Self-compassion improves emotion regulation and mental health outcomes: A pilot study of an online self-compassion program for autistic adults.

LAY ABSTRACT: Self-compassion is when we are aware of our feelings and thoughts, are friendly toward ourselves, and realize everyone feels pain and makes mistakes. Self-compassion is associated with having better mental health and well-being in autistic and non-autistic people. But we do not know if autistic people's self-compassion can be improved through psychoeducation and self-compassion practices. We co-produced an online self-guided self-compassion program based on evidence-based self-compassion practices for autistic adults called the Self-compassion Program for Autistic Adults. This program included live-experiences videos of autistic adults reflecting on their self-compassion and self-critical experiences. This study piloted the program with 39 autistic adults. We wanted to see if these autistic adults' self-compassion, emotion regulation, mental health, and psychological well-being improved after completing this program. We found that the autistic participants' self-compassion, emotion regulation, mental health, and psychological well-being improved significantly after completing the program over 5 weeks. We also found that just over half of the participants reported experiencing negative reactions associated with self-compassion practices. We suggested some clinical implications, including a recommendation for emotion regulation interventions to incorporate self-compassion to help promote access to the affiliative system. In addition, autistic adults who are psychologically vulnerable may need to work with mental health professionals while developing self-compassion to help manage the possible negative reactions associated with some self-compassion practices.

A qualitative exploration of an autism-specific self-compassion program: The ASPAA.

LAY ABSTRACT: Autistic people often struggle to find the right support for their mental health. We wanted to change that by trying a new approach to help autistic adults with their emotions and well-being. We focused on something called "self-compassion," which is a way of being kind and understanding toward ourselves. This approach has worked well for many people, but we didn't know if it would work for autistic individuals. We invited 39 autistic adults to join an online program that taught them about self-compassion. The program lasted 5 weeks and included educational materials, meditation exercises, and self-reflection activities. We asked the participants for feedback each week and at the end of the program. From their responses, we discovered four important things. First, self-compassion had a big positive impact on the well-being of autistic adults. Second, they faced some challenges during the program. Third, they saw self-compassion as a journey that takes time and practice. Finally, they described how they valued changes to help autistic people engage with the program. Our findings show that self-compassion can really help autistic adults. We learned about the benefits they experienced and the difficulties they faced. Most importantly, we found that personalized support is crucial for autistic individuals. By creating programs that consider their specific needs, we can improve their mental health and make their lives better.

Creating the Global Criminal Justice Survey: A Questionnaire Designed to Gather Perspectives from the Autism Community and Criminal Justice Professionals.

Autistic people's perceptions of their interactions with criminal justice professionals are predominantly negative; however, little is known about the state of interactions on a global scale. To further understanding, a comprehensive stakeholder questionnaire was created. Aspects of reliability and validity including evidence for test content and internal structure were gathered using expert reviews, cognitive interviewing, pilot data collection, and a larger data collection effort (N = 1618). Data was gathered from the autism community through perspectives of parents/caregivers as well as from self-reported autistic adults. Criminal justice professionals included law enforcement officers, corrections professionals, probation and parole officers, forensic psychologists and legal professionals. The scale development process was detailed in order to sufficiently document the initial psychometric evidence and share the steps taken to gain diverse stakeholder input. This study is a critical first step in generating further information to facilitate policy and program development with wide applicability.

Exploring Identity Importance for Autistic Adults and Associations with Disclosure Experiences: A Brief Report.

Background: A strong autistic identity can help to support mental well-being, reduce anxiety and depression, increase self-esteem, and strengthen a shared community for autistic people. Autistic people are regularly faced with a decision to disclose their autistic identity to others and report a range of experiences after disclosure. The purpose of this brief report was to examine the association between identity and disclosure decisions in a sample of autistic adults to gather preliminary evidence justifying future research. Specifically, we were interested in learning more about how autistic identity is associated with one's approach to disclosure, while also exploring associations with other identities such as ethnic, gender, sexual, and religious identity. Methods: Participants (N = 111) completed an online questionnaire about their intersecting identities and their approach to disclosure. The research team that conducted this study was composed of both autistic and nonautistic researchers. Results: Results demonstrated that participants who felt their autistic identity and sexual identity were highly important also reported frequent disclosure of being autistic. Religious, gender, and ethnic identity were not associated with one's disclosure decisions or their disclosure outcomes. Conclusion: Overall, the results of this study emphasize the link between autistic and sexual identities and autism disclosure, but more research in this space is needed to better support the wider autism community.

Why is this an important issue?: Autistic identity is when a person feels a connection to others who are autistic, or to the larger autistic community. Disclosure, or sharing being autistic, is a complex decision that can have a significant impact on an autistic person's life. Both disclosure and autistic identity can be linked to the quality of life for many autistic adults. What was the purpose of this study?: We wanted to know whether autistic identity and disclosure were connected. We wondered whether people who felt a stronger sense of autistic identity would be more likely to share that they were autistic with other people. We also studied other identities such as religious identity, sexual identity, and gender identity­to see whether they were also connected to a person's autism disclosure decisions. What did the researchers do?: We used an online survey to ask 111 autistic adults about their identity and their autism disclosure decisions. The research team that conducted this study included both autistic and nonautistic researchers. What were the results of the study?: Autistic participants in our study who felt their autistic identity and sexual identity were highly important also told us they disclosed their autistic identity often to others in their life. Other identities, such as religious identity and ethnic identity, did not seem to relate to a person's autism disclosure in our study. What do these findings add to what was already known?: This research is the start of what we know about the connection between the identities of an autistic person and their disclosure decisions. Preliminary research like this study helps to show a reason for more research on this topic to increase knowledge and acceptance. What are potential weaknesses in the study?: This study does not cover the experiences of all autistic people, only those who could use technology to complete an online survey. Also, the design of the study only allows us to conclude that disclosure and identity are related, but we cannot yet say whether one influences the other. How will these findings help autistic adults now or in the future?: This research can help to justify additional investigations into this topic and demonstrate the importance of listening to autistic voices to understand their experiences with disclosure and how they may be influenced by their identities. For practitioners such as educators or therapists who work with autistic adults, this research can lead to knowledge that supports mental well-being.

Using Experience Sampling Methodology to Capture Disclosure Opportunities for Autistic Adults.

Background: Despite a recent surge in literature contributing to our understanding of autistic individuals' disclosure experiences, the findings remain mixed. Research based on autistic people's perspective often indicates negative outcomes, while research that focuses on nonautistic perspectives is more positive. In addition, no disclosure study has used ecologically valid research methods, which help to reduce the risk of memory biases and are more representative of real-world experiences. The aim of this research was to capture outcomes from real-world disclosure opportunities as reported by a diverse range of autistic adults. Methods: Thirty-six autistic adults reported their disclosure opportunities through experience sampling methodology (58% female, 28% male, and 14% nonbinary), multiple times per day or week for 2 months. Importantly, we embedded coproduction from conception to dissemination, ensuring that the outputs are relevant and beneficial for the autistic community. Results: In total, participants recorded 231 disclosure opportunities (M = 6.42, SD = 4.83). Two-thirds of opportunities (n = 153) were categorized as disclosure, where the participants decided to share they were autistic, and 33.8% (n = 78) were labeled nondisclosure, where the participants decided not to share that they were autistic. Qualitative thematic analysis of open responses resulted in five themes that illustrated the thought processes during disclosure opportunities, the reactions of others, and reflections following disclosure for autistic adults in our study. Conclusion: These findings show that disclosure decisions and outcomes are complex and are influenced by both internal and external factors. Both support for autistic adults navigating this process and knowledge for nonautistic individuals on the experiences of their autistic friends, family, and community members will help to alleviate negative experiences and improve the mental well-being of autistic adults who face these decisions daily.

Why is this an important issue?: Disclosure is choosing to tell someone that you are autistic. Nondisclosure is choosing not to tell someone you are autistic. This can be difficult for many people and can have a significant impact on their life. What was the purpose of this study?: We wanted to explore disclosure opportunities for autistic people. We wanted to know what these experiences looked like over 2 months and on a daily basis. What did the researchers do?: The research team asked autistic adults to complete a survey through a smartphone application every time they considered sharing that they were autistic over 2 months. The questions asked participants about their thoughts, feelings, and behaviors right after the experience. What were the results of the study?: Our participants shared 231 disclosure opportunities with us over 2 months. Some people shared no experiences, while others shared up to 19 experiences. On average, people shared six experiences. People told us how these opportunities went, and we found five common threads ("themes") across their experiences. First, when deciding whether to disclose or not, autistic people considered how safe they felt in their environment and with the people around them. Autistic people often thought about what they were hoping to gain by disclosing, and if there was nothing to gain, they decided against it. We learned that disclosure takes a lot of energy. We also learned that other people responded to disclosure in positive, neutral, and negative ways across all contexts. Finally, we found that our participants tried to learn from their experiences before the next time they thought about disclosure. What do these findings add to what was already known?: Our findings were similar to previous research that explored how complex autistic disclosure is. However, by gathering information in real time (instead of relying on recall), we learned that a decision to disclose is not only weighing up personal advantages and disadvantages, but also takes into consideration how safe the person feels in a particular environment and how much energy they feel they have at the time. We also learned that sometimes people do not disclose because they are worried about how someone might respond, but other times they simply feel there is no benefit to disclosure. What are the potential weaknesses in the study?: We understand that the experiences of our participants may not apply to all autistic people. Also, because participants had to use a computer or smartphone to be in the study, the findings may be different for individuals who were not able to participate. How will these findings help autistic adults now or in the future?: The findings help us to listen to autistic voices and learn about their experiences. We have used the results to make resource guides. This includes a guide for autistic people (including an easy English version) and a guide for nonautistic people. These resource guides can be found within the Supplementary Data, on our research website, or by getting in touch with the authorship team.Link to "a guide for autistic people" https://www.autismspectrum.org.au/uploads/documents/Research/Disclosure-opportunities-resource-guide-for-Autistic-people-Easy-English.pdf Link to "easy English version" https://www.autismspectrum.org.au/uploads/documents/Research/Disclosure-opportunities-resource-guide-for-Autistic-people_2022-12-12-005526_vgvt.pdf Link to "non-autistic people" https://www.autismspectrum.org.au/Supporting-Autistic-people-who-may-want-to-disclose.

The Inter-Relationship of Emotion Regulation, Self-Compassion, and Mental Health in Autistic Adults.

Background: Emotion regulation is one of the key factors that influence mental health outcomes in autistic and nonautistic populations. Recent research has also identified self-compassion as a negative correlate of depression and positive correlate of psychological well-being in autistic adults. Empirical evidence from the general population supports the notion that being kind and compassionate toward oneself during stressful and difficult moments can help with one's ability to regulate negative emotions, which then has flow-on effects on mental health outcomes. However, the inter-relationship between self-compassion, emotion regulation, and mental health has not been examined in autistic samples. Therefore, the aim of this study was to determine if emotion regulation mediates the relationship between self-compassion and anxiety or depression in a sample of autistic adults. Methods: Participants were 153 adults (meanage = 35.70, standard deviationage = 12.62) who had either self-reported a clinical diagnosis of autism spectrum disorder or self-identified as autistic. They completed an online survey capturing self-compassion, emotion regulation, anxiety, and depression. We hypothesized that emotion regulation would mediate the relationship between self-compassion and anxiety or depression, and self-compassion would not mediate the relationship between emotion regulation and anxiety or depression. Results: As predicted, only emotion regulation mediated the relationship between self-compassion and mental health outcomes. Self-compassion did not mediate the relationship between emotion regulation and mental health outcomes. Conclusion: This study provides preliminary evidence for the role that self-compassion plays in improving emotion regulation and mental health in autistic adults. If this mechanism of emotion regulation mediating the relationship between self-compassion and mental health is consistently found in future studies, then it would be helpful for future research to examine the clinical benefits of including a self-compassion component in emotion regulation interventions to improve mental health outcomes of autistic adults.

Why is this an important issue?: Many autistic individuals are diagnosed with mental illnesses such as anxiety or depression. Having a mental illness leads to negative consequences such as feelings of loneliness and sleep problems. Research findings show that improving autistic people's ability to regulate emotions can reduce symptoms of mental illnesses. Being compassionate toward ourselves during stressful and difficult moments can help us better regulate our negative emotions such as anger, sadness, and fear. Better emotion regulation then improves mental health. Research in the general population supports this proposal. But no research has studied the relationship between self-compassion, emotion regulation, and mental health in autistic adults. What was the purpose of this study?: This study aims to look at the relationship between self-compassion, emotion regulation, and mental health in a sample of autistic adults. What did the researchers do?: We designed an online survey and asked autistic adults to complete this survey. Several autism and autistic organizations around the world helped us spread the word about this study (we are grateful for their support!). The survey contained questions capturing people's self-compassion levels, emotion regulation difficulties, and symptoms of anxiety and depression. One hundred and fifty-three autistic adults completed the survey. These participants either self-reported a diagnosis of autism or self-identified as autistic. What were the results of the study?: We found that autistic adults with higher levels of self-compassion had better emotion regulation and fewer symptoms of anxiety and depression. What do these findings add to what was already known?: Researchers and clinicians have designed various treatments to improve autistic people's emotion regulation. And we know that some of these treatments also improve mental health. We need to identify the components that should be included in the treatments to make them most effective. If future research continues to find this relationship between self-compassion, emotion regulation, and mental health, then adding a self-compassion component to emotion regulation treatments may be helpful. What are potential weaknesses in the study?: This study has several weaknesses: Online survey design­we could not conduct diagnostic assessments to confirm the participant's autism diagnosis. But we have used a questionnaire called the Autism Spectrum Quotient; all participants who self-identified as autistic met the cutoff for autism.Data collection­we collected data from participants at one point, which meant we could not identify the direction of the relationships between variables.Gender of autistic people­a larger proportion of our participants were women, which does not match the typical autism gender ratio of 1:4 (female:male). How will these findings help autistic adults now or in the future?: We hope this study will start the conversation on the relevance of increasing self-compassion for improving emotion regulation and mental health in autistic adults. Therefore, this study may inform the design of future interventions for improving autistic adults' emotion regulation and mental health.

Poly-victimization of autistic adults: An investigation of individual-level correlates.

Autistic people experience high rates of violence and victimization which is largely due to structural injustices, including stigma and social attitudes. Identifying and addressing systemic and structural factors is vitally important, however effecting change in embedded social structures is likely to take some time, even with concerted efforts. In the meantime, it is important to understand whether there are other individual-level factors that may assist in developing preventative and protective strategies for autistic people. The current study investigated the role of individual-level risk factors in the victimization of autistic people. Specifically, we examined whether characteristics that are common among autistic people that is, lower social competence, higher compliance and emotion regulation difficulties or more ADHD features (inattention, impulsiveness and hyperactivity) were associated with poly-victimization in a community sample of 228 adults (118 autistic, 110 non-autistic). Our results show that only ADHD features were predictive of poly-victimization once socio-demographic background variables (age, sexual orientation) were adjusted for. Group status was not a significant predictor in the model and there were no interaction effects between any of the characteristics and group status. These findings suggest that, regardless of whether a person is autistic, ADHD features may place individuals at higher risk of experiencing multiple forms of violence in adulthood. Further research using longitudinal designs and larger, diverse samples is needed. Furthermore, the regression model only accounted for about one-third of the variance in poly-victimization which highlights the importance of looking beyond individual-level risk factors to structural and systemic factors that contribute to disproportionate victimization of autistic people.

'Most people have no idea what autism is': Unpacking autism disclosure using social media analysis.

LAY ABSTRACT: Autism disclosure - that is sharing their autism diagnosis or identity with a person or people - is a difficult decision for many autistic people. While telling people they are autistic can be positive and helpful, it can also create a lot of problems. What we have learnt is that disclosure is really complicated. Rather than asking research participants questions about what might happen, we looked at what people were saying on public social media posts (Reddit and Twitter) about what did happen. We used three years of posts that were related to autism disclosure from a wide range of adults (autistic and non-autistic). Four main ideas were created from our data, with the key finding being that society does not understand autism. This lack of understanding creates problems for autistic people in work, dating, healthcare and mental health. The remaining ideas were that autistic people should have privacy and be treated with respect, that autistic representation can help society and that non-autistic people need to do more to help autistic people. Our findings support that society needs to do more through autism advocacy, better media representation and more public role models. Increasing the accuracy of understanding of autism across society will mean that autistic people can feel safer to disclose if they want to.

'Maybe we just seem like easy targets': A qualitative analysis of autistic adults' experiences of interpersonal violence.

LAY ABSTRACT: Research has consistently shown that autistic children are more likely to be victimised than non-autistic children. More recently, studies have also found that autistic adults report experiencing more violence than non-autistic adults however the circumstances surrounding these incidents and the reasons for this are not clear. We wanted to learn more about violence during adulthood for autistic people including what led up to these incidents and what happened afterwards. We spoke to 22 autistic adults who had experienced violence and analysed what they told us to look for common themes. They told us that violence was commonplace in their own lives and in the lives of other autistic people that they know, so much so that they had even come to expect it to happen. They also talked about the negative effect these experiences had on their mental health, the way they felt about themselves and their ability to trust people. This was made worse if people did not believe them when they disclosed what had happened to them. They told us that certain autistic characteristics might make them more vulnerable like being too trusting or going along with people just to please them. They thought that some of these characteristics had been shaped by their experiences, especially being told that that their thoughts, feelings or behaviours were wrong and being pressured to change the way they behaved to 'fit in'. These findings are important in helping us to understand how to improve the personal safety of autistic people.

The Extent and Nature of Autistic People's Violence Experiences During Adulthood: A Cross-sectional Study of Victimisation.

This study investigated the extent and nature of violence experiences reported by autistic adults. Autistic (n = 118) and non-autistic (n = 110) adults completed a questionnaire about their experiences of sexual harassment, stalking and harassment, sexual violence and physical violence since the age of 15. Autistic adults reported higher rates of all violence types, multiple forms of violence and repeated instances of the same type of violence. Typical gender differences in the patterns of violence (more physical violence reported by men and more sexual violence reported by women) were apparent in the non-autistic but not the autistic group. Findings add to the limited research in this area and highlight the need to identify risk and protective factors. Policy and practice implications are also discussed.

"Self-compassion changed my life": The self-compassion experiences of autistic and non-autistic adults and its relationship with mental health and psychological wellbeing.

Self-compassion is a gentle way of relating to oneself, linked to a host of mental health benefits in non-autistic people. Although many autistic individuals report high anxiety and depression symptoms, no research to-date has examined the self-compassion experiences of autistic individuals and determined if self-compassion is associated with psychopathology. Therefore, the purpose of the current study was to address this research gap. The participants (153 autistic and 93 non-autistic adults) completed on online survey and 11 autistic participants were also interviewed. Autistic participants reported significantly lower self-compassion than non-autistic adults, and in both groups, those with higher self-compassion reported higher psychological wellbeing and lower depression symptoms. Demographic predictors of self-compassion were identified. These findings have both clinical and research implications.

Understanding the vocational functioning of autistic employees: the role of disability and mental health.

PURPOSE: Employment rates for autistic people are low, despite increasing employment-focused programmes. Given the reported complexities for autistic people in finding and keeping work and flourishing there, further exploration is needed to understand how best to help employers accommodate autistic employees. MATERIAL AND METHODS: We assessed 88 employed autistic adults, without comorbid intellectual disability and examined whether self-reported disability and mental health symptoms were associated with two measures of vocational functioning: disability days off work and vocational disability. RESULTS: Nearly half (47%) reported at least one disability day absence in the previous month. Autism severity and IQ were not associated with either measure of vocational functioning. Greater disability and higher mental health symptoms were associated with both types of vocational functioning. However, the associations of anxiety and stress with both vocational outcomes were attenuated to null in a multivariable model. Disability (B = 6.74, p = 0.009; B = 1.18, p < 0.001) and depression (B = 4.46, p = 0.035; B = 1.01, p = 0.049) remained independently associated with both outcomes. CONCLUSIONS: Clinicians and vocational support programmes addressing modifiable factors may need to focus on addressing mental health comorbidities, specifically depression rather than anxiety, or core features of autism to improve vocational outcomes for autistic people. Implications for RehabilitationIndividual-level interventions that reduce disablement, particularly in social areas, and depressive symptoms as a way of reducing days off work and improving workplace activities in autistic employees are recommended.Organisations can accommodate autistic employees by encouraging use of mental health programmes or looking at how the workplace environment can be adapted to limit social disability.

Autism assessment via telehealth during the Covid 19 pandemic: Experiences and perspectives of autistic adults, parents/carers and clinicians.

BACKGROUND: The COVID-19 pandemic has seen a rapid increase in the use of telehealth to deliver services to autistic individuals and their families. Research into the provision of autism assessments via telehealth is limited and few studies have explored clinician perspectives of conducting diagnostic assessments for autism in this way. The objective of this study was to examine the acceptability of a new telehealth model from the perspective of key stakeholder groups in an Australian community-based sample i.e. clients undergoing assessment, parent/carers and expert clinicians. METHODS: Sixteen adult clients (M age = 39.00, SD age = 14.39) and fifty-six parent/carers of children and adults (M age = 44.09, SD age = 9.87) undergoing autism assessments completed an online survey about their experiences of assessments via telehealth. Of these, six clients and twelve parent/carers agreed to participate in follow up interviews. Seven clinicians were also interviewed. RESULTS: In this study, the majority of adults and parent/carers reported that they, or the person they cared for, felt comfortable interacting with the clinician, would be willing to undergo future assessments via telehealth and were not concerned that important information had been missed during the assessment. Although the clinicians were slightly less satisfied with tele-assessment process compared to face-to-face and relied on external sources of information more than they would during a face-to-face assessment, their overall confidence in their diagnostic decision making remained high. CONCLUSION: Autism assessment via telehealth may be an acceptable alternative in some circumstances. However, a telehealth service should consider screening clients for suitability and adequately preparing clients for tele-assessments.

Perceptions of social and work functioning are related to social anxiety and executive function in autistic adults.

LAY ABSTRACT: Many autistic adults have trouble in social situations and at work. Researchers do not know exactly why autistic people might find it difficult in these environments, and no studies to date have looked the way anxiety or other cognitive processes might affect autistic peoples' ability to socialise and succeed in getting and keeping jobs. Anxiety (how much you worry) and difficulty with getting stuff done or switching attention (known as executive function) can be concerns for autistic people and may contribute to social and work difficulties. This study looked at the relationships between the way autistic people perceived their anxiety and executive functioning and their ability to socialise and work. Sixty-two autistic participants completed questionnaires related to their ability to socialise and work, their social anxiety and their executive function. We found that participants who thought that they had poorer ability to work also found themselves to have more difficulties with executive function and they were more socially anxious. Our results showed that how autistic participants perceived their social anxiety and executive function were important in their perception of their social skills and work ability. This study supports the idea that anxiety and executive function could be targeted in interventions to support autistic people and their social and work outcomes.

Does a Person's Autism Play a Role in Their Interactions with Police: The Perceptions of Autistic Adults and Parent/Carers.

This study aimed to describe the impact that autistic characteristics (core features of autism and co-occurring conditions) have on interactions with police. Twelve autistic adults and 19 parent/carers were interviewed about interactions with police in the past 5 years. Using content analysis, it was found that in most (92.3%) interactions, autistic characteristics were described as having a role in the police interaction, either as a causal factor or more commonly by affecting the conduct of the interaction. In the latter case, the impact was associated with negative perceptions of the interaction. By sampling a more representative group across age, gender, functional abilities and context, this study provides insight into factors that underlie many autistic individual's reported dissatisfaction with police interactions.

Interactions Between the Police and the Autistic Community in Australia: Experiences and Perspectives of Autistic Adults and Parents/Carers.

This study aimed to describe the experiences of autistic people who had interacted with police in Australia in the previous 5 years. Fifty autistic adults and 61 parent/carers completed a questionnaire and 30 participants took part in an interview. Participants were most commonly interacting with police in the context of seeking assistance or as victims of crime. Autistic adults were largely unsatisfied with their interactions and reluctant to disclose their autism. Parent/carers reported significantly higher satisfaction than autistic adults and incidents involving children were rated more highly than those involving adults. Suggestions for improved interactions included increased autism awareness amongst police and use of appropriate accommodations. Areas for future research in relation to the evaluation of police training is discussed.

Characterization of a 520 kb deletion on chromosome 15q26.1 including ST8SIA2 in a patient with behavioral disturbance, autism spectrum disorder, and epilepsy.

We present a patient with a behavioral disorder, epilepsy, and autism spectrum disorder who has a 520 kb chromosomal deletion at 15q26.1 encompassing three genes: ST8SIA2, C15orf32, and FAM174B. Alpha-2,8-Sialyltransferase 2 (ST8SIA2) is expressed in the developing brain and appears to play an important role in neuronal migration, axon guidance and synaptic plasticity. It has recently been implicated in a genome wide association study as a potential factor underlying autism, and has also been implicated in the pathogenesis of bipolar disorder and schizophrenia. This case provides supportive evidence that ST8SIA2 haploinsufficiency may play a role in neurobehavioral phenotypes.

Brief report: an exploratory study comparing diagnostic outcomes for autism spectrum disorders under DSM-IV-TR with the proposed DSM-5 revision.

The proposed revision for Autism spectrum disorders (ASDs) in the Diagnostic and Statistical Manual of Mental Disorders--Fifth Edition (DSM-5) represents a shift from the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition, Text Revision (DSM-IV-TR). As the proposed DSM-5 criteria require a higher minimum number of symptoms to be present compared to DSM-IV-TR, there have been some concerns about the impact that this will have on diagnostic outcomes. Therefore, the current study aimed to compare diagnostic outcomes using both DSM-IV-TR and DSM-5 criteria for 132 children. Of the 111 participants who received an ASD diagnosis under DSM-IV-TR, 26 did not meet DSM-5 criteria. The majority of these had received a DSM-IV-TR PDD-NOS diagnosis. Implications of the results and the proposed DSM-5 changes to the ASD criteria are discussed.

Investigating the clinical usefulness of the Social Responsiveness Scale (SRS) in a tertiary level, autism spectrum disorder specific assessment clinic.

The Social Responsiveness Scale (SRS; Constantino and Gruber in Social Responsiveness Scale (SRS). Western Psychological Services, Los Angeles, 2005) is a commonly used screening tool for identifying children with possible autism spectrum disorder (ASD). This study investigated the relationship between SRS scores and eventual diagnostic outcome for children referred to a tertiary level, autism specific assessment service. Forty eight children (mean age = 8.10; 92% male) underwent a comprehensive ASD assessment. Parent and teacher SRS scores were subsequently compared with diagnostic outcome. Sensitivity was high (91% for parent report; 84% for teacher report), however specificity was much lower (8% for parent report; 41% for teacher report). Results demonstrate a need for caution when interpreting SRS results based on current cut-off scores, particularly in children with previously identified social developmental problems.