The role of PTSD and TBI in post-deployment sleep outcomes.

The purpose of this study was to evaluate the main and interaction effects of PTSD and TBI on sleep outcomes in veterans. Post-deployment combat veterans (N = 293, 87.37% male) completed clinical interviews to determine diagnosis and severity of PTSD and deployment TBI history, as well as subjective measures of sleep quality, sleep duration, and restedness. Sleep-related medical diagnoses were extracted from electronic medical records for all participants. PTSD and TBI were each associated with poorer ratings of sleep quality, restedness, shorter sleep duration, and greater incidence of clinically diagnosed sleep disorders. Analyses indicated main effects of PTSD on sleep quality (p < .001), but no main effects of TBI. PTSD severity was significantly associated with poorer sleep quality (p < .001), restedness (p = .018), and shorter sleep duration (p = .015). TBI severity was significantly associated with restedness beyond PTSD severity (p = .036). There were no interaction effects between diagnostic or severity variables. PTSD severity is a driving factor for subjective ratings of sleep disturbance beyond PTSD diagnosis as well as TBI diagnosis and severity. Despite this, poor sleep was apparent throughout the sample, which suggests post-deployment service members may globally benefit from routine screening of sleep problems and increased emphasis on sleep hygiene.

Socialization and nonverbal communication in atypically developing infants and toddlers.

Emphasis on early identification of atypical development has increased as evidence supporting the efficacy of intervention has grown. These increases have also directly affected the availability of funding and providers of early intervention services. A majority of research has focused on interventions specific to an individual's primary diagnoses. For example, interventions for those with cerebral palsy (CP) have traditionally focused on physiological symptoms, while intervention for individuals with Autism Spectrum Disorder (ASD) focus on socialization, communication, and restricted interests and repetitive behaviors. However deficits in areas other than those related to their primary diagnoses (e.g., communication, adaptive behaviors, and social skills) are prevalent in atypically developing populations and are significant predictors of quality of life. Therefore, the purpose of the current study was to examine impairments in socialization and nonverbal communication in individuals with Down's syndrome (DS), CP, and those with CP and comorbid ASD. Individuals with comorbid CP and ASD exhibited significantly greater impairments than any diagnostic group alone. However, individuals with CP also exhibited significantly greater impairments than those with DS. The implications of these results are discussed.

How does ASD symptomology correlate with ADHD presentations?

Elevated rates of attention deficit/hyperactivity disorder (ADHD) symptoms have been documented in the autism spectrum disorder (ASD) population. However, the recent restructuring of the ASD diagnostic category and its respective symptom structure has elicited concern about how these changes may impact prevalence rates, the deliverance of services, and the rates of comorbid psychopathology. At present, few researchers have investigated the prevalence rates of specific ADHD presentations within ASD populations. As we seek to increase our understanding of ADHD symptom manifestation in ASD populations it is important to establish base rates of attention and hyperactive symptoms. The current manuscript sought to investigate the prevalence of inattention and impulsive symptoms in 1722 infants and toddlers. Individuals were separated into three diagnostic groups for analyses, a DSM-5 ASD group, an atypically developing group, and a DSM-IV-TR ASD group. Initial analysis extended previous research by demonstrating significantly elevated rates of inattention/impulsive symptoms in toddlers meeting DSM-5 criteria for ASD when compared to the DSM-IV-TR ASD and atypically developing groups. Additional analysis demonstrated that ASD symptom severity was positively correlated with inattention/impulsive symptoms regardless of primary diagnosis. Lastly, analyses examined the exhibition of inattention and impulsive symptoms separately within diagnostic groups. Results suggest that the expression of impulsive and inattentive symptoms did not significantly differ within diagnostic groups.

An examination of the relationship between autism spectrum disorder, intellectual functioning, and comorbid symptoms in children.

There is a deficiency of research looking at how rates of comorbid psychopathology are effected by autism spectrum disorder (ASD) and intellectual functioning level. The present study aimed to extend the literature in this area by evaluating how ASD and IQ scores are related to ratings on a measure of comorbid symptoms. Twenty-three children with ASD and 87 children without ASD participated in this study. Rates of tantrum behavior, avoidant behavior, worry/depressed, repetitive behavior, under-eating, over-eating, and conduct behavior were examined utilizing the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC). Correlational and multiple regression analyses were then conducted. ASD diagnosis significantly predicted rates of tantrum behavior, avoidant behavior, and repetitive behavior. Children with ASD tended to have higher rates of all three of these comorbid symptoms than children without ASD. Although not statistically significant, there was a negative correlation between IQ and rates of comorbid symptoms, such that children with higher IQ scores tended to have lower rates of comorbid symptoms. The implications of these findings on assessment and intervention are discussed.

Examination and validation of a measure of anxiety specific to children with autism spectrum disorders.

OBJECTIVE: Investigated the use of a combined scale (Worry/Depressed and Avoidant scales) from the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC) as a measure of anxiety. Alternative methods of measuring anxiety were examined using the ASD-CC in an ASD population. METHODS: Participants included 147 children, age 2-16 years, evincing a mixture of behavior problems. Comparisons between scores on the ASD-CC and Behavior Assessment System for Children, Second Edition (BASC-2) were examined to determine the most efficacious method of measuring anxiety and to establish convergent and discriminant validity. RESULTS: The worry/depressed subscale was the most effective subscale of the ASD-CC to measure anxiety with proven incremental validity over the combined scale. CONCLUSION: The worry/depressed subscale is the best measure of anxiety utilizing the ASD-CC in children with an ASD. Additionally, convergent and discriminant validity was demonstrated by comparing the scale with similar and dissimilar scales of the BASC-2.