자폐스펙트럼장애 아동 대인관계 척도개발

BackgroundThe incidence of autism spectrum disorders (ASD) is on the rise. Currently, 1 in 59 children are identified with ASD in the United States. ASD refers to a range of neurological disorders that involve some degree of difficulty with communication and interpersonal relationships. The range of the spectrum for autism disorders is wide with those at the higher functioning end often able to lead relatively independent lives and complete academic programs even while demonstrating social awkwardness. Those at the lower functioning end of the autism spectrum often demonstrate physical limitations, may lack speech, and have the inability to relate socially with others. As persons with ASD age, options such as employment become increasingly important as a consideration for long‐term personal planning and quality of life. While many challenges exist for persons with ASD in obtaining and maintaining employment, some research shows that, with effective behavioral and social interventions, employment can occur. About 37% of individuals with ASD report having been employed for 12 months or more, 4 years after exiting high school. However, several studies show that individuals with ASD are more likely to lose their employment for behavioral and social interaction problems rather than their inability to perform assigned work tasks. Although Westbrook et al. (2012a, 2013, 2015) have reviewed the literature on interventions targeting employment for individuals with ASD, this review is outdated and does not account for recent developments in the field.ObjectivesThe objective of this review is to determine the effectiveness of employment interventions in securing and maintaining employment for adults and transition‐age youth with ASD, updating two reviews by Westbrook et al. (2012a, 2013).Search MethodsThe comprehensive search strategy used to identify relevant studies included a review of 28 relevant electronic databases. Search terminology for each of the electronic databases was developed from available database thesauri. Appropriate synonyms were used to maximize the database search output. Several international databases were included among the 28 databases searched. In addition, the authors identified and reviewed gray literature through analysis of reference lists of relevant studies. Unpublished dissertations and theses were also identified through database searches. The programs of conferences held by associations and organizations relevant to ASD and employment were also searched. In sum, the search strategy replicated and expanded the prior search methods used by Westbrook et al. (2012a, 2013).Selection CriteriaSelection criteria consisted of an intervention evaluation using a randomized controlled trial or quasi‐experimental design, an employment outcome, and a population of individuals with ASD.Data Collection and AnalysisWe updated the search from Westbrook et al., replicating and broadening the information retrieval processes. Our wide array of sources included electronic databases, gray literature, and conference and organization websites. Once all potentially relevant studies were located, pairs of coders evaluated the relevance of each title and abstract. Among the studies deemed potentially relevant, 278 were subjected to full‐text retrieval and screening by pairs of coders. Because many intervention studies did not include employment outcomes, only three studies met our inclusion criteria. Given the small number of included studies, meta‐analytic procedures were not used; rather, we opted to use more narrative and descriptive analysis to summarize the available evidence, including an assessment of risk of bias.ResultsThe systematic review update identified three studies that evaluated employment outcomes for interventions for individuals with ASD. All three studies identified in the review suggest that vocation‐focused programs may have positive impacts on the employment outcomes for individuals with ASD. Wehman et al. indicated that participants in Project SEARCH had higher employment rates than control participants at both 9‐month and 1‐year follow‐up time points. Adding autism spectrum disorder supports, Project SEARCH in Wehman et al.'s study also demonstrated higher employment rates for treatment participants than control participants at postgraduation, 3‐month follow‐up, and 12‐month follow‐up. Smith et al. found that virtual reality job interview training was able to increase the number of job offers treatment participants received compared to control participants.Authors' ConclusionsGiven that prior reviews did not identify interventions with actual employment outcomes, the more recent emergence of evaluations of such programs is encouraging. This suggests that there is a growing body of evidence regarding interventions to enhance the employment outcomes for individuals with ASD but also greater need to conduct rigorous trials of vocation‐based interventions for individuals with ASD that measure employment outcomes.

Impaired social functioning is a hallmark feature of autism spectrum disorder (ASD), often requiring treatment throughout the life span. PEERS(®) (Program for the Education and Enrichment of Relational Skills) is a parent-assisted social skills training for teens with ASD. Although PEERS(®) has an established evidence base in improving the social skills of adolescents and young adults with ASD in North America, the efficacy of this treatment has yet to be established in cross-cultural validation trials. The objective of this study is to examine the feasibility and treatment efficacy of a Korean version of PEERS(®) for enhancing social skills through a randomized controlled trial (RCT).The English version of the PEERS(®) Treatment Manual (Laugeson & Frankel, 2010) was translated into Korean and reviewed by 21 child mental health professionals. Items identified as culturally sensitive were surveyed by 447 middle school students, and material was modified accordingly. Participants included 47 teens between 12 and 18 years of age with a diagnosis of ASD and a verbal intelligence quotient (IQ) ≥ 65. Eligible teens were randomly assigned to a treatment group (TG) or delayed treatment control group (CG). Primary outcome measures included questionnaires and direct observations quantifying social ability and problems directly related to ASD. Secondary outcome measures included scales for depressive symptoms, anxiety, and other behavioral problems. Rating scales for parental depressive symptoms and anxiety were examined to detect changes in parental psychosocial functioning throughout the PEERS(®) treatment. Independent samples t-tests revealed no significant differences at baseline across the TG and CG conditions with regard to age (14.04 ± 1.64 and 13.54 ± 1.50 years), IQ (99.39 ± 18.09 & 100.67 ± 16.97), parental education, socioeconomic status, or ASD symptoms (p < 0.05), respectively. Results for treatment outcome suggest that the TG showed significant improvement in communication and social interaction domain scores on the Autism Diagnostic Observation Schedule, interpersonal relationship and play/leisure time on the subdomain scores of the Korean version of the Vineland Adaptive Behavior Scale (p's < 0.01), social skills knowledge total scores on the Test of Adolescent Social Skills Knowledge-Revised (p < 0.01), and decreased depressive symptoms on the Child Depression Inventory following treatment (p < 0.05). Analyses of parental outcome reveal a significant decrease in maternal state anxiety in the TG after controlling for potential confounding variables (p < 0.05). Despite cultural and linguistic differences, the PEERS(®) social skills intervention appears to be efficacious for teens with ASD in Korea with modest cultural adjustment. In an RCT, participants receiving the PEERS(®) treatment showed significant improvement in social skills knowledge, interpersonal skills, and play/leisure skills, as well as a decrease in depressive symptoms and ASD symptoms. This study represents one of only a few cross-cultural validation trials of an established evidence-based treatment for adolescents with ASD.

The Autism Spectrum Disorders - Diagnosis for Adults (ASD-DA) with intellectual disability was designed to quickly provide relevant information to establish a diagnosis of the most common Autism Spectrum Disorders (ASD) (autism, pervasive developmental disorder not otherwise specified and Asperger’s syndrome) (Matson et al. 2007a). The ASD-DA was adapted and translated into Spanish and administered to a sample of 156 adults with severe (n = 67, 42.9%) and profound (n = 89, 57.1%) intellectual disability. Seventy-one (45.5%) participants had a diagnosis of intellectual disability and autism spectrum disorder, and the other eighty-five (54.5%) had a diagnosis of intellectual disability without autism spectrum disorder. The reliability scores of the scales implied values in the “good-to-excellent” range (0.78–0.95), and test-retest reliability was obtained with good values for most of the items on the scale. A three-factor structure was replicated via confirmatory factor analysis. Participants with and without ASD showed significant differences in the three ASD-DA scales and in their total scores. Using a receiver operating characteristics (ROC) curve, a score of 21 on the ASD-DA scale showed good specificity (0.97) and sensitivity (0.92) values with respect to DSM-IV-TR criteria.

Alexithymia is defined as a limited ability in the cognitive processing of emotions. Literature suggested its negative influence on interpersonal relationship, documenting elevated alexithymia in individuals with Autism Spectrum Disorder (ASD) compared to control groups. However, the study of alexithymia in school-age children with ASD remains largely unexplored as well as its effect on specific child socioemotional outcomes such as quality of attachment relationships. This study examines alexithymia and perceived attachment to parents in twenty-four children with ASD (without intellectual disability) and 24 typically developing (TD) children (mean age 10 years) using the self-reported Alexithymia Questionnaire for Children (AQC) and the Inventory of Parent and Peer Attachment (IPPA). Measures of family SES as well as child intelligence were collected. Data revealed that ASD children showed higher levels of Alexithymia compared to TD group. In addition, 21% of participants with ASD exceed alexithymia categorical cut-off. By contrast, no difference emerged in the perception of attachment to parents. Moreover, alexithymia, but not ASD status, was found to predictive of child perception of attachment to parents. We observed no significant effect of child age and verbal IQ. Our findings showed that alexithymia was more common in children with ASD, whereas attachment was similar between groups. Difficulties in identifying and describing one’s own feelings may hinder the construction of a positive representation of parent-child attachment relationship regardless of child clinical status. Thus, alexithymia seems to play a key role on the way school-age children with and without ASD perceive their relationship with their parents.

Background: In recent years, an increase in the prevalence of autism spectrum disorder (ASD) has been observed in adolescent psychiatric wards. Individuals with ASD have poor social skills and are more likely to have difficulty with interpersonal relations. In addition to such difficulty, inpatients with ASD may be under the influence of adverse environments such as a lack of understanding and abuse, which may result in low self-esteem. Therefore, the aim of this study was to evaluate the usefulness of a pilot study to improve self-esteem through metacognition and strength awareness promotion in adolescents with ASD. Methods: A five-session intervention program (45 to 60 minutes each) was carried out in 12 adolescents (12 to 18 years old) with ASD. The program was performed for each adolescent separately, as individuals with ASD often exhibit uneasiness when finding themselves in an environment where a group of others is present. Metacognition, self-affirmation, and self-esteem scales were administered before and after the program, and the results were compared. Results: Metacognition and self-esteem were increased after the program, both had a large effect size. There were no significant differences in some of the self-affirmation subscales, but the effect size was medium to large. Conclusion: The program activated metacognition, promoted strength awareness, and increased selfesteem in adolescents with ASD

Neurological, structural, and behavioral abnormalities are widely reported in individuals with autism spectrum disorder (ASD); yet there are no objective markers to date. We postulated that by using dominant and nondominant ear data, underlying differences in auditory evoked potentials (AEPs) between ASD and control groups can be recognized. The primary purpose was to identify if significant differences exist in AEPs recorded from dominant and nondominant ear stimulation in (1) children with ASD and their matched controls, (2) adults with ASD and their matched controls, and (3) a combined child and adult ASD group and control group. The secondary purpose was to explore the association between the significant findings of this study with those obtained in our previous study that evaluated the effects of auditory training on AEPs in individuals with ASD. Factorial analysis of variance with interaction was performed. Forty subjects with normal hearing between the ages of 9 and 25 years were included. Eleven children and 9 adults with ASD were age- and gender-matched with neurotypical peers. Auditory brainstem responses (ABRs) and auditory late responses (ALRs) were recorded. Adult and child ASD subjects were compared with non-ASD adult and child control subjects, respectively. The combined child and adult ASD group was compared with the combined child and adult control group. No significant differences in ABR latency or amplitude were observed between ASD and control groups. ALR N1 amplitude in the dominant ear was significantly smaller for the ASD adult group compared with their control group. Combined child and adult data showed significantly smaller amplitude for ALR N1 and longer ALR P2 latency in the dominant ear for the ASD group compared with the control group. In our earlier study, the top predictor of behavioral improvement following auditory training was ALR N1 amplitude in the dominant ear. Correspondingly, the ALR N1 amplitude in the dominant ear yielded group differences in the current study. ALR peak N1 amplitude is proposed as the most feasible AEP marker in the evaluation of ASD.

Background: This narrative review considers implications for the increasing prevalence of diagnosed autism spectrum disorder (ASD) in clinical settings. Clinicians and researchers can be guided through an improved understanding of associated factors increasing the risk for suicidality and suicide in individuals manifesting symptoms of ASD and high ASD traits (ASDTs). Methods: A systematic literature review is supplemented with reverse citations to ensure updated information. By title and abstract, 456 articles were identified. Of those, 50 were used initially, and 15 were later added manually or through reverse citations. Results: Higher suicidal thoughts and behaviors (STBs) and suicide rates exist across the age spectrum in individuals with ASD/high ASDTs compared to matched comparison groups from the general population. Associated, poorly understood factors include comorbid psychiatric conditions and suicide risk factors that overlap with ASD symptoms. Increased risk of STB in higher functioning ASD is emphasized. Interpersonal conflict and depression are significant risk factors, as are comorbid borderline personality, bipolar disorder, anxiety, and obsessive-compulsive disorders. Conclusion: Multiple diagnostic challenges are considered that affect appropriate care to address the increasing incidence of STB and suicide in ASD. This overview integrates extant knowledge for case formulation and treatment planning. It provides support for more focused research to improve ASD-related screening instruments and to address the unique features of ASD-related psychopathology. Improved training is needed for clinicians in screening and preventive efforts and to enhance their competence and comfort for addressing and treating STBs in those with ASDTs and ASD. (N=248).

Catatonia is a complex neuropsychiatric syndrome involving a constellation of psychomotor disturbances including catalepsy, waxy flexibility, stupor, mutism, negativism, agitation, posturing, stereotypes, mannerisms, grimacing, echolalia, and echopraxia. Catatonia occurs in several conditions including psychotic, affective and neurodevelopmental disorders such as autism spectrum disorder (ASD). ASD is a neurodevelopmental disorder characterized by persistent deficits in communication, social interaction, restricted interests, repetitive behaviours and sensory sensitivities. Catatonia can occur in response to life stressors such as extreme fear or threat, interpersonal conflict, tragic events or following significant loss. Those with ASD may be particularly vulnerable to the negative impact of stressors and the link between catatonia and ASD is being increasingly recognized. The overlapping features of catatonia and ASD make it difficult to differentiate often resulting in delayed or missed diagnosis. Catatonia in ASD remains a significant clinical challenge; it is difficult to diagnose and can pose debilitating difficulties for those affected. Catatonia is a treatable condition and prompt recognition is vital in securing the best possible outcome. We report a complex and unique case of a 15-year-old boy who presented with severe cognitive and functional decline with a background history of significant bullying and deterioration in his mental state. This case posed a diagnostic conundrum leading to a diagnosis of underlying ASD, anxiety and trauma.

Students with autism spectrum disorder (ASD) are attending postsecondary programs at unprecedented rates. Transitions are especially challenging for students with ASD, yet little is known about critical transitions during the college experience. Using the College Adjustment Program Evaluation Scales (CAPES), we examined student and parent perspectives across five dimensions: Student Life, Emotional Adjustment, Independent Living Skills, Interpersonal Relationships, and Self-Advocacy. Sixteen participants--eight students and eight parents, completed the CAPES at the end of fall semester of year one and the end of spring semester year two. Student and parent CAPES ratings were uniformly positive with some differences. We found large effect sizes across dimensions and significant differences in Student Life, Independent Living, and Interpersonal Relationships with parent ratings higher than student ratings. An item analysis revealed specific challenges and skills salient to the results. Implications for supports for students with ASD, higher education practices, and transition research are discussed. Keywords: autism spectrum disorder, transition, college, postsecondary education ********** The purpose of postsecondary education (PSE) and the pathways to it are multifaceted. Postsecondary/higher education in the U.S. has evolved across time (Renn & Reason, 2013), and institutions of higher education have developed empirically-based strategies to serve an increasingly diverse student population and improve the first year experience of students (Pascarella & Terenzini, 2005). Whether or not a student has a disability, the value of PSE to the student and to society are pivotal issues in the current debate over the goal of PSE. Mayhew and colleagues (2016) synthesized over 1,800 studies related to student development during college and report positive long-term effects on cognitive development, critical thinking, academic self-concept, locus of control, independence, self-efficacy, and psychological well-being to name a few. The effects of college on students with disabilities, however, is seldom addressed in the higher education and student affairs literature (Hendrickson, Therrien, Weeden, Pascarella, & Hosp, 2015). Although research is scant, the studies that are available indicate that PSE opportunities appear to significantly improve the transition to adulthood and long-term life outcomes (e.g., academic skills, employment, quality of life) of youth with disabilities (Hart, Grigal, & Weir, 2010; Neubert & Redd, 2008). Preliminary psychological wellbeing data indicate that students with ASD and cognitive disabilities and their typical college counterparts are similarly affected by college (Hendrickson, Vander Busard, Rodgers, & Scheidecker, 2013). Hendrickson et al. (2015) compared a national sample of first year college students with and without cognitive disabilities on student engagement and their perceptions of academic challenge, active and collaborative learning, student-faculty interaction, the campus environment, and educationally enriching experiences. They found that students with intellectual disabilities who attended a structured, inclusive, campus-based program did not differ significantly from typical college students in their responses to the National Survey of Student Engagement (NSSE; Pascarella, Seifert, & Blaich, 2010). McGregor and colleagues (2016) report that college students with learning disabilities (LD) were less satisfied with their college experience than other students, had more obstacles caused by nonacademic responsibilities, and felt that there was a bias against individuals with disabilities. McGregor and colleagues' data showed that students with LD who sought and received accommodations were in more frequent contact with faculty and experienced less difficulty with assignments than peers with LD who did not. …

Autism Spectrum Disorder (ASD) or Autism is considered as a psychological neurodevelopment disorder which affects people. It is characterized by a wide range of conditions that difficult their social skills, as well as their verbal and non-verbal communication. According to the Centers for Disease Control, Autism affects an estimated 1 in 59 children in the USA. Technological advances seek to benefit the most vulnerable groups of society, creating tools that enhance the development of their abilities and skills. In this sense, Serious Games are structure-oriented videogames designed to learning or therapies in a fun environment. With this principle, “JOINME” game was developed using a natural user interface to benefit the progress of interpersonal relationships in children aged between 5 and 10, diagnosed with high-functioning ASD. For experimentation, a case study was applied. It was built from the adaptation of the KidsLife scale through a pre-test and post-test. As a result, a significant improvement of 8.17% in the development of interpersonal relationships was obtained in the kids. It reinforced their mathematical reasoning, recognition of emotions, and comprehensive reading.

Objective: This study is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The objective was to use a systematic review approach to identify, number, and link functional ability and disability concepts used in the scientific ASD literature to the nomenclature of the ICF‐CY (Children and Youth version of the ICF, covering the life span). Methods: Systematic searches on outcome studies of ASD were carried out in Medline/PubMed, PsycINFO, ERIC and Cinahl, and relevant functional ability and disability concepts extracted from the included studies. These concepts were then linked to the ICF‐CY by two independent researchers using a standardized linking procedure. New concepts were extracted from the studies until saturation of identified ICF‐CY categories was reached. Results: Seventy‐one studies were included in the final analysis and 2475 meaningful concepts contained in these studies were linked to 146 ICF‐CY categories. Of these, 99 categories were considered most relevant to ASD (i.e., identified in at least 5% of the studies), of which 63 were related to Activities and Participation, 28 were related to Body functions, and 8 were related to Environmental factors. The five most frequently identified categories were basic interpersonal interactions (51%), emotional functions (49%), complex interpersonal interactions (48%), attention functions (44%), and mental functions of language (44%). Conclusion: The broad variety of ICF‐CY categories identified in this study reflects the heterogeneity of functional differences found in ASD—both with respect to disability and exceptionality—and underlines the potential value of the ICF‐CY as a framework to capture an individual's functioning in all dimensions of life. The current results in combination with three additional preparatory studies (expert survey, focus groups, and clinical study) will provide the scientific basis for defining the ICF Core Sets for ASD for multipurpose use in basic and applied research and every day clinical practice of ASD. Autism Res 2015, 8: 782–794. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research

Towards a supramodal organization of conceptual knowledge

The relationship between atypical visual processing and social skills in young children with autism

An initial psychometric evaluation of the CBCL 6–18 in a sample of youth with autism spectrum disorders

Introduction: Concerns about the quality of life (QoL) of parents of children with autism spectrum disorder have been raised by previous study. Policy decision-makers and healthcare professionals can be better informed about the environmental factors associated with parental QoL, which will enhance outcomes for both parents and children. The objective of this review is to perform a comprehensive review that assessed the environmental relevant factors associated with quality of life (QoL) of parents of ASD children (under 18 years old). Methodology: To identify the environmental factors associated with parental QoL, a scoping review was conducted using the Arksey and O'Malley original and enhanced framework. Three electronic data bases (PubMed, Scopus &amp; WOS) and reference list checks were used in the search. Results: Social support, family support, residential condition and access to services were all factors linked to parental quality of life in this group. Conclusion: The review clarified environmental factors as one of variables that have association with parental QoL. The results of this analysis also highlighted potential areas of support that have implications on future policy and practices. Keywords : environmental factors, autism spectrum disorder, quality of life, parents, children References CDC. Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ. 2012;61(3):1-19. CDC. Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014;63(2):1-21. Elsabbagh M, Divan G, Koh Y-J, Kim YS, Kauchali S, Marcín C, et al. Global Prevalence of Autism and Other Pervasive Developmental Disorders. Autism Research. 2012;5(3):160-79. McTiernan A, Leader G, Healy O, Mannion A. Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders. 2011;5(3):1215-22. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921-9. Bolton PF. Medical conditions in autism spectrum disorders. Journal of Neurodevelopmental Disorders. 2009;1(2):102-13. Khanna R, Madhavan SS, Smith MJ, Patrick JH, Tworek C, Becker-Cottrill B. Assessment of Health-Related Quality of Life Among Primary Caregivers of Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. 2011;41(9):1214-27.