Christin A. McDonald

Anxiety and Depression in Children with HFASDs: Symptom Levels and Source Differences

The purpose of this study was to: (1) examine symptom levels of anxiety and depression in children with high-functioning autism spectrum disorders (HFASDs) compared with matched control children using child self-reports and parent ratings; and (2) examine source differences within the two condition groups. An overall multivariate effect indicated significantly elevated depression and anxiety symptoms for children with HFASDs based on parent reports; however no significant between-group differences based on child self-reports. Within-condition source comparisons (parent vs. child) revealed a significant multivariate effect indicating a significant difference in symptoms of depression and anxiety for the HFASD group but none for the control. Correlations between parent and child reports for the HFASD group suggested some positive association between child-reports and parent-reports for depressive symptoms only; however, the difference in average scores reflected a substantial discrepancy in the magnitude of symptoms by rater. Implications for clinical assessment and future research are provided.

Comparison of Adaptive Behavior Measures for Children with HFASDs

Adaptive behavior rating scales are frequently used to gather information on the adaptive functioning of children with high-functioning autism spectrum disorders (HFASDs), yet little is known about the extent to which these measures yield comparable results. This study was conducted to (a) document the parent-rated VABS-II, BASC-2, and ABAS-II adaptive behavior profiles of 6- to 11-year-olds with HFASDs (including relative strengths and weaknesses); (b) examine the extent to which these measures yielded similar scores on comparable scales; and (c) assess potential discrepancies between cognitive ability and adaptive behavior across the measures. All three adaptive measures revealed significant deficits overall for the sample, with the VABS-II and ABAS-II indicating relative weaknesses in social skills and strengths in academic-related skills. Cross-measure comparisons indicated significant differences in the absolute magnitude of scores. In general, the VABS-II yielded significantly higher scores than the BASC-2 and ABAS-II. However, the VABS-II and ABAS-II yielded scores that did not significantly differ for adaptive social skills which is a critical area to assess for children with HFASDs. Results also indicated significant discrepancies between the childrens average IQ score and their scores on the adaptive domains and composites of the three adaptive measures.

Open-Trial Pilot Study of a Comprehensive School-Based Intervention for High-Functioning Autism Spectrum Disorders

There is a notable lack of manualized comprehensive school-based interventions (CSBIs) for children with high-functioning autism spectrum disorders (HFASDs). This pilot study examined the feasibility and initial efficacy of a CSBI for 12 children with HFASDs, aged 6 to 9 years. Treatment included a 3-week summer preparation program followed by a 10-month CSBI, composed of social skills groups, therapeutic activities, face and voice emotion recognition instruction, an individual daily note, and parent training. Feasibility was supported in high levels of treatment fidelity and teacher- and parent-reported acceptability and satisfaction. Pre–post comparisons suggested that children significantly improved their knowledge of target social skills and ability to identify emotions in facial and vocal expressions. According to parent and teacher ratings, children displayed gains in their use of target social skills and broader social performance, as well as reductions in ASD-related features.

VMI-VI and BG-II KOPPITZ-2 for Youth With HFASDs and Typical Youth

The visual-motor skills of 90 youth with high-functioning autism spectrum disorders (HFASDs) and 51 typically developing (TD) youth were assessed using the Beery–Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition (VMI-VI) and Koppitz Developmental Scoring System for the Bender–Gestalt Test–Second Edition (KOPPITZ-2). Within-group comparisons (for both samples) yielded substantive mean differences between the KOPPITZ-2 composite and VMI-VI composite, Visual Perception and Motor Coordination sections of the VMI-VI, and VMI-VI composite and either VMI-VI supplemental tests. Between-group differences were assessed in a matched subsample of 33 participants from each group. The HFASD group scored significantly lower than the TD group on test sections requiring greater motor ability (i.e., VMI-VI composite, VMI-VI Motor Coordination, KOPPITZ-2 composite, and Bender–Gestalt Visual-Motor Test–Second Edition [BG-II]). Correlations between the KOPPITZ-2 composite and VMI-VI composite were .56 for the HFASD and .36 for the TD samples.

Open-Trial Pilot of "Mind Reading" and in Vivo Rehearsal for Children with HFASD.

In this pilot study, the authors evaluated a manualized administration of the Mind Reading (MR) program with in vivo rehearsal to determine the effects on emotion recognition and autism features of eleven 7- to 12-year-old children with High-Functioning Autism Spectrum Disorders (HFASD), and to determine the overall feasibility of the intervention. Following 12 sessions of MR over 6 weeks (M = 15.87 hr per child), emotion recognition and ability to display emotion were rated to be significantly higher than pretest. Significant reductions were found on ratings of autism-associated symptoms on a standardized rating scale completed by parents. Assessment of feasibility indicated high levels of treatment fidelity and high levels of parent- and child-reported satisfaction. Effect size estimates were medium to large for scales on which significant changes were observed. Implications for more controlled studies are proposed.

Community Effectiveness RCT of a Comprehensive Psychosocial Treatment for High-Functioning Children With ASD

This community effectiveness randomized clinical trial examined the feasibility and effectiveness of a comprehensive psychosocial treatment, summerMAX, when implemented by a community agency. Fifty-seven high-functioning children (48 male, 9 female), ages 7–12 years with autism spectrum disorder participated in this study. The 5-week summerMAX treatment included instruction and therapeutic activities targeting social/social-communication skills, interpretation of nonliteral language skills, face-emotion recognition skills, and interest expansion. A behavioral program was also used to increase skills acquisition and decrease autism spectrum disorder symptoms and problem behaviors. Feasibility was supported via high levels of fidelity and parent, child, and staff clinician satisfaction. Significant treatment effects favoring the treatment group over waitlist controls were found on all 5 of the primary outcome measures (i.e., child test of nonliteral language skills and parent ratings of the children’s autism spectrum disorder symptoms, targeted social/social-communication skills, broader social performance, and withdrawal). Staff clinician ratings substantiated the improvements reported by parents. Results of this randomized clinical trial are consistent with those of prior studies of summerMAX and suggest that the program was feasible and effective when implemented by a community agency under real-world conditions.

Community Trial of a Comprehensive Psychosocial Treatment for HFASDs

This community effectiveness trial examined the feasibility and efficacy of a comprehensive psychosocial treatment for 28 children, aged 7 to 10 years with high-functioning autism spectrum disorders (HFASDs). Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition skills, interest expansion, and interpretation of non-literal language skills. A behavioral program was instituted to foster skills acquisition and reduce ASD symptoms and problem behaviors. Feasibility was supported in high levels of fidelity and satisfaction. Significant improvements were found for the children’s non-literal language skills and parent ratings of target social and communicative skills, broader social performance, and ASD symptoms. Secondary staff ratings corroborated parent ratings. Results suggest that the treatment, when administered by a community agency, was feasible and yielded positive outcomes similar to prior randomized clinical trials (RCTs).

Open-trial pilot study of a comprehensive outpatient psychosocial treatment for children with high-functioning autism spectrum disorder.

This study examined the feasibility and initial outcomes of a comprehensive outpatient psychosocial treatment (MAXout) for children aged 7–12 years with high-functioning autism spectrum disorder. The 18-week treatment, two 90-minute sessions per week, included instruction and therapeutic activities targeting social/social communication skills, facial emotion recognition, non-literal language skills, and interest expansion. A behavioral system was implemented to reduce autism spectrum disorder symptoms and problem behaviors and increase skills acquisition and maintenance. Feasibility was supported via high levels of treatment fidelity and parent, child, and staff satisfaction. Significant post-treatment improvements were found for the children’s non-literal language skills and facial emotion recognition skills, and parent and staff clinician ratings of targeted social/social communication skills, broad social skills, autism spectrum disorder symptoms, and problem behaviors. Results suggested that MAXout was feasible and may yield positive outcomes for children with high-functioning autism spectrum disorder.

Informant Discrepancies in the Assessment of ASD Symptoms of High-Functioning Children With ASD Using the SRS–2

ABSTRACT This study compared ratings by parents and teachers of 120 high-functioning children with autism spectrum disorder on the Social Responsiveness Scale–2. Parent ratings were significantly higher than those of teachers; correlations between the informants were low to moderate. Parent–teacher pairs placed 87% of cases above the clinically significant threshold. Implications for screening, diagnosis, and outcome assessment are provided.

Brief Report: Examination of Sex-Based Differences in ASD Symptom Severity Among High-Functioning Children with ASD Using the SRS-2

Prior studies of sex-based differences in autism spectrum disorder (ASD) have yielded mixed findings. This study examined ASD symptom severity and functional correlates in a sample of 34 high-functioning females with ASD (HFASD; M age = 8.93; M IQ = 104.64) compared to 34 matched males (M age = 8.96; M IQ = 104.44) using the Social Responsiveness Scale-Second Edition (SRS-2). Results identified non-significant and minimal differences (negligible-to-small) on the SRS-2 total, DSM-5 symptom subscale, and treatment subscale scores. Significant negative (moderate) correlations were found between the SRS-2 Social Cognition subscale and IQ and language scores and between the SRS-2 Social Motivation subscale and receptive language scores for females only; no significant correlations were found for males.