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The social motivation hypothesis of autism proposes that social communication symptoms in autism-spectrum disorder (ASD) stem from atypical social attention and reward networks, where dopamine acts as a crucial mediator. However, despite evidence indicating that individuals with ASD show atypical activation in extrastriatal regions while processing reward and social stimuli, no previous studies have measured extrastriatal dopamine D2/3 receptor (D2/3R) availability in ASD. Here, we investigated extrastriatal D2/3R availability in individuals with ASD and its association with ASD social communication symptoms using positron emission tomography (PET). Moreover, we employed a whole-brain multivariate pattern analysis of resting-state functional magnetic resonance imaging (fMRI) to identify regions where functional connectivity atypically correlates with D2/3R availability depending on ASD diagnosis. Twenty-two psychotropic-free males with ASD and 24 age- and intelligence quotient-matched typically developing males underwent [11C]FLB457 PET, fMRI, and clinical symptom assessment. Participants with ASD showed lower D2/3R availability throughout the D2/3R-rich extrastriatal regions of the dopaminergic pathways. Among these, the posterior region of the thalamus, which primarily comprises the pulvinar, displayed the largest effect size for the lower D2/3R availability, which correlated with a higher score on the Social Affect domain of the Autism Diagnostic Observation Schedule-2 in participants with ASD. Moreover, lower D2/3R availability was correlated with lower functional connectivity of the thalamus-superior temporal sulcus and cerebellum-medial occipital cortex, specifically in individuals with ASD. The current findings provide novel molecular evidence for the social motivation theory of autism and offer a novel therapeutic target.
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Trastorno del Espectro Autista , Trastorno Autístico , Trastorno del Espectro Autista/diagnóstico por imagen , Trastorno Autístico/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Mapeo Encefálico/métodos , Comunicación , Dopamina , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Vías Nerviosas , Tomografía de Emisión de PositronesRESUMEN
Prior studies explored the early development of memory monitoring and control. However, little work has examined cross-cultural similarities and differences in metacognitive development in early childhood. In the present research, we investigated a total of 100 Japanese and German preschool-aged children's memory monitoring and control in a visual perception task. After seeing picture items, some of which were repeated, children were presented with picture pairs, one of which had been presented earlier and the other was a novel item. They then were asked to identify the previously presented picture. Children were also asked to evaluate their confidence about their selection, and to sort the responses to be used for being awarded with a prize at the end of the test. Both groups similarly expressed more confidence in the accurately remembered items than in the inaccurately remembered items, and their sorting decision was based on their subjective confidence. Japanese children's sorting more closely corresponded to memory accuracy than German children's sorting, however. These findings were further confirmed by a hierarchical Bayesian estimation of metacognitive efficiency. The present findings therefore suggest that early memory monitoring and control have both culturally similar and diverse aspects. The findings are discussed in light of broader sociocultural influences on metacognition.
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Memoria , Metacognición , Niño , Preescolar , Humanos , Teorema de Bayes , Pueblos del Este de Asia , Recuerdo Mental , Instituciones AcadémicasRESUMEN
AIM: Little is known about early manifestations of autism spectrum disorders (ASD) in females, including those who may be overlooked by the current diagnostic criteria. We longitudinally explored sex differences in the trajectories of cognitive and motor functions and adaptive behaviors in children with different levels of autistic traits. METHODS: The participants were 824 children from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), Japan, who were classified into three autistic trait groups-low, moderate, and high-based on the Social Responsiveness Scale-Second Edition. Cognitive and motor functions were measured at seven time-points from 0.5 to 3.5 years of age using the Mullen Scales of Early Learning. Adaptive behaviors were measured at five time-points from 2.7 to 9 years of age using the Vineland Adaptive Behavior Scales-Second Edition. Trajectories were depicted using latent growth curve modeling. RESULTS: Sex-specific trajectories were observed in the high-autistic-trait group, with only males showing a temporary decline in expressive language around the age of 2 years and a slight improvement thereafter. They also showed a slight improvement around 3 years in the adaptive behavior communication domain but a gradual downward trend later. Females in the high-autistic-trait group showed no distinct manifestation before the age of 3 years but showed a downward trend after 3.5 years in the adaptive behavior communication domain. CONCLUSION: Females and males with higher autistic traits than their same-sex peers, independent of clinical diagnosis, may have different phenotypes in certain neurodevelopmental domains during infancy and early childhood.
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Trastorno del Espectro Autista , Trastorno Autístico , Niño , Preescolar , Humanos , Masculino , Femenino , Caracteres Sexuales , Trastorno del Espectro Autista/genética , Desarrollo Infantil , MadresRESUMEN
Prior studies document cross cultural variation in the developmental onset of mindreading. In particular, Japanese children are reported to pass a standard false belief task later than children from Western countries. By contrast, we know little about cross-cultural variation in young children's metacognitive abilities. Moreover, one prominent theoretical discussion in developmental psychology focuses on the relation between metacognition and mindreading. Here we investigated the relation between mindreading and metacognition (both implicit and explicit) by testing 4-year-old Japanese and German children. We found no difference in metacognition between the two cultural groups. By contrast, Japanese children showed lower performance than German children replicating cultural differences in mindreading. Finally, metacognition and mindreading were not related in either group. We discuss the findings in light of the existing theoretical accounts of the relation between metacognition and mindreading.
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Comparación Transcultural , Metacognición , Niño , Preescolar , Comunicación , Decepción , HumanosRESUMEN
While numerous studies have demonstrated that infants and adults preferentially orient to social stimuli, it remains unclear as to what drives such preferential orienting. It has been suggested that the learned association between social cues and subsequent reward delivery might shape such social orienting. Using a novel, spontaneous indication of reinforcement learning (with the use of a gaze contingent reward-learning task), we investigated whether children and adults' orienting towards social and non-social visual cues can be elicited by the association between participants' visual attention and a rewarding outcome. Critically, we assessed whether the engaging nature of the social cues influences the process of reinforcement learning. Both children and adults learned to orient more often to the visual cues associated with reward delivery, demonstrating that cue-reward association reinforced visual orienting. More importantly, when the reward-predictive cue was social and engaging, both children and adults learned the cue-reward association faster and more efficiently than when the reward-predictive cue was social but non-engaging. These new findings indicate that social engaging cues have a positive incentive value. This could possibly be because they usually coincide with positive outcomes in real life, which could partly drive the development of social orienting.
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Señales (Psicología) , Fijación Ocular , Refuerzo Social , Conducta Social , Adulto , Atención , Niño , Humanos , Motivación , Tiempo de Reacción , RecompensaRESUMEN
Many autistic people reportedly engage in camouflaging to navigate everyday social interactions; however, the function of this behavior remains largely unknown. We hypothesized that autistic people camouflage more toward neurotypical others than toward autistic others, employing it as a strategy to "fit in" within the neurotypical-majority community. This study aimed to empirically investigate this hypothesis for the first time. Autistic and neurotypical participants took part in a web-based survey. Data from 48 autistic and 137 neurotypical participants were analyzed. Camouflaging toward autistic and neurotypical others was separately measured using the modified Camouflaging Autistic Traits Questionnaire (CAT-Q). For each CAT-Q item, a sentence describing a hypothetical interaction partner with autistic or neurotypical characteristics was added, creating respective sentence conditions. The interaction effect of the participants' characteristics and sentence conditions was analyzed using a multilevel regression analysis, accounting for differing individual baselines. The analysis revealed an interaction effect between participants' characteristics and sentence conditions. The autistic group showed significantly more camouflaging in the autistic sentence condition than in the neurotypical sentence condition. Conversely, the neurotypical group did not differ significantly in camouflaging levels in the sentence conditions. Contrary to our hypothesis, autistic people demonstrated more camouflaging toward autistic others than toward neurotypical others. This finding questions the assumption that autistic people camouflage to assimilate into a neurotypical-majority society. Instead, it could be conceptualized as a more general social strategy used by autistic people aiming to improve their relationships with others.
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OBJECTIVES: Motor planning is the cognitive process of planning necessary steps for achieving a purposeful movement and is specifically reflected through object manipulation. This study aimed to investigate whether fine motor skills, a surrogate of the motor planning ability of object manipulation, in early childhood are associated with later social skills, in a general-population birth cohort. METHODS: A total of 913 children, participating in the Hamamatsu Birth Cohort for Mothers and Children, were enrolled. Social skills were measured using the Vineland Adaptive Behavior Scales-II, Socialization domain, at age 6 years. Fine motor skills were measured using the Mullen Scales of Early Learning at 14, 24, and 32 months. The associations between fine motor skills at ages 14, 24, and 32 months and social skills at age 6 years were tested separately through multivariable linear regression after adjusting for covariates, including gross motor and language skills at the contemporaneous age, autistic symptoms at age 6 years, and demographic factors. RESULTS: Fine motor skills at 24 and 32 months were significantly associated with social skills at age 6 years (at 24 months: nonstandardized regression coefficient = 1.38 [95% CI, 0.50-2.26], p = 0.002; at 32 months: 1.47 [0.56-2.38], p = 0.001). CONCLUSION: Fine motor skills in early childhood predicted social skills at age 6 years, indicating an association between the complex motor planning ability of object manipulation and later social skills. Children who demonstrate fine motor delay at as early an age as 2 years should be closely monitored by child professionals.
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Destreza Motora , Habilidades Sociales , Preescolar , Niño , Femenino , Humanos , Cognición , Aprendizaje , MadresRESUMEN
The effects of selectively different experience of eye contact and gaze behaviour on the early development of five sighted infants of blind parents were investigated. Infants were assessed longitudinally at 6-10, 12-15 and 24-47 months. Face scanning and gaze following were assessed using eye tracking. In addition, established measures of autistic-like behaviours and standardized tests of cognitive, motor and linguistic development, as well as observations of naturalistic parent-child interaction were collected. These data were compared with those obtained from a larger group of sighted infants of sighted parents. Infants with blind parents did not show an overall decrease in eye contact or gaze following when they observed sighted adults on video or in live interactions, nor did they show any autistic-like behaviours. However, they directed their own eye gaze somewhat less frequently towards their blind mothers and also showed improved performance in visual memory and attention at younger ages. Being reared with significantly reduced experience of eye contact and gaze behaviour does not preclude sighted infants from developing typical gaze processing and other social-communication skills. Indeed, the need to switch between different types of communication strategy may actually enhance other skills during development.
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Desarrollo Infantil/fisiología , Comunicación , Relaciones Interpersonales , Padres , Personas con Daño Visual , Preescolar , Movimientos Oculares/fisiología , Cara , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Relaciones Padres-HijoRESUMEN
Infants adaptively modulate their social behaviours, such as gaze-following, to social context. We propose that such modulations are based on infants' social decision-making, to achieve the most valuable outcome. We propose an 'action value calculator model', which formulates the cognitive mechanisms underlying, and the development of, the decision-making process during interactions.
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Conducta Social , Medio Social , Humanos , LactanteRESUMEN
PURPOSE: Previous studies have reported that people with autism spectrum disorder (ASD) have higher levels of loneliness than neurotypical (NTP) people, most likely because of their difficulties in social communication with their predominantly NTP peers. However, direct investigations on the causal influence of friendship on their feelings of loneliness is scarce. METHODS: In the current study, using the causal mediation analysis, we investigated whether friendship among ASD individuals influences their feelings of loneliness, especially during adolescence when the importance of friendship is typically most elevated. Furthermore, we examined whether individual differences in autistic behavioral features or age affect feelings of loneliness or the qualities of friendship with linear regression analyses. RESULTS: The results demonstrated that the higher levels of loneliness in adolescents with ASD were mediated by one aspect of friendship, companionship. We also found that positive aspects of friendship, but not negative aspects, influence the feelings of loneliness in both ASD and NTP populations. One subcategory of the measured autistic trait, difficulty in imagination, which is associated the ability to consider another's perspective, had a negative relationship with the positive aspects of friendship in the ASD group, but not in the NTP group. CONCLUSION: These findings indicate that the quality of the positive aspects of friendship is similarly important for both adolescents with ASD and NTP adolescents, but the autistic behavioral features could interfere with the experience of such positive friendships.
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As in real life, cinema viewers rely on spontaneous theory of mind (SToM) to interpret characters' mental states. Thus, analyzing cinematic structures offers a unique opportunity to examine ecologically valid sociocognitive processes. We conducted a proof-of-concept study (N = 42) to explore how SToM inferences impact film event comprehension in dramatic irony scenes, where knowledge divergence exists between the audience and characters. We hypothesized that spectators would focus more on characters' mental states in such false-belief inducing scenarios compared to scenarios without such disparity. We used six Harold Lloyd silent comedy clips in a narrative comprehension and spontaneous mental state attribution study with a between-subject (Knowledge Manipulation: Installation vs. Control) and within-subject (Phase: Context vs. Exploitation) comparisons. We provided critical information unknown to the characters only to the Installation group and withheld it from the Control group. By comparing differences in participants' descriptions of the clips during the Context phase (varying across groups) and Exploitation phase (same across groups), we evaluated viewers' processing of the same scenes based on their false- or true-belief representations. Our findings indicate that the Installation group used more cognitive mental state words during the Exploitation phase relative to the Context phase, suggesting that exposure to undisclosed critical information enhances the frequency of spontaneous epistemic state inferences and integration into event models of the exploitation. This research advances neurocinematics by highlighting spontaneous sociocognitive processes in event perception and comprehension and provides a novel dramatic irony film corpus and measures for future moment-to-moment SToM processing studies across cognitive-behavioral, physiological, and neural levels.
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Failure to meet early childhood developmental milestones leads to difficulty in schooling and social functioning. Evidence on the inequality in the burden of developmental delays across population groups, and identification of potential risk factors for suspected developmental delays (SDD) among younger children, are essential for designing appropriate policies and programs. This study explored the level of socioeconomic and maternal education-based inequality in the prevalence of SDD among Nepalese children at subnational level and identified potential risk factors. Individual-level data from the 2019 Nepal Multiple Indicator Cluster Survey was used to estimate the prevalence of SDD among children aged 3-4 years. Regression-based slope index of inequality (SII) and relative index of inequality were used to measure the magnitude of inequality, in terms of household socioeconomic status (SES) and mother's education, in the prevalence of SDD. In addition, a multilevel logistic regression model was used to identify potential risk factors for SDD. The national prevalence of SDD was found to be 34.8%, with relatively higher prevalence among children from rural areas (40.0%) and those from Karnali Province (45.0%) followed by Madhesh province (44.2%), and Sudhurpashchim Province (40.1%). The prevalence of SDD was 32 percentage points higher (SII: -0.32) among children from the poorest households compared to their rich counterparts at the national level. At the subnational level, such inequality was found to be highest in Lumbini Province (SII = -0.47) followed by Karnali Province (SII = -0.37), and Bagmati Province (SII = -0.37). The prevalence of SDD was 36 percentage points higher (SII: -0.36) among children whose mother had no formal education compared to children of higher educated mothers. The magnitude of education-based absolute inequality in SDD was highest in Lumbini Province (SII = -0.44). Multilevel logistic regression model identified lower levels of mother's education, disadvantaged SES and childhood stunting as significant risk factors for SDD. One in each three children in Nepal may experience SDD, with relatively higher prevalence among children from rural areas. Subnational level variation in prevalence, and socioeconomic and education-based inequality in SDD highlight the urgent need for province-specific tailored interventions to promote early childhood development in Nepal.
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Factores Socioeconómicos , Escolaridad , Nepal/epidemiología , Humanos , Masculino , Femenino , Preescolar , Prevalencia , Madres , Factores de RiesgoRESUMEN
OBJECTIVE: Mitochondrial dysfunction has been implicated in the pathophysiology of autism spectrum disorder (ASD) in previous studies of postmortem brain or peripheral samples. The authors investigated whether and where mitochondrial dysfunction occurs in the living brains of individuals with ASD and to identify the clinical correlates of detected mitochondrial dysfunction. METHODS: This case-control study used positron emission tomography (PET) with 2-tert-butyl-4-chloro-5-{6-[2-(2-[18F]fluoroethoxy)-ethoxy]-pyridin-3-ylmethoxy}-2H-pyridazin-3-one ([18F]BCPP-EF), a radioligand that binds to the mitochondrial electron transport chain complex I, to examine the topographical distribution of mitochondrial dysfunction in living brains of individuals with ASD. Twenty-three adult males with high-functioning ASD, with no psychiatric comorbidities and free of psychotropic medication, and 24 typically developed males with no psychiatric diagnoses, matched with the ASD group on age, parental socioeconomic background, and IQ, underwent [18F]BCPP-EF PET measurements. Individuals with mitochondrial disease were excluded by clinical evaluation and blood tests for abnormalities in lactate and pyruvate levels. RESULTS: Among the brain regions in which mitochondrial dysfunction has been reported in postmortem studies of autistic brains, participants with ASD had significantly decreased [18F]BCPP-EF availability specifically in the anterior cingulate cortex compared with typically developed participants. The regional specificity was revealed by a significant interaction between diagnosis and brain regions. Moreover, the lower [18F]BCPP-EF availability in the anterior cingulate cortex was significantly correlated with the more severe ASD core symptom of social communication deficits. CONCLUSIONS: This study provides direct evidence to link in vivo brain mitochondrial dysfunction with ASD pathophysiology and its communicational deficits. The findings support the possibility that mitochondrial electron transport chain complex I is a novel therapeutic target for ASD core symptoms.
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Trastorno del Espectro Autista , Trastorno Autístico , Encefalopatías , Masculino , Adulto , Humanos , Trastorno Autístico/diagnóstico por imagen , Trastorno del Espectro Autista/diagnóstico por imagen , Giro del Cíngulo/diagnóstico por imagen , Giro del Cíngulo/metabolismo , Estudios de Casos y Controles , Piridinas/metabolismo , Tomografía de Emisión de Positrones , Encéfalo/diagnóstico por imagen , Encéfalo/metabolismo , Complejo I de Transporte de Electrón/metabolismo , Ácido Láctico/metabolismoRESUMEN
Gaze following (GF) is fundamental to central aspects of human sociocognitive development, such as acquiring language and cultural learning. Studies have shown that infant GF is not a simple reflexive orientation to an adult's eye movement. By contrast, infants adaptively modulate GF behaviour depending on the social context. However, arguably, the neurophysiological mechanisms underlying contextual modulation of GF remain somewhat unexplored. In this study, we tested the proposition about whether the contextual modulation of infant GF is mediated by the infant's heart rate (HR), which indicates the infant's physiological arousal. Forty-one 6- to 9-month-old infants participated in this study, and infants observed either a reliable face, which looked towards the location of an object, or an unreliable face, which looked away from the location of an object. Thereafter, the infants watched a video of the same model making eye contact or not making any ostensive signals, before shifting their gaze towards one of the two objects. We revealed that reliability and eye contact acted independently to increase HR, which then fully mediates the effects of these social cues on the frequency of GF. Results suggest that each social cue independently enhances physiological arousal, which then accumulatively predicts the likelihood of infant GF behaviour.
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Direction of another person's eye gaze provides crucial information about their attention and intentions, which is essential for an effective social interaction. Event-related potential (ERP) measures offer precise temporal tracking of neural processes related to gaze perception. While the sensitivity of the ERP component N170 to face processing is principally agreed, the research on gaze direction effect on this component is thus far inconsistent. Here, we systematically reviewed literature on the sensitivity of N170 to gaze direction. We analysed if four factors, known to affect the face N170 (i.e., emotion, face orientation, task demand, and stimuli motion), were modulated by gaze direction. N170 sensitivity to gaze was reported the most in the studies that involved deviated faces, dynamic stimuli, and that used explicit tasks directly related to gaze or face processing. The present review provides a much-needed summary of the literature to date, highlighting the complexity of the effect of gaze direction on the N170 component, and the need of systematic studies investigating the combination of these factors.
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Reconocimiento Facial , Fijación Ocular , Humanos , Electroencefalografía , Potenciales Evocados , Atención , Percepción Visual , Estimulación LuminosaRESUMEN
The ability of humans to use rules for organizing action demands a high level of executive control. Situational complexity mediates rule selection, from the adoption of a given rule to the selection of complex rules to achieve an appropriate response. Several rules have been proposed to be superordinate to human behavior in a cognitive hierarchy and mediated by different brain regions. In the present study, using a novel rule-selection task based on pre-response evaluations that require several cognitive operations, we examined whether the task is mediated by a specific region of the prefrontal cortex using near-infrared spectroscopy. We showed that the selection of rules, including prior evaluation of a stimulus, activates broader areas of the prefrontal and premotor regions than response selection based on a given rule. The results are discussed in terms of hierarchical cognitive models, the functional specialization of multiple-cognitive operations in the prefrontal cortex, and their contribution to a novel cognitive task.
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Corteza Prefrontal , Espectroscopía Infrarroja Corta , Humanos , Corteza Prefrontal/diagnóstico por imagen , Función Ejecutiva , EspecializaciónRESUMEN
A number of studies have reported diminished attention to the eyes in individuals with autism spectrum disorder (ASD). These studies predominantly used static images of faces as stimuli. Recent studies, however, have shown enhanced response to eye contact in typically developing (TD) individuals when they observe a person in a live interaction. We investigated physiological orienting to perceived eye contact in adolescents with ASD and TD adolescents when they observed a person in live interaction or viewed a photograph of the same person's face. We measured heart rate (HR) deceleration as an index of attentional orienting. Adolescents with ASD, as well as TD adolescents, showed significant HR deceleration for the direct gaze compared to an averted gaze in the live condition, but not in the photographic condition. The results suggest an intact response to perceived eye contact in individuals with ASD during a live face-to-face interaction. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) have a different eye gaze pattern when observing photographic faces. However, little is known about how individuals with ASD process a real person's face. We measured heart rate (HR) and found that adolescents with ASD showed the typical decline in HR when they made eye contact with a real person, which suggests that both groups of individuals directed their attention to eye contact in a live face-to-face interaction.
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Trastorno del Espectro Autista , Adolescente , Fijación Ocular , Frecuencia Cardíaca , Humanos , Comunicación no VerbalRESUMEN
It is unclear whether neurodevelopmental progress from infancy to early childhood remains stable. Moreover, little is known about the risk factors, if any, affecting neurodevelopmental descending transition patterns and the relationship between these patterns and later childhood adaptive behaviours. We used data of 875 children from the Hamamatsu Birth Cohort Study in Japan. Children's neurodevelopment at 18 and 32 months and adaptive behaviours at 40 months were evaluated. Perinatal factors and infant overweight status at 18 months were investigated to identify descending-transition-associated risk factors. In the latent transition analysis, ultimately, three classes were identified for each time-point, resulting in nine transition patterns; among them, 10.4% of children showed descending class shifts (normal to delayed class). Such decelerated growth was predicted by maternal pre-pregnancy overweight status (odds ratio [OR] 2.49; 95% confidence interval [CI] 1.23, 5.02), low maternal educational history (OR 1.20; 95% CI 1.04, 1.36), and infant overweight status at 18 months (OR 5.89; 95% CI 1.26, 27.45). Children with descending transition showed poor functioning in adaptive behaviours at the age of 40 months. To prevent subsequent poor adaptive functioning, it may be necessary to consider that a certain percentage of children show decelerated growth.
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Sobrepeso , Obesidad Infantil , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Oportunidad Relativa , Sobrepeso/epidemiología , Sobrepeso/etiología , Obesidad Infantil/complicaciones , Embarazo , Factores de RiesgoRESUMEN
Little is known about the trajectory patterns and sex differences in adaptive behaviors in the general population. We examined the trajectory classes of adaptive behaviors using a representative sample and examined whether the class structure and trajectory patterns differed between females and males. We further explored sex differences in neurodevelopmental traits in each latent class. Participants (n = 994) were children in the Hamamatsu Birth Cohort for Mothers and Children (HBC Study)-a prospective birth cohort study. Adaptive behaviors in each domain of communication, daily living skills, and socialization were evaluated at five time points when participants were 2.7, 3.5, 4.5, 6, and 9 years old using the Vineland Adaptive Behavior Scales-Second Edition. Parallel process multigroup latent class growth analysis extracted sex-specific trajectory classes. Neurodevelopmental traits of children at age 9, autistic traits, attention deficit hyperactivity disorder (ADHD) traits, and cognitive ability were examined for females and males in each identified class. A 4-class model demonstrated the best fit. Moreover, a 4-class model that allowed for differences in class probabilities and means of growth parameters between females and males provided a better fit than a model assuming no sex differences. In the communication domain, females scored higher than their male counterparts in all four classes. In the daily living skills and socialization domains, the two higher adaptive classes (Class 1: females, 18.6%; males, 17.8%; Class 2: females, 48.8%; males, 49.8%) had similar trajectories for males and females, whereas in the two lower adaptive behavior classes (Class 3: females, 27.5%; males, 29.4%; Class 4: females, 5.1%; males, 3.0%), females had higher adaptive scores than their male counterparts. In Class 4, females were more likely to have autistic and ADHD traits exceeding the cutoffs, while males were more likely to have below-average IQ. Different trajectories in females and males suggest that adaptive skills may require adjustment based on the sex of the child, when standardizing scores, in order to achieve better early detection of skill impairment.
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BACKGROUND: Current evidence suggests that autistic individuals are at high risk for becoming and remaining in a cycle of homelessness. Key risk factors for homelessness disproportionately affect autistic people; however, we have limited understanding of how to best support autistic individuals accessing services. This gap in the evidence base is particularly acute for autistic women. OBJECTIVE: As a first step to address this gap, we aimed to (1) map gaps in knowledge and practice; (2) identify priority areas for research and (3) develop recommendations for how to implement novel research and practice in this area. METHODS: We conducted a collaborative workshop with an interdisciplinary group of 26 stakeholders to address our aims. Stakeholders included autistic women with experience of homelessness, researchers, health professionals, NGO representatives, and service providers. RESULTS AND RECOMMENDATIONS: Two research priority areas were identified to map the prevalence and demographics of autistic women experiencing homelessness, and to delineate risk and protective factors for homelessness. Priority areas for improving provision of support included staff training to improve communication, awareness of autism and building trust with service providers, and recommendations for practical provision of support by services. CONCLUSIONS: Future research is critical to increase our knowledge of the pathways leading to homelessness for autistic women, and barriers to engaging with homelessness and social services. We need to use this knowledge to develop new ways of delivering targeted and inclusive support for autistic women, which could prevent or shorten periods of homelessness.