This study tested the feasibility and outcomes of an intensive summer social program (summerMAXyc) on the social functioning, ASD-traits, and behaviors of autistic children, ages 4–6 years (N = 12). The manualized 5-week group intervention was delivered 5 days per week, 6 h per day to groups of 6 children each, and it included skills instruction and therapeutic activities targeting social/social-communication skills, emotion recognition, and interest expansion. summerMAXyc utilized direct instruction, modeling, roleplay, feedback, repeated practice, and reinforcement, and parents also participated in weekly group parent training. High levels of fidelity and child and parent satisfaction, as well as no attrition or adverse events supported feasibility. Significant pretest–posttest improvements were found for the primary outcome of child social performance (rated by masked observers), and secondary outcomes of parent-rated ASD-traits, social skills, communication skills, and problem behaviors. The results from 2 main outcome measures were pooled with prior summerMAXyc pilot study results to explore child features potentially associated with pretest–posttest change scores. Findings suggested that change scores were not related to third variables. summerMAXyc was feasible and appeared to yield child benefits. Implications and recommendations for further study are provided.

This study assessed the feasibility and initial outcomes of an innovative group exercise-based social intervention (So Fit) on the social functioning, ASD-features, and physical performance of autistic children, ages 7-12 years (N = 28). The So Fit manualized intervention (prescribed content and instructional procedures) was delivered to groups of 8-11 autistic children, and it consisted of two 60-minute sessions per week over 10 weeks. Each session included a skills instruction component targeting social and physical performance skills (10-15 min) followed by an exercise-based activity (45-50 min) to promote social interactions, practice social skills, and receive feedback. A behavioral reinforcement system was also implemented to foster skills development and improve ASD-features. Lastly, parents participated in three psychoeducational parent training groups on the program, and strategies for teaching, reinforcing, and generalizing skills/behaviors outside the program setting. Fidelity was high, parent and child satisfaction were good, and there were no adverse events/injuries or withdrawals supporting feasibility. Preposttest comparisons indicated significant improvements in parent-rated social skills and ASDfeatures, and on objective observations/tests of child social performance, social knowledge, and physical performance. Additional testing of So Fit in a randomized trial appears warranted and recommendations are provided.

This study examined informant discrepancies for parent and teacher ratings of social skills and behavioral flexibility/regulation of 124 children with autism spectrum disorder (ASD), ages 6 to 11 years. Scores on the Adapted Skillstreaming Checklist (ASC) were examined for mean differences, level of agreement, and moderators of difference scores between informant groups. Results indicated no significant differences between parent and teacher ASC mean scores. Parent and teacher scores were low-to-moderately correlated (intraclass correlation coefficient = .30 and Pearson r = .18) and the Bland-Altman plot and regression analysis revealed no systematic differences in agreement across the range of scores. None of the variables moderated the parent-teacher difference scores. Overall, practitioners should not necessarily anticipate parent-teacher differences when using the ASC for group-level comparisons. However, ratings were less consistent (modest correlations) at the individual child level. Less agreement at the individual child level suggests that practitioners should be prepared to follow-up and clarify the reason(s) for the differences.

Research suggests autistic children learn and generalize visual family-resemblance categories atypically (e.g., Church, et al., 2010, 2015), particularly when learning incidentally from exposure. This may reflect differences in perceptual learning (Mercado et al., 2020). However, it is unknown whether perceptual discrimination learning is also atypical and if differences extend to other modalities. To address this, autistic children with normal language abilities and IQ and typically developing (TD) matched comparison children completed auditory and visual discrimination tasks, after either incidental exposure to or direct training with stimuli presented in either progressive (easy-to-hard) or random orders of difficulty. In the visual task, both autistic and TD children only performed well after progressive training, suggesting limited perceptual learning from incidental visual exposure. In the auditory task, autistic children showed a progressive learning advantage after both exposure and training, but TD children only showed this advantage after training. They also had significantly better auditory discrimination than TD children after progressive training. These findings suggest typical visual discrimination learning after progressive training and enhanced auditory discrimination learning after progressive training and exposure. This enhanced auditory perceptual learning may help explain why these autistic children are socially impaired while retaining the capacity to learn language.

A prior randomized trial found a school social intervention yielded significantly better outcomes (social and autism features) immediately following intervention compared to typical school programming (services-as-usual [SAU]) for children on the autism spectrum. In that study, children in the SAU condition subsequently completed a summer social intervention. This study tested longer-term maintenance of effects for children who completed both interventions. A total of 103 children (ages 6–12 years) on the autism spectrum enrolled and 102 completed the initial RCT. Following the summer social intervention, 90 children from the original RCT completed the longer-term follow-up study. In addition to baseline and posttest in the initial RCT, children from both groups were tested at three follow-up points (five total testing points). At the time of first longitudinal follow-up testing, the children were 1.25–4.25 years post-intervention (ages 8–15 years). Longitudinal multilevel model analyses (and follow-up contrasts) revealed significant improvements for both groups post-intervention on measures of emotion recognition, autism features, and social skills, indicating maintenance of post-intervention improvements over the three follow-up testing points. No between-group differences were found for autism features or social skills over time; however, the school social intervention may have yielded somewhat better emotion recognition skills. Exploratory tests found that child IQ, language level, and length of time since completing the intervention did not moderate outcomes. Both social interventions yielded positive and durable longer-term improvements for children on the autism spectrum. [ClinicalTrials.gov, NCT03338530; November 8, 2017; original retrospectively registered trial]

Although evidence has suggested that social skills interventions yield social and symptom benefits for autistic children, significant variability in outcomes between studies has raised important questions regarding efficacy and moderators of intervention outcomes (i.e., which interventions yield positive effects and which autistic children are most likely to benefit). The efficacy of a comprehensive psychosocial program for autistic children, ages 7–12 years ( N = 88) was tested in a prior randomized controlled trial (RCT). Significant effects favoring the program group (versus waitlist controls) were found at posttest on measures of autism-feature severity, social/social-communication skills, social-cognitive understanding (nonliteral language), and global social skills, and these were maintained at 4–6 week follow-up. In this exploratory study, demographic and clinical variables were tested as potential moderators of outcomes from the prior RCT. Moderation effects were not evident for demographics, or child IQ, expressive language, autistic diagnostic symptoms, or baseline co-occurring externalizing or internalizing symptoms. Child receptive language appeared to moderate the outcome of nonliteral language only. Overall, program effects were, with one exception, unrelated to third variables.

PURPOSE: This study assessed the feasibility and effectiveness of a 10-wk high intensity exercise program offered after-school for children with autism spectrum disorder (ASD) without intellectual disability. METHODS: Children with ASD (n = 11, M age: 9.53 ± 2.1 yr) engaged in a 1 hr after-school high intensity functional training exercise session, 2 d/wk for 10 wks that targeted social skills, ASD symptoms, and physical performance. Each group exercise session included an instruction period, warm-up, high intensity workout, related game, and cool-down. Social skill and symptom outcome measures included the Adapted Skillstreaming Checklist (ASC) and Social Responsiveness Scale 2nd Edition, School Age Form (SRS-2). Physical performance data (i.e., strength, flexibility, PACER aerobic fitness, power) were also collected. Paired t-tests were used to assess pre to post program performance differences. Participant and parent/guardian satisfaction surveys (7-point Likert scale) were administered following completion of the program. RESULTS: Feasibility and safety were supported in high levels of fidelity (96%), participant and parental satisfaction (4.66, 6.53 out of 7, respectively), and attendance (90% of all sessions), and there were no adverse events or injuries. Pre-post comparisons indicated significant improvements and large effects in social skills (ASC = 87.5 to 118.73; d = 1.95) and ASD symptoms (SRS-2 = 83.6 to 71.36; d = .98) and medium-to-large effects on tests of physical performance (PACER [6.9 to 9.9 laps; d = .86], 60 sec max sit-ups [13.3 to 23.5 reps, d = .58], 60 sec max body weight squats [19.5 to 29.6; d = .61]). CONCLUSION: This after-school high intensity exercise program for children with ASD without intellectual disability was feasible (high fidelity, satisfaction) and improved social functioning, ASD symptoms and physical performance.

The Social Competence Observation Scale (SCOS) is an objective observational measure developed to assess the social performance of children with autism spectrum disorder (ASD). This paper describes development of the SCOS and results of initial testing of reliability and treatment sensitivity for a sample of 12 children, ages 4–6 years, with ASD. Based on observations, the measure can yield three scores including a social impairment severity, change, and responder status score. Results suggested good-to-excellent reliability (inter-observer agreement and test–retest) and the SCOS was treatment sensitive to changes resulting from the intervention (at the social impairment severity score, change score, and responder status levels). Lastly, the effect size based on the SCOS social impairment severity score improvements (baseline-to-post-treatment) for the coders was large and was comparable to parent ratings on a standardized measure of ASD social impairment symptom severity. Implications and suggestions for future study are discussed.

Children with ASD are more likely to be involved in bullying compared to typically developing peers; however, studies rarely examine bullying perpetration and the contributing factors among this population. The primary aim of this study was to examine the extent to which parent-reported ASD symptoms, social skills, and comorbid externalizing and internalizing symptoms predicted bullying perpetration in a sample of 390 children with ASD without intellectual disability. Findings from hierarchical regression analyses indicated that social skill deficits, externalizing symptoms (i.e., hyperactivity, aggression, and conduct problems), and depressive symptoms were associated with higher likelihood of bullying perpetration, while severity of ASD symptoms and anxiety were not significant predictors. Further research is needed to better understand bullying perpetration among children with ASD.

This study reports on two pilot studies developing a telemedicine parent-delivered social skills intervention (PDSSI) for school-aged children with ASD. Pilot study 1 involved initial development, training, and feasibility testing for six parent–child pairs using in-person training and fidelity monitoring. Findings from study 1 supported the intervention procedures through high satisfaction and parent implementation fidelity. Pilot study 2 tested the intervention with 11 parent–child pairs using telemedicine for parent training, fidelity monitoring, and child outcome testing. Findings from study 2 supported feasibility using telemedicine. Study 2 also provided initial data indicating improvements in child social skills knowledge (d = 1.15), social skills (d = 1.75), and ASD characteristics (d = 0.92). Parents reported improvements in their own empowerment (d = 1.09) and stress (d = 0.44). Some outcomes were assessed and maintained at a 16-week follow-up. Overall, results support ongoing testing of this telemedicine PDSSI.

Yoga is a common exercise modality, ranking in the top 20 fitness trends for the last decade. Recent research has suggested that participating in yoga may provide supplemental benefits to muscular strength, when partnered with resistance training, in young adults. However, previous research has methodological limitations that impact the ability to properly understand the effects of yoga on muscular strength. PURPOSE: To determine the effects of a 6-week Hatha yoga intervention on total body muscular strength in healthy, resistance-trained, young adults. METHODS: Resistance-trained adults (n = 18); age: 23.1 ± 2.0 y; 61% females) were randomized to either the yoga intervention (n = 10) or control group (n = 8). The yoga intervention involved 18 Hatha yoga sessions over 6 weeks, while the control group maintained normal activities. Both groups continued their resistance training programs. Muscular strength was assessed pre- and post-intervention using 1-RM for bench press, deadlift, and squat using standard procedures. Data were analyzed using a 2 (time) x 2 (group) repeated measures ANCOVA, controlling for sex, with an alpha level set at 0.05. RESULTS: There was a significant difference in bench press 1-RM due to time (p < 0.001) with an increase in 1-RM following the intervention (pre: 55.4 ± 9.9 kg vs. post: 59.2 ± 10.0 kg). Deadlift 1-RM also increased across the intervention (pre: 96.7 ± 19.0 kg vs. post: 103.0 ± 18.1 kg; p = 0.04). There were no differences in 1-RM for bench press (p = 0.08) or deadlift (p = 0.29) between the two groups. There was a significant increase in squat 1-RM across time (pre: 79.5 ± 15.2 kg vs. post: 86.3 ± 15.4 kg; p < 0.001). Further, the yoga group had a significantly higher squat 1-RM (90.8 ± 15.0 kg) compared to the control group (75.0 ± 15.0 kg; p = 0.04). CONCLUSIONS: A 6-week Hatha yoga intervention does not improve deadlift and bench press 1-RM differently than resistance training alone. However, yoga may provide beneficial improvements to the 1-RM for squat in resistance-trained, young adults. Future research would be beneficial to investigate alternate forms of yoga on muscular strength such as Vinyasa yoga. Research should also aim to determine whether supplementing resistance training with yoga is beneficial in other populations such as older individuals and those with musculoskeletal disorders.

Members of the astacin family of metalloproteinases such as human bone morphogenetic protein 1 (BMP-1) have previously been linked to cell differentiation and pattern formation during development through a proposed role in the activation of latent growth factors of the TGF-beta superfamily. Recent findings indicate that BMP-1 is identical to pro-collagen C-proteinase, which is a metalloproteinase involved in extracellular matrix (ECM) formation. This observation suggests that a functional link may exist between astacin metalloproteinases, growth factors and cell differentiation and pattern formation during development. Taken together, current studies indicate that BMP-1 and possibly other astacin metalloproteinases are multifunctional enzymes that act directly on growth factors and the ECM. In combination, these dual actions would have profound effects on developmental processes.

OBJECTIVES:The present research used a continuous measurement approach to extend the evidence that autism is associated with significant struggles in physical health as well as mental health and psychological well-being.METHODS:The relationship of autism characteristics to physical health and psychological well-being was examined in 294 individuals (M age = 70.51, SD age = 8.17, age range = 53-96). The sample is 57.4% female (n = 166) and primarily White (n = 270, 96.8%). The majority of the participants did not identify as having an autism diagnosis (n = 284, 96.6%). Participants completed the Autism-Spectrum Quotient Scale alongside self-report measures of physical health, mental health, and psychological well-being.RESULTS:Autism characteristics correlated strongly with challenges in social engagement due to poor health (r = 0.46), depression (r = 0.39) and anxiety (r = 0.47), limitations due to poor mental health (r = 0.41), satisfaction with life (r = -0.47), and psychological well-being (r = -0.62).DISCUSSION:These findings help shed light on the challenges experienced by individuals aging with elevated autism characteristics. The limitations of this study and prior work on this topic help identify important avenues for future research in this area.

Objective This study tested the efficacy of an intensive outpatient psychosocial treatment for children with autism spectrum disorder (ASD) without intellectual disability (ID). Method Eighty-eight children (ages 7-12 years) were randomly assigned to the treatment or control (waitlist) condition. The 18-week cognitive-behavioral treatment (two 90-min sessions per week) included small-group instruction and therapeutic activities targeting social/social-communication skills, face-emotion recognition, nonliteral language skills, and interest expansion. A behavioral system was used to increase skills development and reduce ASD symptoms. Efficacy was tested immediately following treatment (posttest), with maintenance assessed 4-6 weeks later (follow-up). Measures included parent ratings of the children's social/social-communication skills, ASD symptoms, broad social skills, and behavior symptoms, child tests of social-cognitive skills (emotion recognition and nonliteral language), and behavioral observations. Results Significant effects favoring the treatment group were found at posttest on the primary measures of ASD symptoms (Social Responsiveness Scale, Second Edition; Constantino & Gruber, 2012) and social/social-communication skills (Adapted Skillstreaming Checklist; Lopata, Thomeer, Volker, Nida & Lee, 2008), and secondary measures of nonliteral language skills, broad social skills, and behavior symptoms (measures of emotion-recognition skills and social behaviors during structured game sessions were non-significant). The significant treatment effects found at posttest were all maintained at follow-up. Conclusions The outpatient treatment improved several core areas of functioning for children with ASD without ID. Additional elements may be needed to expand the efficacy of the treatment so that the observed skills/symptom improvements generalize to social interactions during gameplay.

This study examined the psychometric characteristics of the Cambridge-Mindreading Face-Voice Battery for Children (CAM-C) for a sample of 333 children, ages 6–12 years with ASD (with no intellectual disability). Internal consistency was very good for the Total score (0.81 for both Faces and Voices) and respectable for the Complex emotions score (0.72 for Faces and 0.74 for Voices); however, internal consistency was lower for Simple emotions (0.65 for Faces and 0.61 for Voices). Test–retest reliability at 18 and 36 weeks was very good for the faces and voices total (0.76–0.81) and good for simple and complex faces and voices (0.53–0.75). Significant correlations were found between CAM-C Faces and scores on another measure of face-emotion recognition (Diagnostic Analysis of Nonverbal Accuracy-Second Edition), and between Faces and Voices scores and child age, IQ (except perceptual IQ and Simple Voice emotions), and language ability. Parent-reported ASD symptom severity and the Emotion Recognition scale on the SRS-2 were not related to CAM-C scores. Suggestions for future studies and further development of the CAM-C are provided. Facial and vocal emotion recognition are important for social interaction and have been identified as a challenge for individuals with autism spectrum disorder. Emotion recognition is an area frequently targeted by interventions. This study evaluated a measure of emotion recognition (the CAM-C) for its consistency and validity in a large sample of children with autism. The study found the CAM-C showed many strengths needed to accurately measure the change in emotion recognition during intervention.

Background: The historical focus on autism as a childhood disorder means that evidence regarding autism in adulthood lags significantly behind research in other age groups. Emerging studies on the relationship of age with autism characteristics do not target older adult samples, which presents a barrier to studying the important variability that exists in life span developmental research. This study aims to further our understanding of the relationship between the Autism-Spectrum Quotient Scale and age in a large adult sample. Methods: The present study examines the relationship of Autism-Spectrum Quotient Scale (AQ) scores with age in 1139 adults, ages 18-97 years. Participants came from three distinct samples-a sample of primarily students, a sample of MTurk participants, and a sample of primarily community dwelling older adults. The majority of the participants did not self-report an autism diagnosis (91%), were female (67%), and identified as White (81%). Participants completed the AQ primarily via online surveys. Researchers scored the AQ following six common scoring practices. Results: Results of preregistered analyses indicate that autism characteristics measured by the AQ are not strongly associated with age (r values from -0.01 to -0.11). Further findings indicate that the measurement of autism characteristics is consistent across age into late life using both multiple groups and local structural equation modeling approaches to measurement invariance (comparative fit indices = 0.82-0.83, root mean square error = 0.06) as well as reliability analysis. Finally, demographic and autism-related variables (sex, race, self-identified autism spectrum disorder diagnosis, and degree of autism characteristics) did not moderate the relationship between age and autism characteristics. Conclusion: These results suggest that self-reports of autism characteristics using the AQ do not vary strongly by age in this large age-representative sample. Findings suggest that the AQ can potentially serve as a useful tool for future research on autism across the life span. Important limitations on what we can learn from these findings point toward critical avenues for future research in this area. Lay summary Why was this study done?: Self-report questionnaires of autism characteristics are a potentially important resource for studying autism in adulthood. This study sought to provide additional information about one of the most commonly used self-report questionnaires, the Autism-Spectrum Quotient Scale (AQ), across adulthood.What was the purpose of this study?: This study intended to determine if there is a relationship between scores on the AQ and age. Researchers also worked to identify which of the multiple different ways of scoring the AQ worked best across adulthood.What did the researchers do?: Researchers collected data from over a thousand participants aged 18-97 years. Participants from three different age groups completed online surveys to self-report their levels of autism characteristics on the AQ. Researchers tested the relationship between AQ scores and age with six different commonly used ways to calculate AQ scores. Researchers used multiple statistical techniques to evaluate various measurement properties of the AQ.What were the results of the study?: The results indicate that autism characteristics measured by the AQ are not strongly associated with age. Along with that, there is evidence that certain approaches to measuring of autism characteristics are consistent across age into late life and do not vary with demographic and autism-related factors.What do these findings add to what was already known?: These results add to the growing evidence that self-reports of autism characteristics using the AQ in general samples are not strongly associated with age across adulthood. These findings also provide guidance about ways of scoring the AQ that work well through late life.What are potential weaknesses in the study?: While the AQ has a degree of relationship with autism diagnoses, this is far from perfect and has not been evaluated in the context of aging research. Therefore, findings from the present research must be carefully interpreted to be about autism characteristics not diagnoses. The sample was also limited in a number of other ways. As in any studies including a broad age range of individuals, the oldest participants are likely quite healthy, engaged individuals. This may particularly be the case given the higher mortality rates and health challenges seen with autism. Similarly, as with any self-report research, this research is limited to those individuals who could answer questions about their autism characteristics. The sample was also predominantly White and nonautistic. Finally, the research was limited to one point in time and so cannot tell us about how autism characteristics may change across adulthood.How will these findings help autistic adults now or in the future?: These findings support the potential for the AQ to be a useful tool for future research on autism in adulthood. For example, researchers can use measures such as the AQ to study how autism characteristics change over time or are associated with aging-related issues such as changes in physical health and memory. Such research may be able to provide a better understanding of how to support autistic individuals across adulthood.

This study assessed the potential short-term effects of COVID-19 stay-at-home restrictions on ratings of ASD and comorbid symptoms severity and adaptive functioning of 69 youth, ages 8–16 years with ASD without intellectual disability. Parent/caregiver ratings were being collected in fall and spring over approximately two years when the restrictions were imposed four months prior to the final data collection point. Results indicated no significant changes in parent/caregiver ratings of ASD symptom severity, comorbid symptoms severity, social skills, or adaptive behaviors following the stay-at-home restrictions and little variability across the four data collection points. Although findings suggested minimal short-term effects on these symptoms and adaptive skills, ongoing monitoring is needed to assess longer-term impacts.

This study tested the feasibility and initial efficacy of a cognitive-behavioral summer treatment (summerMAXyc) for high-functioning young children, ages 4–6 years, with ASD (HFASD; without intellectual disability). The treatment was conducted 5 days per week, 6 h per day, over 5 weeks in the summer and included skills instruction and therapeutic activities targeting social/social-communication skills, facial-emotion recognition, and interest expansion. Skills instruction sessions and therapeutic activities utilized direct instruction, modeling, role-play, performance feedback, and repeated practice. A behavioral system was also implemented to increase skills development and reduce ASD symptoms and disruptive behaviors, and parents participated in weekly parent training. Feasibility was supported in high levels of treatment fidelity and child, parent, and staff clinician satisfaction, and there was no attrition or adverse events/responses. Results of the primary outcome measure (coding of the children’s social performance by naïve raters) indicated that 10 of the 12 children were treatment responders (d = 1.76). Significant post-treatment improvements were also found on secondary measures (parent and staff clinician ratings) of social/social-communication skills and ASD symptoms, as well as a range of adaptive behaviors (effect sizes in the medium and large ranges). Results supported the feasibility of the treatment and suggested that it may yield positive outcomes for 4–6 year olds with HFASD. Recommendations for ongoing testing are provided.

The present study compared parent ratings to self-report ratings of depression, anxiety, hyperactivity, attention problems, and atypical behaviors in youth with high-functioning autism spectrum disorder (HFASD) and typically developing (TD) controls. Measures included parent and self-report forms from the Behavioral Assessment System for Children-Second Edition (BASC-2), and self-report forms from the Children’s Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC). Results across all five BASC-2 scales indicated parent ratings for the HFASD condition were significantly higher than HFASD self-ratings, and were significantly higher than parent and self-ratings from the TD condition. In addition, average self-report scores did not differ significantly between HFASD and TD conditions on any of the BASC-2 scales, the CDI, or the MASC.