Associations between autistic traits, depression, social anxiety and social rejection in autistic and non-autistic adults.

Autistic people frequently experience negative judgements from non-autistic people, often fuelled by misconceptions that autistic people lack empathy. Understanding responses to negative social judgement among autistic people is crucial because of the potential negative impact on wellbeing and future interactions. We investigated the role of autistic traits, social anxiety, and depression on behavioural indices of social rejection in 20 autistic (AUT; 11 males) and 40 non-autistic (N-AUT; 21 males) university students. Participants completed the Social Judgement Task (SJT) where they predicted whether they were liked by another person, then received feedback on whether those evaluations were correct. Participants also completed an Age Judgement Task (AJT) where they estimated the age of the pictured person. The AUT group had lower positive expectation scores, meaning less tendency to predict being liked. Across the whole sample, higher social anxiety predicted greater tendency to anticipate rejection from others, not autistic traits. These findings suggest early experiences of rejection might lead to a negative self-bias in autistic people and emphasise the importance of using a transdiagnostic approach by showing that social anxiety rather than autistic traits is associated with expectation of social rejection.

No transfer of arousal from other's eyes in Williams syndrome.

Typically developing humans automatically synchronize their arousal levels, resulting in pupillary contagion, or spontaneous adaptation of pupil size to that of others. This phenomenon emerges in infancy and is believed to facilitate social interaction. Williams syndrome (WS) is a genetic condition characterized by a hyper-social personality and social interaction challenges. Pupillary contagion was examined in individuals with WS (n = 44), age-parallel-matched typically developing children and adults (n = 65), and infants (n = 79). Bayesian statistics were used. As a group, people with WS did not show pupillary contagion (Bayes factors supporting the null: 25-50) whereas control groups did. This suggests a very early emerging atypical developmental trajectory. In WS, higher pupillary contagion was associated with lower autistic symptoms of social communication. Diminished synchronization of arousal may explain why individuals with WS have social challenges, whereas synchronization of arousal is not a necessary correlate of high social motivation.

Anxiety, concerns and COVID-19: Cross-country perspectives from families and individuals with neurodevelopmental conditions.

Background: The COVID-19 pandemic had a major impact on the mental health and well-being of children with neurodevelopmental conditions (NDCs) and of their families worldwide. However, there is insufficient evidence to understand how different factors (e.g., individual, family, country, children) have impacted on anxiety levels of families and their children with NDCs developed over time. Methods: We used data from a global survey assessing the experience of 8043 families and their children with NDCs (mean of age (m) = 13.18 years, 37% female) and their typically developing siblings (m = 12.9 years, 45% female) in combination with data from the European Centre for Disease Prevention and Control, the University of Oxford, and the Central Intelligence Agency (CIA) World Factbook, to create a multilevel data set. Using stepwise multilevel modelling, we generated child-, family- and country-related factors that may have contributed to the anxiety levels of children with NDCs, their siblings if they had any, and their parents. All data were reported by parents. Results: Our results suggest that parental anxiety was best explained by family-related factors such as concerns about COVID-19 and illness. Children's anxiety was best explained by child-related factors such as children's concerns about loss of routine, family conflict, and safety in general, as well as concerns about COVID-19. In addition, anxiety levels were linked to the presence of pre-existing anxiety conditions for both children with NDCs and their parents. Conclusions: The present study shows that across the globe there was a raise in anxiety levels for both parents and their children with NDCs because of COVID-19 and that country-level factors had little or no impact on explaining differences in this increase, once family and child factors were considered. Our findings also highlight that certain groups of children with NDCs were at higher risk for anxiety than others and had specific concerns. Together, these results show that anxiety of families and their children with NDCs during the COVID-19 pandemic were predicted by very specific concerns and worries which inform the development of future toolkits and policy. Future studies should investigate how country factors can play a protective role during future crises.

Friendships in Children with Williams Syndrome: Parent and Child Perspectives.

Although children with Williams syndrome (WS) are strongly socially motivated, many have friendship difficulties. The parents of 21 children with WS and 20 of the children themselves participated in a semi-structured interview about the children's friendships. Parents reported that their child had difficulties sustaining friendships and low levels of interaction with peers. Barriers to friendships included difficulties with play and self-regulating behaviour. However, there was within-group variability, with a small number of children reported to have strong friendships. While parents reported friendship challenges, all of the children named at least one friend, and most said that they had never felt excluded by their peers. Future research is needed to determine optimal ways to support children with WS in their friendships.

The Quality of Everyday Eye Contact in Williams Syndrome: Insights From Cross-Syndrome Comparisons.

Past research shows that individuals with Williams syndrome (WS) have heightened and prolonged eye contact. Using parent report measures, we examined not only the presence of eye contact but also its qualitative features. Study 1 included individuals with WS (n = 22, ages 6.0-36.3). Study 2 included children with different neurodevelopmental (ND) conditions (WS, autism spectrum condition, fragile X syndrome, attention-deficit/hyperactivity disorder) and children with neurotypical development (NT; n = 262, ages 4.0-17.11). Unusual eye contact features, including staring, were found in approximately half of the WS samples. However, other features such as brief glances were frequently found in WS and in all ND conditions, but not NT. Future research in ND conditions should focus on qualitative as well as quantitative features of eye contact.

Psychological distress and positive gain in mothers of children with autism, with or without other children with neurodevelopmental disorders.

Although a wealth of literature has focused on the parenting experiences of mothers of children with autism spectrum disorder (ASD), there is a lack of research about mothers who are parenting a child with ASD, and who have other children with neurodevelopmental disorders. In this matched-comparison study, 10 mothers of a child with ASD and other typically developing children (ASD-TD) were compared to 10 mothers of a child with ASD who also had other children with neurodevelopmental disorders (ASD-NDD). Mothers completed self-report measures of mental health and positive gain. Results indicated no significant between-group differences for mental health, although mothers in the ASD-NDD group reported increased positive gain compared to mothers in the ASD-TD group. Further research is needed to understand practical support needs and theory development.

Williams syndrome: on the role of intellectual abilities in anxiety.

BACKGROUND: Individuals with Williams syndrome (WS) have an elevated risk for anxiety disorders throughout the life span, making it a research priority to identify the individual factors associated with anxiety. Most of the existing literature is based on questionnaire data and suggests that impaired executive functions (EF) increase the risk for anxiety in WS. The aim of this study was to use direct measures by trained clinicians to investigate the effects of general intelligence, inhibition, sustained attention, and working memory on anxiety in WS, to further elucidate potential underlying mechanisms. METHOD: Twenty-four individuals with WS participated in the study (mean age: 29 years, range: 9-53 years), together with at least one of their parents. The MINI international neuropsychiatric interview for DSM-5 was completed to establish clinical diagnosis of anxiety, and the Clinical Global Impression Scale - Severity was used for an expert rating of symptom severity. Intellectual abilities were measured using the Wechsler scales, and attention and inhibition using the Conner's Continuous Performance Test. In addition, a parent-report questionnaire measuring EF, learning and memory was collected. RESULTS: In contrast to the apriori hypothesis, there was no significant association between anxiety and core elements of EF such as working memory, sustained attention, and inhibition (i.e. the process of restraining one's impulses or behaviour). Using ordinal logistic regression analyses, we showed that decreasing intelligence quotient (IQ) and age are associated with elevated anxiety. We confirmed these results in between-groups analyses (anxiety disorder vs no current anxiety disorder), and low IQ was associated with higher risk of having an anxiety diagnosis. In addition, Bayesian statistics gave substantial evidence for no significant association between anxiety and inhibition. CONCLUSION: By using direct measures of psychological pathology and functioning, the current results provide a deeper characterisation of the WS phenotype and provide novel insights into the potential mechanisms underpinning anxiety.

"Intolerance of uncertainty" mediates the relationship between social profile and anxiety in both Williams syndrome and autism.

Anxiety is the most significant mental health concern for both Williams syndrome (WS) and autism. Whilst WS and autism are characterized by some syndrome-specific social differences, less is known about cross-syndrome profiles of anxiety symptoms. Previous research has shown that Intolerance of Uncertainty (IU) is a core mechanism of anxiety maintenance for clinically anxious populations and for autistic children, adolescents, and adults. The only published study in this area for WS has shown some similar patterns-with an added emphasis on the role of sensory sensitivities-in a sample of older teens and adults (mean age = 24), with the authors highlighting the need for younger samples to consider developmental influences. Here we report a cross-syndrome, cross-sectional mediation analyses of children diagnosed with WS or autism, including data from parent surveys of 90 children with WS (n = 48) or autism (n = 42). Group differences showed higher trait levels on all measures for the autism group. Importantly, the relationship between social profile and anxiety was fully mediated by IU level for both groups. This suggests possible similar core mechanisms underlying anxiety in these conditions, and the possibility of generalized intervention approaches especially related to managing distress related to uncertainty in multiple contexts. LAY SUMMARY: Autism and Williams Syndrome share some similarities in social profile and also in anxiety traits, but there are also some key differences as well. Comparing them side-by-side at the same time improved identification of ways to reduce feelings of anxiety. We found that the intolerance of uncertainty affected the relationship between social profile and anxiety in the same way for young children diagnosed with autism or Williams syndrome, meaning that intervention approaches could be similar for both.

An EEG investigation of alpha and beta activity during resting states in adults with Williams syndrome.

BACKGROUND: Williams syndrome (WS) is neurodevelopmental disorder characterised by executive deficits of attention and inhibitory processing. The current study examined the neural mechanisms during resting states in adults with WS in order to investigate how this subserves the attention and inhibitory deficits associated with the syndrome. METHOD: Adopting electroencephalography (EEG) methodology, cortical electrical activity was recorded from eleven adults with WS aged 35 + years during Eyes Closed (EC) and Eyes Open (EO) resting states, and compared to that of thirteen typically developing adults matched for chronological age (CA) and ten typically developing children matched for verbal mental ability (MA). Using mixed-design analyses of variance (ANOVA), analyses focused on the full alpha (8-12.5 Hz), low-alpha (8-10 Hz), upper-alpha (10-12.5 Hz), and beta (13-29.5 Hz) bands, as these are thought to have functional significance with attentional and inhibitory processes. RESULTS: No significant difference in alpha power were found between the WS and CA groups across all analyses, however a trend for numerically lower alpha power was observed in the WS group, consistent with other developmental disorders characterised by attentional/inhibitory deficits such as Attention Deficit Hyperactivity Disorder (ADHD). In contrast, comparable beta power between the WS and CA groups during both EC/EO conditions suggests that their baseline EEG signature is commensurate with successful attentional processing, though this needs to be interpreted with caution due to the small sample size. Analyses also revealed an unusual trend for low variability in the EEG signature of the WS group, which contradicts the heterogeneity typically observed behaviourally. CONCLUSIONS: This novel finding of low variability in the EEG spectra in the WS group has been previously associated with poor behavioural performance in ADHD and is highly informative, highlighting future research needs to also consider how the role of low variability in the EEG profile of WS manifests in relation to their behavioural and cognitive profiles.

Peer Relationships in Children with Williams Syndrome: Parent and Teacher Insights.

Although children with Williams syndrome (WS) are reported to show a strong motivation towards social interaction, evidence suggests many experience difficulties with peer relations. Less is known regarding the characteristics of such difficulties. Parents and teachers of 21 children with WS (7- to 16 years) completed questionnaires measuring aspects of social functioning and peer interactions. Parents and teachers reported that children with WS demonstrated significantly greater peer problems than population norms, including difficulties sustaining friendships and increased social exclusion. More substantial social functioning difficulties were associated with greater peer relation problems. The study provides multi-informant evidence of peer relationship difficulties in children with WS that require further consideration within the broader WS social phenotype.

Profiles of academic achievement and attention in children with and without Autism Spectrum Disorder.

BACKGROUND: Academic outcomes for autistic individuals are heterogeneous, but the reasons for this are unknown. Attention is known to predict learning in typical development, but there is less evidence about this relationship in Autism Spectrum Disorders (ASD), even though attention is reported as atypical in this group. AIMS: To investigate reading and maths achievement profiles for children with and without an ASD, focusing on the role of attention in these profiles and to enable a better understanding of individual differences. METHODS: Reading, maths and attention abilities of 22 autistic children (6-16 years) and 59 TD children (6-11 years) were measured using standardised assessments. RESULTS: A hierarchical cluster analysis that included all children (N = 81) revealed three distinct transdiagnostic subgroups, characterised by children with good, average, and poorer divided attention and academic achievement respectively. Children with poorer attention and achievement displayed relative weaknesses in maths, while children with average or above-average attention and achievement showed no such weakness. CONCLUSIONS: The findings provide a novel insight into the relationship between attention and achievement and understanding individual differences in ASD and typical development.

Hearing the feeling: Auditory emotion perception in Williams syndrome.

BACKGROUND: Studies investigating recognition of facial expressions of emotions in Williams syndrome (WS) have reported difficulties in recognising negative expressions of emotion and a reliance on atypically developing underlying processes during task performance. AIM: The aim of the study was to extend these findings to the recognition of emotions in auditory domains. METHOD AND PROCEDURES: Children and adolescents with WS, together with chronological (CA) and verbal mental age matched (VMA) typically developing (TD) comparison groups, were asked to judge expressions of happiness, sadness, anger, and fear in vocal and musical conditions. OUTCOMES AND RESULTS: Total emotion recognition scores did not differ between WS and VMA matched groups but profiles of discrimination across emotion categories were markedly different. For all groups, the accessibility of emotion category cues differed across music and speech domains. The results suggested that emotion discrimination is more strongly linked with cognitive ability in WS than in TD. CONCLUSIONS AND IMPLICATIONS: Although WS and TD groups showed a significantly different profile of discrimination across emotion categories, similarities in the pattern of discrimination across domains and in the correlates of auditory emotion processing were observed. The results are discussed in the context of typical and atypical developmental trajectories and compensatory mechanisms in WS.

A cross-syndrome approach to the social phenotype of neurodevelopmental disorders: Focusing on social vulnerability and social interaction style.

BACKGROUND: Following Annette Karmiloff-Smith's approach to cognitive research, this study applied a cross-syndrome approach to the social phenotype, focusing on social vulnerability (SV) and the factors that contribute to it. AIMS: To (i) identify syndrome-specific differences in SV across four neurodevelopmental disorder (NDD) groups, (ii) determine the contribution of intellectual disability (ID), age or gender to SV, and (iii) explore its relationship with social interaction style (SIS). METHODS AND PROCEDURES: 262 parents of children: Autism (n = 29), Williams syndrome (n = 29), Attention deficit hyperactivity disorder (n = 36), Fragile X syndrome (n = 18), and Neurotypical (n = 150) reported on their child's SV, quality of SIS and other factors (ID, age, gender). OUTCOMES AND RESULTS: Heightened SV was not syndrome-specific. Instead it was found equally across NDD groups (and not in the neurotypical group), and independently of ID, age and gender. Different atypical SISs were also distributed across NDD groups and each were significantly related to SV, independent of the factors above and beyond neurodevelopmental diagnosis. CONCLUSIONS AND IMPLICATIONS: The findings emphasise that social phenotypes are best understood as distributed across diagnostic boundaries and offer opportunities to further test the role of varied atypical SISs in the development of heightened SV.

Does culture shape face perception in autism? Cross-cultural evidence of the own-race advantage from the UK and Japan.

Autism spectrum disorders (ASD) are associated with face perception atypicalities, and atypical experience with faces has been proposed as an underlying explanation. Studying the own-race advantage (ORA) for face recognition can reveal the effect of experience on face perception in ASD, although the small number of studies in the area present mixed findings. This study probed the ORA in ASD by comparing two cultural groups simultaneously for the first time. Children with ASD in the UK (N = 16) and Japan (N = 26) were compared with age- and ability-matched typically developing (TD) children in the UK (N = 16) and Japan (N = 26). Participants completed a two-alternative forced-choice task, whereby they had to recognize a just seen face from a foil which was manipulated in one of four ways (IC: identity change; EE: easy eyes; HE: hard eyes; HM: hard mouth). Face stimuli were Asian and Caucasian, and thus the same stimuli were own and other race depending on the cultural group. The ASD groups in the UK and Japan did not show impaired face recognition abilities, or impairments with recognizing faces depending on manipulations to the eye region, and importantly they showed an ORA. There was considerable heterogeneity in the presence of the ORA in ASD and TD and also across cultures. Children in Japan had higher accuracy than children in the UK, and TD children in Japan did not show an ORA. This cross-cultural study challenges the view that atypical experiences with faces lead to a reduced/absent ORA in ASD.

Siblings of children with Williams syndrome: Correlates of psychosocial adjustment and sibling relationship quality.

BACKGROUND: Previous research has examined adjustment in parents of children with Williams syndrome (WS), but little is known about sibling outcomes. AIMS: To explore sibling adjustment and relationship quality, and their demographic, psychological and behavioural phenotypic correlates from the perspective of caregivers and siblings in families of children with WS. METHODS AND PROCEDURES: Forty-one caregivers of children with WS participated in this questionnaire study on the adjustment and relationship quality of the siblings. In 31 of these families, self-report data were also provided by the siblings themselves. Data were also gathered on potential correlates, including anxiety and social functioning in the child with WS, caregiver mental health, and sibling social support. OUTCOMES AND RESULTS: Sibling adjustment was similar to population norms, though significantly increased caregiver-reported emotional difficulties were found. Siblings reported greater behavioural, emotional and relationship difficulties than caregivers perceived them to have. Some significant associations were found between the behaviour of the child with WS, sibling behaviour problems and sibling relationship quality. CONCLUSIONS AND IMPLICATIONS: A picture of relatively positive sibling adjustment and relationships emerged, but findings of individual differences and some emotional difficulties emphasise the need for an individualised approach to support in families of children with WS.

Short report: Relationships between sensory processing, repetitive behaviors, anxiety, and intolerance of uncertainty in autism spectrum disorder and Williams syndrome.

Autism spectrum disorder (ASD) and Williams syndrome (WS) share psychopathology relating to sensory processing and repetitive behaviors. The relationships between the sensory features and repetitive behaviors in both disorders, and the mechanisms underlying these relationships are not well understood. The aim of this study was to examine the relationships between sensory processing, repetitive behaviors, anxiety, and intolerance of uncertainty in children with ASD and those with WS to better understand the complexity of psychopathology in these disorders. Parents of 19 children with ASD and 16 children with WS, aged between 4 and 9 years, were asked to complete questionnaires assessing their children's sensory experiences, anxiety symptoms, severity and frequency of repetitive behaviors, and level of intolerance of uncertainty. Serial mediation analysis was performed. Direct significant relationships between sensory features and repetitive behaviors were found only for the ASD group. The relationship between sensory processing difficulties and repetitive behaviors was mediated via intolerance of uncertainty in WS. The findings support the value of considering the complexity of the mechanisms underlying the relationship between sensory processing and repetitive behaviors across neurodevelopmental disorders and the mechanisms underlying these aspects of psychopathology in these groups. Understanding these relationships will shed light on some of the most challenging and intractable characteristics of both conditions and inform suitable interventions to improve quality of life for individuals with either ASD or WS. Autism Research 2019, 12: 759-765. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In autism spectrum disorder (ASD) and Williams syndrome (WS) difficulties processing the sensory aspects of the environment, repetitive behaviors and high levels of anxiety co-occur, but the relationships between these features are not well understood. This study found that sensory difficulties were directly associated with repetitive behaviors in children with ASD, but not WS, and in WS this relationship was mediated by intolerance of uncertainty. The findings support the value of considering the complexity of the mechanisms underlying the relationship between sensory processing and repetitive behaviors across neurodevelopmental disorders.

University Students with Autism: The Social and Academic Experiences of University in the UK.

The number of university students with autism is increasing, and it is crucial that these students can access adequate support. An online questionnaire was completed by 26 autistic students and 158 non-autistic students enrolled at UK universities to investigate social and academic experiences. Autistic students self-reported significant challenges and more mental health difficulties than non-autistic students. Significant challenges focused on the social components of university life, including social skills, social support opportunities, and levels of ASD awareness from others. Many strengths were also reported regarding academic skills of autistic university students. Importantly, there were more thoughts of withdrawal by the students with autism highlighting the need for support. These data can inform university student support services.

Implications of capacity in the classroom: Simplifying tasks for autistic children may not be the answer.

BACKGROUND: Research has demonstrated evidence for increased perceptual capacity in autism: autistic people can process more information at any given time than neurotypical individuals. The implications of this for educating autistic pupils have not been investigated. For example, this ability to process more information at any given time may explain why autistic children sometimes process more peripheral task-irrelevant information than neurotypical individuals (e.g. in background classroom wall-displays). AIMS: The current study assessed the impact of different types of background information on autistic and non-autistic children's ability to perform a learning task. METHODS AND PROCEDURES: Autistic (N = 23) and non-autistic (N = 50) children took part in a computer-based task designed to simulate a lesson. They watched three videos of a teacher telling a story, each with a different background condition: blank, relevant images, or irrelevant images. OUTCOMES AND RESULTS: When the visual display contained story-relevant information, both groups recalled background information in addition to the central story. When the background displays were irrelevant to the story, autistic children recalled more background information than their neurotypical peers, yet maintained their ability to recall information from the central story. CONCLUSION AND IMPLICATIONS: The current study suggests that pupils' perceptual capacity- including those on the autistic spectrum - can indeed be capitalised on to support learning in the classroom. To do so, however, we must ensure that the child can use their capacity for task-relevant processing, rather than irrelevant distractions.

Anxiety in Williams Syndrome: The Role of Social Behaviour, Executive Functions and Change Over Time.

Anxiety is a prevalent mental health issue for individuals with Williams syndrome (WS). Relatively little is known about the developmental course of anxiety, or how it links with core features of WS, namely social and executive functioning (EF). In this study, parent-reports of anxiety were compared across a 4-year period (N = 17), and links between anxiety, social and EF were explored from concurrent parent-reports (N = 26). Results indicated that high anxiety persisted over time, and anxiety was related to impairments in both social and executive functioning. Importantly, results indicated that impairments in EFs may drive the links between anxiety and social functioning. This timely investigation provides new insights into anxiety in WS and highlights potential areas for intervention.

Classroom displays-Attraction or distraction? Evidence of impact on attention and learning from children with and without autism.

Paying attention is a critical first step toward learning. For children in primary school classrooms there can be many things to attend to other than the focus of a lesson, such as visual displays on classroom walls. The aim of this study was to use eye-tracking techniques to explore the impact of visual displays on attention and learning for children. Critically, we explored these issues for children developing typically and for children with autism spectrum disorder (ASD). Both groups of children watched videos of a teacher delivering classroom activities-2 of "story-time" and 2 mini lessons. Half of the videos each child saw contained high levels of classroom visual displays in the background (high visual display [HVD]) and half had none (no visual display [NVD]). Children completed worksheets after the mini lessons to measure learning. During viewing of all videos children's eye movements were recorded. The presence of visual displays had a significant impact on attention for all children, but to a greater extent for children with ASD. Visual displays also had an impact on learning from the mini lessons, whereby children had poorer learning scores in the HVD compared with the NVD lesson. Individual differences in age, verbal, nonverbal, and attention abilities were important predictors of learning, but time spent attending the visual displays in HVD was the most important predictor. This novel and timely investigation has implications for the use of classroom visual displays for all children, but particularly for children with ASD. (PsycINFO Database Record