This study examined relations between anxiety, aggression, social understanding, IQ, and diagnosis in a sample of 231 children (ages 2-9) diagnosed with Autism Spectrum Disorders (ASDs; Autistic Disorder, Asperger's Disorder, Pervasive Developmental Disorder Not Otherwise Specified) in a hospital setting. Children were administered tests of IQ, and parents completed measures of remaining variables. ASD diagnosis was associated with level of anxiety, and level of IQ explained this relation. IQ was significantly and positively associated with anxiety. Tests of a developmental model to explain the relation between IQ and anxiety showed that social understanding and aggression mediated the relation for toddlers. For preschool- and early elementary school-aged children, respectively, three-way interactions between IQ, social understanding, and aggression predicted anxiety, and graphs of the interactions suggest that the association between IQ and anxiety is increasingly driven by either aggression or social understanding over the course of childhood.
The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive functioning. For younger children with lower intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Similarly, for older children with higher intellectual functioning, higher ASD symptom severity was associated with better adaptive functioning than that of those with lower ASD symptom severity. Analyses by subscales suggest that this pattern is driven by the Conceptual subscale. Clinical and research implications are discussed.
The Program for the Evaluation of the Enrichment of Relational Skills (PEERS), a social skills intervention for high functioning adolescents with autism spectrum disorder (ASD), has been proven efficacious in randomized control trials. However, the effectiveness of the PEERS program in community settings has not been studied. The present small-scale pilot study examined the effectiveness of the PEERS program in a community setting. Five adolescents and their caregivers participated in the PEERS intervention. Results indicated that the adolescents showed significant improvement in their social engagement, social cognition, social communication, social motivation, and knowledge of PEERS skills and concepts from pre- to post-intervention. Furthermore, adolescents showed significant reductions in their internalizing and autistic symptoms from pre- to post-intervention. The findings from this small-scale pilot study support the effectiveness of the PEERS program in community-based settings.
Trauma-informed care (TIC) is increasingly used to address and prevent adverse childhood experiences. However, research on the implementation process of TIC has lagged, limiting its impact and sustainability. The goal of this two-study project was to provide a summary of staff-and system-level contextual factors relevant to TIC implementation. Method: Study 1 was a secondary data analysis of survey data from 760 staff members from human services, health, and education practice settings familiar with TIC. Independent-samples t tests were used to evaluate differences between lower-and higherimplementing organizations on staff-and system-level TIC implementation drivers. These drivers were then coded using the Consolidated Framework for Implementation Research (CFIR). Study 2 was a content analysis of the empirical literature on TIC. Study 2 produced information on the staff-and system-level facilitators of and barriers to TIC implementation, which were then also coded using the CFIR. Results: Study 1 suggested that the attributes of the individuals implementing TIC and the implementation climate of the organization played the most central roles. Study 2 identified available resources and the strength and quality of the evidence underpinning the intervention as important contextual factors for TIC implementation. Conclusion: This study used a well-established framework, the CFIR, to elucidate key contextual factors related to the successful implementation of TIC, with the goal of informing the efforts of researchers, practitioners, and policymakers.
Clinical Impact StatementAttending to the organizational context and the characteristics of staff and of the intervention is critical to increasing the impact and sustainability of TIC.
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