Behavioral gender differences in school-age children with autism.

This study examined differences in internalizing and externalizing behaviors between school-aged boys and girls diagnosed with autism spectrum disorder (ASD). Eighty-nine children between the ages of 8 and 16 years participated in this study: 17 girls (M = 11.5 years, SD = 2.3) and 72 boys (M = 11.3 years, SD = 2.2). Participants were matched on the Autism Diagnostic Observation Schedule, Second Edition and Full-Scale IQ (FSIQ > 64). The results indicated that, girls had higher reported instances of Bullying, less Anger Control, and poorer Emotional Self-Control than boys on the Behavior Assessment System for Children, Second Edition. Groups did not differ on subscales of the Social Communication Scale. While evidence of increased externalizing behaviors is less common in girls, there is evidence supporting these differing behaviors that warrant further research.

Self-Esteem, Internalizing Symptoms, and Theory of Mind in Youth With Autism Spectrum Disorder.

Self-esteem is a potent indicator of mental health in typically developing (TYP) individuals. It is surprising that there have been few comprehensive investigations of self-esteem in children and adolescents with autism spectrum disorder (ASD), given that they are at high risk for comorbid mental health problems, such as depression and anxiety. The objectives of the current study were to assess how youth with ASD rate their self-esteem compared to age-matched TYP youth and to examine how self-esteem relates to internalizing psychopathology and theory of mind in the two groups. Seventy-three children and adolescents, ages 9 to 17, were administered a battery of questionnaires assessing self-esteem and internalizing symptoms, as well as tasks designed to measure theory of mind. Results indicated that youth with ASD rated their self-esteem significantly lower than did TYP youth. Self-esteem was strongly related to depression in both groups but was negatively related to theory of mind only for youth with ASD. These results may provide important insights into how individuals with ASD form evaluations of their own self-worth and illustrate how increasing self-awareness in individuals with ASD is not without risks.

Writing Self-Concept, Text Engagement, and Writing Practices Across Contexts: Comparisons Between School-Age Children on the Autism Spectrum and Their Non-Autistic Peers.

PURPOSE: Autistic children demonstrate highly variable written language skills. Existing research has focused on examining autistic children's performance on direct assessments of written language. In contrast, few studies have sought to understand how autistic children conceptualize their writing abilities or engage with writing across different contexts compared to non-autistic peers. METHODS: This study used a researcher-designed questionnaire to examine writing self-concept, text engagement with different writing activities, and writing practices and beliefs across school and non-school contexts in school-age (10-18 years old) autistic children compared to their non-autistic peers. Data analysis approaches included "multiple indicators, multiple causes" (MIMIC) modeling; correlational and multiple regression analysis; non-parametric Mann-Whitney U tests; and principal components analysis. RESULTS: Groups did not differ in their writing self-concept ratings. Furthermore, both groups engaged with a variety of different writing activities to a similar extent except for text messages being lower for the autistic group. Five components were extracted via principal components analysis on items related to writing practices and beliefs across contexts; groups did not differ across the components. Overall, the non-autistic group showed more consistent relationships between writing self-concept as well as writing practices and beliefs with performance on a narrative writing task when compared to the autistic group. CONCLUSION: Results offer a preliminary understanding into how autistic children engage with writing across contexts for a variety of purposes when compared to their non-autistic peers and offer implications for continued research and educational practice.

Feasibility and Initial Efficacy of an Adapted Telepractice Listening Comprehension Intervention for School-Aged Children with Autism.

This study evaluates the feasibility and initial efficacy of an 11-week listening comprehension intervention, Building Vocabulary and Early Reading Strategies (BVERS) that was delivered remotely to 14 elementary-aged children with autism spectrum disorder. Children were randomly assigned to one of two groups: BVERS only, or BVERS with a parent instructional component (BVERS + PC). Results indicate that the intervention was feasible to implement. All parents were satisfied with intervention implementation, and 8 of 10 stated that they were satisfied with their child's outcomes following the intervention. Results of a Wilcoxon signed-rank test showed growth in listening comprehension following the intervention, but no growth in narrative retell or vocabulary. There were no group differences in change scores from pre- to post-test.

The Construct Validity of the Childhood Joint Attention Rating Scale (C-JARS) in School-Aged Autistic Children.

Preliminary evidence from the Childhood Joint Attention Rating Scale (C-JARS; Mundy et al., 2017) suggests symptoms related to diminished joint attention and the spontaneous sharing of experience with others can be assessed with a parent-report measure in children and adolescents with autism. This study was designed to expand on the previous study by examining the validity of both a Social Symptom (SS) and a Prosocial (PS) scale of the C-JARS in a study of school-aged autistic children (n  = 89) with and without co-occurring intellectual disability (ID), as well as an age matched neurotypical sample (n  = 62). Results indicated that both C-JARS scales were sensitive and specific with respect to identifying the diagnostic status of the children. In addition, the PS scale was sensitive to differences in cognitive abilities (IQ) and sex differences in the autism group. These results are consistent with the hypothesis that joint attention and spontaneous sharing of experience symptoms are not only characteristic of preschool children with autism but may also constitute a developmentally continuous dimension of the social phenotype of autism that can be measured in school-aged children.

Conducting oral and written language adapted tele-assessments with early elementary-age children with autism spectrum disorder.

Background and aims: Due to the COVID-19 pandemic, tele-health has gained popularity for both providing services and delivering assessments to children with disabilities. In this manuscript, we discuss the process of collecting standardized oral language, reading, and writing tele-assessment data with early elementary children with autism spectrum disorder (ASD) and offer preliminary findings related to child and parent engagement and technology issues. Methods: The data presented are from pretest assessments during an efficacy study examining the electronic delivery of a listening comprehension intervention for children with ASD. Pretest sessions included a battery of standardized language, reading, and writing assessments, conducted over Zoom. The authors operationalized and developed a behavioral codebook of three overarching behavioral categories (parent involvement, child disengagement, and technology issues). Researchers coded videos offline to record frequencies of indicated behaviors across participants and assessment subtests. Results: Involvement from parents accounted for the highest number of codes. Children showed some disengagement during assessment sessions. Technology issues were minimal. Behavioral categories appeared overall limited but varied across participants and assessments. Conclusions: Parent involvement behaviors made up approximately two-thirds of the coded behaviors. Child disengagement behaviors made up approximately one-fourth of the coded behaviors, and these behaviors occurred more frequently across many different participants (with lower frequencies but greater coverage across children). Technology problems specific to responding to assessment items were relatively uncommon. Implications: Clear guidelines including assessment preparation, modification of directions, and guidelines for parents who remain present are among the implications discussed. We also provide practical implications for continued successful adapted tele-assessments for children with ASD.

Code-related literacy profiles of kindergarten students with autism.

LAY ABSTRACT: Many children and young students with autism have difficulties learning how to read. This study investigated early literacy development in children with autism spectrum disorder during their first year of formal schooling. The study found that children with autism spectrum disorder differ greatly on their early literacy skills, with some showing strengths in their understanding of the alphabet, spelling, and reading words. Other students in the sample had difficulties with these early reading skills. The findings of this study are important to better understand the most effective way to teach early literacy skills to children with autism spectrum disorder.

Brief Report: The Factors Associated with Social Cognition in Children with Autism Spectrum Disorder.

This study examined whether school-aged autistic children without co-occurring intellectual disabilities (autisticWoID) show similar difficulty on Theory of Mind (ToM) tasks as young autisticWoID children and if these difficulties are related to problems in domain-general aspects of cognition. Eighty-one autisticWoID and 44 neurotypical (NT) children between the ages of 8-16 years participated in this study and were matched on verbal IQ. ToM performance significantly and independently differentiated many, but not all, autisticWoID and NT participants above and beyond the effects of working memory and inferential thinking. However, these cognitive variables did not fully explain difficulties with social cognition in autisticWoID children. These findings have implications for understanding autism, the factors that may impact intervention for social cognition in autism, and the factors that impact the education of autistic children who may struggle in general education classrooms.

The Self in Self-Regulated Writing of Fourth to Ninth Graders with Dysgraphia.

Dysgraphia, a specific learning disability, impairs legible and automatic letter production by hand, which can interfere with written composing. The goal of the current study was not to investigate effective methods for teaching self-regulated writing to students with dysgraphia, but rather to investigate their self that is involved in their self-regulated writing. Students with dysgraphia in grades 4 to 9 (17 males; 3 females, M=139.44 months, SD=12.15) composed six personal narratives about themselves and their relationships to others. Five indicators of self/self-others, informed by Theory of Mind (Frith & Frith, 2010), were coded in the six personal narratives. They also completed normed measures of self-regulation of attention and of written composing. Correlations identified which coded indicators of self/self-others and which measures of attention regulation were significantly related to the same written composing measure to be used as predictors in multiple regressions. Results showed that coded quality of Text Organization (Self Schema in Personal Story) for "My Life Before the School Years" as first predictor AND either Focused or Switching Attention as second predictor jointly accounted for significant variance and each predictor explained unique variance in writing fluency (timed composing). Implications of findings for educational practice and future research are discussed.

Production and comprehension of pronouns in individuals with autism: A meta-analysis and systematic review.

LAY ABSTRACT: This research compared pronoun use in individuals with autism and typically developing peers. Meta-analysis and systematic review of 20 selected articles were used to determine whether significant differences existed in the use of pronouns overall as well as in personal, ambiguous, possessive, reflexive, and clitic pronoun usage. Summary effects indicated significant differences between individuals with autism and their typically developing peers in the use of pronouns overall as well as in ambiguous, clitic, and reflexive pronoun usage, but not in personal and possessive pronoun usage. Results indicate wide variation in the way individuals with autism use pronouns. Since individual outcomes appear to be moderated by multiple factors, including cognitive ability, first language, and overall language development, it is recommended these be considered in assessment and treatment.

Growth in narrative retelling and inference abilities and relations with reading comprehension in children and adolescents with autism spectrum disorder.

Background and aims: Extant research indicates that children and adolescents with autism spectrum disorder (ASD) without an intellectual disability (ID) often experience difficulty comprehending written texts that is unexpected in comparison with their cognitive abilities. This study investigated the development of two key skills, narrative and inference abilities, that support higher level text comprehension and their relation to lexical-semantic knowledge, ASD symptomatology, and age. Three questions were addressed: 1.) What was the nature of narrative and inference skill development over time? 2.) What was the relation between narrative or inference development and lexical-semantic knowledge, ASD symptomatology, and age? 3.) Did initial narrative and inferencing skills, and the development of these skills, predict reading comprehension outcomes? Methods: Data from 81 children and adolescents with ASD without ID (FIQ ≥ 75) between the ages of 8-16-years-old at timepoint 1 were collected at 15-month intervals across three timepoints. ASD symptomatology was assessed with the ADOS-2. Standardized narrative retelling, inference, reading comprehension, lexical-semantic knowledge and cognitive assessments were administered. Latent growth curve models were conducted to examine narrative and inference skill development, and conditional growth models were fit to examine the relation between growth trajectories and covariates (lexical-semantic knowledge, ASD symptomatology, age) as well as with the reading comprehension distal outcome. Results: Narrative retelling skills followed a linear trajectory of growth and were a relative strength in this sample, while inference skills were well below average and declined over time relative to age-normed standard scores. Lexical-semantic knowledge explained significant heterogeneity in initial narrative and inference skills, whereas ASD symptomatology was only related to initial narrative retelling abilities and age was only related to initial inference abilities. Timepoint 3 reading comprehension skill (in the below average range) was significantly explained by initial narrative retelling and inference abilities. Conclusions: The results of this study indicate that narrative retelling and inference skills are important for successful reading comprehension for individuals with ASD without ID and that lexical-semantic knowledge underpins these skills. Furthermore, the observation that ASD symptom severity was associated with narrative retelling skills is consistent with the hypothesis that problems in narrative reading skills are associated with the autism phenotype. Finally, inference skill was a particular challenge for individuals in this sample, although age was positively associated with better performance on the assessment.Implications: These findings suggest that narrative and inference skills, in addition to lexical-semantic knowledge, are important to target beginning in elementary grades to improve reading comprehension outcomes for children and adolescents with ASD without ID.

Attention and written expression in school-age, high-functioning children with autism spectrum disorders.

High-functioning children with autism spectrum disorders often find writing challenging. These writing difficulties may be specific to autism spectrum disorder or to a more general clinical effect of attention disturbance, as these children are often comorbid for attention-deficit/hyperactivity disorder (ADHD) symptomatology (and children with attention-deficit/hyperactivity disorder often also find writing challenging). To examine this issue, this study investigated the role of attention disturbance on writing in 155 school-age children across four diagnostic groups: high-functioning autism spectrum disorder (HFASD) with lower ADHD symptoms (HFASD-L), HFASD with higher ADHD symptoms (HFASD-H), ADHD symptoms but no autism spectrum disorder symptoms, and typical development. Both HFASD subgroups and the ADHD group displayed lower word production writing scores than the typical development group, but the clinical groups did not differ. The HFASD-H and ADHD groups had significantly lower theme development and text organization writing scores than the typical development group, but the HFASD-L and typical development groups were not significantly different. The findings support prior research reporting writing problems in children with autism spectrum disorder but also suggest that children with HFASD-H may be at greater risk for writing difficulties than children with HFASD-L. Better understanding the role of attention in writing development could advance methods for assessment and intervention for children with high-functioning autism spectrum disorder at risk for writing difficulties.

Brief Report: Investigating Relations Between Self-Concept and Performance in Reading and Math for School-Aged Children and Adolescents with Autism Spectrum Disorder.

A typically developing student's perceptions of his or her own capabilities (academic self-concept), is predictive of later academic achievement. However, little is known about academic self-concept in youth with autism spectrum disorder (ASD). To understand whether students math self-concept and reading self-concept predicted their performance, 44 school-aged children and adolescents with ASD and 36 age-matched individuals with typical development (TYP) rated their perceived math and reading abilities and were administered standardized achievement measures. Results showed self-concept was predictive of performance in math and reading in the TYP group. For youth with ASD, there was agreement between self-concept and performance only in math. These findings suggest that educators should be cautious when interpreting the self-assessments of reading ability in students with ASD.