Autism Spectrum Disorder Phenotypes Based on Sleep Dimensions and Core Autism Symptoms.

Previous studies have used cluster analysis to address the diagnostic heterogeneity of autism spectrum disorder, but have been limited by identifying subgroups solely on the basis of core autism symptoms. The present study aimed to identify sleep phenotypes and their clustering with core autism symptoms in youth diagnosed with autism. 1397 patients (1-17y, M = 6.

Cognitive Disengagement Syndrome and Autism Traits are Empirically Distinct from each Other and from Other Psychopathology Dimensions.

Recently, an association between cognitive disengagement syndrome (CDS), formerly sluggish cognitive tempo, and autism has been documented, but it is not known if the association is due to overlapping autism and CDS traits or if CDS is empirically distinct from autism. Mothers rated 2,209 children 4-17 years (1,177 with autism, 725 with ADHD-Combined type, and 307 with ADHD-Inattentive type) on the Pediatric Behavior Scale. Factor analysis of the Pediatric Behavior Scale items indicated that CDS and autism traits are empirically distinct from each other without cross-loading and are distinct from eight other factors (attention deficit, impulsivity, hyperactivity, oppositional behavior, irritability/anger, conduct problems, depression, and anxiety).

Somatic Symptoms in a Population-Based Sample from Childhood to Adolescence: Stability and Concurrent and Longitudinal Predictors.

The present study investigated group and individual stability and predictors of somatic symptoms from childhood to adolescence in a population-based sample. 259 youth were evaluated at 6-12 years (M 8.1) and 8 years later (M 15.

Reactive, Proactive, Relational, and Slow Dissipation of Aggression in Children.

Objective: This study investigated the associations between aggression subtypes (reactive, proactive, relational, and slow dissipation of aggression), callous-unemotional traits (CU), irritability (IRR), and sex among children.

Method: The sample included 508 children 5 to 12 years of age, rated by their mothers.

Results: A 4-factor model of aggression subtypes (reactive, proactive, relational, slow dissipation) provided a good fit to the data.

Oppositional Defiant Disorder in Autism and ADHD.

Our study compared oppositional defiant disorder (ODD) in children with autism to ADHD-Combined presentation and ADHD-Inattentive presentation. Mothers of 2,400 children 3-17 years old with autism and/or ADHD completed the Pediatric Behavior Scale. ADHD-Combined was most strongly associated with ODD, with an ODD prevalence of 53% in children with ADHD-Combined only.

Prevalence and Correlates of Poor Safety Awareness and Accidental Injury in ASD, ADHD, ASD + ADHD, and Neurotypical Youth Samples.

The purpose of the present study is to compare risk and predictors of poor safety awareness and accidental injuries in ASD, ADHD, and neurotypical samples. Neurodivergent groups (ADHD-I n = 309; ADHD-C n = 747; ASD-only n = 328; ASD + ADHD n = 1,108) were 2-17 years old. The neurotypical group (n = 186) was 6-12 years of age.

Physical Aggression Toward Others and Self: Correlates in Autism, Attention-Deficit/Hyperactivity Disorder, and Population-Based Child Samples.

Objective: This is the first study investigating physical aggression toward others and toward self (self-injurious behavior [SIB]) and its association with comorbid disorders and symptoms and demographics in large autism, ADHD, and population-based samples.

Method: The referred sample comprised 2,456 children (1,415 with autism, 739 with ADHD-combined, and 302 with ADHD-inattentive) aged 2 to 17 years. The population-based sample consisted of 665 children evaluated at baseline (6-12 years of age) and 259 reevaluated at follow-up (12-17 years).

Cognitive Disengagement Syndrome (CDS) (Formerly Sluggish Cognitive Tempo), Autism, and Insomnia Symptoms in Childhood Predict CDS in Adolescence: A Longitudinal Population-Based Study.

Our study is the first using multiple variables to compare concurrent with longitudinal predictors of cognitive disengagement syndrome (CDS). The population-based sample comprised 376 youth (mean baseline age 8.7 and follow-up 16.

Agreement between mother, father, and teacher ratings of cognitive disengagement syndrome (sluggish cognitive tempo) in children with autism and children with ADHD.

No studies have analyzed differences between mother, father, and teacher ratings of cognitive disengagement syndrome (CDS; formerly sluggish cognitive tempo). The sample included 1,115 children with autism and/or attention-deficit/hyperactivity disorder (ADHD) 4-16 years of age who were rated by mothers on the Pediatric Behavior Scale. Subsets of these children were also rated by fathers and/or teachers, resulting in 896 mother/father, 964 mother/teacher, and 745 father/teacher dyads.

Comparison of the Cognitive Disengagement and Hypoactivity Components of Sluggish Cognitive Tempo in Autism, ADHD, and Population-Based Samples of Children.

An international Sluggish Cognitive Tempo (SCT) Work Group proposed a new term for SCT, "cognitive disengagement syndrome," that more accurately describes the syndrome than does SCT. According to the Work Group, symptoms of SCT represent a cognitive dimension (cognitive disengagement) and a motor dimension (hypoactivity). Our study determined (1) if distinct factors representing cognitive disengagement and hypoactivity emerged when SCT items were factor analyzed and (2) the degree of differences in cognitive disengagement and hypoactivity within diagnostic groups.

Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome.

Objective: The aim of this work was 2-fold: (1) to evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT); and (2) to arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients.

Method: An international Work Group was convened that, in early 2021, compiled an online archive of all research studies on SCT and summarized the current state of knowledge, noted methodological issues, and highlighted future directions, and met virtually on 10 occasions in 2021 to discuss these topics and terminology.

Results: Major progress has been made over the last decade in advancing our understanding of SCT across the following domains of inquiry: construct measurement and stability; genetic, environmental, pathophysiologic, and neuropsychological correlates; comorbid conditions; functional impairments; and psychosocial and medication interventions.

Sluggish cognitive tempo: Association with neuropsychological test scores, motor incoordination, and dysgraphia in elementary school children.

Research on the relationship between sluggish cognitive tempo (SCT) and scores on neuropsychological tests (such as those measuring processing speed and reaction time) is inconclusive, and the association between SCT and motor incoordination and dysgraphia has not been objectively investigated. Mothers of 413 elementary school children (6-12 years of age) rated their children on the Pediatric Behavior Scale (PBS), which yields psychological problem scores, including SCT. Children were administered an extensive battery of neuropsychological tests assessing processing and performance speed, working memory, immediate and delayed recall, sustained attention, response inhibition, cognitive flexibility, fine motor manipulative skill, verbal fluency and retrieval, set shifting, and interference control, as well as intelligence and reading and math achievement.

Relationship between sluggish cognitive tempo, IQ and academic achievement test scores, and academic impairment in autism, ADHD, and elementary school samples.

Sluggish cognitive tempo (SCT) is of renewed interest. The relationship between SCT, IQ and achievement scores, and academic impairment ratings was investigated in 218 students with autism and 676 with ADHD (6-16 years) and 549 elementary school students (IQ ≥ 80). Mothers rated their children on the Pediatric Behavior Scale.

Relationship Between Sluggish Cognitive Tempo and Age and IQ in Preschool and School-Age Children and Adolescents with Autism and with ADHD.

Relationships between sluggish cognitive tempo (SCT) and age and IQ were investigated in children with autism and/or ADHD covering broader age and IQ ranges than in previous studies. Mothers rated 1436 children with autism and 1,056 with ADHD (2-17 years, IQs 9-149) on Pediatric Behavior Scale SCT items. Increasing age correlated with SCT in the autism, ADHD-Combined, and ADHD-Inattentive samples.

Cross-Sectional Age Analysis of Sleep Problems in 2 to 17 Year Olds with ADHD Combined, ADHD Inattentive, or Autism.

Sleep problems are common in autism and ADHD. No study has compared sleep problems by age in 2 to 17 year olds with autism versus ADHD-Combined versus ADHD-Inattentive type. Mothers rated 1415 youth with autism and 1041 with ADHD on 10 Pediatric Behavior Scale sleep items.

Relationship between sluggish cognitive tempo and sleep, psychological, somatic, and cognitive problems and impairment in children with autism and children with ADHD.

Sluggish cognitive tempo SCT) is a topic of renewed interest. Much remains to be learned about its association with symptoms and diagnoses that have received little research attention, particularly sleep disturbance, somatic complaints, and autism. Our study is the first to explore the relationship between SCT and sleep, internalizing, externalizing, somatic, and cognitive problems, impairment, and demographics in large samples of children with autism, ADHD-Combined, and ADHD-Inattentive.

Relative Frequency of Psychiatric, Neurodevelopmental, and Somatic Symptoms as Reported by Mothers of Children with Autism Compared with ADHD and Typical Samples.

No study has analyzed the relative occurrence of a broad range of symptoms reported by mothers of children with autism, ADHD-Combined, and ADHD-Inattentive and typical controls. Mothers rated 1436 children with autism, 1056 with ADHD without autism, and 186 controls, 2-17 years, on 41 internalizing, externalizing, neurodevelopmental, and somatic problems. Most children with autism had symptoms of ADHD, oppositional defiant disorder, disruptive mood dysregulation disorder, and expressive language disorder and almost half had dysgraphia and receptive language disorder.

Symptom scores and medication treatment patterns in children with ADHD versus autism.

Most children with autism have ADHD, and children with ADHD-Combined and children with autism have high rates of irritable, oppositional, and aggressive behavior. Despite similar symptoms, prescribing practices may differ between autism and ADHD, which has not been examined in a single study. 1407 children with autism and 1036 with ADHD without autism, 2-17 years, were compared with 186 typical peers.

Irritability and Limited Prosocial Emotions/Callous-Unemotional Traits in Elementary-School-Age Children.

Affective traits, including irritability and limited prosocial emotions/callous-unemotional traits (LPE/CU), each explain significant variance in youth conduct problems but few studies have examined these constructs simultaneously. This study examined whether irritability, LPE/CU, or their combination explained significant variance in measures of internalizing or externalizing psychopathology, aggression, peer problems, impairment, or parenting. Participants were 219 elementary-school-age children, including 178 with attention-deficit/hyperactivity disorder, oppositional defiant disorder, and/or conduct disorder and 41 typically developing children.

Sleep Disturbances Increase the Impact of Working Memory Deficits on Learning Problems in Adolescents with High-Functioning Autism Spectrum Disorder.

Sleep disturbances (SD) are prevalent in individuals diagnosed with Autism Spectrum Disorder (ASD). Less is known about the effects of SD on cognition and learning in adolescents with high-functioning ASD (HF-ASD). Adolescents with HF-ASD (N = 96) were evaluated for the relationships of SD to working memory and learning problems.

Response to Allen (2018): Points of agreement and disagreement on reactive attachment disorder.

Reactive attachment disorder (RAD) is a very rare, understudied, and controversial disorder. Research in Developmental Disabilities (RIDD) recently published our research study, "Reactive attachment/disinhibited social engagement disorders: Callous-unemotional traits and comorbidity" (Mayes, Waschbusch, Calhoun, Breaux, & Baweja, 2017) investigating comorbidity in children with RAD and demonstrating a high prevalence of conduct disorder and callous-unemotional traits, consistent with previous research. Allen (2018) responded with a paper published in RIDD criticizing our study and offering his points of view.

Brief Report: How Accurate is Teacher Report of Autism Symptoms Compared to Parent Report?

The Checklist for Autism Spectrum Disorder (CASD) completed by a psychologist (following standardized procedures integrating parent interview data, teacher report, and clinical observations) was compared with the CASD completed independently by mothers and teachers in 168 children with ASD and 40 with ADHD (1-12 years). The 30 CASD autism symptoms are scored as present or absent. Using mother scores 36% of children with ASD scored below the autism diagnostic cutoff, and 75% scored below the cutoff based on teacher scores.

Brief Report: Checklist for Autism Spectrum Disorder: Most Discriminating Items for Diagnosing Autism.

The smallest subset of items from the 30-item Checklist for Autism Spectrum Disorder (CASD) that differentiated 607 referred children (3-17 years) with and without autism with 100% accuracy was identified. This 6-item subset (CASD-Short Form) was cross-validated on an independent sample of 397 referred children (1-18 years) with and without autism and on data from 1417 children in the CASD standardization sample and 1052 children in the CASD normative sample, resulting in 98.5, 97.

The association between Disruptive Mood Dysregulation Disorder symptoms and sleep problems in children with and without ADHD.

Background: Many youth experience persistent irritability and recurrent temper outbursts, conceptualized by DSM-5 as Disruptive Mood Dysregulation Disorder (DMDD). Sleep deprivation impairs emotion regulation which could increase rates of DMDD symptoms, especially in those with preexisting regulatory impairments, as seen with ADHD. However, there has been little examination of the relationship between chronic sleep problems and DMDD symptoms.