Person- and identity-first language in autism research: A systematic analysis of abstracts from 11 autism journals.

LAY ABSTRACT: There are many ways to refer to an individual who is on the autism spectrum. A recommended approach has been to use person-first language (PFL), such as "person with autism." A different approach is to use identity-first language (IFL), such as "autistic person." Recent studies focused on different groups of people (e.g. autistic self-advocates, parents, and practitioners) show that some groups prefer PFL (practitioners) while others prefer IFL (autistic self-advocates). However, less is known about how researchers use PFL and IFL in academic writing (e.g. studies published in scientific journals) involving autistic research participants. Our study examined 12,962 journal abstracts (short summaries of scientific articles) from 11 academic journals that publish autism research findings. We wanted to know (a) about the use of PFL and IFL across abstracts, and (b) how PFL and IFL use has changed annually over time. We examined data for all journals individually and grouped together. Our findings showed that journal abstracts generally use PFL (65%) with some using either IFL (16%) or both PFL and IFL (20%). However, journals varied, with some showing a clear majority for PFL and a couple for IFL. Examining trends over time across journals showed that while PFL appeared to be the majority for most journals, IFL has steadily increased in the recent few years. Our study helps us understand how autism researchers write about autistic individuals and offers implications for helping researchers intentionally make choices about the language used in their autism research studies.

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.

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.

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.

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.

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.

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.

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.

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.

Observing Visual Attention and Writing Behaviors During a Writing Assessment: Comparing Children with Autism Spectrum Disorder to Peers with Attention-Deficit/Hyperactivity Disorder and Typically Developing Peers.

Children with autism spectrum disorder (ASD) demonstrate heterogeneous writing skills that are generally lower than their typically developing (TD) peers and similar to peers with attention difficulties like attention-deficit/hyperactivity disorder (ADHD). Recent evidence suggests children with ASD spend less time engaging in writing tasks compared to their peers, but previous studies have not examined engagement specifically within the writing task environment. This study used video observation data collected from 121 school-age children (60 children with ASD, 32 children with ADHD, and 29 TD children) to compare differences in visual attention and writing task behaviors and relationships between task behaviors and age, cognitive skills, and ASD and ADHD symptom severity. Findings indicated that groups mostly spent time looking at and writing on the draft, though this was lowest in the ASD group. No differences were found between the ASD and ADHD groups after accounting for task behavior durations as percentages of total used task time. Groups spent little time looking at their outlines and looking away from the task, with all groups spending relatively more time looking at the task picture. Time spent engaged with the draft showed a positive relationship with writing performance across groups, but a negative relationship between time spent looking at the task picture and writing performance only appeared for the ADHD group. The ASD and ADHD groups showed negative associations between draft engagement and ASD symptom severity but not ADHD symptom severity. Implications are discussed for understanding writing task engagement in research and instructional contexts. LAY SUMMARY: Children with autism spectrum disorder (ASD) demonstrate variable writing skills. Here, we examine how children with ASD engage during a writing task by using video observation data to compare their engagement to peers with and without attention difficulties. Findings indicate (a) lower draft engagement and similar task disengagement in children with ASD compared to their peers and (b) moderate-to-strong relationships between writing scores and ASD symptom severity with within-task engagement in children with ASD and their peers with attention difficulties.

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.

Secondary Analysis of Reading-Based Activities Utilizing a Scripted Language Approach: Evaluating Interactions Between Students With Autism and Their Interventionists.

Students with autism spectrum disorder (ASD) often exhibit challenges with reading development. Evidence-based interventions and specialized approaches to reading instruction are currently being implemented across educational contexts for learners with ASD (Machalicek et al., 2008), yet there is limited understanding of how core ASD features may impact effective delivery of instruction and student participation. We begin to address this need by evaluating the reciprocity between instructional talk and student participation within a reading intervention utilizing a scripted language approach that was being piloted on students with ASD. Method This study used archival video-recorded observations from the beginning of a reading intervention to examine the interactions between 20 students (18 boys, two girls) with ASD (7-11 years old, M = 9.10, SD = 1.74) and their interventionists (n = 7). Lag sequential analysis was used to examine the frequency of student initiations and responses following the interventionists' use of responsive, open-ended, closed-ended, and directive language. Results Findings describe the types of and illustrate the variability in interactions between students and their interventionists, as well as highlight language categories that are linked to student participation. Conclusions These data provide a snapshot of the nature and quality of interactions between students with ASD and their interventionists. Findings suggest that delivery of instruction, including the language that interventionists use, may be an important area of focus when evaluating the effectiveness of reading-based practices across educational settings for learners with ASD, even within the confines of highly structured interventions.

Comparing the writing skills of autistic and nonautistic university students: A collaboration with autistic university students.

LAY ABSTRACT: We do not know very much about the writing skills of autistic university students. Studies with autistic children and teenagers show that some autistic young people have difficulties writing. Other autistic people are talented writers. In fact, some autistic people would rather write than speak. Good writers often imagine other people's points of view when writing. Autistic people sometimes have difficulties understanding others' points of view. Yet, autistic people often work much harder to understand others' points of view than not-autistic people do. We collaborated with autistic university student researchers to see if autistic university students are better or worse at writing than nonautistic students. Autistic university students in our study were better writers than nonautistic students. Autistic students in our study had higher nonverbal intelligence than nonautistic students. Autistic students also put themselves under more pressure to write perfectly than nonautistic students did. Autistic students did not show any difficulties understanding other minds. This study shows that some autistic university students have stronger writing skills and higher intelligence than nonautistic university students. Yet, autistic students may be too hard on themselves about their writing. Fun activities that help students explore their ideas without pressure (like theater games) may help autistic students be less hard on their writing. Teachers can help autistic students express themselves through writing by encouraging them to write about their interests, by giving them enough time to write, and by letting them write using computers if they want to. This study shows that collaborations with autistic people can help us understand strengths that can help autistic people succeed.

A Developmental Study of Mathematics in Children with Autism Spectrum Disorder, Symptoms of Attention Deficit Hyperactivity Disorder, or Typical Development.

This study examined mathematics achievement in school-aged children with autism spectrum disorder (ASD), symptoms of attention-deficit/hyperactivity disorder (ADHD), or typical development (TD) over a 30-month period and the associations between cognitive and reading abilities with mathematics achievement in children with ASD. Seventy-seven children with ASD without intellectual disability (ASD-WoID), 39 children with ADHD, and 43 children with TD participated in this study. The results revealed that the ASD-WoID and ADHD samples displayed significant and comparable delays in problem solving and calculation abilities. Lower VIQ was related to lower math achievement across all subgroups. The ASD-WoID sample differed from comparison samples in terms of their pattern of mathematical achievement and the role of cognitive abilities in the development of mathematics competence.

Overt planning behaviors during writing in school-age children with autism spectrum disorder and attention-deficit/hyperactivity disorder.

BACKGROUND: The planning behaviors of children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) during writing remain overlooked. Targeted examination of planning behaviors may help to better understand their heterogeneous writing skills. AIMS: This study examined overt planning behaviors of three groups of school-age children (ASD, ADHD, and typically developing [TD]) during the planning stage of a standardized narrative writing assessment. Aims explored group differences in time spent planning, between- and within-group differences in overt planning behaviors, and relationships between planning behaviors and writing performance as well as age, cognitive skills, and diagnostic symptom severity. METHODS AND PROCEDURES: This study included 121 9-17-year-old children (60 ASD, 32 ADHD, and 29 TD). Video recordings captured overt planning behaviors during a two-minute prewriting planning stage. OUTCOMES AND RESULTS: Not all participants planned, but group membership overwhelmingly did not influence planning likelihood. Groups differed in time spent engaging with the outline (29 %-70 %), with the TD group spending the most time. Groups spent similar amounts of time looking away from the task (< 10 %) and looking at the task picture (20 %-33 %). The TD and ASD groups demonstrated more similar within-group-level differences in planning behavior s, while the ADHD group appeared more variable. The ADHD and TD groups but not the ASD group showed stronger associations between planning behaviors and writing performance. CONCLUSIONS AND IMPLICATIONS: Children with ASD and ADHD differed relative to each other and to TD peers in specific planning behaviors. Implications are discussed regarding instructional practices and needed future research to examine planning during writing in children with developmental disabilities.

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.

Longitudinal stability of reading profiles in individuals with higher functioning autism.

The reading difficulties of individuals with autism spectrum disorders have been established in the literature, with particular attention drawn toward reading comprehension difficulties. Recent papers have highlighted the heterogeneous nature of reading abilities in this population by utilizing statistical methods that allow for investigations of unique reading profiles. This article extends this literature by investigating reading profiles longitudinally, to investigate the stability of reader profiles across time. Latent profile and transition analyses were conducted to establish categorically distinct reading profiles at two time points, 30 months apart. This study also examined whether age and autism symptom severity were related to the profiles at each time point. Finally, transitions between profiles at each time point were identified. Age did not predict profile membership, but there were significant differences in symptom severity that were largely stable over time. Results indicate that heterogeneous reading profiles exist within the autism population, ranging from average reading ability to severe difficulties across different reading subskills. The data from this study demonstrate that reading profiles of children and adolescents with autism spectrum disorders shift when examined across time.

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.

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.