Antecedents and Consequences of Child Externalizing Problems: Differences in Dynamic Parent-Child Processes.

Given that noncompliance is the most common externalizing problem during middle childhood and reliably predicts significant conduct problems, innovations in elucidating its etiology are sorely needed. Evaluation of in-the-moment antecedents and consequences of child noncompliance improves traction on this goal, given that multiple theories contend that child noncompliance and parent behavior mutually influence each other through negative reciprocation as well as contingent praise processes. Among a sample of 140 families (child age: 6-10 years; 32.1% female), the present study capitalized on intensive repeated measures of observed child noncompliance and parent negative talk and praise objectively coded during three unique tasks. We employed dynamic structural equation modeling to evaluate within-dyad parent-child behavioral dynamics and between-dyad differences therein. Results provided mixed support for hypotheses and suggested that antecedents and consequences of child noncompliance differed according to task demands and child ADHD symptoms. Contrary to models of coercive cycles, during child-led play, parent negative talk was more likely following prior child noncompliance, but child noncompliance was less likely following prior parent negative talk. As expected, during parent-led play, parent praise was less likely following prior child noncompliance, which was also less likely following prior parent praise. Relative to youth with fewer symptoms, for children with elevated ADHD symptoms, during a challenging clean-up task, child noncompliance was less stable and less contingent on prior parent negative talk. Results are discussed in terms of their implications of real-time parent-child interactions for typical and atypical development of externalizing problems.

Reduced Visual Evoked Potential Amplitude in Autistic Children with Co-Occurring Features of Attention-Deficit/Hyperactivity Disorder.

Provided the significant overlap in features of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), there is a critical need to identify transdiagnostic markers that could meaningfully stratify subgroups. The objective of this study was to compare the visual evoked potential (VEP) between 30 autistic children, 17 autistic children with co-occurring ADHD presentation (ASD + ADHD), and 21 neurotypical children (NTC). Electroencephalography was recorded while children passively viewed a pattern-reversal stimulus. Mean amplitude of the P1 event-related potential was extracted from a midline occipital channel and compared between groups. P1 mean amplitude was reduced in the ASD + ADHD group compared to the ASD and NTC groups, indicating a distinct pattern of brain activity in autistic children with co-occurring ADHD features.

Beyond group differences: Exploring the preliminary signals of target engagement of an executive function training for autistic children.

Understanding both for whom and how interventions work is a crucial next step in providing personalized care to children with autism spectrum disorder (ASD). Autistic children present with heterogeneity both within core ASD criteria and with respect to co-occurring mental health challenges, which may affect their ability to benefit from intervention. In a secondary data analysis of a randomized control trial evaluating an executive function (EF) training with 70 7- to 11-year-old autistic children, we explored: (1) whether co-occurring attention-deficit/hyperactivity disorder (ADHD) features or anxiety features at baseline moderated the extent to which children benefited from the EF training. In other words, we asked, "For whom is training effective?" We also explored: (2) the extent to which changes in a brain-based measure of target engagement predicted the clinical outcomes of the EF training. This is a step towards asking, "How is training effective?" We found that EF training improved behavioral inhibition only for children with clinically significant co-occurring ADHD features. Anxiety features, while prevalent, did not moderate EF training efficacy. Finally, for the EF training group only, there was a significant correlation between pre-to-post change in an EEG-based measure of target engagement, N2 incongruent amplitude during a flanker task, and change in repetitive behaviors, a behavioral outcome that was reported in the parent RCT to have improved with training compared to waitlist control. This study provides preliminary evidence that EF training may differentially affect subgroups of autistic children and that changes at the neural level may precede changes in behavior. LAY SUMMARY: Understanding both for whom and how interventions work will help us provide personalized care to children with autism spectrum disorder (ASD). Autistic children present with many different strengths and challenges. Co-occurring mental health challenges may affect how much autistic children benefit from intervention. We analyzed secondary data from a rigorously designed pilot intervention study, a randomized control trial (RCT), that enrolled 70 7- to 11-year-old autistic children to assess whether a set of computer-based executive function (EF) training games improved their performance. Executive functions include being able to shift between tasks, inhibit a response, and keep information in working memory. In the current study, we explored: (1) whether children's co-occurring attention-deficit/hyperactivity disorder (ADHD) features or anxiety features, measured before the EF training began, affected how much they benefited from the EF training. In other words, we asked, "For whom is training effective?" We also explored: (2) whether children's brain-based changes in EF predicted their performance in everyday life (e.g., parent report on a survey). This is a step toward asking, "How is training effective?" We found that EF training improved children's inhibition ability, but only for children with clinically significant ADHD features. While many children in our sample also had anxiety features, we found that anxiety levels did not affect how well the EF training worked. Finally, for children who received the EF training, changes in a brain-based measure of conflict monitoring (i.e., being able to noticing differences in stimuli) predicted changes in children's repetitive behaviors. This study provides early evidence that EF training may be more effective for some autistic children than others, especially those with ADHD features.