Training Law Enforcement Officers About Autism: Evaluation of Adding Virtual Reality or Simulation to a Traditional Training Approach.

Prevalence rates of autism spectrum disorder (ASD) across the globe and lifespan suggest that law enforcement officers (LEOs) are likely to interact with autistic people in their professional duties. In developed countries, LEOs have professional encounters with autistic individuals, and research strongly supports LEOs need training to increase their knowledge about autism and confidence interacting with autistic people. The purpose of the present study is to compare three training approaches with LEOs: (a) a training presentation alone (P), (b) a training presentation combined with virtual reality simulation (P + VR), and (c) a training presentation combined with in-vivo simulation (P + SIM). The primary outcomes are LEO knowledge of autism and self-reported confidence in responding to autism calls. The present study included 259 LEOS who completed a survey assessing autism knowledge and confidence in level of skill before and after participating in ASD-specific training for LEOs. Findings support that participant knowledge of autism and confidence in responding significantly increased for all LEOs equally across training conditions. Results support that formalized training in ASD significantly impacts LEO's knowledge of ASD and confidence responding to calls. As such, standardized training for LEOs is needed to assure appropriate knowledge and confidence when responding to calls involving autistic persons.

Intellectual, Adaptive, and Behavioral Functioning Associated with Designated Levels of Support in a Sample of Autistic Children Referred for Tertiary Assessment.

The diagnostic criteria for autism spectrum disorder in the DSM-5-TR features the option to designate levels of support for social communication (SC) and restricted, repetitive behaviors (RRB). These levels are conceptual in nature, but research indicates standardized assessment outcomes correspond with clinician-assigned levels of support. The purpose of the present study was to identify factors that influence designated levels of support for SC and RRBs when diagnosing autism. Standardized assessment scores across intellectual functioning, adaptive skills, and ASD symptomology were analyzed to determine corresponding levels of support in SC and RRBs assigned by clinicians for 136 autistic children following a comprehensive diagnostic evaluation. At diagnosis, approximately 46% of participants were described as needing substantial support (Level 2) for SC and 49% were described as needing substantial support (Level 2) for RRB. There was a consistent pattern of higher to lower intellectual and adaptive functioning needing Level 1-Level 3 support. Autism assessment results followed a gradient of fewer to greater autism symptoms from Level 1 to Level 3 support. Findings indicated clinician-assigned levels of support for SC and RRB were associated with intellectual functioning, adaptive functioning, autism symptomology, and age, but not sex.

Interprofessional education on autism and intellectual disabilities: Program description and initial evaluation.

Project INTERprofessional Autism Collaborative Training (INTERACT) is an interprofessional education program designed to prepare graduate students in psychology, special education, and speech-language pathology to work with autistic children with moderate to severe intellectual disabilities. The rising prevalence of autism, coupled with increased appreciation for interprofessional approaches to service delivery, indicates the need for university training programs to prepare graduate students to work interprofessionally with this population; yet descriptions of such programs and their effectiveness are not reported in the literature. In this article, we explain the process through which an interprofessional faculty team developed Project INTERACT, describe the sequence of coursework and team-based clinical experiences that comprise the program, and present preliminary data regarding its effectiveness. Twenty-four graduate students in psychology, special education, and speech-language pathology participated in this quantitative study. We report results from three rating scales that participants completed at program entry, midpoint, and program exit. Participants endorsed positive attitudes toward interprofessional practice and demonstrated high levels of knowledge about autism. Self-rated knowledge and abilities in interprofessional practice increased significantly by program exit. Project INTERACT scholars developed knowledge and skills related to understanding, assessing, and treating autistic children with intellectual disabilities, through the lens of team-based interprofessional collaboration. We discuss implications for practice with Project INTERACT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Parent-child interaction therapy (PCIT) with families of children with autism spectrum disorder.

Background and Aims: Parent-child interaction therapy (PCIT) is an evidence-based behavioral parent training program designed for preschool-age children that emphasizes supporting parent-child interaction patterns to improve child behavior and enhance the quality of parent-child relationships. PCIT has been deemed efficacious in treating children with disruptive behavior disorders, and recent studies have shown promising results utilizing aspects of PCIT with children with autism spectrum disorder (ASD), but none of these studies applied the entire PCIT intervention per manual protocol. The present study is the first to test the efficacy of PCIT, without modification, with families of preschool-age children with ASD without comorbid behavioral difficulties. Methods: This study employed a single-subject multiple-probe design to evaluate the efficacy of PCIT with four families with children with ASD between the ages of 2 and 4 years old (M = 40 months) over a 4-month period. Results: PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands. Parents reported greater confidence in parenting abilities post-treatment and significant improvement in the core areas of autism symptomatology. Parents endorsed significant improvement in aspects of the parent-child relationship, such as attachment and involvement. Conclusions: Parents of children with ASD demonstrated more positive and effective parenting behavior and reported enhancements in the parent-child relationship after participating in PCIT. Children were more compliant to parental commands and exhibited improvements in social and behavioral functioning. Increases in positive parenting behaviors and child compliance to parental requests were maintained 1 month after treatment and outside the clinic setting during generalization sessions. Parents of children with ASD reported a high degree of satisfaction with PCIT. Implications: The present study provides initial evidence of the efficacy of utilizing PCIT with families of preschool-age children with ASD and supports the continued investigation of the efficacy of PCIT with this population.

Law enforcement officers' interactions with autistic individuals: Commonly reported incidents and use of force.

Little research exists examining interactions between law enforcement officers (LEOs) and autistic individuals. The present study includes responses from 130 LEOs who participated in autism-specific training and completed surveys assessing professional experiences responding to calls that involved individuals with known autism spectrum disorder (ASD) diagnosis. The purpose of the present study was to determine the types of incidents LEOs respond to involving autistic people, and the level of force used in response to the incident. Analysis revealed four categories captured the majority of reported incidents: disruptive behavior, suspected abuse/neglect, elopement, and noncriminal behavior. The most commonly reported responses by LEOs included providing support and extreme controlling behaviors, with female officers more likely to report utilizing supportive behaviors and less force compared to male counterparts.

Implementation of telehealth during COVID-19: Implications for providing behavioral health services to pediatric patients.

The coronavirus pandemic and in-person contact restrictions necessitated rapid implementation of telehealth, specifically videoconferencing, to provide essential care to patients. This study surveyed 25 pediatric behavioral health providers at a single center during their first month of utilizing telehealth during coronavirus disease 2019 (COVID-19). Twenty-one participants completed a pre-questionnaire distributed prior to telehealth service delivery, and 23 providers completed a post-questionnaire approximately three weeks later. Results indicate the majority of behavioral health providers had no experience providing telehealth services prior to COVID-19. The majority of participating behavioral health providers utilized telehealth to provide pediatric patient care within the first month of access to telehealth. Participants' confidence in their ability to provide telehealth services significantly increased within the first month of implementation, regardless of previous training in telehealth. This study identified differences between anticipated and actual barriers to treatment, with technological issues identified as the largest actual barrier to service delivery. Participants indicated a preference for in-person service delivery, which they reported allows for better rapport-building, behavioral observations, reduced technological barriers, and fewer distractions. However, most participants reported they intend to continue utilizing telehealth for certain types of behavioral health services (e.g., diagnostic interviews and outpatient therapy) after the pandemic has subsided.

Measuring Police Officer Self-efficacy for Working with Individuals with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is currently one of the most researched of all childhood developmental disorders and is receiving attention in many domains. The purpose of this study was to design and provide psychometric evidence for a scale that measures police officer self-efficacy for working with individuals with ASD. Psychometric properties of a scale designed to measure knowledge of ASD were also explored. Data from 620 police officers were collected and a 13-item scale was created and evaluated. Results indicated that the scale represented a unidimensional construct. Knowing more about officers' knowledge and beliefs in their own capabilities to work with individuals with ASD can help inform future police education and training efforts.

Law Enforcement Officers' Preparation for Calls Involving Autism: Prior Experiences and Response to Training.

Highly publicized interactions between law enforcement officers (LEOs) and individuals with autism spectrum disorder (ASD) have raised questions about LEOs' training related to ASD. In the present study, 157 LEOs participated in ASD-specific training and completed pretest and posttest surveys of autism knowledge, confidence, and self-monitoring. The majority of LEOs responded to calls involving someone with ASD in the last year, with 20% of these calls resulting in involuntary psychiatric hospitalization. LEO knowledge of ASD, self-confidence in responding to calls, and self-monitoring of performance increased from pretest to posttest. Compared to male counterparts, female officers were less likely to use force and handcuffs when responding to ASD-related calls. Female officers' self-confidence increased significantly more than male officers.

An Exploration of Law Enforcement Officers' Training Needs and Interactions with Individuals with Autism Spectrum Disorder.

Semi-structured interviews were employed to (a) characterize LEOs' knowledge of ASD, (b) understand interactions between LEOs and individuals with ASD, and (c) identify training needs to prepare LEOs for interactions with the ASD community. Researchers utilized a constructivist grounded theory approach to analyze data from 17 participants: (a) six LEOs, (b) six adults with ASD, and (c) five caregivers. Common themes included the (a) potential for misinterpretations of behavior of individuals with ASD; (b) helpfulness of an identification system/symbol for ASD; (c) need for interactive, mandatory training unique to LEOs' needs; and, (d) importance of building community connections between LEOs and individuals with ASD. Findings are discussed within the context of previous research related to law enforcement and ASD.

Can I teach students with Autism Spectrum Disorder?: Investigating teacher self-efficacy with an emerging population of students.

Currently, 1 in 68 children in the U.S. is diagnosed with Autism Spectrum Disorder (ASD; Centers for Disease Control & Prevention, 2015) and this growing population of learners has been noted as one of the most challenging groups to teach. Teacher self-efficacy, the belief teachers hold about their instructional capabilities, has been shown to differ according to contextual factors, such as the type of students teachers face. The purpose of this investigation was to develop an instrument that can used to measure teachers' self-efficacy for effectively working with students with ASD. Study 1 involved the development and evaluation of a new instrument, the Teacher Self-Efficacy for Students with Autism Scale (TSEAS) with a sample of general and special education teachers in the U.S. (N = 120). Study 2 involved a cross-validation of the measure with teachers in Australia (N = 85). Results indicated that the scale represented a unidimensional construct in both studies. Self-efficacy for teaching students with ASD was distinct from, though positively related to, general teaching self-efficacy, job satisfaction, and self-regulation. Using a student-specific teaching self-efficacy measure might provide more useful information for supporting teachers' beliefs for teaching students with ASD.

Brief Report: Descriptive Analysis of Law Enforcement Officers' Experiences with and Knowledge of Autism.

Individuals with Autism Spectrum Disorder (ASD) may interact with law enforcement officers (LEOs) as victims of crime, witnesses to crime, or suspects of crime. Interactions between LEOs and those with ASD may go awry which raises questions about levels of training, experiences, and knowledge acquired by LEOs. Seventy-two LEOs reported on their experiences and training related to ASD and completed a survey of autism knowledge. The majority (72.2%) of LEOs reported no formal training for interacting with individuals with ASD. For LEOs responding to calls involving ASD, officers with prior training reported better preparation. Officers' responses to the knowledge survey varied considerably. Results support the need for formalized training in ASD for LEOs.

Correlates of DSM-5 Autism Spectrum Disorder Levels of Support Ratings in a Clinical Sample.

The DSM-5 features level of support ratings for social communication (SC) and restrictive and repetitive behaviors (RRB) for individuals with autism spectrum disorder (ASD). We contrasted cognitive, adaptive, and autism severity scores across SC and RRB groups for 158 individuals with ASD diagnosed in a developmental disabilities clinic. Roughly 46% of individuals were identified by licensed psychologists' clinical judgement as needing Level 2 SC support and 49% were identified as needing Level 2 RRB support. No individuals were rated as needing a combination of Level 1/Level 3 supports across domains. MANOVA and direct discriminant analysis revealed that both SC and RRB groups showed a graded pattern of higher adaptation/lower autism severity to lower adaptation/higher autism severity from Level 1 to Level 3.

Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q).

ASD knowledge deficits contribute to disparities in the timing and quality of ASD services. To address the limitations with existing measures of ASD knowledge, we developed and examined the Autism Stigma and Knowledge Questionnaire (ASK-Q), which comprehensively assesses multiple subdomains of ASD knowledge while maintaining strong psychometric support and cross-cultural utility. ASK-Q items derived from the published research are organized into four subscales: (i) diagnosis, (ii) etiology, (iii) treatment, and (iv) stigma. ASK-Q items were selected based on ratings of face, construct, and cross-cultural validity by a group of 16 international researchers. Using Diagnostic Classification Modeling we confirmed the proposed factor structure and evaluated the statistical validity of each item among a lay sample of 617 participants.

Introduction to bifactor polytomous item response theory analysis.

A bifactor item response theory model can be used to aid in the interpretation of the dimensionality of a multifaceted questionnaire that assumes continuous latent variables underlying the propensity to respond to items. This model can be used to describe the locations of people on a general continuous latent variable as well as on continuous orthogonal specific traits that characterize responses to groups of items. The bifactor graded response (bifac-GR) model is presented in contrast to a correlated traits (or multidimensional GR model) and unidimensional GR model. Bifac-GR model specification, assumptions, estimation, and interpretation are demonstrated with a reanalysis of data (Campbell, 2008) on the Shared Activities Questionnaire. We also show the importance of marginalizing the slopes for interpretation purposes and we extend the concept to the interpretation of the information function. To go along with the illustrative example analyses, we have made available supplementary files that include command file (syntax) examples and outputs from flexMIRT, IRTPRO, R, Mplus, and STATA. Supplementary data to this article can be found online at http://dx.doi.org/10.1016/j.jsp.2016.11.001. Data needed to reproduce analyses in this article are available as supplemental materials (online only) in the Appendix of this article.

An international review of autism knowledge assessment measures.

Autism spectrum disorder-specific knowledge deficits contribute to current disparities in the timing and quality of autism spectrum disorder services throughout the United States and globally. This study conducted a systematic review of Western and International literature to examine measures used to assess autism spectrum disorder knowledge. This review identified 44 unique autism spectrum disorder knowledge measures across 67 studies conducted in 21 countries. Measures used in each study were evaluated in terms of psychometric strength. Of the 67 studies reviewed, only 7% were rated as using a measure with strong psychometric support compared to 45% that were rated as using a measure with no reported psychometric support. Additionally, we examined content overlap and subdomains of autism spectrum disorder knowledge assessed (e.g. etiology, symptoms) and cross-cultural adaptation procedures utilized in the field. Based on these findings, the need for a cross-culturally valid and psychometrically sound measure of autism spectrum disorder knowledge is discussed and recommendations for improving current assessment methods are presented, including suggestions for measure subdomains.

Efficacy of behavioral interventions for reducing problem behavior in persons with autism: an updated quantitative synthesis of single-subject research.

Problem or challenging behaviors are highly prevalent among persons with autism and bring along major risks for the individual with autism and his/her family. In order to reduce the problem behavior, several behavioral interventions are used. We conducted a quantitative synthesis of single-subject studies to examine the efficacy of behavioral interventions for reducing problem behavior in persons with autism. Two hundred and thirteen studies representing 358 persons with autism met the inclusion criteria and were included in the statistical analyses. Overall, we found that behavioral interventions were on average effective in reducing problem behavior in individuals with autism, but some interventions were significantly more effective than others. The results further showed that the use of positive (nonaversive) behavioral interventions was increasing over time. The behavioral interventions were on average equally effective regardless of the type of problem behavior that was targeted. Interventions preceded by a functional analysis reduced problem behavior significantly more than interventions not preceded by a functional analysis. Finally, treatment and experimental characteristics, but not participant characteristics, were statistically significant moderators of the behavioral treatment effectiveness.

Prevalence and onset of regression within autism spectrum disorders: a meta-analytic review.

Rates and onset of regression were meta-analyzed from 85 articles representing 29,035 participants with autism spectrum disorders (ASD). Overall prevalence rate for regression was 32.1, 95 % CI [29.5, 34.8] occurring at mean of 1.78 years, 95 % CI [1.67, 1.89]. Regression prevalence rates differed according to four types of regression: language regression, 24.9 %; language/social regression, 38.1 %; mixed regression, 32.5 %; and unspecified regression, 39.1 %. Regression prevalence also differed according to sampling method: population-based prevalence was 21.8 %, clinic-based prevalence was 33.6 %, and parent survey-based prevalence was 40.8 %. Risk of regression was equal for males and females, but higher for individuals diagnosed with autism versus another ASD. Later age of regression onset was predicted by older age of child.

Middle school students' knowledge of autism.

Authors examined 1,015 middle school students' knowledge of autism using a single item of prior awareness and a 10-item Knowledge of Autism (KOA) scale. The KOA scale was designed to assess students' knowledge of the course, etiology, and symptoms associated with autism. Less than half of students (46.1%) reported having heard of autism; however, most students correctly responded that autism was a chronic condition that was not communicable. Students reporting prior awareness of autism scored higher on 9 of 10 KOA scale items when compared to their naïve counterparts. Prior awareness of autism and KOA scores also differed across schools. A more detailed understanding of developmental changes in students' knowledge of autism should improve peer educational interventions.

Clinical characteristics associated with language regression for children with autism spectrum disorders.

We investigated correlates of language regression for children diagnosed with autism spectrum disorders (ASD). Using archival data, children diagnosed with ASD (N = 114, M age = 41.4 months) were divided into four groups based on language development (i.e., regression, plateau, general delay, no delay) and compared on developmental, adaptive behavior, symptom severity, and behavioral adjustment variables. Few overall differences emerged between groups, including similar non-language developmental history, equal risk for seizure disorder, and comparable behavioral adjustment. Groups did not differ with respect to autism symptomatology as measured by the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. Language plateau was associated with better adaptive social skills as measured by the Vineland Adaptive Behavior Scales. Implications and study limitations are discussed.

Brief report: sociometric status and behavioral characteristics of peer nominated buddies for a child with autism.

We examined social and behavioral correlates of children selected by their peers to serve as peer buddies for an unfamiliar child with autism (CWA). Participants were 293 children from two public elementary schools who completed social status, behavioral, and peer buddy nomination measures. Peer buddy nominations for a CWA were related to: (a) perceived unpopularity; (b) being viewed as helpful and smart; and (c) lacking influence regarding popularity within the classroom. In contrast, peer buddy nominations for a typical boy were related to being viewed as popular, helpful, and self-confident. Students may select a social niche for CWA based on principles of peer homophily. Limitations and suggestions for future research are discussed.