Delineating the autistic phenotype in children with neurofibromatosis type 1

Background Existing research has demonstrated elevated autistic behaviours in children with neurofibromatosis type 1 (NF1), but the autistic phenotype and its relationship to other neurodevelopmental manifestations of NF1 remains unclear. To address this gap, we performed detailed characterisation of autistic behaviours in children with NF1 and investigated their association with other common NF1 child characteristics. Methods Participants were drawn from a larger cross-sectional study examining autism in children with NF1. The population analysed in this study scored above threshold on the Social Responsiveness Scale-Second Edition (T-score ≥ 60; 51% larger cohort) and completed the Autism Diagnostic Interview-Revised (ADI-R) and/or the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). All participants underwent evaluation of their intellectual function, and behavioural data were collected via parent questionnaires. Results The study cohort comprised 68 children (3–15 years). Sixty-three per cent met the ADOS-2 ‘autism spectrum’ cut-off, and 34% exceeded the more stringent threshold for ‘autistic disorder’ on the ADI-R. Social communication symptoms were common and wide-ranging, while restricted and repetitive behaviours (RRBs) were most commonly characterised by ‘insistence on sameness’ (IS) behaviours such as circumscribed interests and difficulties with minor changes. Autistic behaviours were weakly correlated with hyperactive/impulsive attention deficit hyperactivity disorder (ADHD) symptoms but not with inattentive ADHD or other behavioural characteristics. Language and verbal IQ were weakly related to social communication behaviours but not to RRBs. Limitations Lack of genetic validation of NF1, no clinical diagnosis of autism, and a retrospective assessment of autistic behaviours in early childhood. Conclusions Findings provide strong support for elevated autistic behaviours in children with NF1. While these behaviours were relatively independent of other NF1 comorbidities, the importance of taking broader child characteristics into consideration when interpreting data from autism-specific measures in this population is highlighted. Social communication deficits appear similar to those observed in idiopathic autism and are coupled with a unique RRB profile comprising prominent IS behaviours. This autistic phenotype and its relationship to common NF1 comorbidities such as anxiety and executive dysfunction will be important to examine in future research. Current findings have important implications for the early identification of autism in NF1 and clinical management.

Parental (STEM) Occupations, the Home Numeracy Environment, and Kindergarten Children’s Numerical Competencies

Children’s early numerical competencies are of great importance for later academic achievement. Young children gain these competencies in the context of the home numeracy environment (HNE). Additionally, child characteristics and families’ socioeconomic status (SES) are associated with children’s competencies. In this study, we investigated parents’ occupations (i.e., STEM or non-STEM occupation) as a specific aspect of the SES to understand whether parental occupations are associated with children’s numerical competencies and whether such an association may depend on the HNE. We analysed data from a sample of N = 190 children (Mage = 63.58 months; SD = 4.41) at two measurement points. Correlational analyses and crossed-lagged models were conducted to predict children’s numerical competencies by a global measure of the HNE and parental STEM vs. non-STEM occupations. We found significant associations between parents’ learned and current occupations and the HNE. Further, significant associations between parents’ learned occupations and children’s numerical competencies were observed. However, parents’ current occupations were not significantly associated with children’s numerical competencies. Consequently, more specific facets of the SES instead of a global measure seem to be associated with children’s numerical competencies. A greater focus on specific differences between family characteristics and their potential impact on children’s HNE and the development of their numerical competencies seems expedient.

Investigating the Associations Between Child Autistic Symptoms, Socioeconomic Context, and Family Life: A Pilot Study

Objective: The day-to-day experience of families with an Autistic child may be shaped by both, child characteristics and available resources, which often are influenced by the socioeconomic context of the family. Using a socioecological approach, this study explored the quantitative associations between child autistic symptoms, family socioeconomic status, and family life.Methods: Data came from the Pediatric Autism Research Cohort—PARC Study (pilot). Parents of children with a recent diagnosis of autism completed a set of assessments, including the Autism Family Experience Questionnaire, Autism Impact Measure, and a Sociodemographic Questionnaire. A series of multiple, iterative linear regression models were constructed to ascertain quantitative associations between child autistic symptoms, socioeconomic context, and family life.Results: A total of 50 children (mean age: 76 months; SD: 9.5 months; and 84% male) with data on the variables of interest were included in the analysis. The frequency of child autistic symptoms was associated with family life outcomes (p = 0.02 and R2 = 24%). Once autistic symptom frequency, symptom impact, and sociodemographic variables were considered, parents of higher educational attainment reported worse family life outcomes compared to their lesser-educated counterparts. This cumulative regression model had considerable explanatory capability (p = 0.01, R2 = 40%).Conclusion: This study demonstrates the utility of using a socioecological approach to examine the dynamic interplay between child characteristics and family circumstances. Our findings suggest that family life for parents (of an autistic child) who have obtained higher education is reported (by the parents themselves) as less satisfactory compared to that of parents without higher education, once adjusted for the autistic symptom frequency of child, symptom impact, and income. These findings can inform the design and delivery of more family-centered care pathways during the years following a diagnosis of autism.

Supporting One’s Own? Grandparents’ Help to Grandchildren Who Live With Other Unrelated Children

The structures of young families today are becoming increasingly complex, which may impact grandparents’ involvement. I examine whether grandparents’ support to adult children’s households differs for those with biological grandchildren only, versus households with both biological and non-biological (step, unrelated) grandchildren. The resource dilution hypothesis and sociobiology theory suggest that grandparents will be less supportive of grandchildren when other unrelated children co-reside in their households. Grandparents (mean age 62.23) in the Add Health Parent Study (2015-2017) reported on instrumental and financial help given to each of their adult children's families in the past year. These data were merged with information from their adult children (mean age 36.76) who participated in Add Health Wave V (2016-2018). Adult children’s household structures—biological children only (n=400) or biological + other children (n=51)—were determined using their fertility histories and household rosters. No significant differences were found in the likelihood that grandparents offered any instrumental or financial support to these two household types (controlling for grandparent resources and adult child characteristics). Nor was the level of grandparents’ financial support significantly different for the two groups. However, grandparents gave significantly fewer hours of help to adult children heading households including both biological grandchildren and unrelated children. Grandparents appear less willing to devote time to assisting their grandchildren’s families when their investment is diluted by the presence of unrelated children. Perhaps time with grandchildren is less pleasing or comfortable when unrelated children are present. This same issue does not impact financial giving, which need not involve contact.

Secular trends in early motor development between 1980 and 2010 in Japan

ObjectiveRecent changes in birth characteristics in Japan may have a potential influence on children’s developments. Therefore, we investigated secular trends in gross motor milestones.DesignData were collected from an official Japanese nationwide serial cross-sectional survey conducted every 10 years since 1960. 22 320 participants aged 2–18 months were identified from the four surveys from 1980 to 2010.OutcomesWe assessed whether or not a child achieved four gross motor milestones including rolling over (rolling), sitting without support (sitting), standing with support (standing) and walking alone (walking). The target age was defined as the age when the attainment rate ranged from >5% to >95% of the total. Multivariate logistic regression models were fitted.ResultsThe final cohort included 20 570 children. The target ages were determined as follows: 3–6 months for rolling; 5–9 months for sitting; 6–11 months for standing; and 9–15 months for walking. The attainment rates of sitting, standing and walking in 1990 were higher than those in 2010, even after adjusting for child characteristics (sitting: adjusted OR (aOR)=2.07 (95% CI 1.62 to 2.65); standing: aOR=1.63 (95% CI 1.32 to 2.02); and walking: aOR=1.61 (95% CI 1.34 to 1.95)).ConclusionsThe proportion of children who attained three motor milestones (sitting, standing and walking) by set target ages decreased between 1990 and 2010. The contribution of birth characteristics including a decrease in gestational age and fetal growth, as well as changes in other child characteristics, failed to explain why this decrease occurred.

Are There Resilient Children with ADHD?

Objective: The adverse outcomes associated with ADHD are well known, but less is known about the minority of children with ADHD who may be flourishing despite this neurodevelopmental risk. The present multi-informant study is an initial step in this direction with the basic but unanswered question: Are there resilient children with ADHD? Method: Reliable change analysis of the BASC-3 Resiliency subscale for a clinically evaluated sample of 206 children with and without ADHD (ages 8–13; 81 girls; 66.5% White/Non-Hispanic). Results Most children with ADHD are perceived by their parents and teachers as resilient (52.8%–59.2%), with rates that did not differ from the comorbidity-matched Non-ADHD sample. Conclusion Exploratory analyses highlighted the importance of identifying factors that promote resilience for children with ADHD specifically, such that some child characteristics were promotive (associated with resilience for both groups), some were protective (associated with resilience only for children with ADHD), and some were beneficial only for children without ADHD.

The Relative Reinforcing Value of Cookies Is Higher Among Head Start Preschoolers With Obesity

The relative reinforcing value (RRV) of food measures how hard someone will work for a high-energy-dense (HED) food when an alternative reward is concurrently available. Higher RRV for HED food has been linked to obesity, yet this association has not been examined in low-income preschool-age children. Further, the development of individual differences in the RRV of food in early childhood is poorly understood. This cross-sectional study tested the hypothesis that the RRV of HED (cookies) to low-energy-dense (LED; fruit) food would be greater in children with obesity compared to children without obesity in a sample of 130 low-income 3- to 5-year-olds enrolled in Head Start classrooms in Central Pennsylvania. In addition, we examined individual differences in the RRV of food by child characteristics (i.e., age, sex, and reward sensitivity) and food security status. The RRV of food was measured on concurrent progressive-ratio schedules of reinforcement. RRV outcomes included the last schedule reached (breakpoint) for cookies (cookie Pmax) and fruit (fruit Pmax), the breakpoint for cookies in proportion to the total breakpoint for cookies and fruit combined (RRV cookie), and response rates (responses per minute). Parents completed the 18-item food security module to assess household food security status and the Behavioral Activation System scale to assess reward sensitivity. Pearson’s correlations and mixed models assessed associations between continuous and discrete child characteristics with RRV outcomes, respectively. Two-way mixed effects interaction models examined age and sex as moderators of the association between RRV and Body Mass Index z-scores (BMIZ). Statistical significance was defined as p < 0.05. Children with obesity (17%) had a greater cookie Pmax [F (1, 121) = 4.95, p = 0.03], higher RRV cookie [F (1, 121) = 4.28, p = 0.04], and responded at a faster rate for cookies [F (1, 121) = 17.27, p < 0.001] compared to children without obesity. Children with higher cookie response rates had higher BMIZ (r = 0.26, p < 0.01); and RRV cookie was positively associated with BMIZ for older children (5-year-olds: t = 2.40, p = 0.02) and boys (t = 2.55, p = 0.01), but not younger children or girls. The RRV of food did not differ by household food security status. Low-income children with obesity showed greater motivation to work for cookies than fruit compared to their peers without obesity. The RRV of HED food may be an important contributor to increased weight status in boys and future research is needed to better understand developmental trajectories of the RRV of food across childhood.