Smiling synchronization predicts interaction enjoyment in peer dyads of autistic and neurotypical youth.

LAY ABSTRACT: For autistic and neurotypical youth, having positive social interactions with other youth is an important part of well-being. Other researchers have found that one factor that can make people feel like social interactions have gone well is synchronization. Synchronization happens when peoples' body movements and facial expressions align while they're interacting. We focus on smiling synchronization here because other studies have found that when neurotypical individuals synchronize their smiles more in a social interaction, they say they enjoy that social interaction more. However, no studies have directly tested whether smiling synchrony influences social interaction enjoyment in autistic and neurotypical youth. We measured smiling synchrony in pairs of interacting autistic and neurotypical youth who were meeting each other for the first time. Some pairs were autistic youth interacting with other autistic youth (autistic with autistic participant pairs), some pairs were autistic youth interacting with neurotypical youth (autistic with neurotypical participant pairs), and other pairs were neurotypical youth interacting with neurotypical youth (neurotypical with neurotypical participant pairs). We found that autistic with neurotypical participant pairs had lower smiling synchrony than neurotypical with neurotypical participant pairs. Youth who were in dyads that had more smiling synchrony said they enjoyed interacting with their partner more and that they wanted to interact with their partner again. Our research shows that smiling synchrony is one part of interactions between autistic and neurotypical youth that influences how well youth say the interaction went. Identifying natural opportunities for autistic and neurotypical youth to share positive feelings could be one way to promote positive social interactions between autistic and neurotypical youth.

Examining Adolescents' Mental Health Before and During the COVID-19 Pandemic.

The current study characterized the impact of the COVID-19 pandemic and stay-at-home orders on adolescents' internalizing symptoms and assessed predictors of adolescents' internalizing symptoms during the pandemic. Seventy-nine adolescents (18 autistic, 61 nonautistic) and their parents who participated in a previous study and were at least 10 years old (M = 13.8, SD = 1.7) were invited to participate in three online follow-up surveys post-stay-at-home order (May through November 2020). Measures of children's anxiety and depressive symptoms, parenting practices, family togetherness, conflict, financial problems, and parental mental health during the pandemic were collected. Nonautistic adolescents experienced a significant decrease in anxiety symptoms across the beginning of the pandemic and a significant increase in depressive symptoms from pre- to post-stay-at-home order. Permissive parenting and financial problems predicted adolescents' depressive symptoms. Parental mental health difficulties and permissive parenting predicted adolescents' anxiety symptoms. Results underscore the need to support parents and youth.

Neural sensitivity to social reward predicts links between social behavior and loneliness in youth during the COVID-19 pandemic.

Neural reward network sensitivity in youth is proposed to differentially impact the effects of social environments on social outcomes. The COVID-19 pandemic provided an opportunity to test this hypothesis within a context of diminished in-person social interaction. We examined whether neural sensitivity to interactive social reward moderates the relationship between a frequency of interactive or passive social activity and social satisfaction. Survey reports of frequency of interactions with friends, passive social media use, and loneliness and social satisfaction were gathered in 2020 during mandated precautions limiting in-person contact. A subset of participants (age = 10-17) previously participated in a functional magnetic resonance imaging (fMRI) study examining social-interactive reward during a simulated peer interaction (survey n = 76; survey + fMRI n = 40). We found evidence of differential response to social context, such that youth with higher neural reward sensitivity showed a negative association between a frequency of interactive connections with friends and a combined loneliness and social dissatisfaction component (LSDC) score, whereas those with lower sensitivity showed the opposite effect. Further, high reward sensitivity was associated with greater LSDC as passive social media use increased, whereas low reward sensitivity showed the opposite. This indicates that youth with greater sensitivity to social-interactive reward may be more susceptible to negative effects of infrequent contact than their low reward-sensitive counterparts, who instead maintain social well-being through passive viewing of social content. These differential outcomes could have implications for supporting youth during times of major social disruption as well as ensuring mental health and well-being more broadly.

Social reward network connectivity differs between autistic and neurotypical youth during social interaction.

A core feature of autism is difficulties with social interaction. Atypical social motivation is proposed to underlie these difficulties. However, prior work testing this hypothesis has shown mixed support and has been limited in its ability to understand real-world social-interactive processes in autism. We attempted to address these limitations by scanning neurotypical and autistic youth (n = 86) during a text-based reciprocal social interaction that mimics a "live" chat and elicits social reward processes. We focused on task-evoked functional connectivity (FC) of regions responsible for motivational-reward and mentalizing processes within the broader social reward circuitry. We found that task-evoked FC between these regions was significantly modulated by social interaction and receipt of social-interactive reward. Compared to neurotypical peers, autistic youth showed significantly greater task-evoked connectivity of core regions in the mentalizing network (e.g., posterior superior temporal sulcus) and the amygdala, a key node in the reward network. Furthermore, across groups, the connectivity strength between these mentalizing and reward regions was negatively correlated with self-reported social motivation and social reward during the scanner task. Our results highlight an important role of FC within the broader social reward circuitry for social-interactive reward. Specifically, greater context-dependent FC (i.e., differences between social engagement and non-social engagement) may indicate an increased "neural effort" during social reward and relate to differences in social motivation within autistic and neurotypical populations.

Social-interactive reward elicits similar neural response in autism and typical development and predicts future social experiences.

Challenges in initiating and responding to social-interactive exchanges are a key diagnostic feature of autism spectrum disorder, yet investigations into the underlying neural mechanisms of social interaction have been hampered by reliance on non-interactive approaches. Using an innovative social-interactive neuroscience approach, we investigated differences between youth with autism and youth with typical development in neural response to a chat-based social-interactive reward, as well as factors such as age and self-reported social enjoyment that may account for heterogeneity in that response. We found minimal group differences in neural and behavioral response to social-interactive reward, and variation within both groups was related to self-reported social enjoyment during the task. Furthermore, neural sensitivity to social-interactive reward predicted future enjoyment of a face-to-face social interaction with a novel peer. These findings have important implications for understanding the nature of social reward and peer interactions in typical development as well as for future research informing social interactions in individuals on the autism spectrum.

Theory of mind in naturalistic conversations between autistic and typically developing children and adolescents.

LAY ABSTRACT: Conversation is a key part of everyday social interactions. Previous studies have suggested that conversational skills are related to theory of mind, the ability to think about other people's mental states, such as beliefs, knowledge, and emotions. Both theory of mind and conversation are common areas of difficulty for autistic people, yet few studies have investigated how people, including autistic people, use theory of mind during conversation. We developed a new way of measuring cToM using two rating scales: cToM Positive captures behaviors that show consideration of a conversation partner's mental states, such as referring to their thoughts or feelings, whereas cToM Negative captures behaviors that show a lack of theory of mind through violations of neurotypical conversational norms, such as providing too much, too little, or irrelevant information. We measured cToM in 50 pairs of autistic and typically developing children (ages 8-16 years) during 5-min "getting to know you" conversations. Compared to typically developing children, autistic children displayed more frequent cToM Negative behaviors but very similar rates of cToM Positive behaviors. Across both groups, cToM Negative (but not Positive) ratings were related to difficulties in recognizing emotions from facial expressions and a lower tendency to talk about others' mental states spontaneously (i.e., without being instructed to do so), which suggests that both abilities are important for theory of mind in conversation. Altogether, this study highlights both strengths and difficulties among autistic individuals, and it suggests possible avenues for further research and for improving conversational skills.

Developmental costs associated with early maternal withdrawal.

Neglect is the most prevalent form of maltreatment, but it has been understudied relative to abuse. Additionally, developmental outcomes associated with early maternal withdrawal have been understudied relative to outcomes associated with harsh treatment. However, a large body of studies on rodents has documented the causal effect of low maternal care on altered stress responses in offspring. Other evidence from human studies links early maternal withdrawal to clinical levels of neglect. Studies of both rodents and humans suggest that, rather than the aversive responses (e.g., fight, flight, freeze) modeled in relation to threat of attack or harsh treatment, early maternal withdrawal is associated with increased calling and contact seeking to mothers. Moreover, two longitudinal studies indicate that early maternal withdrawal, but not negative-intrusive interaction, contributes to adolescent borderline psychopathology. The field needs prospective studies with well-operationalized constructs of maternal withdrawal to delineate the distinct developmental pathways that may be associated with neglect.

Intervening With Attachment and Biobehavioral Catch-Up to Reduce Behavior Problems Among Children Adopted Internationally: Evidence From a Randomized Controlled Trial.

Children who have been adopted internationally often exhibit persistent behavior problems. The current study assessed the efficacy of the Attachment and Biobehavioral Catch-up intervention (ABC; Dozier & Bernard, 2019) for reducing behavior problems in 122 children adopted internationally. Behavior problems were measured via parent-report using the Brief Infant Toddler Social Emotional Assessment at a pre-intervention visit and after the intervention when children were between 18 and 36 months. Children's behavior problems were also observed using the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS) after the intervention when children were 48 and 60 months. Parents who received ABC reported fewer child behavior problems than parents who received the control intervention immediately after the intervention through 1.5 years post-intervention. Additionally, children whose parents received ABC exhibited fewer behavior problems within the parent context of the DB-DOS when they were 48 months old (2 years post-intervention) than children whose parents received the control intervention. There were no significant intervention effects on children's observed behavior problems within the examiner contexts. These results support the efficacy of ABC in reducing behavior problems among children adopted internationally. Trial registration: ClinicalTrials.gov NCT00816621.

Examining Associations Between Amygdala Volumes and Anxiety Symptoms in Autism Spectrum Disorder.

BACKGROUND: Anxiety is one of the most common co-occurring conditions in people with autism spectrum disorder. The amygdala has been identified as being associated with anxiety in populations with and without autism, yet associations in autism were based on relatively small or developmentally constrained samples, leaving questions as to whether these results hold at different developmental ages and in a larger, more robust sample. METHODS: Structural neuroimaging and parent report of anxiety symptoms of children ages 5-13 years with (n = 123) and without (n = 171) a diagnosis of autism were collected from the University of Maryland and three sites from the Autism Brain Imaging Data Exchange. Standardized residuals for bilateral amygdala volumes were computed adjusting for site, hemispheric volumes, and covariates (age, sex, Full Scale IQ). RESULTS: Clinically significant anxiety symptoms did not differentiate amygdala volumes between groups (i.e., autism and anxiety, autism without anxiety, without autism or anxiety). No significant association between left or right amygdala volumes and anxiety scores was observed among the sample of individuals with autism. Meta-analytic and Bayes factor estimations provided additional support for the null hypothesis. Age, sex, and autism severity did not moderate associations between anxiety and amygdala volumes. CONCLUSIONS: No relation between amygdala volumes and anxiety symptoms in children with autism was observed in the largest sample to investigate this question. We discuss directions for future research to determine whether additional factors including age or method of assessment may contribute to this lack of association.

Improving social-emotional competence in internationally adopted children with the Attachment and Biobehavioral Catch-up intervention.

Children adopted internationally experience adverse conditions prior to adoption, placing them at risk for problematic social-emotional development. The Attachment and Biobehavioral Catch-up (ABC) intervention was designed to help internationally adoptive parents behave in ways that promote young children's social-emotional competence. Participants included 131 parent-child dyads randomly assigned to receive either ABC (n = 65) or a control intervention (n = 66). In addition, 48 low-risk biologically related parent-child dyads were included as a comparison group. At follow-up assessments conducted when children were 24 to 36 months old, internationally adopted children who received the ABC intervention had higher levels of parent-reported social-emotional competence than children who received a control intervention. In addition, observational assessments conducted when children were 48 and 60 months of age showed that internationally adopted children who received ABC demonstrated higher social-emotional competence than children who received a control intervention. Adopted children who received the control intervention, but not the ABC intervention, displayed more difficulties with social-emotional competence than low-risk children. Finally, postintervention parent sensitivity mediated the effect of ABC on observed child social-emotional competence in parent interactions, controlling for preintervention parent sensitivity. These results demonstrate the efficacy of a parenting-focused intervention in enhancing social-emotional competence among children adopted internationally.

A conceptual model of risk and protective factors associated with internalizing symptoms in autism spectrum disorder: A scoping review, synthesis, and call for more research.

This paper reviews and synthesizes key areas of research related to the etiology, development, and maintenance of internalizing symptoms in children, adolescents, and adults with autism spectrum disorder (ASD). In developing an integrated conceptual model, we draw from current conceptual models of internalizing symptoms in ASD and extend the model to include factors related to internalizing within other populations (e.g., children that have experienced early life stress, children with other neurodevelopmental conditions, typically developing children) that have not been systematically examined in ASD. Our review highlights the need for more research to understand the developmental course of internalizing symptoms, potential moderators, and the interplay between early risk and protective factors. Longitudinal studies incorporating multiple methods and both environmental and biological factors will be important in order to elucidate these mechanisms.

Intervening with Attachment and Biobehavioral Catch-Up to decrease disrupted parenting behavior and attachment disorganization: The role of parental withdrawal.

This randomized controlled trial investigated the efficacy of Attachment and Biobehavioral Catch-up (ABC; Dozier, Bick, & Bernard, 2011) in reducing disrupted parenting behavior (affective communication errors, role/boundary confusion, fearful/disoriented, intrusive/negativity, and withdrawal) and its association with disorganized attachment. Participants were 105 mother-child dyads randomized to receive either ABC or a control intervention (a 10-session home-visiting intervention focused on improving children's cognitive abilities, gross and fine motor abilities, and language development). At the time of study enrollment, mothers were approximately 26.7 years old (SD = 7.8) and predominantly Black or African American (73.9%). At the first follow-up visit, children were approximately 20.7 months old (SD = 6.3) and most were identified as Black or African American (61.9%). Fifty-two percent of children were male (n = 55). Assessments of disrupted parenting behavior and child attachment quality were assessed approximately 7 months postintervention (SD = 5.8). A one-way analysis of variance revealed that parents who received ABC demonstrated lower levels of parental withdrawal than parents who received the control condition. A structural equation model revealed a significant indirect effect of intervention group on attachment quality through lower levels of parental withdrawal. Results add to the efficacy of the ABC intervention and identified parental withdrawal as a mediator of change.

Promoting Compliance in Children Referred to Child Protective Services: A Randomized Clinical Trial.

Early experiences of maltreatment have long-term negative effects on children's compliance. This randomized clinical trial examined whether a brief preventative intervention (Attachment and Biobehavioral Catch-up; ABC) was effective in enhancing compliance in children who had been referred to Child Protective Services. Participants included 101 parent-child dyads who received either ABC or a control intervention when children were infants (M = 9.4 months old, SD = 6.1). When children were approximately 36 months old (M = 38.5, SD = 3.0), ABC children demonstrated significantly better compliance than control children. Further, parent sensitivity, measured 1 month post intervention when children were, on average, 18.4 months old (SD = 6.9) partially mediated the effect of ABC on child compliance at 36 months old.

Enhancing Parenting Quality for Young Children Adopted Internationally: Results of a Randomized Controlled Trial.

Children adopted internationally are often dysregulated biologically and behaviorally due to prior experiences of institutional care or caregiving changes and thus are in need of enhanced parental care. The present study assessed whether parents randomized to receive Attachment and Biobehavioral Catch-up (ABC) demonstrated significant improvements in parenting quality when compared to parents receiving a control intervention. Participants were 120 internationally adopted children and their adoptive parents. Sixty-three (52.5%) of the children and 113 (94.2%) of the primary caregivers were female. Children were adopted from several countries and predominantly from China, Russia, South Korea, and Ethiopia. The majority of parents identified themselves as White/non-Hispanic (95.0%). At the start of intervention, parents ranged in age from 26.2 to 51.1 years old (M= 39.7, SD = 6.0), and children ranged in age from 6.8 months to 48.4 months (M = 21.9, SD = 9.0). Sensitivity (i.e., contingent responsiveness to a child's cues), intrusiveness (i.e., physical and/or verbal behavior that interferes with a child's autonomy), and positive regard (i.e., positive affect expressed towards a child) were assessed at preintervention, immediately postintervention, and at annual follow-up visits. Parents who received ABC showed better parenting quality at postintervention than parents who received a control intervention, and these effects persisted at a 2-year follow-up. Findings add to the growing evidence that ABC improves parenting abilities, extending findings to adoptive parents and demonstrating that improvements in parenting quality were sustained several years after completion of the intervention. Trial registration: ClinicalTrials.gov NCT00816621.

Preliminary indications that the Attachment and Biobehavioral Catch-up Intervention alters DNA methylation in maltreated children.

Maltreatment during development is associated with epigenetic changes to the genome. Enhancing caregiving may mitigate these effects. Attachment and Biobehavioral Catch-Up (ABC) is an intervention that has been shown to improve parent-child relationships and a variety of biological and behavioral outcomes among children that are involved in Child Protective Services. This preliminary study, using a small sample size, explored whether children who received ABC exhibit different methylation patterns than those who received a control intervention. The participants included 23 children aged 6-21 months who were randomized to receive ABC (n = 12) or a control intervention (n = 11). While the children displayed similar methylation patterns preintervention, DNA methylation varied between the ABC and control groups at 14,828 sites postintervention. Functional pathway analyses indicated that these differences were associated with gene pathways that are involved in cell signaling, metabolism, and neuronal development. This study is one of the first to explore parenting intervention effects on children's DNA methylation at the whole genome level in infancy. These preliminary findings provide a basis for hypothesis generation in further research with larger-scale studies regarding the malleability of epigenetic states that are associated with maltreatment.

Enhancing the language development of toddlers in foster care by promoting foster parents' sensitivity: Results from a randomized controlled trial.

Young children in foster care are at increased risk for problematic language development, making early intervention a critical tool in enhancing these children's foundational language abilities. This study examined the efficacy of an early preventative intervention, Attachment and Biobehavioral Catch-up for Toddlers (ABC-T), in improving the receptive vocabulary abilities of toddlers placed in foster care. All the children had been removed from their biological parents' care and placed into foster care. When children were between 24 and 36 months old, foster parents were contacted by research staff and consented to participate. Parents were randomly assigned using a random number generator to receive either ABC-T (n = 45), which aimed to promote sensitive parenting for children who have experienced early adversity, or a control intervention (n = 43). Foster children's receptive vocabulary skills were assessed post-intervention using the Peabody Picture Vocabulary Test, Third Edition, when children were between 36 and 60 months old. Children whose foster parents received ABC-T demonstrated more advanced receptive vocabulary abilities than children whose foster parents received the control intervention. The positive effect of ABC-T on foster children's receptive vocabulary was mediated by increases in foster parents' sensitivity during parent-child interactions. Trial registration: ClinicalTrials.gov NCT01261806.

Novel Methods for Screening: Contributions from Attachment and Biobehavioral Catch-up.

Preventative interventions are needed across the lifespan, including for children who have experienced maltreatment. However, interventions' effect sizes are typically smaller in real-world settings than in clinical trials. Identifying providers who are likely to implement interventions with fidelity could promote implementation outcomes through targeted allocation of training resources. This study tested two pre-training screening measures as predictors of provider fidelity to Attachment and Biobehavioral Catch-up (ABC), a preventative intervention for maltreated infants. One measure assessed valuing of attachment/openness, and the other used vignettes to assess initial skill in a key intervention component. In a sample of 42 providers across 197 sessions, both screening measures predicted future ABC fidelity, even when controlling for experience and education. These results support the development of screening measures for other interventions, suggesting approaches that target specific qualities and behaviors are likely to predict implementation fidelity.

Attachment states of mind among internationally adoptive and foster parents.

The first aim of the current study was to examine the latent structure of attachment states of mind as assessed by the Adult Attachment Interview (AAI) among three groups of parents of children at risk for insecure attachments: parents who adopted internationally (N = 147), foster parents (N = 300), and parents living in poverty and involved with Child Protective Services (CPS; N = 284). Confirmatory factor analysis indicated the state of mind rating scales loaded on two factors reflecting adults' preoccupied and dismissing states of mind. Taxometric analyses indicated the variation in adults' preoccupied states of mind was more consistent with a dimensional than a categorical model, whereas results for dismissing states of mind were indeterminate. The second aim was to examine the degree to which the attachment states of mind of internationally adoptive and foster parents differ from those of poverty/CPS-referred parents and low-risk parents. After controlling for parental age, sex, ethnicity, and socioeconomic status, (a) internationally adoptive parents had lower scores on the dismissing dimension than the sample of community parents described by Haltigan, Leerkes, Supple, and Calkins (2014); (b) foster parents did not differ from community parents on either the dismissing or the preoccupied AAI dimension; and (c) both internationally adoptive and foster parents had lower scores on the preoccupied dimension than poverty/CPS-referred parents. Analyses using the traditional AAI categories provided convergent evidence that (a) internationally adoptive parents were more likely to be classified as having an autonomous state of mind than low-risk North American mothers based on Bakermans-Kranenburg and van IJzendoorn's (2009) meta-analytic estimates, (b) the rates of autonomous states of mind did not differ between foster and low-risk parents, and

TRAJECTORIES OF CHANGE IN ATTACHMENT AND BIOBEHAVIORAL CATCH-UP AMONG HIGH-RISK MOTHERS: A RANDOMIZED CLINICAL TRIAL.

Using an intensive short-term longitudinal design, this study first examined whether there were significant differences in maternal sensitivity and intrusiveness after completion of Attachment and Biobehavioral Catch-up (ABC; Dozier & the Infant-Caregiver Project Lab, 2013) when compared to a control condition. The second aim was to explore the rate and shape of change in parenting behaviors. Participants were 24 mothers and their biological children, who were randomly assigned to ABC (n = 13) or a control condition (n = 11). A structured play assessment with each mother and her child was video-recorded prior to randomization into the study, before each intervention session, and at a follow-up visit. A total of 270 videos were coded for sensitivity and intrusiveness. Hierarchical linear growth models were used to estimate the total change in parenting qualities across the 10 intervention sessions when comparing ABC to a control condition. Piecewise hierarchical linear growth models were used to investigate patterns of change across the intervention for mothers within ABC. Mothers in the ABC condition showed greater increases in sensitivity and decreases in intrusiveness than mothers in the control condition. There was evidence for nonlinear patterns of change in sensitivity and intrusiveness among mothers in ABC. These results support the effectiveness of ABC in changing sensitivity quickly.