Adolescence can be a time of new and complex social challenges and individuals with Autism Spectrum Disorder (ASD) are in need of evidence-based interventions to bolster their social skills during this critical developmental period. While a number of social skill group interventions have been developed, many of these are in need of further research evidence of their effectiveness. A literature review was conducted and identified a number of strengths and weaknesses in the currently available interventions. The START group was designed to incorporate those strengths and improve upon those weaknesses. A previous pilot study of the START group indicated that it may be an effective intervention for this population. The current study expanded on this pilot study and investigated several important questions about the START group, including its effectiveness when compared to a waitlist control group and the trajectories of improvement of participants. Nineteen adolescents with ASD participated, and a number of outcome measures were utilized to examine social change, including parent report measures, participant self-report measures, behavioral observations, and subjective ratings. The analysis comparing the treatment and control groups resulted in large effect sizes on both the primary parent and participant measures. Other measures also exhibited small to large effect sizes. These results were not found to be statistically significant, which may be attributed to the small sample size. However, the relatively large effect sizes found indicate the clinical and social significance of this intervention. The analysis of the treatment trajectories of participants indicated that most of the outcome measures exhibited statistically significant improvement after only ten weeks of intervention. After this initial gain, the primary parent report measure continued to exhibit statistically significant improvement throughout the duration of the treatment. Other measures indicated positive but non-significant trends toward continued improvement. Possible explanations for this treatment trajectory are discussed. The clinical implications of these findings are explored, as are future research directions.

Despite advances in early interventions for autism spectrum disorder (ASD), disparities in access to contemporary evidence-based treatments remain a serious concern. Numerous barriers, including delays in translating research to community practice, cost of services, extensive time commitments, and geographical distance to trained providers limit the ability for families to take advantage of the latest scientifically based autism interventions. To address this, recent studies have begun to explore parent-implemented interventions via an online or telehealth format. These approaches are particularly beneficial as they improve access to training for families, can fit into busy family schedules, and lower the cost of treatment. The current project examined the feasibility, utility, and preliminary efficacy of a newly developed online course designed to help parents implement an evidence-based naturalistic developmental behavioral intervention, Pivotal Response Treatment (PRT), for their young children with ASD. The new program was examined using a randomized waitlist control trial design. Parents submitted weekly videos capturing their use of treatment strategies, which were coded for PRT fidelity of implementation (FOI) and child social communication behaviors. Results indicate that parent PRT fidelity significantly improved from pre- to post-treatment for those in the immediate treatment condition. Changes in child social communication behaviors were not statistically significant. However, there was a strong trend toward improvements in eye contact following course completion. Qualitative feedback from parents also indicated a high level of satisfaction with the program. Results are discussed in terms of implications for the continued use of online intervention programs for parents of children with ASD.

The high prevalence of challenging behavior is a primary concern among many children with autism. These behaviors, which encompass aggression, self-injury, prolonged tantrums, inflexibility, and defiance, are typically associated with increased family isolation, parental stress, and interference with education or interventional programming. Therefore, families with children on the autism spectrum are in desperate need of accessible, high-quality evidence-based treatments that simultaneously target disruptive behaviors and are congruent with busy family life. This study aimed to gain a better understanding of parent and child progress during their enrollment in an intensive, telehealth-delivered version of Parent Child Interactive Therapy (PCIT) and an emotion-focused modification of the standard PCIT curriculum for young children with autism. Trial results suggest that both approaches can effectively equip parents with positive parenting strategies, but only families who received traditional Parent Directed Intervention (PDI) coaching were observed to experience significant improvements in child externalizing behaviors and parental self-efficacy. Further analyses also revealed comparable improvements in parent responsiveness to their child’s positive behaviors, and core child autism symptoms in both groups. These findings suggest that the Child Directed Intervention (CDI) phase included in both conditions may be effective in increasing parent recognition of child positive behaviors and utilization of “do skills”, and improving core autism symptoms, even when delivered in a brief, intensive telehealth format.

Research has consistently demonstrated that parents of children with Autism Spectrum Disorder (ASD) experience elevated levels of stress when compared to parents of typically developing and developmentally disabled children. High levels of stress have been associated with negative parenting practices, poor parental mental health, and negative child outcomes, including reducing the positive effects of intervention for children with autism. Regardless, there is limited research on direct support for parents. One promising area of therapeutic support focuses on mindfulness. Mindfulness is associated with increased life satisfaction, decreased depression and anxiety, and improved emotion regulation. Due to the normative levels of stress that come with parenting in general, researchers have introduced mindfulness to parents. A literature review identified 6 studies that have implemented some form of mindfulness training specifically with parents of children with autism, all showing promising outcomes. The current study aimed to assess whether an 8-week Mindful Parenting group program positively impacted parents’ reported level of mindfulness, parenting stress and parent-child relationship quality. Twenty-one parents participated and met for 90 minutes weekly in a group format. Self-report questionnaires were collected at intake (pre), after 4 weeks (mid), after completion of the group (post), and at a 5-week follow up session (follow up). Results of within-subject repeated measures analyses of variance (rANOVA) revealed that participation in the group decreased parenting stress, increased overall mindfulness and decreased relational frustration within the parent-child relationship after 8 weeks of participation. These changes were only significant for parenting stress when the follow up data was included in the analysis. Large to medium effects were found for all variables from intake to post and follow up assessment, suggesting clinically meaningful changes in these important areas. The results of the current study suggest that providing group training in mindfulness is a feasible support for parents of children with autism. The implications and limitations of these findings are discussed further.

Social media use has become a popular tool for modern social communication. Many autistic adults report a preference for computer-mediated communication and experience a range of benefits from using social media, including increased happiness and closer friendships. While there are many potential positive consequences to an active online presence, autistic adults are at increased risk of challenges, including cyber-victimization. To date, no interventions exist that specifically support autistic adults with safe and effective social media use. The Socialization, Education, and Learning, For the Internet (SELFI) program is a social media skills group intervention that was developed to support socially vulnerable individuals with online socialization. The present study utilized a pilot randomized controlled trial (RCT) to evaluate the preliminary feasibility, acceptability, and efficacy of the virtual group SELFI program. A total of 26 autistic adults (mean age = 24.3 years) were randomized to the SELFI program or an eight-week waitlist condition, with 19 participants completing the study. Results related to recruitment, attendance, and fidelity of implementation were collected and supported program feasibility. Attrition and surveys from participants and peer mentors reflect treatment acceptability and provide feedback regarding intervention and study protocols. Preliminary results related to treatment outcomes support the SELFI program as efficacious as demonstrated by improvements in Facebook behavior and a reduction in difficulty related to individualized goals. These findings establish a promising foundation of evidence related to the innovative social media skills intervention for autistic adults.

Research shows that children with developmental disabilities, such as autism spectrum disorder (ASD), are at significantly increased risk for adverse childhood experiences (ACEs) and traumatic experiences. Children and families impacted by ASD possess several identifiable risk factors which further amplify their risk for ACEs. There are several characteristics of ASD that may exacerbate posttraumatic stress symptoms in this population, such as pre-existing anxiety-related conditions and poor emotion regulation abilities. However, identifying posttraumatic stress symptoms in this population is difficult due to broad overlap between posttraumatic stress and ASD-related symptoms that leads to diagnostic overshadowing. The current study measured symptoms of posttraumatic stress and social impairment in children with ASD who experienced ACEs and compared them to children with ASD without ACEs and typically developing children with ACEs. Results found that children with ASD who experienced ACEs demonstrated greater rates of comorbid diagnoses of ADHD, depression, and anxiety and demonstrated significantly higher rates of posttraumatic avoidance, depression, anger/aggression, and overall posttraumatic stress compared to children with ASD without ACEs. They did not demonstrate increases in ASD-related symptoms of social impairment as a result of ACEs. ACEs type was predictive of posttraumatic stress symptoms in several domains. In typically developing children, a high number of accumulated ACEs was predictive of clinically significant symptoms of social impairment that may contribute to the diagnostic ambiguity between ASD and posttraumatic stress response to ACEs in children.

Profound autism describes individuals on the autism spectrum who have co-occurring intellectual disability or minimal verbal ability and require continuous access to care. The notable underrepresentation of individuals with profound autism in the research literature has resulted in limited knowledge about their service needs and a lack of evidence-based practices tailored to these needs. This mixed-methods study sought caregiver perspectives on service needs, barriers to service access, and treatment priorities to guide future treatment development and improvement of service delivery. Quantitative findings indicated that regular socialization opportunities were the most frequently endorsed unmet service need, followed by access to primary health care services by autism-trained medical staff, social skills instruction, life skills instruction, occupational therapy, and behavioral support. Lower socioeconomic status was associated with a greater number of unmet service needs. Increased age and greater feelings of sadness were associated with higher likelihoods of needing social skills instruction, life skills instruction, and occupational therapy. Elevated emotional reactivity and higher language level were associated with greater needs for social clubs and activity groups. Thematic analysis of qualitative data revealed a pervasive shortage of individualized services to promote ongoing skill development and socialization opportunities for adolescents and adults with profound autism. Perspectives on treatment priorities indicated a need for integrated service settings with multiple trained providers, evidence-based practices for challenging behaviors and low adaptive functioning, respite care, and service navigation support. Ultimately, this integration of qualitative and quantitative findings provides new insights into service needs for adolescents and adults with profound autism to improve the accessibility and quality of clinical care.

Research suggests individuals with Autism Spectrum Disorder (ASD) have difficulties with daily living skills that affect adaptive behavior, which are a major barrier to success in higher education settings. Adaptive behavior has been shown to be the single-strongest predictor of positive outcomes for individuals with ASD, yet few interventions target the improvement of daily living skills within this population, with even fewer targeting college students. Since interventions that integrate motivational and peer-mediated components have improved social communication in adults with ASD, it is possible that incorporating these methods into a daily living checklist, a type of self-management intervention, may lead to improvements in daily living skills for this population as well. The purpose of this study was to assess whether the use of peer-mediated motivational components would increase (1) the percentage of targeted daily living tasks completed per week. In addition, data was collected to systematically examine if this intervention would (2) increase measures of adaptive behavior skill; (3) decrease symptoms of depression; (4) decrease symptoms of anxiety; (5) increase measures of overall quality of life,. and (6) improve quarterly academic grade reports. Three college students with ASD between the ages of 18 and 20 participated. A multiple baseline across participants design was used, where a baseline condition with a self-management daily living checklist without peer-mediation was compared to a peer-mediated intervention condition with check-ins by a peer mentor to complete the daily living checklist. Follow up data were collected for two participants four weeks after the completion of the intervention. (1) All participants increased the percentage of targeted daily living skill tasks completed each week with large effect sizes, with effects maintained at follow-up for two participants. (2) All participants demonstrated some improvement on subdomains of the Daily Living Skill domain on the VABS-III, and 2 participants improved their overall Adaptive Behavior Composite score on the VABS-III. (3) All participants decreased their total score on the BDI-II. (4) Two participants decreased their total score on the BAI. Additionally, (5) all participants maintained good ratings of quality of life as measured by the QLAA. Finally (6), 2 participants demonstrated maintenance of good academic standing following completion of the intervention. Results are discussed in regards to assisting college students with ASD with improving their daily living skills. Additionally, implications of findings and future directions related to the examination of collateral areas relating to mental health, quality of life, and academic performance are explored. Further research would be helpful to continue to develop and examine interventions to assist college students with ASD to live independently and successfully.

Due to Covid-19, there have been extreme changes to the educational landscape for students.These changes to instruction not only impacted children, but their parents as well as they took on greater responsibilities for instruction. This presented challenges for many students, but particularly for students with Autism Spectrum Disorder (ASD). Reaction to these changes and the format of remote learning resulted in resistance to engage with remote learning, presenting difficulties for both student and parent. However, these challenges may be alleviated with appropriate parent support in motivational strategies to implement during remote learning. Using a multiple baseline across participants design, the current study sought to investigate whether coaching in Pivotal Response Treatment (PRT) and Growth Mindset delivered in a remote format would result in positive outcomes for students and their parents. Participants included 3 parent-student dyads. Parents were provided with education and feedback in implementing motivational strategies for remote learning. Results indicated positive outcomes for both students (increased engagement, decreased maladaptive behavior) and parents (competent implementation of motivational strategies; decreased stress). Additionally, parents reported the coaching and remote format to be socially valid. This research may help to better understand how online formats can be used to support parents during times where they are unable to access in-person resources. Additionally, this study may illuminate further ways that PRT and Growth Mindset can be applied to motivate and increase engagement for students with ASD.