What are the views and experiences of autistic teachers? Findings from an online survey in the UK

Despite significant research into the education of autistic children and young people (CYP) and an increased awareness of the employment needs and rights of autistic adults, little attention has been paid to autistic teachers. We discuss findings drawn from an online survey in the UK in which autistic teachers and other autistic education staff (n = 149) describe the lack of understanding, sensory impacts, mental health issues and the complexities associated with revealing an autism diagnosis as a result of their work. These issues can represent significant impediments to either entering or remaining in the school education profession. Positive experiences were also found and, from a social justice perspective, the possibilities of autistic school staff to constitute a role model for autistic CYP and to facilitate their educational inclusion are considered. Future directions in this under-researched area are also discussed

Extreme Demand Avoidance in Children with Autism Spectrum Disorder: Refinement of a Caregiver-Report Measure

Objectives: Extreme/“pathological” demand avoidance (PDA) describes a presentation found in some children on the autism spectrum, characterized by obsessive resistance to everyday demands and requests. Demands often trigger avoidance behavior (e.g., distraction, excuses, withdrawal into role play). Pressure to comply can lead to escalation in emotional reactivity and behavior that challenges. Methods: Previously, the Extreme Demand Avoidance Questionnaire (EDA-Q) was developed to quantify resemblance to clinical accounts of PDA from caregiver reports. The aim of this study was to refine the EDA-Q using principal components analysis (PCA) and item response theory (IRT) analysis on parent/caregiver-report data from 334 children with ASD aged 5–17 years. Results: PCA and IRT analyses identified eight items that are discriminating indices of EDA traits, and behave similarly with respect to quantifying EDA irrespective of child age, gender, reported academic level, or reported independence in daily living activities. The “EDA-8” showed good internal consistency (Cronbach’s alpha =.90) and convergent and divergent validity with other measures (some of which were only available for a subsample of 233 respondents). EDA-8 scores were not related to parental reports of ASD severity. Conclusions: Inspection of the test information function suggests that the EDA-8 may be a useful tool to identify children on the autism spectrum who show an extreme response to demands, as a starting point for more in-depth assessment

Rethinking the concepts of “local or global processors”: evidence from Williams syndrome, Down syndrome, and Autism Spectrum Disorders

Both Williams syndrome (WS) and Autism Spectrum Disorder (ASD) have been characterised as preferentially processing local information, whereas in Down syndrome (DS) the reported tendency is to process stimuli globally. We designed a cross-syndrome, cross-task comparison to reveal similarities and differences in local/global processing in these disorders. Our in-depth study compared local/global processing across modalities (auditory-verbal/visuo-spatial) and levels of processing (high/low) in the three syndromes. Despite claims in the literature, participants with ASD or WS failed to show a consistent local processing bias, while those with DS failed to show a reliable global processing bias. Depending on the nature of the stimuli and the task, both local and global processing biases were evident in all three neurodevelopmental disorders. These findings indicate that individuals with neurodevelopmental disorders cannot simply be characterised as local or global processors

Defining the cognitive phenotype of autism

Although much progress has been made in determining the cognitive profile of strengths and weaknesses that characterise individuals with autism spectrum disorders (ASDs), there remain a number of outstanding questions. These include how universal strengths and deficits are; whether cognitive subgroups exist; and how cognition is associated with core autistic behaviours, as well as associated psychopathology. Several methodological factors have contributed to these limitations in our knowledge, including: small sample sizes, a focus on single domains of cognition, and an absence of comprehensive behavioural phenotypic information. To attempt to overcome some of these limitations, we assessed a wide range of cognitive domains in a large sample (N = 100) of 14- to 16-year-old adolescents with ASDs who had been rigorously behaviourally characterised. In this review, we will use examples of some initial findings in the domains of perceptual processing, emotion processing and memory, both to outline different approaches we have taken to data analysis and to highlight the considerable challenges to better defining the cognitive phenotype(s) of ASDs. Enhanced knowledge of the cognitive phenotype may contribute to our understanding of the complex links between genes, brain and behaviour, as well as inform approaches to remediation

Parenting Goals: Links with Parenting Strategies in Caregivers of Children with Autism Spectrum Disorder

OBJECTIVES: Parenting goals describe the outcomes that parents aim for when interacting with their child. They have received little attention in research with caregivers of children with autism spectrum disorder (ASD). The present study explored different types (dimensions) of parenting goals reported by caregivers of children with ASD, investigated links between these parenting goals and child characteristics, and explored whether parenting goals were linked to reported use of particular parenting strategies. METHODS: Data from 161 caregivers of children with ASD aged 7–18 years revealed two goal dimensions: “Norm Adherence Goals” (i.e. the perceived importance of the child cooperating with the parent, respecting their authority, and behaving well in public); and “Autonomy Support and Relationship Goals” (i.e. the perceived importance of promoting the child’s resilience, wellbeing, and the quality of the parent-child relationship). RESULTS: Parents who reported that norm adherence goals were particularly important to them were more likely to endorse parenting strategies such as setting rules, using rewards, and giving punishments. These parents also reported using less “Accommodation” (e.g. making allowances for their child, being flexible, avoiding triggers). Autonomy support and relationship goals were very strongly endorsed by nearly all parents, and we therefore could not find strong links between the importance of these goals and parenting strategies. CONCLUSION: These findings suggest that parenting goals might be importantly linked to parenting strategies and could be considered in personalizing interventions in clinical practice. Given that parents’ cognitions about their child’s behaviour and their role as parents likely interact with and influence their parenting goals, we argue that future research should investigate parenting goals, cognitions, and behaviours in parallel

Parenting Strategies Used by Parents of Children with ASD: Differential Links with Child Problem Behaviour

Here, we explored the structure of the ‘Parenting Strategies Questionnaire’, a new scale designed to measure parenting strategies for problem behaviour in ASD. We then examined links between child behaviour and parenting in a sample of 222 predominantly-UK parents of ASD children exhibiting behaviour found difficult or challenging. Analysis revealed three parenting subscales: Accommodation, Reinforcement Approaches and Reducing Uncertainty. Both Accommodation and Reducing Uncertainty were linked to child problem behaviour. Child factors explained up to 29% of the variance in Accommodation, with Socially Inflexible Non-compliance the strongest predictor, and up to 24% of the variance in Reducing Uncertainty, with Intolerance of Uncertainty the strongest predictor. Child factors were not related to Reinforcement Approaches. Longitudinal studies investigating these relationships are needed. Autism Spectrum Disorders (ASD) are neurodevelopmental impairments characterised by difficulties with communication, socialisation, and rigid and repetitive behaviours (Americal Psychiatric Association 2013). Problem behaviour (also referred to as ‘behaviour that challenges’ or, in the past, ‘challenging behaviour’) often occurs in children with ASD, and is more severe in ASD than in other clinical populations (e.g., Brereton et al. 2006; Estes et al. 2009). Forms of problem behaviour include oppositionality, failures to comply, destructiveness and explosiveness (e.g., Gadow et al. 2004). These behaviours are thought to reflect a dysregulated emotional state, resulting in outbursts and prolonged emotional reactions (Mazefsky et al. 2018a, b). Problem behaviour may reflect attempts by the child to reduce anxiety or distress by escaping aversive activities, or reactivity reflecting frustration when things are not on their terms (Brewer et al. 2014; Larson 2006). Demands to comply have been identified as a key trigger of reactivity in ASD (Chowdhury et al. 2016). Some individuals appear more reactive to routine demands (e.g., to wash or get dressed), and others to demands in socially challenging or novel situations (e.g., when visiting friends) (Chowdhury et al. 2016). The former ‘demand-specific’ profile resembles accounts of extreme/‘pathological’ demand avoidance (‘PDA’), which describe avoidance of and reactivity to routine demands in children with ASD (Newson et al. 2003). Some accounts of PDA explicitly attribute these behaviours to elevated anxiety and distress in the context of demands (Newson et al. 2003). In contrast, the latter ‘socially inflexible’ profile, may particularly reflect intolerance of uncertainty: the tendency to “react negatively on an emotional, cognitive, and behavioural level to uncertain situations and events” (Buhr and Dugas 2009, p. 216), which characterizes some children with ASD (Boulter et al. 2014; Larson 2006)

Examining the genetic and environmental associations between autistic social and communication deficits and psychopathic callous-unemotional traits

- BACKGROUND: Difficulties in appropriate social interaction are characteristic of both children with autism spectrum disorders and children with callous-unemotional traits (who are at risk of developing psychopathy). Extant experimental studies suggest that the nature of atypical social cognition that characterises these two profiles is not identical. However, 'empathizing' difficulties have been hypothesised for both groups, raising questions about the degree of aetiological separation between social impairments that characterize each disorder. This study explored the relative contribution of independent vs. shared aetiological influences to social and communication impairments associated with autistic traits and callous-unemotional traits, indexed by parent-report in a population-based cohort of twins. - METHODS: Participants were over 5,000 twin pairs from a UK cohort (the Twins Early Development Study; TEDS), assessed for callous-unemotional traits at 7 years and autistic social and communication impairments at 8 years. Multivariate model-fitting was used to explore the relative contribution of independent vs. overlapping genetic/environmental influences on these traits. - RESULTS: Both social and communication impairments and callous-unemotional traits were highly heritable, although the genetic and environmental influences accounting for individual differences on each domain were predominantly independent. - CONCLUSIONS: Extant evidence from experimental and neuro-imaging studies has suggested that, despite some superficially overlapping behaviours, the social difficulties seen in children with autism spectrum disorders and callous-unemotional traits are largely distinct. The current study is the first to demonstrate considerable aetiological independence of the social interaction difficulties seen in children with autism spectrum disorders and those with callous-unemotional traits