Autism Spectrum Disorders

CASD Chat: October 2023

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Children with autism have restricted interests (often called intense interests) and/or repetitive behaviors. Srishti Rau, Ph.D., provides a review on a research article on how these behaviors and interests change over time as a child grows up.

Why is this research valuable?

A person can receive an autism diagnosis when they have difficulty with social communication skills, demonstrate restricted and repetitive patterns of behaviors or interests (RRBs), and these difficulties get in the person’s or their family’s way (i.e., lead to functional impairment). A lot of research has looked at social communication skills in autism, but there is less research on RRBs, despite being a core feature of autism. It is important to study RRBs because they can get in the way of someone’s social or academic functioning. For example, if a child focuses their attention on spinning objects they may miss opportunities for play and learning. Autistic individuals may find it hard to cope when their RRBs are interrupted and they may get very distressed and even lash out. Also, RRBs may interfere with the family’s overall ability to get things done. For example, parents may spend extra time avoiding situations that can trigger distress for their child such as changes in plans, even if their child would likely enjoy the new activity. Not only is it important to study how RRBs present in children with autism, but it is also valuable to study how they change over time, and what factors influence these changes (e.g., cognitive ability, severity of symptoms during early development).

Goals of the study:

Characterize RRBs in autistic children
Examine how RRBs develop/change over time in autistic children
Examine what factors predict these changes

Who participated in the study and what did the researchers do?

192 children with autism and their parents
Researchers collected information about children at 2, 3, 5, and 9-yearsold—because the same children were seen several times at different ages, this is considered a longitudinal study. They gathered information about:
- Autism symptoms (social communication and RRBs) using a detailed autism interview with parents.
- Children’s cognitive ability by completing activities with them to assess their reasoning skills.
Analyses:
- Factor analysis to determine how to group/ characterize RRBs
- Growth curve analysis was used to determine which factors predicted changes in RRBs over time.

What did the researchers find?

RRBs can fall into two groups:
- Repetitive sensorimotor (RSM) – examples include lining up toys, bringing toys or objects very close to one’s face to peer at them, repetitive hand movements, spinning.
- Insistence on sameness (IS) – examples include becoming upset at changes to one’s routine or changes to the environment that may or may not directly affect the individual, such as insisting on always sitting in the same seat or taking the same route to places.
Changes in RRBs over time and factors that predicted these changes:
- Parents of autistic children reported high levels of RSM over time across all ages (2, 3, 5, and 9 years old) suggesting RSM symptoms remain stably high over time.
  - Having a higher nonverbal IQ (i.e., reasoning in pictures) at 2 years old was associated with milder RSM at 2, as well as fewer RSM symptoms over time.
IS symptoms started out at lower levels and increased over time.
- There was no relationship between nonverbal IQ at age 2 and IS symptoms.
- Milder social communication symptoms at age 2 were associated with more severe IS symptoms at 2.

What’s the take home message?

CASD Staff

The Center for Autism Spectrum Disorders team is composed of a talented and experienced group of faculty, staff and leadership.

Meet the team

Profiles Celebrating Neurodiversity

Steven Kapp is autistic and is a developmental psychologist at the University of Portsmouth and a lecturer in psychology with expertise in autism and neurodiversity. His academic background includes psychology, education, public policy and disability studies, with additional publications in anthropology, medicine and neuroscience reaching diverse audiences and readerships.

Among other accomplishments, he is the director of science in the Autistic Self Advocacy Network, and he substantially influenced the revision of autism's diagnostic criteria in the DSM-5. As an M.A., (2013) and Ph.D., (2016) student in human development and psychology within education at University of California, Los Angeles, he began to research and teach on autism and neurodiversity, and completed his postdoctoral studies in the UK as a research fellow on the Wellcome Trust-funded project Exploring Diagnosis: Autism and Neurodiversity at the University of Exeter (2016-2019).

His research has focused on understanding autism and a means of supporting autistic people. He has a keen interest in understanding autism, including how behaviors such as stimming (repetitive movements and vocalizations) and averted eye contact may serve as functional coping mechanisms.

Other Resources

Education and Support

Arc Maryland, "Together We're Better"

The Arc Maryland, with its statewide partners, provides a school inclusion program called “Together We’re Better” (TWB). The objective of the program is to raise awareness of the value and importance of inclusion of students with disabilities. The program involves a 4-way partnership with the Maryland State Department of Education, the Maryland Developmental Disabilities Council, the Maryland Department of Disabilities, and The Arc Maryland. Visit the website here to see the different components to the program, broken up for elementary, middle and high school students.

DC Autism Collaborative

The DC Autism Collaborative (DC-AC) has developed several resources for parents of young children and professionals (including health providers, early childhood educators, and community leaders) on topics related to autism spectrum disorder (ASD). All materials have been, or are in the processes of being, translated into both Spanish and Amharic. These resources can be downloaded as PDFs, though we encourage you to visit the website here as we plan to update these regularly.

DC Peer Programs for Neurodivergent Youth and Adults

DC Peers is a community organization that offers social meetups, learning workshops, and a welcoming community to neurodiverse groups of teens and adults. Our neurodiverse staff have a lot of personal and lived experience with autism, ADHD and other neurological differences, and we understand and embrace neurodivergent ways of being in the world. In our groups, folks can be themselves and connect – outside of clinics and therapeutic settings.

Social Meetups
- Middle school, art, games, dungeons and dragons, teens discord and adult meetups
Support Groups and Facilitated Discussions
- Teen and adult neurodiversity, women and non-binary persons support, and parent circle
Neurodiversity Workshops
Social Strategies Workshops

Free Webinars Hosted by Social Thinking

Enjoy these information-packed free webinars on your own or make them a powerful group learning event with your colleagues, friends, and family members. Topics include:

Working/learning in groups
Face-to-face communication
Social anxiety
Executive functions
Children’s stress
Self-regulation
Individual webinars on ten core Social Thinking vocabulary

Ivymount Fall Educational Groups

Apply to participate in one of Ivymount’s group programs led by expert teachers and therapists. Fall groups include the hallmark programs Unstuck and OnTarget! or Self Advocacy AND a new Social Club. Groups target different skills including executive functioning, flexibility, self-advocacy, transition, friendship and social interactions. Questions? Email us.

Parent Child Journey Webinars

Dan Shapiro, M.D., is offering new courses for parents of different age groups. To learn more about these courses, please visit his website.

Pathfinders for Autism

Pathfinders for Autism provides a list of programs for all ages including video group for spouses/partners of adults with Asperger's; transitioning services and job skills; baby and family navigator programs, and new this month, Autism from the Autistic Perspective and free pediatric occupational therapy screening and more!

Supporting Mental Well-being

Yetta Myrick, executive director/president of DC Autism Parents (DCAP) and CDC's Act Early Ambassador to the District of Columbia has multiple resources to share with families to support mental well-being.

Research Studies

ASD Research Study

George Washington University and George Mason University are study brain development in autism. As part of the study, participants play child-friendly computer games while we track their gaze and brain function. Families can early up to $90 for participating.

We are recruiting 5-17 year olds with an autism diagnosis.

If you are interested in participating, please contact Chelsea Armour at [email protected] or [email protected].

ASD Research Study - DSCN Lab

Dr. Elizabeth Redcay at the University of Maryland, College Park and her team are studying behavioral and brain responses in children and adolescents on the autism spectrum during social interactions. Participation involves virtual visits, in-person visits, and longitudinal virtual follow ups over the course of about two years. Families can earn up to $1000 for their time.

We are recruiting 11-14 year olds with an autism diagnosis.

If you are interested in participating, please contact Kayla Pereira.

Unstuck and On Target High School Project

There is an exciting new research project from Children’s National Hospital and we are looking to partner with local high schools in the D.C. metro area.

In partnership with educators, autistic youth, and their families, autism experts from Children’s National Hospital have developed an upward extension of the school-based Unstuck and On Target! curriculum for diploma-track, autistic high school students needing executive function and socio-emotional support. This research-based curriculum is designed to be taught at school and targets transition-readiness skills such as self-advocacy, flexible problem-solving, time management, and independent goal-setting and planning skill

We have received funding from the National Institutes of Mental Health to evaluate the (free) curriculum on a larger scale, and we are looking for schools to partner with. Once we receive approval from the school district, we will provide participating schools with free training, materials, and ongoing support for school staff to teach Unstuck at local schools.

If you are a teacher or parent and are interested in hearing more about how to bring Unstuck to your high school or school district, please contact Julianna McKenna.

Resources and Helpful Links

Advocacy Resources

Autistic Self Advocacy Network – Navigating College: A Handbook on Self Advocacy

Resources on Anti-Racism

COVID-19 Safety Resources

COVID-19 National and Local Government Resources