Irritability in Pediatric Psychopathology

2019 ◽  
pp. 215-232
Author(s):  
Carla A. Mazefsky ◽  
Taylor N. Day ◽  
Joshua Golt
Keyword(s):  
Autism Spectrum Disorder ◽  
Emotion Regulation ◽  
Psychiatric Disorder ◽  
Autism Spectrum ◽  
Psychosocial Treatment ◽  
Spectrum Disorder ◽  
Future Research ◽  
Phenotypic Characteristics ◽  
Pediatric Psychopathology ◽  
Pharmacologic Management

Irritability is a common presenting concern in youth with autism spectrum disorder (ASD). This chapter provides an overview of research on irritability in ASD, including informative findings from the related fields of temperament and emotion regulation. The developmental course is described, highlighting irritability as one of the earliest phenotypic characteristics in ASD. ASD-related characteristics that may predispose youth with ASD to experience high or chronic irritability are considered, in addition to conceptualizations of irritability in ASD as resulting from a co-occurring psychiatric disorder. Common approaches to assessment, psychosocial treatment, and pharmacologic management of irritability are summarized. Finally, gaps in our understanding of irritability in ASD are highlighted and promising directions for future research are provided.

Oppositional Defiant Disorder and Related Disruptive Behaviors in Autism Spectrum Disorder

2020 ◽  
pp. 136-158
Author(s):  
Connor M. Kerns ◽  
Chandler Puhy ◽  
Chelsea M. Day ◽  
Steven J. Berkowitz
Keyword(s):  
Autism Spectrum Disorder ◽  
Oppositional Defiant Disorder ◽  
Challenging Behaviors ◽  
Disruptive Behaviors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Oppositional Defiant ◽  
Assessment And Treatment ◽  
Defiant Behavior

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition characterizes oppositional defiant disorder (ODD) as reflecting pervasive patterns of irritable mood, defiant behavior, and/or vindictiveness. Youth with autism spectrum disorder (ASD) exhibit high rates of disruptive behaviors commonly associated with ODD, such as noncompliance, irritability, temper tantrums, and mood dysregulation. This chapter reviews the presentation of ODD in individuals with ASD, including current prevalence estimates, proposed etiology, validated assessment methods, and emerging best practices designed to treat challenging behaviors. Although there is a robust literature describing assessment and treatment procedures for disruptive behaviors in individuals with ASD, conceptualizing these hallmark behaviors within the framework of ODD is relatively novel and not without controversy. Discussion thus includes challenges around the applicability of the diagnostic criteria in this population and future research directions that may provide clarity on this issue.

Exploring Growth in Expressive Communication of Infants and Toddlers With Autism Spectrum Disorder

2021 ◽  
pp. 105381512199557
Author(s):  
Jay Buzhardt ◽  
Anna Wallisch ◽  
Dwight Irvin ◽  
Brian Boyd ◽  
Brenda Salley ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Progress Monitoring ◽  
Autism Spectrum ◽  
Growth Patterns ◽  
Spectrum Disorder ◽  
Future Research ◽  
Infants And Toddlers ◽  
Early Communication ◽  
Children With Asd ◽  
Language Growth

One of the earliest indicators of autism spectrum disorder (ASD) is delay in language and social communication. Despite consensus on the benefits of earlier diagnosis and intervention, our understanding of the language growth of children with ASD during the first years of life remains limited. Therefore, this study compared communication growth patterns of infants and toddlers with ASD to growth benchmarks of a standardized language assessment. We conducted a retrospective analysis of growth on the Early Communication Indicator (ECI) of 23 infants and toddlers who received an ASD diagnosis in the future. At 42 months of age, children with ASD had significantly lower rates of gestures, single words, and multiple words, but significantly higher rates of nonword vocalizations. Children with ASD had significantly slower growth of single and multiple words, but their rate of vocalization growth was significantly greater than benchmark. Although more research is needed with larger samples, because the ECI was designed for practitioners to monitor children’s response to intervention over time, these findings show promise for the ECI’s use as a progress monitoring measure for young children with ASD. Limitations and the need for future research are discussed.

scholarly journals A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care: prevalence, treatment, risk assessment and other clinical considerations

2018 ◽  
Vol 8 (1) ◽  
pp. 58-79 ◽  
Author(s):  
Clare S. Allely
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychiatric Care ◽  
Psychiatric Hospitals ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Bibliographic Databases ◽  
Future Research ◽  
Content Type ◽  
Secure Psychiatric Care

Purpose Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings. Design/methodology/approach Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Findings A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed. Originality/value To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.

Examining bidirectional relationships between parenting and child maladjustment in youth with autism spectrum disorder: A 9-year longitudinal study

2016 ◽  
Vol 29 (4) ◽  
pp. 1199-1213 ◽  
Author(s):  
Lisa M. Dieleman ◽  
Sarah S. W. De Pauw ◽  
Bart Soenens ◽  
Wim Beyers ◽  
Peter Prinzie
Keyword(s):  
Autism Spectrum Disorder ◽  
Longitudinal Study ◽  
Problem Behaviors ◽  
Externalizing Problems ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Controlling Parenting ◽  
Parents And Children ◽  
Child Problems

AbstractLongitudinal bidirectional effects between parents and children are usually studied in samples of typically developing children, but remain understudied in families with a child with autism spectrum disorder. This three-wave longitudinal study examined how parents and children with autism spectrum disorder influence one another, relying on parent reports of parenting behaviors and children's problem behaviors across 9 years, in a sample of 139 youngsters (M age Time 1 = 10.2 years, 83% boys). Cross-lagged analyses indicated that children's externalizing problems at Time 1 predicted negative controlling parenting 6 years later (Time 2) that in turn predicted externalizing problems 3 years later (Time 3). Negative parental control at Time 1 also increased the risk for internalizing problems at Time 2. It was surprising that externalizing problems at Time 2 also predicted positive parental involvement at Time 3. Thus, although results indicate that externalizing problems generally elicit maladaptive reactions in parents, this study also suggests that parents adjust their way of reacting to externalizing child problems as their child reaches adolescence/emerging adulthood. Implications for future research on parenting dynamics in families with a child with autism spectrum disorder are discussed.

Assessment and Treatment of Selective Mutism in a Child With Autism Spectrum Disorder

2020 ◽  
pp. 153465012098345
Author(s):  
Mirela Cengher ◽  
Joy C. Clayborne ◽  
Adrianna E. Crouch ◽  
Julia T. O’Connor
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Interaction ◽  
Environmental Variables ◽  
Behavioral Interventions ◽  
Selective Mutism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Future Research ◽  
Assessment And Treatment

Over 60% of children diagnosed with selective mutism are also diagnosed with Autism Spectrum Disorder. Previous research established that behavioral interventions are effective at increasing speech in children with both diagnoses. However, few studies conducted assessments to determine environmental variables that inhibit speech, and such assessments are necessary for the development of effective and efficient treatments. This case study describes an assessment that evaluated the function(s) of selective mutism. The results confirmed that the participant did not talk to avoid social interaction and that mutism occurred primarily in the presence of multiple, unfamiliar people. Our first treatment focused on increasing tolerance for social interaction, demonstrated by an increase in speech production in the presence of unfamiliar people. Our second treatment focused on increasing qualitative aspects of the participant’s speech (i.e., both responses and initiations). Finally, we taught the participant’s parents to implement the treatment in naturalistic settings, and the participant demonstrated generalization of treatment effects across people and settings. Implications for clinical practice and future research are discussed.

scholarly journals Lagging skills contribute to challenging behaviors in children with autism spectrum disorder without intellectual disability

Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 898-906 ◽  
Author(s):  
Brenna B Maddox ◽  
Patrick Cleary ◽  
Emily S Kuschner ◽  
Judith S Miller ◽  
Anna Chelsea Armour ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Emotion Regulation ◽  
Executive Function ◽  
Intellectual Disability ◽  
Social Skills ◽  
Challenging Behaviors ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Environmental Demands

Many children with autism spectrum disorder display challenging behaviors. These behaviors are not limited to those with cognitive and/or language impairments. The Collaborative and Proactive Solutions framework proposes that challenging behaviors result from an incompatibility between environmental demands and a child’s “lagging skills.” The primary Collaborative and Proactive Solutions lagging skills—executive function, emotion regulation, language, and social skills—are often areas of weakness for individuals with autism spectrum disorder. The purpose of this study was to evaluate whether these lagging skills are associated with challenging behaviors in youth with autism spectrum disorder without intellectual disability. Parents of 182 youth with autism spectrum disorder (6–15 years) completed measures of their children’s challenging behaviors, executive function, language, emotion regulation, and social skills. We tested whether the Collaborative and Proactive Solutions lagging skills predicted challenging behaviors using multiple linear regression. The Collaborative and Proactive Solutions lagging skills explained significant variance in participants’ challenging behaviors. The Depression (emotion regulation), Inhibit (executive function), and Sameness (executive function) scales emerged as significant predictors. Impairments in emotion regulation and executive function may contribute substantially to aggressive and oppositional behaviors in school-age youth with autism spectrum disorder without intellectual disability. Treatment for challenging behaviors in this group may consider targeting the incompatibility between environmental demands and a child’s lagging skills.

scholarly journals Neural correlates of interpersonal space permeability and flexibility in autism spectrum disorder

2020 ◽  
Author(s):  
Claudia Massaccesi ◽  
Alexander Groessing ◽  
Lisa A. Rosenberger ◽  
Helena Hartmann ◽  
Michela Candini ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Interactions ◽  
Effective Connectivity ◽  
Adult Population ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Trust Game ◽  
Future Research ◽  
Adults With Asd ◽  
Interpersonal Space

AbstractInterpersonal space can be defined as a safety zone immediately surrounding our body, which allows us to feel comfortable during social interactions. Previous studies indicate that the size of interpersonal space at which the other is perceived as intrusive (permeability) and the ability to adapt interpersonal distance based on contextual factors (flexibility) are altered in children and adults with Autism Spectrum Disorder (ASD). The present fMRI study aimed at extending the previous findings by investigating the behavioral and neurophysiological underpinnings of interpersonal space permeability and flexibility in adults with ASD.Individuals with ASD and matched controls (CTR) performed a modified version of the stop-distance paradigm for measuring interpersonal space preferences. Participants observed prerecorded videos of two confederates moving towards them and rated their comfort to the observed distance. The assessment of interpersonal space preferences was performed before and after engaging in cooperative and non-cooperative social interactions with the confederates, experimentally induced by means of a repeated trust game.We observed general lower comfort in response to an approaching confederate in the ASD group compared to the CTR group, indicating preference for larger interpersonal space in autism (altered permeability). This preference was accompanied by reduced activity in bilateral dorsal intraparietal sulcus (dIPS) and left fusiform face area (FFA), regions previously shown to be involved in interpersonal space regulation. Furthermore, we observed differences in effective connectivity among dIPS, FFA, and amygdala in ASDs compared to CTRs, depending on the level of experienced comfort. No differences between ASDs and CTRs were observed in the adaptation of interpersonal space following a cooperative and non-cooperative social interaction, suggesting preserved interpersonal space flexibility in the ASD adult population.The present study provides evidence for impaired permeability of interpersonal space in adults with ASD. The findings suggest that a dysregulation of the activity and connectivity of brain areas involved in the processing of interpersonal space may contribute to preference for larger distance and avoidance of physical proximity in ASDs. Future research is needed to examine whether the observed alteration of interpersonal space processing is an effect of or a contributing factor to the social disabilities characterizing autism.

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