Characteristics and correlates of aggressive behavior in autistic youths.

This study aimed to characterize aggressive behaviors in autistic youths and to identify the social environment variables most strongly linked with aggression in this clinical population. Participants were 2142 caregivers of autistic youths (ages 6.0-17.9) recruited from autism research centers across the United States. Caregivers completed self-report and behavior rating inventories that assessed both verbal and physical aggression as well as characteristics of the individual youths (sleep quality, gastrointestinal [GI] symptoms, and autism characteristics) and their families (caregiver stress, global family functioning, and sibling relations), peers (emotional bonding, number of friends), schools (academic functioning), and neighborhoods (perceived community safety). We used descriptive analyses to identify which aggressive acts were most common among autistic youths, and we performed bivariate correlations and multiple linear regression analyses to determine which characteristics of the youths and their social environments were most strongly linked with youth aggression. Verbally aggressive youth behaviors were endorsed by caregivers most frequently. Youth age and sex were not associated with verbal or physical aggression. A combination of youth and social environment characteristics accounted for 42.6% of the variance in verbal aggression and 26.0% of the variance in physical aggression. Thus, those characteristics most strongly linked with verbal and physical aggression were strained sibling relations, caregiver stress, youth sleep problems, and youth repetitive and restrictive behaviors. Viewed together, the results suggest that aggressive behaviors in autistic youths are associated with multiple characteristics pertaining to the individual youths and their immediate social environments. Implications for treatment and research are discussed.

Predictors of Aggression, Disruptive Behavior, and Anger Dysregulation in Youths with Autism Spectrum Disorder.

Youth with autism spectrum disorder (ASD) often experience difficulties related to aggression, disruptive behavior, and regulation of emotions that precipitate these behaviors (i.e., anger). The extent to which aggression, disruptive behaviors, and anger dysregulation are correlated with distinct or overlapping factors has not yet been explored. The present study examined whether aspects of participant demographics, individual youth functioning, caregiver stress, and family warmth contributed to youth aggression, disruptive behavior, and anger dysregulation. Participants were caregivers of 511 youths with ASD. Analyses revealed that significant proportions of variance in aggression, disruptive behaviors, and anger dysregulation were accounted for by shared variables pertaining to demographics, the individual youth, and caregiver stress. Implications of treatment and future research are discussed.

Associations Between Parenting Stress and Quality Time in Families of Youth with Autism Spectrum Disorder.

Increased stress among parents of youth with ASD has been well-documented. However, research on aspects of the parent-child relationship and subsequent links to parenting stress is limited. We assessed parents (N = 511) of youth with ASD to examine relations between parenting stress and parent-child quality time (amount of quality time, shared enjoyment, synchronicity). Elevated parenting stress was associated with less time spent engaging with youth in shared activities and decreased parent and child enjoyment during shared interactions. Parents with elevated stress reported engaging in shared activities and experiencing synchronicity with their child less often than parents below the clinical threshold. Future research should emphasize longitudinal efforts examining the directionality of this relationship to better inform family-focused intervention.

The network structure of the Special Interests Survey.

Despite the prevalence of special interests (SIs) in autistic youth, research on SIs and how they are characterized is limited. Indeed, a significant challenge in identifying and classifying SIs lies in capturing the vast and diverse scope of potential interests in this population. The recently developed Special Interest Survey (SIS) is a caregiver-report measure to improve SI characterization by capturing a broad range of past and current SIs. In the present study, we performed a network analysis of the SIS to examine relations between SIs and identify distinct interest clusters. We analyzed data from 1992 caregivers of autistic youths who completed the SIS. The network of SIs was densely interconnected, characterized by six communities of interests: Fact-seeking, Engineering, Order-seeking, Object Attachment, Entertainment, and Scholarly Pursuits. Findings suggest that the structure of the observed network is likely to generalize to similar samples. Of all the SIs and their respective communities, behaviors related to Fact-seeking were identified as the most central, meaning that endorsement of these interests was most strongly related to co-endorsement of other SIs. These findings lay the groundwork for future work on SIs, such as improved assessment techniques and linkage of SIs to a broad range of demographic variables, youth characteristics, and autism symptoms.

Usual care for youth with autism spectrum disorder: Community-based providers' reported familiarity with treatment practices.

Objective: To examine patterns and predictors of familiarity with transdisciplinary psychosocial (e.g., non-pharmacologic) practices for practitioners treating youths with autism spectrum disorder (ASD) in the United States. Method: Practitioners (n = 701) from behavioral, education, medical, and mental health backgrounds who worked with youth (ages 7-22) with ASD completed the Usual Care for Autism Survey, which assessed provider demographics and self-reported familiarity with transdisciplinary treatment practices for the most common referral problems of ASD. We examined relations between provider-, setting-, and client-level characteristics with familiarity of key groups of the treatment practices (practice sets). Practice sets were identified using exploratory factor analysis (EFA), and demographic predictors of practice subsets were examined using generalized estimating equations (GEE). Results: The EFA yielded a three-factor solution: (1) environmental modifications/antecedent strategies; (2) behavior analytic strategies; and (3) cognitive strategies, with overall familiarity ranked in this order. Medical providers indicated the least familiarity across disciplines. More experience with ASD and treating those with intellectual disabilities predicted greater familiarity with only environmental modifications/antecedent strategies and behavior analytic, but not cognitive strategies. Experience treating low SES clients predicted familiarity with environmental modification and behavior analytic strategies while experience treating high SES clients predicted familiarity with behavior analytic and cognitive strategies. Conclusion: This is the first study to identify transdisciplinary, interpretable sets of practices for treating youth with ASD based on community providers' reported familiarity. Results highlight factors associated with familiarity with practice sets, which is essential for mapping practice availability, and optimizing training and dissemination efforts for youth with ASD.

Supporting Students in Health Service Psychology Training: A Theory-Driven Approach to Meeting the Diverse Needs of Trainees.

The demographic characteristics of health service psychology (HSP) trainees have shifted considerably in recent decades. In what was previously a field comprised predominantly of White men, HSP trainees today represent a much broader range of backgrounds. Nonetheless, the leadership within HSP training (e.g., faculty) remains relatively homogenous, and the training approaches (e.g., mentorship styles, expectations for students) may have failed to evolve to meet the needs of this more diverse pool of trainees. Therefore, there is reason to believe that the training needs of students who represent an array of diverse backgrounds, identities, and life experiences may not be met by existing conceptualizations of and approaches to training. In this article, we discuss several training issues that are specific to a range of trainees, including women, trainees who are parents, sexual/gender minoritized trainees, trainees with disabilities, and trainees from diverse racial and ethnic backgrounds. We draw from social-ecological and feminist mentoring theories to provide recommendations, consistent with APA's (2018) Standards of Accreditation for HSP Doctoral Programs in order to offer recommendations for optimizing the training experiences of HSP trainees across multiple levels of analysis.

An Evaluation of Mechanisms of Change in Multisystemic Therapy for Juvenile Justice-Involved Youths A Decade Following Treatment.

Although researchers have identified the more immediate mechanisms of change in family-based treatments for juvenile justice-involved youths, it is not known whether these same mechanisms continue to prevent criminal offending into adulthood. The present study evaluated whether caregiver-directed improvements in family relations, youth prosocial peer relations, and youth academic performance during multisystemic therapy (MST) for serious and violent juvenile offenders had an impact on young adult involvement in criminal activity and sentencing 10.2 years following treatment. The results showed that improvements in family relations were associated with reduced odds of criminal outcomes a decade later for former MST participants. Furthermore, improvements in youth prosocial peer relations and academic performance were also related to lower odds of long-term criminal activity. These results are consistent with the underlying theory of change in family-based treatments and demonstrate that caregivers are critical to achieving and sustaining decreased antisocial behavior for youths with serious and violent criminal histories.

The social ecology of aggression in youths with autism spectrum disorder.

This study examined the social-ecological correlates of aggressive behavior in 120 youths with autism spectrum disorder. Youths were divided into three groups based on caregiver reports of the youth's aggressive acts: youths who engaged in acts of both physical and verbal aggression, youths who engaged only in acts of physical aggression, and nonaggressive youths. Caregivers and youths completed self-report instruments and behavior rating inventories that assessed youth individual functioning, family relations, and extrafamilial factors (i.e., peer relations, academic performance). Results showed that youths who engaged in both verbal and physical aggression were characterized by poor sleep quality and victimization by peers, and their caregivers evidenced high levels of distress and avoidant coping. In contrast, youths who were physically but not verbally aggressive were distinguished by difficulties in social interaction and communication. In general, each group of youths who were aggressive experienced more problems with repetitive behaviors, family relations, and academic performance than did their nonaggressive counterparts. The implications of these findings for theory, research, and treatment are discussed. Autism Res 2019. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The present study demonstrated that youths with autism spectrum disorder may be classified by the types of aggressive behaviors that they exhibit: youths who are verbally and physically aggressive, physically aggressive only, or not aggressive. Compared to the nonaggressive group, both groups of youths who were aggressive experienced difficulties in their individual, family, peer, and academic functioning. Youths with both verbal and physical aggression showed the most problems in their functioning.