species measure of preferential social orientingWeichselbaum, Claire; Hendrix, Nicole; Albright, Jordan; Dougherty, Joseph D.; Botteron, Kelly N.; Constantino, John N.; Marrus, Natasha (2022-12-14)Background A central challenge in preclinical research investigating the biology of autism spectrum disorder (ASD) is the translation of ASD-related social phenotypes across humans and animal models. Social orienting, an observable, evolutionarily conserved behavior, represents a promising cross-species ASD phenotype given that disrupted social orienting is an early-emerging ASD feature with evidence for predicting familial recurrence. Here, we adapt a competing-stimulus social orienting task from domesticated dogs to naturalistic play behavior in human toddlers and test whether this approach indexes decreased social orienting in ASD. Methods Play behavior was coded from the Autism Diagnostic Observation Schedule (ADOS) in two samples of toddlers, each with and without ASD. Sample 1 (n = 16) consisted of community-ascertained research participants, while Sample 2 involved a prospective study of infants at a high or low familial liability for ASD (n = 67). Coding quantified the child’s looks towards the experimenter and caregiver, a social stimulus, while playing with high-interest toys, a non-social stimulus. A competing-stimulus measure of “Social Attention During Object Engagement” (SADOE) was calculated by dividing the number of social looks by total time spent playing with toys. SADOE was compared based on ASD diagnosis and differing familial liability for ASD. Results In both samples, toddlers with ASD exhibited significantly lower SADOE compared to toddlers without ASD, with large effect sizes (Hedges’ g ≥ 0.92) driven by a lower frequency of child-initiated spontaneous looks. Among toddlers at high familial likelihood of ASD, toddlers with ASD showed lower SADOE than toddlers without ASD, while SADOE did not differ based on presence or absence of familial ASD risk alone. SADOE correlated negatively with ADOS social affect calibrated severity scores and positively with the Communication and Symbolic Behavior Scales social subscale. In a binary logistic regression model, SADOE alone correctly classified 74.1% of cases, which rose to 85.2% when combined with cognitive development. Conclusions This work suggests that a brief behavioral measure pitting a high-interest nonsocial stimulus against the innate draw of social partners can serve as a feasible cross-species measure of social orienting, with implications for genetically informative behavioral phenotyping of social deficits in ASD and other neurodevelopmental disorders.
- Perceived Driving Difficulty, Negative Affect, and Emotion Dysregulation in Self-Identified Autistic Emerging DriversFok, Megan; Owens, Justin M.; Ollendick, Thomas H.; Scarpa, Angela (Frontiers, 2022-01-31)Driving is central to adult independence and autonomy; yet most autistic young adults do not acquire driver’s licenses. It is important to understand barriers to achieving this milestone for autistic adults. Differences in negative affect and emotion dysregulation associated with autism may interfere with managing difficult driving situations. The current study compared perceived driving difficulty (DD), emotion dysregulation, and negative affect in emerging drivers with and without autistic traits (AT), and investigated how emotion dysregulation and negative affect relate to perceived DD. We expected (1) greater perceived DD, emotion dysregulation, and negative affect in participants with AT and (2) a positive correlation of perceived DD with both emotion dysregulation and negative affect in the whole sample. Thirty-seven adolescents and young adults (15 AT) self-reported perceived DD in 15 scenarios and completed the Difficulty in Emotion Dysregulation Scale (DERS) and the Depression, Anxiety, and Stress Scale (DASS). Autistic participants scored significantly higher on mean perceived DD, DERS Impulse subscale, DASS total and DASS Stress subscale scores. Perceived DD positively correlated with the DERS and DASS total scores, all DASS subscales, and DERS Nonacceptance, Goals, and Impulse subscales across the whole sample. The findings highlight the roles of emotion dysregulation and negative affect in perceived DD in emerging drivers with AT. In particular, emotional stress and impulsivity may map onto mechanisms of over-reactivity to negative affect and explain why autistic people perceive particular situations as difficult when driving. Implications and directions for future research are discussed.
- Enhancing Flexibility: A Biosocial Model for Resilience to Adversity in Youth With AutismScarpa, Angela; Swain, Deanna M.; Factor, Reina S.; Dahiya, Angela V.; Bertollo, Jennifer R. (SAGE, 2021)Flexibility is often associated with resilience from adversity. Youth with autism spectrum disorder (ASD) are at risk of stress and trauma yet have inherent difficulties with flexibility, including rigid behaviors, routines, “insistence on sameness,” and lack of social reciprocity. This review highlights literature of physiological and psychological processes related to inflexibility in ASD and proposes a heuristic model to understand mechanisms of resilience in the aftermath of adversity. This article presents the Biosocial Model for Resilience, which posits that interventions that target changes in central, autonomic, and endocrine dysregulation may in turn enhance processes of psychological flexibility (i.e., executive cognitive, emotional, and interpersonal regulation) that increase the likelihood of resilient adjustment in response to stressful experiences. This model of resilience is optimistic in positing that, in addition to critical programs on the prevention of social adversity, future research on flexibility can inform intervention programs that target this specific mechanism to minimize harmful aftereffects in youngsters with ASD.
- Access to Autism Spectrum Disorder Services for Rural Appalachian CitizensScarpa, Angela; Jensen, Laura S.; Gracanin, Denis; Ramey, Sharon L.; Dahiya, Angela V.; Ingram, L. Maria; Albright, Jordan; Gatto, Alyssa J.; Scott, Jen Pollard; Ruble, Lisa (2020-01)Background: Low-resource rural communities face significant challenges regarding availability and adequacy of evidence-based services. Purposes: With respect to accessing evidence-based services for Autism Spectrum Disorder (ASD), this brief report summarizes needs of rural citizens in the South-Central Appalachian region, an area notable for persistent health disparities. Methods: A mixed-methods approach was used to collect quantitative and qualitative data during focus groups with 33 service providers and 15 caregivers of children with ASD in rural southwest Virginia. Results: Results supported the barriers of availability and affordability of ASD services in this region, especially relating to the need for more ASD-trained providers, better coordination and navigation of services, and addition of programs to assist with family financial and emotional stressors. Results also suggested cultural attitudes related to autonomy and trust towards outside professionals that may prevent families from engaging in treatment. Implications: Relevant policy recommendations are discussed related to provider incentives, insurance coverage, and telehealth. Integration of autism services into already existing systems and multicultural sensitivity of providers are also implicated.