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.

Trajectories of Symptom Severity in Children with Autism: Variability and Turning Points through the Transition to School

This study examined the trajectories of autistic symptom severity in an inception cohort of 187 children with ASD assessed across four time points from diagnosis to age 10. Trajectory groups were derived using multivariate cluster analysis. A two trajectory/cluster solution was selected. Change in trajectory slopes revealed a turning point marked by plateauing in symptom reduction during the period of transition to school (age 6) for one of the two trajectories. Trajectories were labelled: Continuously Improving (27%) and Improving then Plateauing (73% of sample). Children in the two trajectories differed in levels of symptom severity, language, cognitive, and adaptive functioning skills. Study findings can inform the development of more personalized services for children with ASD transitioning into the school system.

T117. PROMINENT AND PERSISTENT AUTISTIC TRAITS ARE ASSOCIATED WITH EARLY NON-REMISSION IN FIRST-EPISODE SCHIZOPHRENIA

Background Autistic phenotypic profiles in patients with schizophrenia are reportedly associated with poor outcomes, including higher odds of antipsychotic treatment failure. The Positive and Negative Syndrome Scale for Schizophrenia (PANSS) Autism Severity Scale (PAUSS) has been validated as a tool to identify “autistic profiles” in adolescents and adults with schizophrenia. We used the PAUSS (total score and subscores) to quantify autistic symptom load at different time points in a sample of patients with first episode schizophrenia (FES). We sought to investigate whether showing “prominent and persistent” autistic symptom load was associated with not achieving clinical remission at week 4 after the FES. Methods We analysed a subsample of FES patients from the OPTiMiSE study that was treated with amisulpride in an open-label design and had completed 4 weeks of follow-up. The selected subsample was composed of 55 individuals (27.3% female, mean age 25.6 (6.2) years) at “high-risk of non-remission” at week 2; i.e. patients with schizophrenia (not schizophreniform nor schizoaffective disorder) that showed prominent and persistent baseline-to-2-week negative symptoms (PNS, using Galderisi et al 2013 definition) and that had not achieved clinical remission at week 2 (using Andreasen criteria). Results In the selected subsample, the PAUSS showed acceptable internal consistency at baseline, 2-week, and 4-week visit (all Cronbach’s alpha>0.7). Those with prominent (over the third tertile) and persistent (over the 4-week follow-up) PAUSS total scores, i.e. “autistic FES patients” had, relative to non-autistic FES patients, higher rates of comorbid social phobia (18.2% vs 0%, p= .041), higher PANSS positive, negative and total scores at week 2 and 4 (all p<.01), and a higher proportion of “non-remitters” at week 4 (91.7% vs 51.2%, p=.018). No other differences in demographic or clinical variables were found between both FES groups. Stepwise logistic regression analyses, controlling for potential confounders, revealed that showing a prominent and persistent “autistic phenotype” was associated with not achieving clinical remission at week 4 (B=2.148, OR=8.57, 95% CI= 1.01–73.5, p<0.05). Discussion The delineation of “autistic profiles” with the PAUSS in the early stages of schizophrenia might enable early detection of subjects at higher risk of short-term antipsychotic treatment failure. It may also enable to explore the neurobiological underpinnings of particular phenotypic groups within schizophrenia, which might in turn help advance in the understanding of the pathophysiology and aetiology of psychosis.

Atypical sensory profiles as core features of adult ADHD, irrespective of autistic symptoms

Background:Abnormal sensory sensitivity is a feature of autism-spectrum disorder (ASD), but is also reported in attention-deficit/hyperactivity disorder (ADHD). In many cases, ADHD and ASD are comorbid. This study investigated the prevalence of sensory hyper- and hyposensitivity among adults with ADHD, controlling for autistic symptoms.Method:One hundred and sixteen adults diagnosed with ADHD completed the Adolescent/Adult Sensory Profile-NL (AASP-NL) and the Autism-spectrum Quotient (AQ) questionnaires. Prevalences of hyper- and hyposensitivity and autism-spectrum symptoms were compared to norm values. Multivariate binary logistic regressions were used to determine the association of autistic symptoms, age, gender, ADHD subtype, self-reported severity of ADHD symptoms, comorbid disorders, and use of medication on the sensory hypo- and hypersensitivity in adults with ADHD.Results:Adults with ADHD had more autistic symptoms, and they had both more hyper- and hyposensitivity compared to norm groups. This was especially apparent in the Activity level and Auditory sensory modalities. Sensory hypo- and hypersensitivity were both related to an increased ADHD score, even showing a dose-response relationship, but not to any autistic symptom or comorbid disorder. As much as 43% of the females with ADHD reported sensory hypo- and/or hypersensitivity, compared to 22% of the men.Conclusions:Sensory hypo- and hypersensitivity may be viewed as key features of adult ADHD, especially in females, regardless of any autistic symptoms. Future research should be directed at the implications of this sensory dysregulation for the understanding of the pathophysiology of (female) ADHD, and on the usefulness of assessment of atypical sensory profiles in the diagnostic procedure of ADHD in adults.

Mechanisms of autistic symptom forming in prenatal and early postnatal development

An overview of neuropsychological and neurophysiological studies of disorders observed in autism spec¬trum disorders is presented. The main stages of prenatal and early postnatal ontogenesis in neurotypical development and in autistic disorders are described. A model for the formation of an autistic syndrome in early ontogenesis is proposed. The main behavioral diagnostic signs of self-regulation disorders in autistic spectrum disorders at various stages are listed. This is of interest for specialists working in the field of early diagnosis.