(2014). Age-Related Changes in Conjunctive Visual

1. Iarocci, G., & Armstrong, G. (2014). Age-Related Changes in Conjunctive Visual Search
in Children with and without ASD. Autism Research. Doi: 10.1002/aur.1359
Visual-spatial strengths observed among people with autism spectrum disorder (ASD) may
be associated with increased efficiency of selective attention mechanisms such as visual
search. In a series of studies, researchers examined the visual search of targets that share
features with distractors in a visual array and concluded that people with ASD showed
enhanced performance on visual search tasks. However, methodological limitations, the small
sample sizes, and the lack of developmental analysis have tempered the interpretations of
these results. In this study, we specifically addressed age-related changes in visual search. We
examined conjunctive visual search in groups of children with (n = 34) and without ASD
(n = 35) at 7–9 years of age when visual search performance is beginning to improve, and
later, at 10–12 years, when performance has improved. The results were consistent with
previous developmental findings; 10- to 12-year-old children were significantly faster visual
searchers than their 7- to 9-year-old counterparts. However, we found no evidence of
enhanced search performance among the children with ASD at either the younger or older
ages. More research is needed to understand the development of visual search in both
children with and without ASD.
2. Cervantes, P. E., Matson, J. L., Williams, L. W., & Jang, J. (2014). The effect of cognitive
skills and autism spectrum disorder on stereotyped behaviors in infants and
toddlers. Research
Doi: http://dx.doi.org/10.1016/j.rasd.2014.01.008
Stereotyped behaviors are prominent in both the ASD and ID populations; stereotypies can
impede social skill acquisition, interfere with learning, and adversely affect an individual's
quality of life. The current study explored the effect of cognitive skills and autism spectrum
disorder (ASD) on the rate of stereotypies in 2019 children aged 17–39 months. Cognitive
abilities were assessed using the cognitive developmental quotient (DQ) on the Battelle
Developmental Inventory, Second Edition (BDI-2); two levels of cognitive skill were used:
(1) low (cognitive DQ less than or equal to 70), and (2) typical (cognitive DQ greater than
70). Stereotypies were examined utilizing the Baby and Infant Screen for Children with
aUtIsm Traits, Part 3 (BISCUIT-Part 3). Children with ASD were found to have greater rates
of overall stereotyped behaviors compared to children with atypical development, regardless
of cognitive level; however, children with ASD and typical cognitive ability evinced the
highest rate of stereotypies. An examination of specific stereotyped behaviors (i.e., unusual
play with objects, repeated and unusual vocalizations, repeated and unusual body
movements) revealed disparate results. Research and clinical implications regarding these
findings are discussed.
3. Pierce et al. (2014). Ethnicity Reporting Practices for Empirical Research in Three AutismRelated
Journals. Journal
Doi: 10.1007/s10803-014-2041-x
This review examines ethnicity reporting in three autism-related journals (Autism, Focus on
Autism and Other Developmental Disabilities, and Journal of Autism and Developmental
Disorders) over a 6-year period. A comprehensive multistep search of articles is used to
identify ethnicity as a demographic variable in these three journals. Articles that identified
research participants’ ethnicity were further analyzed to determine the impact of ethnicity as
a demographic variable on findings of each study. The results indicate that ethnicity has not
been adequately reported in these three autism related journals even though previous
recommendations have been made to improve inadequacies of descriptive information of
research participants in autism research (Kistner and Robbins in J Autism Dev Disord 16:77–
82, 1986). Implications for the field of autism spectrum disorders are discussed in addition to
further recommendations for future research.
4. Wolff et al. (2014). Longitudinal patterns of repetitive behavior in toddlers with
autism. Journal of Child Psychology and Psychiatry. Doi: 10.1111/jcpp.12207
Recent evidence suggests that restricted and repetitive behaviors may differentiate children
who develop autism spectrum disorder (ASD) by late infancy. How these core symptoms
manifest early in life, particularly among infants at high risk for the disorder, is not well
Prospective, longitudinal parent-report data (Repetitive Behavior Scales-Revised) were
collected for 190 high-risk toddlers and 60 low-risk controls from 12 to 24 months of age.
Forty-one high-risk children were classified with ASD at age 2. Profiles of repetitive
behavior were compared between groups using generalized estimating equations.
Longitudinal profiles for children diagnosed with ASD differed significantly from high- and
low-risk children without the disorder on all measures of repetitive behavior. High-risk
toddlers without ASD were intermediate to low risk and ASD positive counterparts. Toddlers
with ASD showed significantly higher rates of repetitive behavior across subtypes at the 12month time point. Repetitive behaviors were significantly correlated with adaptive behavior
and socialization scores among children with ASD at 24 months of age, but were largely
unrelated to measures of general cognitive ability.
These findings suggest that as early as 12 months of age, a broad range of repetitive
behaviors are highly elevated in children who go on to develop ASD. While some degree of
repetitive behavior is elemental to typical early development, the extent of these behaviors
among children who develop ASD appears highly atypical.
5. Musser, E. D., et al. (2014). Shared familial transmission of autism spectrum and attentiondeficit/hyperactivity disorders. Journal of Child Psychology and Psychiatry.
Doi: 10.1111/jcpp.12201
To determine whether familial transmission is shared between autism spectrum disorders and
attention-deficit/hyperactivity disorder, we assessed the prevalence, rates of comorbidity, and
familial transmission of both disorders in a large population-based sample of children during
a recent 7 year period.
Study participants included all children born to parents with the Kaiser Permanente
Northwest (KPNW) Health Plan between 1 January 1998 and 31 December 2004
(n = 35,073). Children and mothers with physician-identified autism spectrum disorders
(ASD) and/or attention-deficit/hyperactivity disorder (ADHD) were identified via electronic
medical records maintained for all KPNW members.
Among children aged 6–12 years, prevalence was 2.0% for ADHD and 0.8% for ASD; within
those groups, 0.2% of the full sample (19% of the ASD sample and 9.6% of the ADHD
sample) had co-occurring ASD and ADHD, when all children were included. When mothers
had a diagnosis of ADHD, first born offspring were at 6-fold risk of ADHD alone
(OR = 5.02, p < .0001) and at 2.5-fold risk of ASD alone (OR = 2.52, p < .01). Results were
not accounted for by maternal age, child gestational age, child gender, and child race.
Autism spectrum disorders shares familial transmission with ADHD. ADHD and ASD have a
partially overlapping diathesis.
6. Magiati, I., Tay, W., & Howlin, P. (2014). Cognitive, language, social and behavioural
outcomes in adults with autism spectrum disorders: A systematic review of
longitudinal follow-up studies in adulthood. Clinical Psychology Review.
Doi: http://dx.doi.org/10.1016/j.cpr.2013.11.00
Although increasing numbers of children diagnosed with Autism Spectrum Disorders (ASD)
are now entering adolescence and adulthood, there is limited research on outcomes post
childhood. A systematic review of the existing literature was conducted.
PsycINFO, PubMed, MedLine and CINAHL were systematically searched using keywords
related to ASD and adolescent and adult outcomes. Studies of individuals diagnosed with
ASD in childhood and followed up into adulthood were identified and reviewed. Only studies
with samples sizes > 10, mean age at outcome > 16 years and at least one previous
assessment in childhood (< 16 years) were included.
Twenty-five studies meeting criteria were identified. Reported outcomes in adulthood were
highly variable across studies. Although social functioning, cognitive ability and language
skills remained relatively stable in some studies, others reported deterioration over time.
Adaptive functioning tended to improve in most studies. Diagnosis of autism or ASD was
generally stable, although severity of autism-related behavioural symptoms was often
reported to improve. Childhood IQ and early language ability appeared to be the strongest
predictors of later outcome, but few studies examined other early variables associated with
adult functioning.
Implications of the findings are discussed in relation to methodological challenges in
longitudinal outcome research and future research directions.
7. Gulsrud, A. C., Hellemann, G. S., Freeman, S. F. N., Kasari, C. (2014). Two to Ten Years:
Developmental Trajectories of Joint Attention in Children With ASD Who Received
Doi: 10.1002/aur.1360
This study follows 40 children who were participants in a randomized controlled early
intervention trial (Kasari et al.) from early childhood (2–5 years of age) to elementary school
age (8–10 years). To fully utilize the available longitudinal data, the general linear mixed
model was the primary analytical approach. The growth trajectories of joint attention skills
(pointing, coordinated joint looking, and showing) and expressive language outcomes in
these children were estimated based on five time points during the measurement period. The
children were grouped by diagnosis at the last follow-up (autism, autism spectrum disorder
(ASD), no diagnosis) and by their original treatment group assignment (joint attention,
symbolic play, control), and differences between these groups were evaluated. Results
showed that joint attention skills of coordinated joint looking and showing increased over
time, and pointing to share interest increased over the first year measured and decreased
thereafter. These trajectories were influenced by both original treatment assignment and
diagnostic status at follow-up. In addition, a cross-lagged panel analysis revealed a causal
relationship between early pointing and later language development. This study highlights the
longitudinal and developmental importance of measures of early core deficits in autism, and
suggests that both treatment and ASD symptomatology may influence growth in these skills
over time.
8. Samango-Sprouse et al. (2014). Identification of infants at risk for autism spectrum
disorder and developmental language delay prior to 12 months. Autism.
Doi: 10.1177/1362361314521329
Studies have shown an increased head circumference and the absence of the head tilt reflex as
possible risk factors for autism spectrum disorder, allowing for early detection at 12 months
in typically developing population of infants. Our aim was to develop a screening tool to
identify infants prior to 12 months at risk for autism spectrum disorder and developmental
learning delay, not affected by literacy or primary parental language, and provide immediate
determination of risk for autism spectrum disorder. An abrupt head circumference
acceleration and the absence of head tilt reflex by 9 months were used to identify infants at
risk for autism spectrum disorder. Stability of early findings was then investigated when
compared to comprehensive standardized neurodevelopmental assessment results and
complete neurological and genetics evaluations. A total of 1024 typically developing infants
were enrolled by 9 months, with 14 identified as at risk for autism spectrum disorder and 33
for developmental learning delay. There was a good positive predictive value for the
identification of autism spectrum disorder prior to 12 months. This study demonstrates an
efficient means to identify infants at risk for autism spectrum disorder by 9 months of age and
serves to alert primary care providers of infants who are vulnerable for autism spectrum
disorder before symptoms are discernible by clinical judgment of primary care providers,
parental concerns, or by screening questionnaires.
9. Zaidman-Zait et al. (2014). Examination of Bidirectional Relationships Between Parent
Stress and Two Types of Problem Behavior in Children with Autism Spectrum
Disorder. Journal of Autism and Developmental Disorders. Doi: 10.1007/s10803-0142064-3
Path analysis within a structural equation modeling framework was employed to examine the
relationships between two types of parent stress and children’s externalizing and internalizing
behaviors over a 4-year period, in a sample of 184 mothers of young children with autism
spectrum disorder. Parent stress was measured with the Parenting Stress Index-Short Form
and child behavior was measured with Child Behavior Checklist/1.5–5. Across all time
points, parent general distress predicted both types of child behaviors, but not vice versa. In
addition, there was modest evidence of a bidirectional relationship between parenting distress
and both types of child behaviors from 12 months post-diagnosis to age 6. Results are
compared to previous work in this area, with implications for early intervention.
10. Kulage, K. M., Smaldone, A. M., & Cohn, E. G. (2014). How Will DSM-5 Affect Autism
Diagnosis? A Systematic Literature Review and Meta-analysis. Journal of Autism
and Developmental Disorders. Doi: 10.1007/s10803-014-2065-2
We conducted a systematic review and meta-analysis to determine the effect of changes to
the Diagnostic and Statistical Manual (DSM)-5 on autism spectrum disorder (ASD) and
explore policy implications. We identified 418 studies; 14 met inclusion criteria. Studies
consistently reported decreases in ASD diagnosis (range 7.3–68.4 %) using DSM-5 criteria.
There were statistically significant pooled decreases in ASD [31 % (20–44), p = 0.006] and
DSM-IV-TR subgroups of Autistic disorder [22 % (16–29), p < 0.001] and pervasive
developmental disorder-not otherwise specified (PDD-NOS) [70 % (55–82), p = 0.01];
however, Asperger’s disorder pooled decrease was not significant [70 % (26–94), p = 0.38].
DSM-5 will likely decrease the number of individuals diagnosed with ASD, particularly the
PDD-NOS subgroup. Research is needed on policies regarding services for individuals
lacking diagnosis but requiring assistance.
11. Matsuyoshi et al. (2014). Individual differences in autistic traits predict the perception of
direct gaze for males, but not for females. Molecular Autism, 5:12.
Doi: 10.1186/2040-2392-5-12
Despite the emphasis of autism spectrum disorders as a continuum of social communication
disabilities and the sexual heterogeneity of phenotypic manifestations, whether gaze
processing constitutes an autistic endophenotype in both sexes remains unclear. Using the
Autism-Spectrum Quotient and a psychophysical approach in a normal population (N = 128),
here we demonstrated that individual differences in autistic traits predicted direct-gaze
perception for males, but not for females. Our findings suggest that direct-gaze perception
may not be taken as a definitive indicator of autistic spectrum, and highlight the importance
of sex differences when considering relationships between autistic traits and behaviors.
12. Iao, L-S., & Leekam, S. R. (2014). Nonspecificity and theory of mind: New evidence
from a nonverbal false-sign task and children with autism spectrum disorders. Journal
Doi: http://dx.doi.org/10.1016/j.jecp.2013.11.017
Understanding of false belief has long been considered to be a crucial aspect of “theory of
mind” that can be explained by a domain-specific mechanism. We argue against this claim
using new evidence from a nonverbal false representation task (false-sign task) with typically
developing children and children with autism spectrum disorders (ASD). Experiments 1 and
2 showed that typically developing children (mean age = 62.67 months) were equivalent in
their performance across nonverbal and verbal forms of both the false-belief and false-sign
tasks. Results for these two misrepresentation tasks differed from the results of an outdated
representation task (“false”-photograph task). Experiment 3 showed that children with ASD
had difficulties with the false representation tasks, and this could not be explained by
executive functioning or language impairments. These findings support the view that children
with ASD might not have a specific theory-of-mind deficit.
13. Cascio et al. (2014). Affective neural response to restricted interests in autism spectrum
disorders. Journal of Child and Adolescent Psychiatry, 55(2), 162-171.
Doi: 10.1111/jcpp.12147
Restricted interests are a class of repetitive behavior in autism spectrum disorders (ASD)
whose intensity and narrow focus often contribute to significant interference with daily
functioning. While numerous neuroimaging studies have investigated executive circuits as
putative neural substrates of repetitive behavior, recent work implicates affective neural
circuits in restricted interests. We sought to explore the role of affective neural circuits and
determine how restricted interests are distinguished from hobbies or interests in typical
We compared a group of children with ASD to a typically developing (TD) group of children
with strong interests or hobbies, employing parent report, an operant behavioral task, and
functional imaging with personalized stimuli based on individual interests.
While performance on the operant task was similar between the two groups, parent report of
intensity and interference of interests was significantly higher in the ASD group. Both the
ASD and TD groups showed increased BOLD response in widespread affective neural
regions to the pictures of their own interest. When viewing pictures of other children's
interests, the TD group showed a similar pattern, whereas BOLD response in the ASD group
was much more limited. Increased BOLD response in the insula and anterior cingulate cortex
distinguished the ASD from the TD group, and parent report of the intensity and interference
with daily life of the child's restricted interest predicted insula response.
While affective neural network response and operant behavior are comparable in typical and
restricted interests, the narrowness of focus that clinically distinguishes restricted interests in
ASD is reflected in more interference in daily life and aberrantly enhanced insula and anterior
cingulate response to individuals’ own interests in the ASD group. These results further
support the involvement of affective neural networks in repetitive behaviors in ASD.
14. Kirby, A. V., Dickie, V. A., & Baranek, G. T. (2014). Sensory experiences of children
words. Autism.
Doi: 10.1177/1362361314520756
First-person perspectives of children with autism spectrum disorder are rarely included in
research, yet their voices may help more clearly illuminate their needs. This study involved
phenomenological interviews with children with autism spectrum disorder (n = 12, ages 4–
13) used to gain insights about their sensory experiences. This article addresses two study
aims: determining the feasibility of interviewing children with autism spectrum disorder and
exploring how they share information about their sensory experiences during the qualitative
interview process. With the described methods, children as young as 4 years old and across a
broad range of autism severity scores successfully participated in the interviews. The manner
with which children shared information about their sensory experiences included themes of
normalizing, storytelling, and describing responses. The interviews also revealed the
importance of context and the multisensory nature of children’s experiences. These findings
contribute strategies for understanding the sensory experiences of children with autism
spectrum disorder with implications for practice and future research.
15. Zuckerman, K. E., Hill, A. P., Guion, K., Voltolina, L., & Fombonne, E.
(2014). Overweight and Obesity: Prevalence and Correlates in a Large Clinical
Sample of Children with Autism Spectrum Disorder. Journal of Autism and
Developmental Disorders. Doi: 10.1007/s10803-014-2050-9
Autism Spectrum Disorders (ASDs) and childhood obesity (OBY) are rising public health
concerns. This study aimed to evaluate the prevalence of overweight (OWT) and OBY in a
sample of 376 Oregon children with ASD, and to assess correlates of OWT and OBY in this
sample. We used descriptive statistics, bivariate, and focused multivariate analyses to
determine whether socio-demographic characteristics, ASD symptoms, ASD cognitive and
adaptive functioning, behavioral problems, and treatments for ASD were associated with
OWT and OBY in ASD. Overall 18.1 % of children met criteria for OWT and 17.0 % met
criteria for OBY. OBY was associated with sleep difficulties, melatonin use, and affective
problems. Interventions that consider unique needs of children with ASD may hold promise
for improving weight status among children with ASD.
16. Suh, J., Eigsti, I-M., Naigles, M., Kelley, E., & Fein, D. (2014). Narrative Performance of
Optimal Outcome Children and Adolescents with a History of an Autism Spectrum
(ASD). Journal
Autism and
Doi: 10.1007/s10803-014-2042-9
Autism Spectrum Disorders (ASDs) have traditionally been considered a lifelong condition;
however, a subset of people makes such significant improvements that they no longer meet
diagnostic criteria for an ASD. The current study examines whether these “optimal outcome”
(OO) children and adolescents continue to have subtle pragmatic language deficits. The
narratives of 15 OO individuals, 15 high-functioning individuals with an ASD (HFA), and 15
typically developing (TD) peers were evaluated. Despite average cognitive functioning, the
ASD group produced narratives with fewer central “gist” descriptions, more ambiguous
pronominal referents, idiosyncratic language, speech dysfluency (more repetitions and selfcorrections), and were less likely to name story characters. The OO participants displayed
only very subtle pragmatic and higher-level language deficits (idiosyncratic language and
self-correction dysfluency).
17. Wong, J. D., Mallick, M. R., Greenberg, J. S., Hong, J., Coe, C. L. (2014). Daily Work
Stress and Awakening Cortisol in Mothers of Individuals with Autism Spectrum
Disorders or Fragile X Syndrome. Family Relations, 63(1), 135-147.
Doi: 10.1111/fare.12055
The effect of daily work stress on the next morning's awakening cortisol level was
determined in a sample of 124 mothers (M age = 49.89, SD = 6.33) of adolescents and adults
with developmental disabilities and compared to 115 mothers (M age = 46.19, SD = 7.08) of
individuals without disabilities. Mothers participated in 8 days of diary telephone interviews
and provided saliva samples. Multilevel models revealed that mothers of individuals with
developmental disabilities had lower awakening cortisol levels than comparison mothers.
Work stress interacted with parental status to predict the awakening cortisol level on the
following morning. When mothers of individuals with developmental disabilities experienced
a work stressor, their awakening cortisol level was significantly higher on the subsequent
morning, but for comparison mothers, work stressors were not significantly associated with
cortisol level. Findings extend understanding of the differential impacts of specific types of
stressors on physiological functioning of mothers of individuals with and without
developmental disabilities.
18. Menion, A., & Leader, G. (2014). Epilepsy in autism spectrum disorder. Research in
Doi: http://dx.doi.org/10.1016/j.rasd.2013.12.012
The purpose of this review is to provide an overview of the research on epilepsy in autism
spectrum disorder (ASD). Topics explored are the prevalence of epilepsy in ASD, the
importance of studying epilepsy, as well as the questionnaire measures used to assess
epilepsy side-effects. Research on the relationships between epilepsy and parental stress and
psychological distress, developmental regression, language and communication, adaptive
behavior, social skills, autism severity, challenging behavior, comorbid psychopathology,
gastrointestinal symptoms, sleep problems, sensory issues and quality of life are also
discussed. Finally, recommendations for treatment are given as well as areas where future
research is needed.
19. Patten et al. (2014). Vocal Patterns in Infants with Autism Spectrum Disorder: Canonical
Babbling Status and Vocalization Frequency. Journal of Autism and Developmental
Disorders. Doi: 10.1007/s10803-014-2047-4
Canonical babbling is a critical milestone for speech development and is usually well in place
by 10 months. The possibility that infants with autism spectrum disorder (ASD) show late
onset of canonical babbling has so far eluded evaluation. Rate of vocalization or “volubility”
has also been suggested as possibly aberrant in infants with ASD. We conducted a
retrospective video study examining vocalizations of 37 infants at 9–12 and 15–18 months.
Twenty-three of the 37 infants were later diagnosed with ASD and indeed produced low rates
of canonical babbling and low volubility by comparison with the 14 typically developing
infants. The study thus supports suggestions that very early vocal patterns may prove to be a
useful component of early screening and diagnosis of ASD.
20. McGarth et al. (2014). A Comprehensive Assessment of Parental Age and Psychiatric
Disorders. JAMA Psychiatry. DOI: 10.1001/jamapsychiatry.2013.4081.
IMPORTANCE There has been recent interest in the findings that the offspring of older
fathers have an increased risk of both de novo mutations and neuropsychiatric disorders.
However, the offspring of younger parents are also at risk for some adverse mental health
outcomes. OBJECTIVE To determine the association between maternal and paternal age and
a comprehensive range of mental health disorders. DESIGN, SETTING, AND
PARTICIPANTS A comprehensive, population-based record linkage study using the Danish
Psychiatric Central Research Register from January 1, 1995, through December 31, 2011. A
total of 2 894 688 persons born in Denmark from January 1, 1955, through December 31,
2006, were followed up during the study period. EXPOSURES Maternal and paternal age at
the time of offspring's birth. MAIN OUTCOMES AND MEASURES We examined a broad
range of International Classification of Diseases-defined mental disorders, including
substance use; schizophrenia and related disorders; mood disorders; neurotic, stress-related,
and somatoform disorders; eating disorders; specific personality disorders; and a range of
developmental and childhood disorders. The incidence rate ratios for each mental disorder
outcome were estimated by log linear Poisson regression with adjustments for the calendar
period, age, sex, and age of the other parent. RESULTS The cohort was observed for 42.7
million person-years, during which 218 441 members of the cohort had their first psychiatric
contact for any psychiatric disorder. Based on the overall risk of psychiatric disorders, the
offspring of younger and older parents were at increased risk compared with those of parents
aged 25 to 29 years. When the offspring were examined for particular disorders, the nature of
the relationship changed. For example, the offspring of older fathers were at an increased risk
of schizophrenia and related disorders, mental retardation, and autism spectrum disorders. In
contrast, the offspring of young mothers (and to a lesser extent young fathers) were at an
increased risk for substance use disorders, hyperkinetic disorders, and mental retardation.
CONCLUSIONS AND RELEVANCE The offspring of younger mothers and older fathers
are at risk for different mental health disorders. These differences can provide clues to the
complex risk architecture underpinning the association between parental age and the mental
health of offspring.
21. Idring et al. (2014). Parental age and the risk of autism spectrum disorders: findings from
a Swedish population-based cohort. International Journal of Epidemiology.
Doi: 10.1093/ije/dyt262
Background: The objectives of this study were to examine the independent and dependent
associations of maternal and paternal age and risk of offspring autism spectrum disorders
(ASD), with and without intellectual disability (ID).
METHODS: The sample consisted of 417 303 Swedish children born 1984-2003. ASD case
status (N = 4746) was ascertained using national and regional registers. Smoothing splines in
generalized additive models were used to estimate associations of parental age with ASD.
RESULTS: Whereas advancing parental age increased the risk of child ASD, maternal age
effects were non-linear and paternal age effects were linear. Compared with mothers at the
median age 29 years, those <29 had similar risk, whereas risk increased after age 30, with an
odds ratio (OR) of 1.75 [95% (CI): 1.63-1.89] at ages 40-45. For fathers, compared with the
median age of 32 years, the OR for ages 55-59 was 1.39 (1.29-1.50). The risk of ASD was
greater for older mothers as compared with older fathers. For example, mothers aged 40-45
(≥97.2th percentile) had an estimated 18.63 (95% CI: 17.25-20.01) ASD cases per 1000
births, whereas fathers aged 55-59 (≥99.7th percentile) had 16.35 (95% CI: 15.11-17.58)
ASD cases per 1000 births. In analyses stratified by co-parental age, increased risk due to
advancing paternal age was evident only with mothers ≤35 years. In contrast, advancing
maternal age increased risk regardless of paternal age. Advancing parental age was more
strongly associated with ASD with ID, compared with ASD without ID.
CONCLUSIONS: We confirm prior findings that advancing parental age increases risk of
ASD, particularly for ASD with ID, in a manner dependent on co-parental age. Although
recent attention has emphasized the effects of older fathers on ASD risk, an increase of n
years in maternal age has greater implications for ASD risk than a similar increase in paternal
22. Strauss, K., Esposito, M., Polidori, G., Vicari, S., Valeri, G., & Fava, L. (2014).
Facilitating play, peer engagement and social functioning in a peer group of young
autistic children: Comparing highly structured and more flexible behavioral
approaches. Research in Autism Spectrum Disorders, 8(4), 413-423.
Doi: http://dx.doi.org/10.1016/j.rasd.2014.01.002
This study examined the differential effect of a highly structured adult-directed behavioral
treatment condition and a more flexible child-oriented blending of behavioral and
developmental treatment strategies in a clinical group setting with autistic children. The
children with autism following the more flexible child-oriented treatment condition engaged
significantly more in higher-order play activities allowing for peer proximity and
demonstrated better social functioning during activities with other autistic peers. A relation of
child-oriented teaching utilizing less intrusive prompting to more developmentally
appropriate play as well as social functioning was found. The findings suggest that childoriented play and social skill interventions in the clinical context, although being applied in a
group of autistic children, may facilitate social functioning and engagement.
23. Case-Smith, J., Weaver, L. L., & Fristad, M. A. (2014). A systematic review of sensory
processing interventions for children with autism spectrum disorders. Autism.
Doi: 10.1177/1362361313517762
Children with autism spectrum disorders often exhibit co-occurring sensory processing
problems and receive interventions that target self-regulation. In current practice, sensory
interventions apply different theoretic constructs, focus on different goals, use a variety of
sensory modalities, and involve markedly disparate procedures. Previous reviews examined
the effects of sensory interventions without acknowledging these inconsistencies. This
systematic review examined the research evidence (2000–2012) of two forms of sensory
interventions, sensory integration therapy and sensory-based intervention, for children with
autism spectrum disorders and concurrent sensory processing problems. A total of 19 studies
were reviewed: 5 examined the effects of sensory integration therapy and 14 sensory-based
intervention. The studies defined sensory integration therapies as clinic-based interventions
that use sensory-rich, child-directed activities to improve a child’s adaptive responses to
sensory experiences. Two randomized controlled trials found positive effects for sensory
integration therapy on child performance using Goal Attainment Scaling (effect sizes ranging
from .72 to 1.62); other studies (Levels III–IV) found positive effects on reducing behaviors
linked to sensory problems. Sensory-based interventions are characterized as classroombased interventions that use single-sensory strategies, for example, weighted vests or therapy
balls, to influence a child’s state of arousal. Few positive effects were found in sensory-based
intervention studies. Studies of sensory-based interventions suggest that they may not be
effective; however, they did not follow recommended protocols or target sensory processing
problems. Although small randomized controlled trials resulted in positive effects for sensory
integration therapies, additional rigorous trials using manualized protocols for sensory
integration therapy are needed to evaluate effects for children with autism spectrum disorders
and sensory processing problems.