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Community-based Parent Education for Caregivers of Children Newly Diagnosed with Autism Spectrum Disorder

Milgramm, Anna; Corona, Laura L; Janicki-Menzie, Cortney; Christodulu, Kristin V
Parents of children with autism spectrum disorder (ASD) frequently report high levels of stress related to the process of receiving an ASD diagnosis and navigating the intervention landscape. Parent education programs offer one approach to providing families with support, information, and resources following a child's diagnosis. Given the heterogeneity of such programs, there have been calls within the literature for increased characterization and systematic evaluation of this type of parent-focused intervention. The present study describes the structure and content of a community-based, group-format parent education program for families of children newly diagnosed with ASD. Following program participation, parents reported reductions in parenting stress, increases in knowledge and empowerment, and high levels of satisfaction. Implications and future research directions are discussed.
PMID: 33893937
ISSN: 1573-3432
CID: 5480062

Continuity and Stability of Parenting of Infants by Women at Risk for Perinatal Depression

Goodman, Sherryl; Bakeman, Roger; Milgramm, Anna
OBJECTIVE/UNASSIGNED:The present study aimed to enhance understanding of continuity and stability of positive parenting of infants, across age and different settings in women with a history of depression who are at elevated risk for postpartum depression. DESIGN/UNASSIGNED:= 103) with a history of major depression and their infants were observed during 5-min play and feeding interactions when their infants were 3, 6, and 12 months of age. Summary scores representing mothers' positive parenting were computed separately for each age and context based on ratings of five parenting behaviors. Mothers' depressive symptom levels were assessed at each infant age. RESULTS/UNASSIGNED:Continuity (consistency of level) and stability (consistency of rank order) were assessed across age and context at both the group and individual level. Across-age analyses revealed continuity in the play context and discontinuity in the feeding context, albeit only at the group level, as well as weak to moderate stability. Across-context analyses revealed higher positive parenting scores in play than feeding at all time points as well as weak to moderate stability. Variations in positive parenting across age and context were independent of mothers' postpartum depressive symptom levels. CONCLUSIONS/UNASSIGNED:Findings based on normative samples may not generalize to women with a history of depression, who may benefit from interventions aimed at enhancing their positive parenting over the course of infancy, regardless of postpartum depressive symptom level. Results also underscore the importance of assessing parenting at multiple age points and across varying contexts.
PMID: 35330876
ISSN: 1529-5192
CID: 5480072

Brief Report: Predictors of Teacher-Rated Academic Competence in a Clinic Sample of Children With and Without Autism Spectrum Disorder

Milgramm, Anna; Christodulu, Kristin V; Rinaldi, Melissa L
The rising prevalence of autism spectrum disorder (ASD) necessitates a greater understanding of the academic experience of diagnosed children. The present study investigates several predictors of teacher-reported academic competence among a sample of elementary school children. All children in the sample were referred for an ASD evaluation and approximately half received a diagnosis. Children with and without ASD did not differ on overall academic competence, social skills, or problem behaviors. Regression analyses indicated that cognitive ability, social skills, and problem behaviors accounted for significant variance in academic competence. Moderation analyses indicated that the relations between the predictors and academic competence were comparable for children with and without ASD. Implications and future directions are discussed.
PMID: 32886257
ISSN: 1573-3432
CID: 5480042

Context-Specific Dyadic Attention Vulnerabilities During the First Year in Infants Later Developing Autism Spectrum Disorder

Macari, Suzanne; Milgramm, Anna; Reed, Jessa; Shic, Frederick; Powell, Kelly K; Macris, Deanna; Chawarska, Katarzyna
OBJECTIVE:Although some eye-tracking studies demonstrate atypical attention to faces by 6 months of age in autism spectrum disorder (ASD), behavioral studies in early infancy return largely negative results. We examined the effects of context and diagnosis on attention to faces during face-to-face live interactions in infants at high familial risk (HR) and low familial risk (LR) for ASD. METHOD:Participants were 6-, 9-, and 12-month-old siblings of children with ASD who were later determined to have ASD (n = 21), other developmental challenges (HR-C; n = 74), or typical development (TD) (HR-TD; n = 32), and low-risk, typically developing controls (LR-TD; n = 49). Infants were administered the social orienting probes task, consisting of five conditions: dyadic bid, song, peek-a-boo, tickle, and toy play. Attention to an unfamiliar examiner's face was coded by blinded raters from video recordings. RESULTS:At all ages, the ASD group spent less time looking at the examiner's face than the HR-C, HR-TD, and LR-TD groups during the Dyadic Bid and Tickle conditions (all p <.05), but not during the Song, Peek-a-Boo, or Toy Play conditions (all p >.23). Lower attention to faces during Dyadic Bid and Tickle conditions was significantly correlated with higher severity of autism symptoms at 18 months. CONCLUSION:During the prodromal stages of the disorder, infants with ASD exhibited subtle impairments in attention to faces of interactive partners during interactions involving eye contact and child-directed speech (with and without physical contact), but not in contexts involving singing, familiar anticipatory games, or toy play. Considering the convergence with eye-tracking findings on limited attention to faces in infants later diagnosed with ASD, reduced attention to faces of interactive partners in specific contexts may constitute a promising candidate behavioral marker of ASD in infancy.
PMID: 32061926
ISSN: 1527-5418
CID: 5480032

Brief Report: Family Recreation for Individuals with Autism Spectrum Disorder

Milgramm, Anna; Wilkinson, Emma; Christodulu, Kristin
ISSN: 1034-912x
CID: 5480082

Atypical Emotional Electrodermal Activity in Toddlers with Autism Spectrum Disorder

Vernetti, Angelina; Shic, Frederick; Boccanfuso, Laura; Macari, Suzanne; Kane-Grade, Finola; Milgramm, Anna; Hilton, Emily; Heymann, Perrine; Goodwin, Matthew S; Chawarska, Katarzyna
Past studies in autism spectrum disorder (ASD) indicate atypical peripheral physiological arousal. However, the conditions under which these atypicalities arise and their link with behavioral emotional expressions and core ASD symptoms remain uncertain. Given the importance of physiological arousal in affective, learning, and cognitive processes, the current study examined changes in skin conductance level (ΔSCL) in 41 toddlers with ASD (mean age: 22.7 months, SD: 2.9) and 32 age-matched toddlers with typical development (TD) (mean age: 21.6 months, SD: 3.6) in response to probes designed to induce anger, joy, and fear emotions. The magnitude of ΔSCL was comparable during anger (P = 0.206, d = 0.30) and joy (P = 0.996, d = 0.01) conditions, but significantly lower during the fear condition (P = 0.001, d = 0.83) in toddlers with ASD compared to TD peers. In the combined samples, ΔSCL positively correlated with intensity of behavioral emotional expressivity during the anger (r[71] = 0.36, P = 0.002) and fear (r[68] = 0.32, P = 0.007) conditions, but not in the joy (r[69] = -0.15, P = 0.226) condition. Finally, ΔSCL did not associate with autism symptom severity in any emotion-eliciting condition in the ASD group. Toddlers with ASD displayed attenuated ΔSCL to situations aimed at eliciting fear, which may forecast the emergence of highly prevalent internalizing and externalizing problems in this population. The study putatively identifies ΔSCL as a dimension not associated with severity of autism but with behavioral responses in negatively emotionally challenging events and provides support for the feasibility, validity, and incipient utility of examining ΔSCL in response to emotional challenges in very young children. LAY SUMMARY: Physiological arousal was measured in toddlers with autism exposed to frustrating, pleasant, and threatening tasks. Compared to typically developing peers, toddlers with autism showed comparable arousal responses to frustrating and pleasant events, but lower responses to threatening events. Importantly, physiological arousal and behavioral expressions were aligned during frustrating and threatening events, inviting exploration of physiological arousal to measure responses to emotional challenges. Furthermore, this study advances the understanding of precursors to emotional and behavioral problems common in older children with autism. Autism Res 2020, 13: 1476-1488. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
PMID: 32896980
ISSN: 1939-3806
CID: 5480052

Brief Report: Reductions in Parenting Stress in the Context of PEERS-A Social Skills Intervention for Adolescents with Autism Spectrum Disorder

Corona, Laura L; Janicki, Cortney; Milgramm, Anna; Christodulu, Kristin V
Social skills intervention is an evidence-based practice for enhancing communication and interpersonal skills in individuals with autism spectrum disorder (ASD). Participation in the Program for the Education and Enrichment of Relational Skills (PEERS®), a manualized social skills intervention for adolescents with ASD, is associated with improved social skills and peer interactions, as well as decreased autism symptoms. Participation in PEERS® has also been linked to increased parent self-efficacy and decreased family chaos. The present study examined parenting stress in the context of PEERS®. Following participation in PEERS®, parents reported lower levels of parenting stress associated with adolescent mood and social isolation. These findings provide further evidence of the family-wide benefits of adolescent-focused social skills intervention.
PMID: 31473951
ISSN: 1573-3432
CID: 5480022