Connie Anderson

Risk factors for bullying among children with autism spectrum disorders

Although children with disabilities have been found to be at an increased risk of bullying, there are limited studies investigating predictors of bullying involvement in children with autism spectrum disorders. The current study presents findings from 1221 parents of children diagnosed with autism spectrum disorder who were selected from a national web-based registry. Parents completed a survey dedicated to the school and bullying experiences of their child, and multivariate logistic regression analyses were conducted to identify child and school risk factors for involvement as victim, bully, or bully–victim. Additional analyses examined the risk of bullying involvement based on the amount of time spent in general education classrooms. Children diagnosed with Asperger’s disorder, attending a public school or a school with a general education population, were at the greatest risk of being victimized in the past month. Children with comorbid conditions and a high level of autistic traits were the most likely to be victims, bullies, and bully–victims. Finally, children in full inclusion classrooms were more likely to be victimized than those who spend the majority of their time in special education settings. Future research studies should be invested in finding appropriate supports for children with autism spectrum disorder placed in inclusive settings.

Occurrence and Family Impact of Elopement in Children With Autism Spectrum Disorders

OBJECTIVES: Anecdotal reports suggest that elopement behavior in children with autism spectrum disorders (ASDs) increases risk of injury or death and places a major burden on families. This study assessed parent-reported elopement occurrence and associated factors among children with ASDs. METHODS: Information on elopement frequency, associated characteristics, and consequences was collected via an online questionnaire. The study sample included 1218 children with ASD and 1076 of their siblings without ASD. The association among family sociodemographic and child clinical characteristics and time to first elopement was estimated by using a Cox proportional hazards model. RESULTS: Forty-nine percent (n = 598) of survey respondents reported their child with an ASD had attempted to elope at least once after age 4 years; 26% (n = 316) were missing long enough to cause concern. Of those who went missing, 24% were in danger of drowning and 65% were in danger of traffic injury. Elopement risk was associated with autism severity, increasing, on average, 9% for every 10-point increase in Social Responsiveness Scale T score (relative risk 1.09, 95% confidence interval: 1.02, 1.16). Unaffected siblings had significantly lower rates of elopement across all ages compared with children with ASD. CONCLUSIONS: Nearly half of children with ASD were reported to engage in elopement behavior, with a substantial number at risk for bodily harm. These results highlight the urgent need to develop interventions to reduce the risk of elopement, to support families coping with this issue, and to train child care professionals, educators, and first responders who are often involved when elopements occur.

The association between bullying and the psychological functioning of children with autism spectrum disorders

Objective: Bullying has become a major national concern, particularly as it affects children with disabilities. The current study aimed to determine the association between psychiatric comorbid conditions, involvement in bullying (victim, bully, or bully–victim), and the immediate psychological correlates of bullying among children with autism spectrum disorders (ASDs). Methods: A national sample of 1221 parents completed a survey dedicated to the bullying and school experiences of their child with ASD, reporting on the immediate consequences of bullying involvement, including their childs psychological well-being and any psychiatric comorbidity. Multivariate logistic regressions were performed to determine whether specific psychiatric comorbidities were associated with an increased risk of involvement as victim, bully, or bully–victim. Analyses of variance determined the relationship between bullying frequency and psychological functioning. All models adjusted for child and school covariates. Results: Children who were frequently victimized were more likely to present with internalizing symptoms, whereas children who frequently bullied others were more likely to exhibit emotion regulation problems. Children who were identified as frequent bully–victims presented with both internalizing symptoms and emotion regulation problems. Children with attention-deficit hyperactivity disorder (ADHD) and depression were more likely to have been victimized, whereas children with conduct disorder (CD) or oppositional defiant disorder (ODD) were more likely to have bullied other children. Children identified as bully–victims were more likely to have ADHD, CD, or ODD. Conclusions: Children with ASDs who had displayed bullying behaviors in the past month exhibited psychological impairments, including psychiatric comorbidity. The frequency of bullying behaviors was significantly associated with the level of impairment.

The association between child autism symptomatology, maternal quality of life, and risk for depression

Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother’s quality of life, and mother’s risk for depression in a sample of 1,110 mothers recruited from a web-based registry of families with children with an ASD. Higher autism symptomatology and a greater number of co-occurring psychiatric disorders in the child were associated with an increased risk for current treatment of maternal depression and a lower maternal quality of life. The results highlight the importance of screening for depression, particularly in mothers of children with ASD and mental health and behavioral challenges.

Characterizing the daily life, needs, and priorities of adults with autism spectrum disorder from Interactive Autism Network data

Using online survey data from a large sample of adults with autism spectrum disorder and legal guardians, we first report outcomes across a variety of contexts for participants with a wide range of functioning, and second, summarize these stakeholders’ priorities for future research. The sample included n = 255 self-reporting adults with autism spectrum disorder aged 18–71 years (M = 38.5 years, standard deviation = 13.1 years) and n = 143 adults with autism spectrum disorder aged 18–58 years (M = 25.0 years, standard deviation = 8.2 years) whose information was provided by legal guardians. Although the self-reporting subsample had much higher rates of employment, marriage/partnership, and independent living than are typically seen in autism spectrum disorder outcome studies, they remained underemployed and had strikingly high rates of comorbid disorders. Data on both descriptive outcomes and rated priorities converged across subsamples to indicate the need for more adult research on life skills, treatments, co-occurring conditions, and vocational and educational opportunities. Stakeholders also placed priority on improving public services, health care access, and above all, public acceptance of adults with autism spectrum disorder. Findings must be interpreted in light of the self-reporting subsample’s significant proportion of females and of later-diagnosed individuals. This study underscores the need for lifespan research; initiatives will benefit from incorporating information from the unique perspectives of adults with autism spectrum disorder and their families.

Involvement in Bullying among Children with Autism Spectrum Disorders: Parents' Perspectives on the Influence of School Factors

Children with developmental disabilities are at an increased risk for involvement in bullying, and children with autism spectrum disorders (ASDs) may be at particular risk because of challenges with social skills and difficulty maintaining friendships, yet there has been little empirical research on involvement in bullying among children with ASD. The current study presents findings from a cross-sectional national survey of 1,221 parents of children with ASDs regarding their childrens experience with bullying (as both a victim and a perpetrator), as well as the parents’ perceptions of the school and their involvement in school-based prevention efforts. Structural equation modeling analyses revealed parents rate their childs school climate more negatively if their children had been bullied in the past month. Parents who viewed the school more positively were more likely to be involved in their childs school. These findings highlight the potential role a positive school climate may play in protecting children with ASDs from the harmful effects of bullying, as well as the potential benefits of involving parents in school-based activities. Moreover, the current study identifies children with Aspergers to be at particular risk for being bullied when compared with children with other ASDs.

Survey of Vaccine Beliefs and Practices Among Families Affected by Autism Spectrum Disorders

Despite the evidence base on the overall safety and efficacy of vaccines, some parents have concerns about a link between routine childhood vaccines and adverse neurological outcomes, specifically autism spectrum disorder (ASD). Few researchers have specifically examined the decision-making process of families caring for children with ASD and their siblings, although these families may question and possibly alter vaccine schedules for subsequent children after a child’s ASD diagnosis. Our goal was to examine immunization beliefs and practices to help elucidate this decision-making process by conducting an online survey of families with an ASDaffected child participating in a US autism registry. We hypothesized that among families with an ASDaffected child, maternal education level, geographic region and secular trends, and belief in a vaccine–autism link in an index child’s ASD all influence uptake of the childhood vaccine series among younger siblings.

Mood Disorders in Mothers of Children on the Autism Spectrum Are Associated with Higher Functioning Autism

Mood disorders occur more frequently in family members of individuals with autism spectrum disorders (ASD) than in the general population. There may be associations between maternal mood disorder history patterns and specific ASD phenotypes. We therefore examined the relationship between maternal mood disorders and child autism spectrum disorders in 998 mother-child dyads enrolled in a national online autism registry and database. Mothers of children with ASD completed online questionnaires addressing their childs ASD as well as their own mood disorder history. In multivariate logistic regression models of ASD diagnoses, the odds of an Asperger disorder versus autistic disorder diagnosis were higher among those children whose mothers had a lifetime history of bipolar disorder (OR 2.11, CI 1.20, 3.69) or depression (OR 1.62, CI 1.19, 2.19). Further, maternal mood disorder onset before first pregnancy was associated with higher odds (OR 2.35, CI 1.48, 3.73) of an Asperger versus autism diagnosis among this sample of children with ASD. These data suggest that differences in maternal mood disorder history may be associated with ASD phenotype in offspring.

Young Adults on the Autism Spectrum at College: Successes and Stumbling Blocks

There is limited information on outcomes for young adults with autism spectrum disorder (ASD), including achievement at college. Qualitative interviews were conducted with 18 families reporting a degree-seeking college experience for their young adult with ASD. Interview transcripts were analyzed using a grounded theory approach. Four themes surrounding success and failure at college emerged. Preparation Beyond Academics involved challenges associated with ASD, such as social, executive functioning, and mental health issues, and to what extent these had been addressed prior to leaving high school. Student/College Fit related to whether a student’s capabilities were matched to college location, size, and culture, while Campus Supports and Family Supports concerned assistance provided by colleges and families, respectively. Implications for future practice are discussed.

Barriers to Receipt of Services for Young Adults With Autism

Through qualitative analysis of parent interviews, we explore challenges accessing appropriate services and supports for YAs on the autism spectrum after high school. OBJECTIVES: In this study, we examine experiences of families of young adults (YAs) on the autism spectrum to better understand dynamics leading to poor YA outcomes. METHODS: Twenty parents of YAs with autism spectrum disorder (ASD) who had completed high school in the past 15 years took part in a 90-minute interview. They described their YA’s experiences at the transition from high school and current status with regards to services or postsecondary education. Qualitative interviews were digitally recorded, transcribed, and analyzed by using the constant comparative method associated with a grounded theory approach. RESULTS: Few adults with ASD were receiving autism-specific assistance no matter their level of cognitive functioning. Existing systems, such as service agencies and college disability support offices, had seldom been designed to meet their needs. Some families gave up on services, some used self-directed services they had to manage themselves, and others paid out of pocket for services they could access no other way. Inadequate services often led to YA failure and worsening of symptoms. The majority of families bore the financial and emotional brunt of finding or creating services and community experiences to meet their adult child’s needs. CONCLUSIONS: Parent narratives highlight the difficulties that are faced as families attempt to access appropriate services for YAs on the autism spectrum at all levels of functioning. These insights can help pediatricians understand family concerns and develop anticipatory guidance strategies. More research is needed to identify potential solutions to challenges faced by specific subgroups of YAs with ASD.