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Does maternal depression affect reports of child Autism Spectrum Disorder symptoms?
What is the research about?
To help make a diagnosis of ASD, researchers must depend upon the parent reports of their child’s symptoms. However, it is possible that the parents’ mood could influence how they view their child’s behaviour. This study examined whether or not a mother’s symptoms of depression made a difference to her reports of her child’s skills and behaviour, possibly increasing the likelihood that a diagnosis of ASD would be made.
What did the researchers do?
214 2- to 4-year old children (85% boys) with a recent diagnosis of ASD, and their mothers took part in this study. Using the Autism Diagnostic Interview – Revised (ADI-R), trained clinicians interviewed the mothers about their child’s behaviour. The children were also observed as they took part in tests of their social and communication abilities during the Autism Diagnostic Observation Schedule (ADOS). The mothers then filled out a survey called the Social Responsiveness Scale (SRS) to rate their children’s symptoms of autism. The mothers used the Symptoms Checklist-90 (SCL-90) to answer questions about their own feelings, moods, and behaviour. The data were then analyzed to see if there were relationships between any of these different test results.
What did the researchers find?
The researchers found that nearly one third of the mothers in this study were depressed, a higher rate than is usual in the general population. The data analysis revealed that when filling out a survey on their own, mothers with depression were more likely to report their child’s ASD symptoms as being more serious than what was observed by trained clinicians. When carefully questionned by the testing clinician the mothers reported less severe child symptoms compared to their own survey reports. The analysis showed, too, that the worse the mother’s symptoms of depression, the worse were her reports of her child’s ASD symptoms. The researchers did not find a relationship between the mother’s depression and the severity of her child’s ASD symptoms.
Take Home Message
This study showed that many mothers of children newly diagnosed with ASD are depressed. Their depression seems to influence the way they view and report on the severity of their child’s ASD symptoms. An important finding is that the mothers’ symptoms of depression did not worsen their child’s ASD symptoms. The authors conclude that instead of relying solely on the mother’s reports of her child’s skills and behaviour, especially if she is depressed, researchers and clinicians should include in their assessment the opinions and observations of several people who know the child.
Note: This Research Report was written by T. Bennett and colleagues and was published in the Journal of Child Psychology and Psychiatry. 2012.Depression, Anxiety and Problem Behaviours in Young Children with ASD
What is the research about?
Most research about disobedient, aggressive, or hostile behaviour or depression and anxiety in children with ASD has been conducted with school-aged children. Little is known about when these conditions begin or how they develop over time. In typically developing children the risk factors for both these types of mood and behaviour problems are difficult temperament, poor family environment with parental depression, poor relationship within families, and poor parenting practices, as well as cognitive difficulties, gender, and low income. It is not known what role these risk factors play in young children with ASD.
What did the researchers do?
Just after this group of 392 children, aged 2 to 4 years, had been diagnosed with ASD, the researchers examined their behaviour. The “parent most knowledgeable,” usually the mother, was interviewed about her child’s behaviour and mood and the child was observed by clinicians for signs and symptoms of mood and behaviour problems. The researcher then interviewed the mothers and tracked the children’s behaviour on four occasions: just after diagnosis; about 7 months after the 1st visit, about 6.5 months after that, and then 25 months after the previous visit.
What did the researchers find?
researchers found that both mood and behaviour problems tended to start early in life, persist as the child grows and develops, and are related to poorer social development. As well, compared to typically developing children with mood and behaviour problems, the children with ASD had more severe symptoms. The children in this study who had mood or behaviour problems tended to have both, together. Most of the children showed low symptom levels that declined over time, although girls were more likely to have depression and/or anxiety that required treatment. Other children tended to have stable high levels of both mood and behaviour problems, and others had high levels of mood problems, with a moderate degree of behaviour problems that declined over time.
Take Home Message
In this study about 25% of the children had mood or behaviour problems that were severe enough and persistent enough to require treatment, and were likely to occur together. The risk for these conditions was not related to intelligence or to the severity of their ASD symptoms, but was related to family low income and the child’s gender. Girls were more likely to experience depression and/or anxiety.
Note: This Research Report was written by T. Vaillancourt and colleagues, and was published in Development and Psychopathology. 2017.Effects of Personal and Social Resources on Parenting Stress in Mothers of Children with ASD
What is the research about?
Raising a child with Autism Spectrum Disorder (ASD) presents unique parenting challenges. How parents respond to them can have a strong influence on their own stress levels. Parental stress, in turn, could have negative effects on the long-term well-being of both parents and their children. This study looked at the relationship between child behavior problems, coping strategies, social resources, and parenting stress in mothers of young children with autism spectrum disorder.
What did the researchers do?
The researchers invited 283 mothers of young children who had recently been diagnosed with ASD to take part in this study. Mothers completed questionnaires about their family’s characteristics, such as income level, and family functioning and the ways mothers cope, and their available social supports. They also participated in some direct assessments of their child’s abilities and behavior, like language skills. Data were collected at the beginning of the study, and then again 2 years later.
What did the researchers find?
At the beginning of the study, researchers found several factors were related to increased maternal stress. These were high levels of child behavior problem, family dysfunction, and the mothers’ efforts to cope by sleeping more or just trying to forget or ignore problems (termed “disengaged emotion-focused coping). They also found that mothers who used high levels of social support and “active engaged problem-focused” ways of coping, such as trying to solve the problem, get help, or take positive meaning out of their difficult situation, had lower levels of parenting stress
Take Home Message
The stress levels of mothers of children with ASD can be reduced by having enough social support from friends, extended family, community or religious groups, positive family relationships and functioning, and using active problem-focused ways of coping. Being aware of how stress can affect mothers and the whole family, could help influence the use of better coping skills. An understanding of these factors could also help to direct the efforts of community programs designed to support them.
Note: The original Research Report was written by A. Zaidman-Zait and colleagues, and was published in Autism. 2016.Effects of Language Environments on Children with ASD
What is the research about?
There is a lack of research about the effect of a two-language (bilingual) environment on the language development of children with autism spectrum disorder (ASD). Families will sometimes choose to speak only one of their languages to their child with ASD, fearing that use of two languages will confuse or overload him/her. This study examined what differences, if any, the use of one or two languages in the home had on the language development of a group of child participants in the Pathways in ASD Study.
What did the researchers do?
The researchers selected 20 preschool child participants in the Pathways study who came from two-language (bilingual) homes, and 40 preschool children in the study from single-language (monolingual) homes. The group of monolingual children was chosen to match the bilingual children in terms of age and IQ. All of the children could say at least 30 words. Several signs of language development, such as age of first words, were measured in all the children.
What did the researchers find?
The researchers found that There was no difference in language development between the children with ASD There was no difference in language development between the children with ASD who were being raised in bilingual compared to monolingual environments.
Take home message
This study did not show any negative impacts of a bilingual environment on the language development of children with ASD.
This Research Report was written by J. K. Ohashi and colleagues, and was published in Research in Autism Spectrum Disorders. 2012.Language Impairment and Early Social Skills in Different Groups of Children with ASD
What is the research about?
Children with Autism Spectrum Disorder (ASD) who have problems using spoken language to communicate can also have problems with social interactions. The aim of the study was to determine if children with ASD with intellectual disability or ASD with language impairment have more problems with social skills development than do children with ASD, alone.
What did the researchers do?
The researchers tested the social and language skills of over 300 2- to 4-year-old children (82% boys) and their families. More than 50% of the children were receiving or had already received language or communication therapy by the time this research began. This study compared the social skills and abilities of children with ASD alone, to children with ASD and intellectual disability, and children with ASD and language impairment. The testing was done at the time of each child’s diagnosis, 6 months later, and then again 12 months after their diagnosis. For this study, language impairment referred to difficulty with the use of present, past, or future tenses, or correct use of I, me, you, we; the structures of speech, such as where words go in sentences; and vocabulary, that being, the number of words known and used appropriately by the child.
What did the researchers find?
The researchers showed that the children diagnosed with both ASD and intellectual disability or ASD with language impairment were more likely to have been referred for assessment at an earlier age than were children diagnosed with ASD alone. At 12 months after diagnosis, compared to children with ASD alone, this group of children also was more impaired in their ability to show interest in, understand, and respond to other people socially. Many of the children with ASD and language impairment seemed to “catch up”, and most were not language impaired 12 months after diagnosis. However, children with ASD and intellectual disability were more severely impaired than either of the other two groups and did not improve the way the other children did.
Take Home Message
Young children with ASD who are found to have specific language impairments or intellectual disability at the time of diagnosis are likely to be at risk of having social development problems as they grow up. These findings suggest that clinicians should start looking for signs of developmental delays and differences in younger children, to help improve early identification and treatment of children with ASD.
This Research Report was written by T. Bennett and colleagues and was published in the Journal of Autism and Developmental Disorders. 2014.Social and Language Development in Preschoolers with Autism Spectrum Disorder
What is the research about?
Children with ASD can have different levels of impairment of their social and communications skills. This study looked at whether, or not both of these skill levels develop at the same rate as each other as children with ASD grow up, or if the skills levels begin to differ from each other over time. The study also looked at whether, or not the levels of each of these skills at the time of diagnosis influenced the development of the other.
What did the researchers do?
At the beginning of the study the researchers used tests to determine the social and language skills of children aged 2 to 4, who were participating in the Pathways in ASD Study. Some of the tests were done directly with the children, while other information was gathered from surveys given to their parents. The same tests and surveys were given 6 months, and then 12 months later.
What did the researchers find?
The researchers discovered that the two different sets of skills were highly related to each other at the beginning of the study. However, as time passed, they became more and more independent of each other. By the 12-month testing point, there was little or no relationship between the development of language and social skills levels.
Take Home Message
This was the first study to show whether, or not social skills and language skills influence each other as children with ASD grow up. The findings of this study suggest that it is important that both social skills and language skills are treated from the time of diagnosis to help improve the child’s overall development.
This Research Report was written by T.A. Bennett and colleagues and was published in the Journal of Child Psychology and Psychiatry. 2015.Service utilization in a sample of Canadian preschool children with ASD
What is the research about?
Early intervention in children with ASD is known to be important to their future development and ability to reach their full potential. In Canada, the provincial, rather than federal, governments are responsible for providing funding for ASD treatment. This means that each province dictates the types of treatments and their costs. This study describes the kinds of services received by preschool children after their diagnosis of ASD in five large urban areas in Canada.
What did the researchers do?
The researchers gathered information from the parents of 414 children aged between 2 and 5 years, living in five major cities in Canada. The parents filled out surveys as soon as possible after diagnosis, 6 months later, 12 months later, and then at school entry. The types of services were listed as no services, behaviour interventions, developmental treatments, and general services such as music therapy, therapeutic horseback riding, or community recreation programs.
What did the researchers find?
The survey completion rates were 88% at time of diagnosis and 73% at time of school entry. At the study start, 80% of all the children were receiving some sort of treatment and about 95% were receiving some service at school entry. Just after diagnosis, the children were most likely to be receiving a developmental intervention like speech-language pathology. After that, children were most likely to receive combination treatments, such as applied behavioural analysis, and speech-language therapy. There were differences found in the types of treatments used in the five cities, meaning that no specific treatment or “dose” of that treatment was being used.
Take home message
It is a matter of concern that the majority of children in these major urban centres in Canada were receiving treatment, but there was no consistency across provinces on what treatment was given. This indicates that there is no agreement about what is the best kind of treatment, how much treatment, and for how long it is given. As a matter of equity, efforts should be made to determine what is best practice and to ensure that all children receive the most effective treatment no matter where they live.
This Research Report was written by J. Volden and colleagues, and was published in Paediatrics and Child Health. 2016.Stability and Change in Thinking and Daily Living Skills in Preschoolers with ASD
What is the research about?
The researchers looked at whether or not the thinking, memory, and planning (cognitive) skills and ability and daily living skills like feeding self, communicating with others (adaptive) skills of preschoolers diagnosed with Autism Spectrum Disorder (ASD) were related to one another at the time of diagnosis and if they both improved or got worse at the same rate as the children grew.
What did the researchers do?
The researchers used data gathered on 369 families participating in the Pathways in ASD study. 84% of the child participants were male. Tests were done with the children to determine their cognitive ability and the parents were interviewed about their child’s adaptive behaviour, and about their ability to walk or use their hands (motor skills). These tests and interviews were done about the time the child was diagnosed, at 2, 3, or 4 years of age, 1 year later, and then again at about age 6, just prior to school entry.
What did the researchers find?
The researchers found that the adaptive behaviour skills in children with no or mild to moderate cognitive delays improved between diagnosis and at 1-year follow up. The scores changed little between the 1-year follow up and testing at age 6. For children with severe cognitive delays, however, their adaptive behaviours did not improve until around the age of 4. Most children without delay in adaptive behaviour at diagnosis had no delay at school entry. About 40% of children with adaptive behaviour delays at diagnosis had no delays as they got older. There were large increases in cognitive ability over time in all groups.
Take Home Message
This study showed that children with ASD who were found at time of diagnosis to have delays in both cognitive and adaptive skills were more likely to a variety of outcomes. The findings of this study are important in that they show that some children with ASD with intellectual disability can have strengths compared to children with average IQ. It is known that adaptive skills can be a relative strength. It is known that IQ, particularly for those in the lower range, does not do a good job of describing abilities, and that adaptive functioning is what determines the kinds of supports that are needed.
This Research Report was written by H. Flanagan and colleagues, and published in the Journal of Autism and Developmental Disorders. 2015.Developmental Pathways of Preschool Children with ASD
What is the research about?
Studies have shown that the IQ and language ability of children with ASD can predict later outcomes. Child outcomes can also be influenced by autistic symptom severity and adaptive functioning, which refers to learning how to perform daily life tasks. This study looked at whether, or not data these two factors could be used to predict developmental outcomes of children with ASD.
What did the researchers do?
The researchers collected data on the autism symptoms severity and adaptive functioning of 421 Canadian children aged 2 to 4 years (355 males, 66 females), who had recently been diagnosed with ASD. The children were observed, and their parents were interviewed and filled out questionnaires to provide information about their abilities. The data on these children were collected at the time of diagnosis and then three more times until they were 6 years of age. The data on autism symptoms severity and adaptive functioning were analyzed to see if there were distinct developmental groups of children.
What did the researchers find?
Based on the data on autism symptom severity, the researchers found two distinct developmental groups. One group had less severe symptoms that improved over time. The second group had more severe symptoms that remained the same over time. Three groups emerged based on data collected on adaptive functioning. One group had lower adaptive functioning that worsened over time; a second had moderate adaptive functioning that remained the same over time; and the third group had higher adaptive functioning that improved over time. The researchers found that children could have less severe symptoms of autism, yet have lower levels of adaptive functioning that did not change over time. Children could have any combination of these two pathways. They also found that girls were more likely to fall in the less severe symptom and improving adaptive functioning developmental groups. As well, the age at time of diagnosis, both language and intelligence at the start of the study were related to the adaptive functioning group membership.
Take Home Message
Adaptive functioning and autistic symptom severity are largely independent developmental factors that have serious impacts on the development of children with ASD. Interventions based on each child’s individual strengths and weaknesses should be used to make decisions about treatment.
Note: This research report was written by P. Szatmari and colleagues, and was published in The Journal of the American Medical Association. 2015.Autism Policy in Canada
What is the research about?
Developing and applying appropriate ASD policies is a source of discussion and debate between parents, policymakers, and researchers. The authors wanted to understand the reasons for conflicts and disagreements about ASD policy among the parents, researchers, and policymakers. Parents usually discuss their first-hand experiences with their children and suggest what they feel needs to be done to improve their quality of life. Researchers can support these claims using evidence from their studies. Policymakers must then consider these requests, while still balancing their own obligations to provide equitable and cost-effective interventions. This study looked at what still needs to be done regarding ASD policymaking.
What did the researchers do?
The researchers wanted to learn about the current state of autism policy throughout the country. They asked 15 parents, 13 policymakers, and 11 researchers, from 8 provinces, to talk about different aspects of policymaking. The topics included their current understanding of provincial policies and services for children with autism, what they believed the most important unresolved policy issues were, their experiences interacting with the other two groups, and how they could possibly work together in the future. These responses were then analyzed to look for any similarities, and allowing the researchers to determine where a consensus regarding what needs to be done exist.
What did the researchers find?
All the participants agreed on the need for a more comprehensive approach to autism services
across the spectrum and throughout the lifespan. There was strong belief in the need to provide greater support during the transitions into school and into adulthood, expanding existing services to reach more disadvantaged children and families and increasing public investments in children’s mental health and development. Another finding was that policymakers struggled with the need to provide services to all children, not just those with ASD. All three groups agreed that more should be done for all groups of children with developmental problems.
Take Home Message
What emerged from this study is that parents, policymakers and researchers agree on the need for more comprehensive autism services. Overall, the researchers want it to be clear that more public resources should be made available to better support all children with mental health and developmental difficulties, in addition to ASD. These researchers’ finding of an overall consensus amongst the groups involved regarding the next steps of policy development suggests that these goals could be reached in the future.
NOTE: The original Research Report was written by C. Shepherd and C. Waddell, and was published in the Journal of Autism and Developmental Disorders. 2015.Parent Stress and Child Behaviour Problems
What is the research about?
Children with Autism Spectrum Disorder (ASD) often show different kinds of behaviour problems. Past research has found that increased levels of problem behaviours in children with ASD were related to reports of increased stress in their parents. The goal of this study was to examine the nature of the relationship between the problem behaviours of young children with ASD and their mothers’ personal stress/distress.
What did the researchers do?
The Pathways in ASD researchers gathered information from surveys filled out by the mothers in 184 families within 4 months of their child’s diagnosis of ASD, 12 months later, and when the child was six years old. The information focused on the mothers’ symptoms of stress and the children’s problem behaviours, defined as either acting out, like aggression or tantrums, or feelings and behaviours that are hurtful in oneself, like depression or anxiety. The researchers looked at general feelings of depression or isolation in the mothers, and distress, like feeling trapped by their role as a parent.
What did the researchers find?
Higher levels of both general and parental distress predicted that the children would have increased levels of acting out or depression or anxiety. Children’s problem behaviours did not predict whether, or not the parents would have general distress but did predict whether or not the parents would have distress related to their parenting role.
Take Home Message
Clinicians and others working with the parents of children diagnosed with ASD should ask if the parents are coping and how they are feeling. One way to help parents is to help them learn new skills, like behaviour management, that help them feel that they are good parents and that lessen unhelpful feelings of guilt.
This Research Report was written by A. Zaidman-Zait and colleagues, and was published in the Journal of Autism and Developmental Disorders. 2014.