Emotion regulation and emotion dysregulation in children and adolescents with Autism Spectrum Disorder: A meta-analysis of evaluation and intervention studies.

Children and adolescents with Autism Spectrum Disorder (ASD) often experience challenges in emotion regulation (ER) and emotion dysregulation (ED) which can interfere with their adaptive functioning. This study aimed to systematically review and meta-analyze the evidence on ER/ED in children and/or adolescents with ASD, examining its relationship with the following variables: internalizing and externalizing symptoms, cognitive function and social skills, and the effectiveness of non-pharmacological interventions addressing ER difficulties. Both electronic and manual searches were conducted to identify potential studies. Fifty-five studies were included in the meta-analysis. A statistically significant between-group difference was found, suggesting greater ER/ED challenges in the ASD group. Also, the ASD group showed more maladaptive ER strategies and fewer adaptive ER strategies compared to the non-ASD participants. Additionally, more severe ASD and poorer social skills were associated with greater ED and poorer ER skills, respectivelly. Furthermore, there was a significant correlation between internalizing symptomatology and both adaptive and maladaptive ER strategies. Studies of non-pharmacological interventions showed significant improvement in both ER and ED. These results imply that assessing ER/ED in children and adolescents with ASD should be part of the evaluation process, and it should also be a focal point for intervention in this population.

Predictors of autism spectrum disorder diagnosis in a spanish sample of preterm children with very low birthweight: A cross-sectional study.

Background and Aims: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a higher likelihood of being diagnosed in preterm populations. Likewise, low birthweight has also been connected with an increased likelihood of ASD. The objectives were to study the frequency and define the relationship between ASD, gestational age, birthweight, and growth percentiles for preterm children. Methods: A sample of preterm children with very low birthweight was selected from the Spanish population at 7-10 years old. Families were contacted from the hospital, and they were offered an appointment to conduct a neuropsychological assessment. The children who showed signs of ASD were referred to the diagnostic unit for differential diagnosis. Results: A total of 57 children completed full assessments, with 4 confirmed ASD diagnoses. The estimated prevalence was 7.02%. There were statistically significant weak correlations between ASD and gestational age (τb = -0.23), and birthweight (τb = -0.25), suggesting there is a higher likelihood of developing ASD for those born smaller or earlier in their gestation. Conclusion: These results could improve ASD detection and outcomes for this vulnerable population while also supporting and enhancing previous findings.

Eye-Tracking Studies in Adults with Autism Spectrum Disorder: A Systematic Review and Meta-analysis.

Eye-tracking studies have shown potential in effectively discriminating between autism spectrum disorder (ASD) and non-ASD groups. The main objective of the present study was to conduct a systematic review and meta-analysis of eye-tracking studies in adults with ASD. A total of 22 studies were included for meta-analysis. Eyes and Non-Social regions proved better for discriminating between ASD and non-ASD adults, while fixation duration seems to be the outcome to choose. Active engaged tasks seem to reduce differences between ASD and non-ASD adults, regardless of the emotional content of the stimuli/task. Proportional fixation duration on eyes and non-social areas in non-active tasks (e.g. free viewing) seems to be the best eye-tracking design for increasing the sensitivity and specificity in ASD adults.

Neuropsychological profile of executive functions in autism spectrum disorder and schizophrenia spectrum disorders: a comparative group study in adults.

As assessed by numerous neuropsychological tasks, individuals with autism spectrum disorder (ASD) and schizophrenia spectrum disorders (SSDs) have similar impairments related to executive functions (EFs). The neuropsychological profile of these two conditions was examined using the three-component EFs' framework of Miyake and Friedman (Cogn Psychol 41(1):49-100, 2000). This approach assesses Inhibition (suppression of unwanted and irrelevant information/responses), Updating (use and control of contents of working memory), and Shifting (disengagement between activities or mental tasks) using nine different tasks. In line with previous research, we expected greater performance deficits in ASD in all three components compared to SSD, as well as faster responses for the SSD group. A self-paced task format allowed us to examine whether unlimited time given for a task would lead to better performance. The sample was constituted by the control group (N = 25), ASD group (N = 24), and SSD group (N = 12). Groups did not differ on Inhibition performance. In Updating, individuals with SSD performed poorer than the other groups. As for Shifting, both groups demonstrated poorer performance compared to controls, with the SSD group presenting the greatest difficulties. In terms of reaction time (RT), SSD participants' RT were the slowest on Inhibition and Shifting tasks. There was a positive correlation between performance and time spent on Inhibition and Shifting only for the SSD group, which demonstrates that their performance improves when there are no time constraints. Our work provides a better understanding of spared and impaired EFs, which could be useful for designing strategies aimed at improving specific EFs in each group.

Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study.

LAY ABSTRACT: Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.

Effect of a Focused Social and Communication Intervention on Preterm Children with ASD: A Pilot Study.

While advances in intensive neonatal care have greatly improved survival rates among preterm infants, incidence of neurodevelopmental disorders in this group is still high, with autism spectrum disorder (ASD) being one of the most frequent. To this end, we conducted a social-communication intervention aimed at investigating efficacy in social-communicative skills. Eighteen children (preterm and full-term with ASD and preterm children) aged 18 through 20 months participated in the study. Our findings indicate that most participants in the intervention groups registered significant improvements in terms of socio-communicative skills, cognitive development, and language. Accordingly, these pilot data underscore the need for further research and implementation of early interventions in young preterm children with ASD.

Spanish Cultural Validation of the Modified Checklist for Autism in Toddlers, Revised.

The Modified Checklist for Autism in Toddlers-revised/follow-up (M-CHAT-R/F) was developed to reduce the number of cases requiring telephone verification. The aim of this study was to validate a Spanish version of the M-CHAT-R/F in the Spanish public health system. The M-CHAT-R/F was translated, culturally adapted, and then administered to 6625 children. Of the 39 positive screening cases, 15 children were diagnosed with autism spectrum disorder (ASD) and 24 with non-ASD disorders or delays. The sensitivity was 0.79 and specificity of 0.99. Positive and negative predictive values were 0.39 and 0.99, respectively. These results are similar to the English equivalent, though observed prevalence was lower. This study supports Spanish National Health System policy makers to consider a universal ASD screening program.

Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives.

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents' opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child's age, delays in accessing services, and active stakeholders' participation when looking to improve services.

Correction to: Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives.

The original version of this article unfortunately contained a mistake in one of the co-author's family name. The correct name should be María Victoria Martín-Cilleros instead of María Victoria Cilleros-Martín.

Spanish Validation of the Autism Quotient Short Form Questionnaire for Adults with Autism Spectrum Disorder.

The objective of this study was to adapt and validate the abbreviated version of the "Autism-Spectrum Quotient" (AQ-Short) in a sample of Spanish native adults. A total of 46 individuals with ASD, 41 ASD-relatives, 17 patients with schizophrenia spectrum disorders and 190 non-clinical adults were administered the Spanish version of the AQ-Short. The results of the confirmatory factorial analysis found two high-order factors (Social Behaviour and Numbers/Patterns) and four subscales (Social Skills, Routines, Switching and Imagination). The reliability analysis showed very good internal structure and test-retest reliability. The AQ-Short also showed moderate convergent validity with ADOS-2. Differences by group were found in the ASD group when compared to other groups. Gender differences were only found in the non-clinical group.

Trastorno del espectro autista y prematuridad: hacia un programa de cribado prospectivo / Autism spectrum disorder and prematurity: towards a prospective screening program

Introducción. La prevalencia de trastornos del espectro autista (TEA) comunicada en estudios actuales en grupos de riesgo como son los recién nacidos pretermino o con bajo peso al nacer, es más alta que en la población normal. Este hecho ha supuesto el incremento en los últimos anos de estudios de cribado que investigan posibles factores de riesgo de TEA en los recién nacidos pretermino y su trayectoria evolutiva. Objetivo. Exponer los resultados de los principales estudios de cribado de recién nacidos pretermino a fin de presentar recomendaciones de cribado en esta población de riesgo. Desarrollo. Los resultados de los estudios presentados sugieren la posibilidad de que la trayectoria del desarrollo sociocomunicativo y conductual de los recién nacidos pretermino difiera de lo esperado si su nacimiento se hubiera producido a término, lo que apoya el hecho de que se realicen programas de cribado basados en una monitorización evolutiva del desarrollo y se utilicen herramientas de cribado adaptadas a esta población de riesgo. Conclusión. Los menores prematuros son un grupo de riesgo que muestra características diferenciales para el cribado de TEA (AU)

Introduction. The prevalence of autism spectrum disorders (ASD) reported in current studies in risk groups such as preterm or low birth weight infants is higher than in the normal population. This fact has led to the increase in recent years of screening studies that investigate possible risk factors for ASD in preterm newborns and their developmental trajectory. Aim. To present the results of the main screening studies of preterm newborns in order to propose screening recommendations for this population at risk. Development. The results of the studies presented suggest the possibility that the trajectory of socio-communicative and behavioral development of preterm infants differed from what was expected if their birth had occurred at term. This supports the fact that screening programs are carried out based on developmental surveillance and that it is advisable to use screening tools adapted to this population at risk. Conclusion. Premature children are a risk group that shows differential characteristics for the screening of ASD (AU)

Building a theoretical framework for autism spectrum disorders screening instruments in Europe.

BACKGROUND: This study addresses the need for a theoretical base to develop more effective early autism spectrum disorders (ASD) detection tools. The structure that underlies early ASD detection is explored by evaluating the opinions of experts on ASD screening tools currently used in Europe. METHOD: A process of face and content validity was performed. First, the best constructs were selected from the relevant tests: Checklist for Early Signs of Developmental Disorders (CESDD), Checklist for Autism in Toddlers (CHAT), Early Screening of Autistic Traits Questionnaire (ESAT), Modified Checklist for Autism in Toddlers (M-CHAT), Social Communication Questionnaire (SCQ) and Communication and Symbolic Behaviour Scales Developmental Profile (CSBS-DP). The diagnostic content validity model by Fehring (1986, 1994) was adapted to make the selection. Afterwards, the items, taken from these tests, were selected to fit into each construct, using the same methodology. RESULTS: Twelve of the 18 constructs were selected by the experts and 11 items were chosen from a total of 130, reduced to eight after eliminating tautologies. CONCLUSIONS: Mapping these constructs and items on to the DSM-5 diagnostic criteria for ASD indicated good face and content validity. Results of this research will contribute to efforts to improve early ASD screening instruments and identify the key behaviours that experts in ASD see as the most relevant for early detection.

Prevalence of Schizophrenia Spectrum Disorders in Average-IQ Adults with Autism Spectrum Disorders: A Meta-analysis.

Since their separation as independent diagnostics, autism spectrum disorders (ASD) and schizophrenia spectrum disorders (SSD) have been conceptualized as mutually exclusive disorders. Similarities between both disorders can lead to misdiagnosis, especially when it comes to average-IQ adults who were not identified during childhood. The aim of this review was to examine the occurrence of SSD in average-IQ adults with ASD. Electronic and manual searches identified a total of 278 references, of which 10 were included in a meta-analysis. The pooled prevalence of SSD in the total ASD sample was close to 6%, pointing to a high co-occurrence of the two conditions. Further research is needed to determine the factors that predispose members of this population to the emergence of psychotic disorders.

Early Detection and Intervention of ASD: A European Overview.

Over the last several years there has been an increasing focus on early detection of Autism Spectrum Disorder (ASD), not only from the scientific field but also from professional associations and public health systems all across Europe. Not surprisingly, in order to offer better services and quality of life for both children with ASD and their families, different screening procedures and tools have been developed for early assessment and intervention. However, current evidence is needed for healthcare providers and policy makers to be able to implement specific measures and increase autism awareness in European communities. The general aim of this review is to address the latest and most relevant issues related to early detection and treatments. The specific objectives are (1) analyse the impact, describing advantages and drawbacks, of screening procedures based on standardized tests, surveillance programmes, or other observational measures; and (2) provide a European framework of early intervention programmes and practices and what has been learnt from implementing them in public or private settings. This analysis is then discussed and best practices are suggested to help professionals, health systems and policy makers to improve their local procedures or to develop new proposals for early detection and intervention programmes.

Detección precoz y estabilidad en el diagnóstico en los trastornos del espectro autista / Early detection and stability of diagnosis in autism spectrum disorders

Introducción. La intervención temprana en los niños con un trastorno del espectro autista (TEA) depende de una detección precoz y fiable. Aunque de manera general se habla de un diagnóstico estable, se ha evidenciado la necesidad de profundizar más en los factores que influyen en dicha estabilidad. Pacientes y métodos. Los participantes de la muestra fueron 142 menores con TEA (118 varones y 24 mujeres), con una mediana de 33 meses y un recorrido intercuartílico de 12 en la primera evaluación, y con una mediana de 47 meses y un recorrido intercuartílico de 29 en el seguimiento. Los diagnósticos se realizaron con las siguientes pruebas: escala Merrill Palmer revisada, escala de Leiter revisada, escala de inteligencia de Wechsler para preescolar y primaria III y escala de inteligencia de Wechsler para niños revisada y IV; además de la escala Vineland y la escala de observación diagnóstica del autismo genérica (ADOS-G), basándose el diagnóstico clínico en los criterios diagnósticos del Manual diagnóstico y estadístico de los trastornos mentales, cuarta edición, texto revisado (DSM-IV-TR), y quinta edición (DSM-5). Para la evaluación de la estabilidad diagnóstica, se realizaron tablas de contingencia para las valoraciones del diagnóstico en función del juicio clínico y los resultados de la ADOS-G. Resultados. El diagnóstico clínico basado en los criterios del DSM-IV-TR, el DSM-5 y el juicio clínico se mantiene estable a través del tiempo en un 96% de los casos. Si se valora la estabilidad diagnóstica teniendo en cuenta los resultados del ADOS-G (n = 30), el 87% de los casos mantiene el diagnóstico. El ANOVA muestra diferencias estadísticamente significativas para las medidas del factor intrasujeto del cociente intelectual y la edad social global, pero no para el diagnóstico. Conclusiones. La estabilidad diagnóstica se beneficia de un uso informado del criterio clínico y de la participación de un equipo multidisciplinar (AU)

Introduction. Early intervention for children with an autism spectrum disorder (ASD) depends on early and reliable detection. In general, diagnosis is stable, but evidence shows the need to go deeper into the factors that influence this stability. Patients and methods. A sample of 142 children with ASD (118 boys and 24 girls) with a median of 33 months of age and an interquartile range of 12 in the first evaluation. In the follow-up the median was 47 months and an interquartile range of 29. The following tests were applied to evaluate the children: Merrill-Palmer Scale-R, Leitter-R, WIPPSI-III, WISC-R and WISC-IV; as well as Vineland Scale and ADOS-G, based on clinical diagnosis to DSM-IV-R and DSM-5. For the evaluation of the diagnostic stability, contingency tables were performed for diagnostic assessments based on clinical judgment and the results of the ADOS-G. Repeated measures ANOVA was used to analyze the differences between measures of cognitive functioning, adaptive behavior and diagnosis. Results. The clinical diagnosis based on DSM-IV-TR, DSM-5 and clinical judgment remains stable over time in 96% of cases. If the diagnostic stability is measured based on the results of ADOS-G (n = 30), 87% of cases diagnosed maintained the diagnosis. The ANOVA showed statistically significant differences for measures of within-subject factors and global social age, but not for diagnosis. Conclusion. The diagnostic stability can be improved by utilizing clinical judgment and the participation of a multidisciplinary team (AU)

[From early detection to early care: intervention strategies based on prospective screening]. / De la detección precoz a la atención temprana: estrategias de intervención a partir del cribado prospectivo.

INTRODUCTION. The challenge of early detection can be tackled from an evolutionary perspective. Early intervention treatments have shown themselves to be effective provided that they are applied systematically as part of the strategic planning of the treatment. AIMS. The aim of this study is to provide an updated review in response to the criticism targeted towards early detection and to offer some considerations on the intervention strategy. Our research is based on a review of the early care techniques that are commonly used within the field of autism and it intends to reflect the most significant aspects that can be deduced from the experiments and studies carried out to date. CONCLUSIONS. From the findings of the review it can be concluded that early detection may be more efficient if carried out within the framework of developmental surveillance, which also offers the opportunity to provide guidance on the child's development. Early care is an effective resource for attending to the needs of children with autism. Professionals have the duty to assess the work they do on available treatments with a reflexive, judicious attitude, taking into account the values and preferences of the families. Programmes must focus on the core symptoms and apply the active ingredients of the treatment.

TITLE: De la deteccion precoz a la atencion temprana: estrategias de intervencion a partir del cribado prospectivo.Introduccion. El reto de la deteccion precoz puede realizarse desde una perspectiva evolutiva. Los tratamientos de intervencion temprana han demostrado su eficacia siempre y cuando se apliquen sistematicamente en el marco de una planificacion estrategica del tratamiento. Objetivos. Proporcionar una revision actualizada para responder a las criticas a la deteccion precoz y aportar una reflexion sobre la estrategia de intervencion, basada en la revision de las tecnicas de atencion temprana usuales en el campo del autismo, reflejando los aspectos mas relevantes que se deducen de las experiencias y estudios llevados a cabo hasta el momento. Conclusiones. Tras la revision realizada se concluye que la deteccion precoz puede ser mas eficiente si se lleva a cabo en el marco de la vigilancia del desarrollo, que ademas ofrece la oportunidad de proporcionar orientacion sobre el desarrollo del menor. La atencion temprana constituye un recurso eficaz para atender las necesidades del menor con autismo. Los profesionales tienen la responsabilidad de evaluar el trabajo que hacen con una actitud reflexiva y critica sobre los tratamientos disponibles tomando en consideracion los valores y las preferencias de las familias. Los programas deben centrarse en los sintomas nucleares aplicando ingredientes activos del tratamiento.

De la detección precoz a la atención temprana: estrategias de intervención a partir del cribado prospectivo / From early detection to early care: intervention strategies based on prospective screening

Introducción. El reto de la detección precoz puede realizarse desde una perspectiva evolutiva. Los tratamientos de intervención emprana han demostrado su eficacia siempre y cuando se apliquen sistemáticamente en el marco de una planificación estratégica del tratamiento. Objetivos. Proporcionar una revisión actualizada para responder a las críticas a la detección precoz y aportar una reflexión sobre la estrategia de intervención, basada en la revisión de las técnicas de atención temprana usuales en el campo del autismo, reflejando los aspectos más relevantes que se deducen de las experiencias y estudios llevados a cabo hasta el momento. Conclusiones. Tras la revisión realizada se concluye que la detección precoz puede ser más eficiente si se lleva a cabo en el marco de la vigilancia del desarrollo, que además ofrece la oportunidad de proporcionar orientación sobre el desarrollo del menor. La atención temprana constituye un recurso eficaz para atender las necesidades del menor con autismo. Los profesionales tienen la responsabilidad de evaluar el trabajo que hacen con una actitud reflexiva y crítica sobre los tratamientos disponibles tomando en consideración los valores y las preferencias de las familias. Los programas deben centrarse en los síntomas nucleares aplicando ingredientes activos del tratamiento (AU)

Introduction. The challenge of early detection can be tackled from an evolutionary perspective. Early intervention treatments have shown themselves to be effective provided that they are applied systematically as part of the strategic planning of the treatment. Aims. The aim of this study is to provide an updated review in response to the criticism targeted towards early detection and to offer some considerations on the intervention strategy. Our research is based on a review of the early care techniques that are commonly used within the field of autism and it intends to reflect the most significant aspects that can be deduced from the experiments and studies carried out to date. Conclusions. From the findings of the review it can be concluded that early detection may be more efficient if carried out within the framework of developmental surveillance, which also offers the opportunity to provide guidance on the child’s development. Early care is an effective resource for attending to the needs of children with autism. Professionals have the duty to assess the work they do on available treatments with a reflexive, judicious attitude, taking into account the values and preferences of the families. Programmes must focus on the core symptoms and apply the active ingredients of the treatment (AU)