Carolyn McCormick

Preliminary Findings of a Telehealth Approach to Parent Training in Autism

Telehealth or online communication technologies may lessen the gap between intervention requirements for children with autism spectrum disorders (ASDs) and the available resources to provide these services. This study used a video conferencing and self-guided website to provide parent training in the homes of children with ASD. The first eight families to complete the 12-week online intervention and three-month follow up period served as pilot data. Parents’ intervention skills and engagement with the website, as well as children’s verbal language and joint attention skills were assessed. Preliminary research suggests telehealth may support parental learning and improve child behaviors for some families. This initial assessment of new technologies for making parent training resources available to families with ASD merits further, in-depth study.

Sensory symptoms in children with autism spectrum disorder, other developmental disorders and typical development: A longitudinal study

Sensory symptoms are prevalent in autism spectrum disorder but little is known about the early developmental patterns of these symptoms. This study examined the development of sensory symptoms and the relationship between sensory symptoms and adaptive functioning during early childhood. Three groups of children were followed across three time points from 2 to 8 years of age: autism spectrum disorder, developmental delay, and typical development. At each time point, parents filled out questionnaires regarding their child’s sensory symptoms and adaptive functioning. At the initial time point, parents of children with autism spectrum disorder reported more sensory symptoms in their children than parents in the typical development group. Parents in the autism spectrum disorder group reported more sensory symptoms than parents in the developmental delay group within smell, taste, and auditory domains. While the typical development group decreased in reported sensory symptoms across the study period, the clinical groups demonstrated no significant change across assessment points. Sensory symptoms for all groups were not independently predictive of adaptive functioning when verbal mental age was also included in the model. The young age range at the initial assessment and pattern of results suggest that sensory symptoms are present early in the etiology of autism spectrum disorder and other developmental disorders and remain stable over time.

Electrodermal and Behavioral Responses of Children With Autism Spectrum Disorders to Sensory and Repetitive Stimuli

Parents frequently report that their children with autism spectrum disorders (ASD) respond atypically to sensory stimuli. Repetitive behaviors are also part of the ASD behavioral profile. Abnormal physiological arousal may underlie both of these symptoms. Electrodermal activity (EDA) is an index of sympathetic nervous system arousal. The goals of this study were twofold: (1) to pilot methods for collecting EDA data in young children and (2) to examine hypothesized relationships among EDA, and sensory symptoms and repetitive behaviors in children with ASD as compared with children with typical development. EDA was recorded on 54 young children with ASD and on 33 children with typical development (TD) during a protocol that included baseline, exposure to sensory and repetitive stimuli, and play. Parents completed standardized questionnaires regarding their childs sensory symptoms and repetitive behaviors. Frequency and type of repetitive behavior during play was coded offline. Comparisons between EDA data for ASD and TD groups indicated no significant between‐group differences in any measures. Parents of children with ASD reported more abnormal responses to sensory stimuli and more repetitive behaviors, but scores on these measures were not significantly correlated with EDA or with frequency of observed repetitive behaviors. Parent report of frequency and severity of sensory symptoms was significantly correlated with reports of repetitive behaviors in both groups. Although parents of children with ASD report high levels of sensory symptoms and repetitive behaviors, these differences are not related to measured EDA arousal or reactivity. Autism Res 2014, 7: 468–480.

Telehealth Parent Training in the Early Start Denver Model Results From a Randomized Controlled Study

Telehealth training may benefit parents’ use of early intervention for children with autism spectrum disorder (ASD). This study is one of the few randomized trials to compare telehealth parent training in the Early Start Denver Model (P-ESDM) with a community treatment-as-usual, early intervention program. Parents were randomized to 12 weekly 1.5-hr videoconferencing sessions with website access to P-ESDM learning resources or to monthly 1.5-hr videoconferencing sessions with website access to alternative resources to support their intervention. Telehealth training facilitated higher parent fidelity gains and program satisfaction for more of the P-ESDM than the community group at the end of the 12-week training and at follow-up. Children’s social communication skills improved for both groups regardless of parent fidelity. Findings suggest the feasibility of telehealth training with improved parent intervention usage and satisfaction from the program. However, the impact of these effects on children’s development over time is yet to be understood.

Diminished respiratory sinus arrhythmia response in infants later diagnosed with autism spectrum disorder: RSA response in infants with ASD outcome

Indicators of risk for developing Autism Spectrum Disorder (ASD) are difficult to detect within the first year of life. In this study, infants who were originally followed prospectively to examine general developmental risks due to substance exposure interacted with their mother and an unfamiliar experimenter for 2‐min episodes at 4 months of age. Electrocardiogram was collected to measure respiratory sinus arrhythmia (RSA) and the session was video recorded for behavioral coding. Two groups of infants were compared: infants with a diagnosed ASD outcome (N = 8) and matched controls (N = 186). Infants were compared on mean RSA and infant behavioral codes for each 2‐min episode. No significant group differences were revealed on RSA or behavior during interactions between the infants and mothers. However, in response to play with a stranger, infants with an ASD outcome had lower RSA (M = 2.49, 95% CI [2.30, 2.98]) than controls (M = 3.12, 95% CI [3.06, 3.18]). During the interaction with a stranger, lower RSA response was associated with more protesting behaviors (P < 0.01), whereas higher RSA response was associated with more social monitoring (P = 0.001). Lower RSA suggests that 4‐month‐old infants later diagnosed with ASD exhibited poorer autonomic regulation during interaction with an unfamiliar adult than did controls. Physiological regulation during interactions with a new social partner may be disrupted early in infancy in children with ASD, as indicated here by lower RSA, and therefore be a potential target for developing early risk screening tools for ASD. Autism Res 2018, 11: 726–731.

Sensitivity to audio-visual synchrony and its relation to language abilities in children with and without ASD: Mid-life social outcomes for adults

Autism Spectrum Disorder (ASD) is often accompanied by deficits in speech and language processing. Speech processing relies heavily on the integration of auditory and visual information, and it has been suggested that the ability to detect correspondence between auditory and visual signals helps to lay the foundation for successful language development. The goal of the present study was to examine whether young children with ASD show reduced sensitivity to temporal asynchronies in a speech processing task when compared to typically developing controls, and to examine how this sensitivity might relate to language proficiency. Using automated eye tracking methods, we found that children with ASD failed to demonstrate sensitivity to asynchronies of 0.3s, 0.6s, or 1.0s between a video of a woman speaking and the corresponding audio track. In contrast, typically developing children who were language‐matched to the ASD group, were sensitive to both 0.6s and 1.0s asynchronies. We also demonstrated that individual differences in sensitivity to audiovisual asynchronies and individual differences in orientation to relevant facial features were both correlated with scores on a standardized measure of language abilities. Results are discussed in the context of attention to visual language and audio‐visual processing as potential precursors to language impairment in ASD. Autism Res 2018, 11: 645–653.

Brief Report: Factors Influencing Healthcare Satisfaction in Adults with Autism Spectrum Disorder.

The current study investigated healthcare satisfaction and factors related to satisfaction in 92 adults with Autism Spectrum Disorder (ASD). Participants or their caregiver completed a survey about their experiences with primary care and specialty physicians. Respondents reported a high level of satisfaction with their healthcare. The only factor significantly associated with satisfaction was age, with participants under age 26 reporting significantly higher levels of satisfaction than participants above age 26. Participants under age 26 also were significantly more likely to live at home, have private health insurance, and have others making their healthcare decisions than participants above age 26. Results indicate that healthcare satisfaction can be high for adults with ASD that have good family and community support.

Developmental Disability and Fragile X Syndrome: Clinical Overview

Fragile X syndrome (FXS) is caused by mutation of a single gene (FMR1) on the X chromosome and is the leading cause of inherited developmental disability, as well as the leading single gene cause of autism. Individuals with FXS have well-described physical and behavioral phenotypes; however, considerable variability in phenotype expression has been explained by a number of environmental, genetic, and biological/physiological factors. The brain and molecular genetic basis of FXS has been relatively well described through numerous human studies and animal models, and as such, it provides a useful model for understanding links between genes, brain, and behavior; specific conditions such as autism, attention-deficit/hyperactivity disorder, and anxiety disorders; and for testing pharmacological, behavioral, and gene therapies.