Patterns in reporting and participant inclusion related to race and ethnicity in autism intervention literature: Data from a large-scale systematic review of evidence-based practices.

LAY ABSTRACT: Researchers who study autism-related interventions do a poor job reporting data related to the race and ethnicity of autistic individuals who participate in their studies, and of those who do report these data, the participants are overwhelmingly White. This is problematic for many reasons, as we know little about how interventions are meeting the needs of culturally and linguistically diverse populations, and we assume that interventions are effective for all when they have been developed and validated primarily with and for White children. This study examined the reporting patterns of autism intervention researchers whose work was included in a large-scale systematic review of the intervention literature published between 1990 and 2017. We found that only 25% of studies (out of 1,013 included in the review) included data related to the race and ethnicity of their participants, with minimal change in reporting patterns across the years. In studies with reported data, White participants had the highest rate of participation, with a large gap between the next highest rates of participation among Hispanic/Latino, Black, and Asian participants. Other race and ethnicity groups had very low representation. This study includes additional analyses which examine how the reporting patterns and the inclusion of racially and ethnically diverse participants varies across study types, interventions, and outcome areas. Reporting this data is merely a starting point to begin to address the many disparities in autism-related healthcare, education, and research practices, and this article includes broader implications and next steps to ensure the field becomes more equitable and inclusive.

Stability of Literacy Profiles of Adolescents With Autism Spectrum Disorder and Associations With Stakeholder Perceptions of Appropriate High School Support Needs.

Purpose For many individuals with autism spectrum disorder (ASD), postsecondary outcomes are poor. This may be due to insufficient academic supports, particularly with regard to literacy skills, during high school. More information is needed about skill profiles so that we can better differentiate support for students with varying social, communication, cognitive, and academic proficiency levels. This study was designed to (a) identify unique literacy profiles of high school students with ASD, (b) assess profile stability over time, (c) identify predictors of profile membership, and (d) analyze stakeholder reports of required school support intensity. Method Participants were a diverse sample of high school students with ASD, 14-21 years old (N = 544), their parents, and their teachers who participated in a randomized controlled trial of a comprehensive treatment model for high school students with ASD. Standardized measures were administered to assess nonverbal IQ, autism symptomatology, language/adaptive communication, reading comprehension, academic knowledge, and parent/teacher report of school support needs intensity. Latent transition analysis was conducted to examine sample heterogeneity and to explore the stability of the profiles. Associations between profiles and reports of support intensity were examined. Results Four literacy profiles were identified that were stable over 2 years: Emergent Literacy/Comprehensive Support, Low Literacy/Intensive Support, Average Literacy/Moderate Support, and Average Literacy/Limited Support. Parent and teacher reports of school support intensity generally aligned with the profiles. Conclusions These analyses provide insight into the diverse literacy and support needs in ASD. Implications for practice and the role of speech-language pathologists in assessment and intervention are discussed. Supplemental Material https://doi.org/10.23641/asha.13495119.

Educational Interventions for Children and Youth with Autism: A 40-Year Perspective.

Commemorating the 40 th anniversary of the Diagnostic and Statistical Manual (DSM) III, the purpose of this commentary is to describe school-based and school-relevant interventions and instructional approaches for children and youth with autism that have been developed and employed during that time period. The commentary begins with a brief description of foundational research that provides an historical context. Research themes shaped by science, ethics, social policy, and the changes in the DSM provide an organization for describing the evolution of intervention and instructional practices over the four previous decades. The commentary concludes with a discussion of school-contextual variables that influence implementation and the promise of the "iSciences" for closing the research to practice gap in the future.

Exploring Developmental and Behavioral Heterogeneity among Preschoolers with ASD: A Cluster Analysis on Principal Components.

Children with autism spectrum disorder (ASD) present with heterogeneous levels of abilities and deficits. The identification of subgroups within a specific age range could be useful for understanding prognosis and treatment planning. We applied Hierarchical Clustering on Principal Components (HCPC) with a sample of 188 preschoolers with ASD and identified three distinct subgroups based on multiple developmental and behavioral domains. Cluster 1 was characterized by relatively high cognitive, language and adaptive abilities, and relatively low levels of social symptoms, repetitive behaviors, and sensory issues within the sample. Cluster 2 was characterized by similarly high cognitive, language and adaptive abilities compared to Cluster 1, but more severe social deficits as well as repetitive and sensory behaviors. Finally, Cluster 3 was characterized by lower cognitive, language and adaptive abilities, and more severe social, repetitive, and sensory symptoms. These findings provide insights into how considering multiple developmental and behavioral domains and core autism symptoms simultaneously can distinguish subgroups of young children with ASD and provide more comprehensive developmental profiles. Moreover, the unique profile of children in Cluster 2 highlighted the usefulness of including different measures and informants when evaluating the abilities and deficits of preschoolers with ASD and the importance of understanding the relationships among different developmental and behavioral factors in this specific population. Autism Res 2020, 13: 796-809. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism exhibit a range of abilities and deficits in different developmental and behavioral areas, making it difficult to tailor treatment and predict outcomes. We identified three distinct subgroups among 188 preschoolers with autism spectrum disorder distinguished by the combination of measures from multiple developmental and behavioral domains. The findings revealed the importance of comprehensive profiling of the child's abilities and deficits to inform subgrouping within autism.

Sex Differences in Social Participation of High School Students with Autism Spectrum Disorder.

There is lack of consensus in the literature regarding sex differences in social outcomes for individuals on the autism spectrum. Furthermore, little research has focused on the social experiences of high school students with autism spectrum disorder (ASD) during the school day. Using a large racially/ethnically diverse sample of high school students with ASD receiving special education services (n = 547; 76 females, 471 males), we examined sex differences in social interactions of youth both during and after school. We also tested for sex differences in background and phenotypic characteristics including autism severity, IQ, adaptive behavior, and mental health. Results indicated few statistically significant differences between males and females in social interactions and phenotypic characteristics (including raw scores of autism symptom severity). However, analysis of standardized scores of autism symptoms suggested that symptom scores for females with ASD diverged more from same-sex peers in the normed sample than scores of males with ASD. Lack of sex difference in social participation for youth with ASD in this study stands in contrast to patterns of sex differences in the general population. Findings suggest that few differences between males and females with ASD, both in social participation and autism symptom severity, might result in females with ASD being more dissimilar to their same-sex peers than males with ASD. Implications of findings for understanding sex differences in ASD across the life course are discussed. LAY SUMMARY: The present study examined sex differences in social participation in a large, diverse sample of high school students with autism spectrum disorder (ASD). Males and females were very similar in their social interactions both at school and outside of school, based on reports by teachers and parents. Level of autism symptoms was also similar for males and females. However, standardized scores of autism symptoms, which take into account age and sex specific norms, suggested that females with ASD may have behaviors that are more divergent from their same-sex peers than males with ASD.

Quality of high school programs for students with autism spectrum disorder.

The purpose of the study was to examine the quality of high school programs for students with autism spectrum disorder in the United States. The Autism Program Environment Rating Scale-Middle/High School was used to rate the quality of programs for students with autism spectrum disorder in 60 high schools located in three geographic locations in the United States (CA, NC, and WI). Findings indicated that the total quality rating across schools was slightly above the adequate criterion. Higher quality ratings occurred for program environment, learning climate, family participation, and teaming domains. However, quality ratings for intervention domains related to the characteristics of autism spectrum disorder (e.g. communication, social, independence, functional behavior, and transition) were below the adequate quality rating level. Also, quality ratings for transition were significantly higher for modified (primarily self-contained) programs than standard diploma (primarily served in general education) programs. School urbanicity was a significant predictor of program quality, with suburban schools having higher quality ratings than urban or rural schools, controlling for race, school enrollment size, and Title 1 eligibility status. Implications for working with teachers and school teams that support high school students with autism spectrum disorder should include a targeted focus on transition programming that includes a breadth of work-based learning experiences and activities that support social-communication domains.

Assessing Quality of Program Environments for Children and Youth with Autism: Autism Program Environment Rating Scale (APERS).

The purpose of this study was to examine the psychometric properties of the Autism Program Environment Rating Scale (APERS), an instrument designed to assess quality of program environments for students with autism spectrum disorder. Data sets from two samples of public school programs that provided services to children and youth with autism spectrum disorder were utilized. Cronbach alpha analyses indicated high coefficients of internal consistency for the total APERS and moderate levels for item domains for the first data set, which was replicated with the second data set. A factor analysis of the first data set indicated that all domain scores loaded on one main factor, in alignment with the conceptual model, with this finding being replicated in the second data set. Also, the APERS was sensitive to changes resulting from a professional development program designed to promote program quality.

Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review.

The purpose of this study was to identify evidenced-based, focused intervention practices for children and youth with autism spectrum disorder. This study was an extension and elaboration of a previous evidence-based practice review reported by Odom et al. (Prev Sch Fail 54:275-282, 2010b, doi: 10.1080/10459881003785506 ). In the current study, a computer search initially yielded 29,105 articles, and the subsequent screening and evaluation process found 456 studies to meet inclusion and methodological criteria. From this set of research studies, the authors found 27 focused intervention practices that met the criteria for evidence-based practice (EBP). Six new EBPs were identified in this review, and one EBP from the previous review was removed. The authors discuss implications for current practices and future research.

Observational learning by individuals with autism: a review of teaching strategies.

Observational learning is the process used to explain the acquisition of novel behaviors or performance of previously acquired behaviors under novel conditions after observing the behavior of another person and the consequences that follow the behavior. Many learners with autism do not attend to environmental stimuli at a level sufficient to learn a range of prosocial behaviors through observation of others. Modeling, group or dyadic instruction, and explicit observation training can improve the extent to which individuals with autism learn through observation. This article reviews previous research that involved observational learning by individuals with autism and outlines future research that could benefit instructional practices.

Brief report: concurrent validity of autism symptom severity measures.

The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an assessment of symptom severity. The purpose of this study was to examine whether symptom severity and/or diagnostic status of preschool-aged children with ASD (N = 201) were similarly categorized on these measures. For half of the sample, children were similarly classified across the four measures, and scores on most measures were correlated, with the exception of the ADOS and SRS-P. While the ADOS, CARS, and SRS are reliable and valid measures, there is some disagreement between measures with regard to child classification and the categorization of autism symptom severity.

Using the Language Environment Analysis (LENA) system in preschool classrooms with children with autism spectrum disorders.

This study describes the language environment of preschool programs serving children with autism spectrum disorders (ASDs) and examines relationships between child characteristics and an automated measure of adult and child language in the classroom. The Language Environment Analysis (LENA) system was used with 40 children with ASD to collect data on adult and child language. Standardized assessments were administered to obtain language, cognitive, and autism severity scores for participants. With a mean of over 5 hours of recording across two days several months apart, there was a mean of 3.6 child vocalizations per minute, 1.0 conversational turns (in which either the adult or child respond to the other within 5 seconds) per minute, and 29.2 adult words per minute. Two of the three LENA variables were significantly correlated with language age-equivalents. Cognitive age-equivalents were also significantly correlated with two LENA variables. Autism Diagnostic Observation Schedule severity scores and LENA variables were not significantly correlated. Implications for using the LENA system with children with ASD in the school environment are discussed.