School participation of autistic youths: The influence of youth, family and school factors.

LAY ABSTRACT: School-aged youths have a basic human right to participate in educational and recreational activities at school. Yet, autistic youths are at high risk of being excluded from school and from school-based activities. It is important to understand how this occurs, to ensure that all autistic youths have opportunities to participate in school activities that are equal to the opportunities of their non-autistic peers. The present study investigated multiple influences on the school participation of autistic youths, including youth factors (age and autistic traits), family factors (parent education level and parental self-efficacy for supporting their child's schoolwork) and school factors (the impact of problems autistic youths experienced with the physical and social environments of school). Using an online survey, we gathered the views and experiences of the parents of 200 autistic youths aged between 4 and 16 years, in the Netherlands. We found that among the factors, only the impact of problems that autistic youths experienced with the physical environment of school was associated with their school participation. In particular, autistic youths who experienced greater difficulties with the physical environment of school had lower levels of school participation. Our findings highlight the pressing need to modify school environments to better accommodate the needs of autistic youths so that they can participate easily and comfortably.

The impact of loose-parts-play on schoolyard social participation of children with and without disabilities: A case study.

BACKGROUND: Outdoor social participation in the school playground is crucial for children's socio-emotional and cognitive development. Yet, many children with disabilities in mainstream educational settings are not socially included within their peer group. We examined whether loose-parts-play (LPP), a common and cost-effective intervention that changes the playground play environment to enhance child-led free play, can promote social participation for children with and without disabilities. METHOD: Forty-two primary school children, out of whom three had hearing loss or autism, were assessed for two baseline and four intervention sessions. We applied a mixed-method design, combining advanced sensors methodology, observations, peer nominations, self-reports, qualitative field notes and an interview with the playground teachers. RESULTS: Findings indicated for all children a decrease during the intervention in social interactions and social play and no change in network centrality. Children without disabilities displayed also an increase in solitude play and in the diversity of interacting partners. Enjoyment of LPP was high for all children, yet children with disabilities did not benefit socially from the intervention and became even more isolated compared with baseline level. CONCLUSIONS: Social participation in the schoolyard of children with and without disabilities did not improve during LPP in a mainstream setting. Findings emphasize the need to consider the social needs of children with disabilities when designing playground interventions and to re-think about LPP philosophy and practices to adapt them to inclusive settings and goals.

Do My Reactions Outweigh My Actions? The Relation between Reactive and Proactive Aggression with Peer Acceptance in Preschoolers.

Aggressive behaviors negatively impact peer relations starting from an early age. However, not all aggressive acts have the same underlying motivations. Reactive aggression arises as a response to an antecedent behavior of someone else, whereas proactive aggression is initiated by the aggressor and is instrumental. In this study, we aim to understand the relation between reactive and proactive aggression and peer acceptance in preschoolers. Parents of 110 children aged between 3 and 6 years old rated their children's manifestation of reactive and proactive aggressive behaviors. To assess the children's peer acceptance score within their class, they completed a paired comparisons task. The outcomes confirmed that reactive aggression in particular is negatively related to peer acceptance at the preschool age. Our results provide insights for the needs and directions of future research and interventions.

The early development of emotion recognition in autistic children: Decoding basic emotions from facial expressions and from emotion-provoking situations.

Autism is associated with challenges in emotion recognition. Yet, little is known about how emotion recognition develops over time in autistic children. This four-wave longitudinal study followed the development of three emotion-recognition abilities regarding four basic emotions in children with and without autism aged 2.5 to 6 years over three years. Behavioral tasks were used to examine whether children could differentiate facial expressions (emotion differentiation), identify facial expressions with verbal labels (emotion identification), and attribute emotions to emotion-provoking situations (emotion attribution). We confirmed previous findings that autistic children experienced more difficulties in emotion recognition than non-autistic children and the group differences were present already from the preschool age. However, the group differences were observed only when children processed emotional information from facial expressions. When emotional information could be deduced from situational cues, most group differences disappeared. Furthermore, this study provided novel longitudinal evidence that emotion recognition improved with age in autistic children: compared to non-autistic children, autistic children showed similar learning curves in emotion discrimination and emotion attribution, and they showed greater improvements in emotion identification. We suggest that inclusion and respect in an environment free of stereotyping are likely to foster the development of emotion recognition among autistic children.

Social connectedness at the playground before and after COVID-19 school closure.

Social connectedness at school is crucial to children's development, yet very little is known about the way it has been affected by school closures during COVID-19 pandemic. We compared pre-post lockdown levels of social connectedness at a school playground in forty-three primary school-aged children, using wearable sensors, observations, peer nominations and self-reports. Upon school reopening, findings from sensors and peer nominations indicated increases in children's interaction time, network diversity and network centrality. Group observations indicated a decrease in no-play social interactions and an increase in children's involvement in social play. Explorative analyses did not reveal relations between changes in peer connectedness and pre-lockdown levels of peer connectedness or social contact during the lockdown period. Findings pointed at the role of recess in contributing to children's social well-being and the importance of attending to their social needs upon reopening.

Short report: Longitudinal study on emotion understanding in children with and without developmental language disorder.

BACKGROUND: Children with Developmental Language Disorder (DLD) have difficult access to social interactions, which could in turn limit their opportunities to learn about others' emotions. AIMS: This study aimed to investigate the developmental trajectories of emotion understanding in young children with and without DLD. METHODS AND PROCEDURES: 95 DLD children and 149 non-DLD children were tested twice, with an approximately two-year interval (Mage = 3.58 years at Time 1), on three indices for emotion understanding (discrimination, identification, and attribution in emotion-evoking situations). OUTCOMES AND RESULTS: At Time 2, DLD children fell behind their non-DLD peers on the non-verbal task for emotion discrimination, while catching up on the verbal tasks for emotion identification and attribution. The two groups developed most of these skills with a similar improvement over time, but DLD children showed a greater increase in positive emotion identification and attribution with age than non-DLD children. CONCLUSIONS AND IMPLICATIONS: The findings showed the potential of DLD children to understand others' emotions in verbal tasks to a similar extent as their non-DLD peers. However, DLD children may still face difficulties understanding more implicit emotional messages in real-life situations, and longitudinal follow-ups are required to reveal these challenges.

See the self through others' eyes: The development of moral emotions in young children with autism spectrum disorder.

Despite the important social functions of moral emotions, they are understudied in the autism spectrum disorder (ASD) population. This three-wave longitudinal study is among the first to examine the development of moral emotions and their associations with theory of mind in 3- to 7-year-old children with ASD, using observational tasks. One hundred and forty-two children (52 with ASD) were followed over a period of 2 years. We found that while the expressions of shame and guilt remained stable in non-ASD children, they decreased with age in children with ASD. No group differences were found in the levels or the developmental trajectories of pride. Besides, better false-belief understanding was uniquely related to the expressions of pride in children with ASD. Our findings highlight the importance of enhancing understanding of moral emotion development and related factors in children with ASD.

Longitudinal effects of emotion awareness and regulation on mental health symptoms in adolescents with and without hearing loss.

Emotion awareness (EA) and regulation (ER) are each known to associate with mental health symptoms, yet there is a paucity of longitudinal studies examining them jointly during adolescence. Furthermore, little is known about these skills and their relations in deaf and hard-of-hearing (DHH) adolescents, who are at risk for reduced emotion socialization and for more mental health symptoms. This longitudinal study examined the development and unique contributions of EA (emotion differentiation, emotion communication and bodily unawareness) and ER (approach, avoidance and worry/rumination) to internalizing and externalizing symptoms in adolescents with and without hearing loss. Using self- and parent's reports, we assessed 307 adolescents (age 9-15) three times over 18-month period. We found stability over time in development of EA and avoidance ER, increase in approach ER and decrease in worry/rumination. High levels and increases over time in two aspects of EA, emotion differentiation and communication, and in approach and avoidance ER were related to decreases in depressive symptoms. An increase in approach ER was also related to a decrease in anxiety symptoms. Yet, low levels or decreases in worry/rumination were related to decreased levels of depressive, anxiety and externalizing symptoms. Hearing loss did not moderate any of the variables or relations tested. Preliminary tests suggested heterogeneity within the DHH group according to educational placement, language abilities and parental education level. Overall, findings pointed at unique contributions of EA and ER to mental health development, suggesting that DHH adolescents, especially in mainstream schools, do not differ from their hearing peers in their emotion awareness and regulation.

Toward feeling, understanding, and caring: The development of empathy in young autistic children.

LAY ABSTRACT: Empathy is a highly valued human capacity. Yet, autistic people are often portrayed as lacking in empathy. Recent research, which views empathy as a complex construct emerging from multiple interrelated emotional and cognitive processes, argues that, although many autistic people do have difficulty understanding others' emotions, and this may hinder them from responding to others in a prosocial manner, they are not indifferent to other people's feelings. Hoping to contribute to a better understanding of the unique challenges that autistic children face in their empathy development, we followed the development of four empathy abilities: emotion contagion, attention to others, emotion acknowledgment, and prosocial actions, in 1- to 6-year-old autistic children, in comparison with non-autistic children. Once a year, for 4 consecutive years, children's empathy abilities were evaluated by experimenters who acted out emotional episodes to provoke empathy in children, and by parents who filled out empathy questionnaires. We found that autistic children experienced indeed more difficulty attending to others, acknowledging others' emotions, and initiating prosocial actions toward others. However, according to parents, they did not differ from their non-autistic peers in feeling along with others' negative emotions. This indicates that it might not be the case that autistic children did not want to act empathetically toward others. Rather, they might not know how to do so. Notably, despite these difficulties, when looking at children's developmental trajectories, autistic children showed similar improvements over time as non-autistic children. This provides evidence that autistic children have the potential to learn and to improve their empathy skills.

Correction: Nasri et al. A Novel Data-Driven Approach to Examine Children's Movements and Social Behaviour in Schoolyard Environments. Children 2022, 9, 1177.

The authors request the following corrections because the changes made according to the second round of the review process were not included in the original publication [...].

A Novel Data-Driven Approach to Examine Children's Movements and Social Behaviour in Schoolyard Environments.

(1) Many children in schoolyards are excluded from social interactions with peers on a daily basis. For these excluded children, schoolyard environments often contain features that hinder, rather than facilitate, their participation. These features may include lack of appropriate play equipment, overcrowded areas, or insufficient supervision. These can generate negative situations, especially for children with special needs-such as attention deficit or autism-which includes 10% of children worldwide. All children need to be able to participate in their social environment in order to engage in social learning and development. For children living with a condition that limits access to social learning, barriers to schoolyard participation can further inhibit this. Given that much physical development also occurs as a result of schoolyard play, excluded children may also be at risk for reduced physical development. (2) However, empirically examining schoolyard environments in order to understand existing obstacles to participation requires huge amounts of detailed, precise information about play behaviour, movement, and social interactions of children in a given environment from different layers around the child (physical, social, and cultural). Recruiting this information has typically been exceedingly difficult and too expensive. In this preliminary study, we present a novel sensor data-driven approach for gathering information on social interactions and apply it, in light of schoolyard affordances and individual effectivities, to examine to what extent the schoolyard environment affects children's movements and social behaviours. We collected and analysed sensor data from 150 children (aged 5-15 years) at two primary special education schools in the Netherlands using a global positioning system tracker, proximity tags, and Multi-Motion Receivers to measure locations, face-to-face interactions, and activities. Results show strong potential for this data-driven approach to examine the triad of physical, social, and cultural affordances in schoolyards. (3) First, we found strong potential in using our sensor data-driven approach for collecting data from individuals and their interactions with the schoolyard environment. Second, using this approach, we identified and discussed three schoolyard affordances (physical, social, and cultural) in our sample data. Third, we discussed factors that significantly impact children's movement and social behaviours in schoolyards: schoolyard capacity, social use of space, and individual differences. Better knowledge on the impact of these factors could help identify limitations in existing schoolyard designs and inform school officials, policymakers, supervisory authorities, and designers about current problems and practical solutions. This data-driven approach could play a crucial role in collecting information that will help identify factors involved in children's effective movements and social behaviour.

Being Deaf in Mainstream Schools: The Effect of a Hearing Loss in Children's Playground Behaviors.

Naturalistic playground observations are a rich source of information when studying the social interactions of preschool children. On the playground, children can interact with their peers, explore different places and activities, and engage in different types of play. For deaf and hard of hearing (DHH) children, interactions at a playground can be more difficult because of the large number of auditory stimuli surrounding them. Constraints in the access to the social world on the playground might hamper DHH children's interactions with their typically hearing (TH) peers, activities, and play. This pilot study aimed to examine the playground behaviors of preschool DHH children across three aspects: social levels, type of activities, and play choices. For this purpose, 12 preschool DHH children were observed during recess time, and their behaviors were coded and compared to their 85 TH peers. The preliminary findings indicate that DHH children spend less time in social interactions compared to their TH peers and that they still face difficulties when socially engaging with their TH peers. These findings suggest that interventions should focus on three aspects: the physical environment awareness of TH peers about communicating with DHH children, and the use of exercise play to facilitate social interactions between DHH children and their TH peers.

Family Systems and Emotional Functioning in Deaf or Hard-of-Hearing Preschool Children.

This study examined how deaf or hard-of-hearing (DHH) and typically hearing (TH) children may differ in their family system and emotional functioning and examined the relations between family system and children's emotional functioning. Parents of 106 DHH and 99 TH children (2-6 years) reported on family cohesion and adaptability, parental emotion communication, and their child's emotional functioning. The DHH children were rated lower on family cohesion and positive emotion expression than the TH children. Higher levels of family cohesion related to more positive emotion expression in TH children but not in DHH children. For all children, higher levels of family cohesion related to fewer negative emotion expressions and more parental emotion communication related to more negative emotion expression. The results emphasize the importance of sharing leisure activities together and open communication within the family, which can support DHH and TH children's experience of emotions and their expressions of them.

Friendship quality among autistic and non-autistic (pre-) adolescents: Protective or risk factor for mental health?

LAY ABSTRACT: Autistic young people are often misunderstood by non-autistic young people, and this can lead to difficulties in their friendships. We know that friendship is very important for our mental health. For non-autistic young people, having good friendships is linked to better mental health and having problems in friendship can cause mental health problems. This study aimed to compare the positive and negative features of friendship that autistic non-autistic young people experience. The study also aimed to understand if having positive or negative friendship features is related to signs of mental health problems (anxiety and depression). 306 young people aged 9-16 took part in this study. These were 86 autistic boys, 18 autistic girls, 91 non-autistic boys and 111 non-autistic girls. The findings of this study showed that autistic young people have less positive friendship features than non-autistic young people. For all young people in the study, having more positive friendship features was related to fewer signs of depression, while having more negative friendship features was related to more signs of depression. Just for autistic girls, having more positive friendship features was related to more signs of anxiety. These findings show that support is needed to help autistic young people have more positive friendships. For example, by teaching non-autistic young people how to be supportive friends to their autistic peers.

Reading emotional faces in deaf and hard-of-hearing and typically hearing children.

Reading emotions from other people's facial expressions is an important skill that guides social interactions. With limited auditory input and atypical emotion socialization, deaf and hard-of-hearing (DHH) children may develop atypical processing patterns when reading emotional faces. The current study aimed at understanding whether and how DHH and typically hearing (TH) children differed at 3 emotion processing levels: gaze patterns, physiological arousal, and interpretation. Fifty-five DHH children and 72 TH children completed an emotional face matching task in which they were presented with happy, angry, fearful, and emotionally neutral faces. During the task participants' eye gazes and pupil diameter were measured by an eye-tracking device. The DHH and TH children both paid most attention to the eye region when reading emotional faces. Yet, a contrast between happy faces and nonhappy faces was observed in physiological arousal and interpretation tendency in the DHH children only: Nonhappy facial expressions were more arousing and were confused more often than happy expressions, which may reflect the DHH children being less experienced in processing nonhappy expressions due to limited access to the social environment. The results highlighted the importance of looking into the qualitative differences between typical and atypical development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotions in Deaf and Hard-of-Hearing and Typically Hearing Children.

For deaf and hard-of-hearing (DHH) children living in an environment where their access to linguistic input and social interactions is compromised, learning emotions could be difficult, which may further affect social functioning. To understand the role of emotion in DHH children's social life, this study investigated emotional functioning (i.e., emotion recognition, empathy, emotion expression), and its relation with social functioning (i.e., social competence and externalizing behaviors), in 55 DHH children and 74 children with typical hearing (aged 3-10 years; Mage = 6.04). Parental reports on children's emotional and social functioning and factors related to DHH children's hearing were collected. Results showed similar levels of emotional and social functioning in children with and without hearing loss. Use of auditory intervention and speech perception did not correlate with any measures in DHH children. In both groups, higher levels of empathy related to higher social competence and fewer externalizing behaviors; emotion recognition and positive emotion expression were unrelated to either aspect of social functioning. Higher levels of negative emotion expression related to lower social competence in both groups, but to more externalizing behaviors in DHH children only. DHH children in less linguistically accessible environments may not have adequate knowledge for appropriately expressing negative emotions socially.

The School Career of Children With Hearing Loss in Different Primary Educational Settings-A Large Longitudinal Nationwide Study.

Children with hearing loss (HL) are at risk for a lower educational achievement. This longitudinal study compared the school career of a nationwide Dutch cohort with and without HL based on descriptive data of the governmental authority Statistics Netherlands. From 2008 to 2018, 3,367,129 children, of whom 1,193 used cochlear implants (CIs) and 8,874 used hearing aids (HAs), were attending primary and/or secondary education. Sixty-one percent of children with HL attended mainstream and 31% special primary education. Compared to mainstreamed pupils without HL, mainstreamed pupils with HL achieved lower levels for language and mathematics in primary education but eventually attended comparable types of secondary education. Children with HL attending special primary education attained lower types of secondary education compared to mainstreamed peers with and without HL. These findings suggest that future educational (and as a result professional) attainment of a child with HL depends on the type of primary educational setting.

The Developmental Trajectory of Empathy and Its Association with Early Symptoms of Psychopathology in Children with and without Hearing Loss.

Empathy enables people to share, understand, and show concern for others' emotions. However, this capacity may be more difficult to acquire for children with hearing loss, due to limited social access, and the effect of hearing on empathic maturation has been unexplored. This four-wave longitudinal study investigated the development of empathy in children with and without hearing loss, and how this development is associated with early symptoms of psychopathology. Seventy-one children with hearing loss and cochlear implants (CI), and 272 typically-hearing (TH) children, participated (aged 1-5 years at Time 1). Parents rated their children's empathic skills (affective empathy, attention to others' emotions, prosocial actions, and emotion acknowledgment) and psychopathological symptoms (internalizing and externalizing behaviors). Children with CI and TH children were rated similarly on most of the empathic skills. Yet, fewer prosocial actions were reported in children with CI than in TH children. In both groups, affective empathy decreased with age, while prosocial actions and emotion acknowledgment increased with age and stabilized when children entered primary schools. Attention to emotions increased with age in children with CI, yet remained stable in TH children. Moreover, higher levels of affective empathy, lower levels of emotion acknowledgment, and a larger increase in attention to emotions over time were associated with more psychopathological symptoms in both groups. These findings highlight the importance of social access from which children with CI can learn to process others' emotions more adaptively. Notably, interventions for psychopathology that tackle empathic responses may be beneficial for both groups, alike.

Correction: Low Empathy in Deaf and Hard of Hearing (Pre)Adolescents Compared to Normal Hearing Controls.

[This corrects the article DOI: 10.1371/journal.pone.0124102.].

The Roles of Shame and Guilt in the Development of Aggression in Adolescents With and Without Hearing Loss.

This longitudinal study examined how shame and guilt contribute to the development of reactive and proactive aggression in adolescents with and without hearing loss. Adolescents between 9 and 16 years old (adolescents with hearing loss (n = 80; Mage = 11.91) and without hearing loss (n = 227; Mage = 11.63)) completed self-reports on three occasions with an interval of 9 months. Mixed model analyses revealed that both reactive aggression and proactive aggression decreased with age, whereas shame and guilt peaked in early adolescence. Adolescents with hearing loss reported higher levels of proactive aggression, lower levels of shame and guilt, and showed protracted development for guilt compared to their hearing peers. In both groups, shame contributed to an increase in reactive aggression, whereas guilt contributed to a decrease in proactive aggression. These longitudinal associations highlight the unique role that shame and guilt play in the development of adolescent aggression.